An August 25 2022 Texas Tribune article, “Texans who perform abortions now face up to life in prison, $100,000 fine,” explained that after Roe v. Wade was overturned in June 2022, Texas had turned abortion laws into a morass of uncertainty and fear:
Performing an abortion is now a felony punishable by up to life in prison in Texas after the state’s trigger law, which has only narrow exceptions to save the life of a pregnant patient, went into effect [on August 25 2022].
The law was “triggered” when the U.S. Supreme Court issued its judgment in Dobbs v. Jackson [in June 2022], the case that overturned Roe v. Wade and allowed states to set their own laws about abortion.
Abortion clinics across Texas had already stopped performing the procedure, fearing prosecution under state laws that were on the books before Roe v. Wade.
Texas now has three significant abortion bans in place and several administrative regulations governing the procedure, setting up a potential conflict as the largest state to ban abortion navigates this new legal landscape.
By late August 2022, Republican candidates, confronted with the reality of the extreme unpopularity of their attacks on abortion rights, were scrambling to revise their stated positions, in some cases quietly altering their campaign materials to focus on their opponents’ stances.
And on September 13 2022, disregarding his own previous arguments about “states’ rights,” Sen. Lindsey Graham (R-South Carolina) announced the reintroduction of a bill aimed at banning abortion at the federal level — reflecting a chaotic and rapidly devolving approach to abortion within the GOP.
A popular September 14 2022 r/politics submission also claimed the state of Texas was trying to delay publication of maternal death data for political reasons, until after the November 2022 midterms:
That r/politics submission included a link to a September 13 2022 Houston Chronicle article with a headline matching the post’s title. It corroborated the claim that anticipated data on maternal mortality in Texas had been withheld after state health officials missed a deadline:
Texas health officials have missed a key window to complete the state’s first major updated count of pregnancy related deaths in nearly a decade, saying the findings will now be released next summer [of 2023], most likely after the Legislature’s biennial session.
The delay, disclosed earlier [in September 2022] by the Department of State Health Services, means lawmakers won’t likely be able to use the analysis, covering deaths from 2019, until the 2025 legislative cycle. The most recent state-level data available is nine years old.
Per the story, Department of State Health Services commissioner Dr. John Hellerstedt claimed that the information, if released, might cause “a great deal of misunderstanding about what the data really means”:
In a hearing [in September 2022] with the state’s Maternal Mortality and Morbidity Review Committee, DSHS commissioner Dr. John Hellerstedt said the agency wanted to better align its methodology with that of other states, and that there hadn’t been enough staff and money to finish the review for a scheduled Sept. 1  release.
“The information we provide is not easily understood, and not easily and readily comparable to what goes on in other states,” Hellerstedt told the committee. “And the fact it isn’t easily understood or easily comparable in my mind leaves room for a great deal of misunderstanding about what the data really means.”
The setback comes four months before the start of the legislative session [in January 2023] and two months before the midterm election [in November 2022], which has been dominated in part by the state’s new Republican-led abortion ban. Those restrictions have placed more scrutiny on the state’s maternal mortality rate, which is among the 10 highest in the country, according to national estimates that track pregnancy-related complications while pregnant or within a year of giving birth.
Maternal mortality data in Texas was notably poor even prior to the state’s September 2021 near-total ban on abortion. A 2018 release by the University of Texas Health Science Center at Tyler/University of Texas System (“Severe Maternal Morbidity in Communities Across Texas”) reported:
In 2013-2014, severe maternal morbidity affected more than 50,000 women in the U.S. (approximately 14.4 per 1,000 deliveries). Texas has approximately 400,000 births annually, accounting for 10% of all births in the U.S. Thus, maternal health outcomes in Texas has national implications. According to a recent report, the severe maternal morbidity rate in Texas in 2015 was 19.7 per 1,000 deliveries.
This analysis of severe maternal morbidity rates in Texas, and the large and small area maps that accompany it, are intended to improve the quantity and quality of information on a critical indicator of maternal health and safety in Texas. The hope is that these maps can inform policies and resource allocation at the state and local level, guide further research, and ultimately, help strengthen the design and evaluation of interventions to meet specific community needs.
In May 2019, PBS published “The fight to end Texas’ high maternal mortality rate,” and addressed disparity in outcomes for women of color in Texas. After the September 2021 law went into effect in Texas, Time.com published a story (“Texas’ Abortion Law Could Worsen the State’s Maternal Mortality Rate”) estimating the short-term and long-term effects of the law on maternal mortality in Texas:
A new analysis from Dr. David Eisenberg, a board certified obstetrician-gynecologist who provides abortions in Missouri and Illinois, estimates that with the new law in effect, the state could see increases in maternal mortality of up to 15% overall, and up to 33% for Black women next year. The estimate is based on previous research that has established a clear link between abortion restrictions and maternal mortality. Black patients are often disproportionately impacted by abortion restrictions, and they are far more likely to die in to pregnancy-related deaths than white or Hispanic women.
In another study, published in the American Journal of Preventive Medicine in 2019, researchers looked at maternal mortality data from 38 states and Washington, D.C. and found that gestational limits on abortion and Planned Parenthood clinic closures each significantly increased maternal mortality. They found that laws restricting abortion based on gestational age increased maternal mortality by 38% and that a 20% reduction in Planned Parenthood clinics increased a state’s maternal mortality rate by 8%.
An absence of state-level maternal mortality data in Texas, regardless of intent, did not eliminate all indicators. A June 2022 Community Impact report, “Maternal mortality rates on the rise in Harris County,” identified signifiers of increases in adverse outcomes at the county level:
The national maternal mortality rate was 23.8 per 100,000 births in 2020, an 18% year-over-year increase, which local health care providers said could partially be attributed to COVID-19. But Black women died at a rate of 55.3 per 100,000 births that year, according to the National Center for Health Statistics.
[Dr. Manda Hall, associate commissioner of community health improvement for the Texas Department of State Health Services] said Texas’ maternal mortality rate consistently ranks higher than the U.S. average. The 2021 March of Dimes Report Card gave Texas a D and Harris County an F due to high rates of preterm births, infant deaths, inadequate prenatal care, social vulnerability factors and state policies.
Researchers at ValuePenguin, an online data analysis tool, gave Texas the lowest score of all 50 states in a May [2022 report] about access to and the quality of prenatal and maternal care.
Health insurance research analyst Robin Townsend said while Texas ranked in the middle of the country when it came to the quality of infant and maternity care, Texas had the lowest percentage of women ages 18-44 with insurance coverage at 73.6% and the lowest percentage of women who had access to a primary care provider at 57%.
Texas’ Department of State Health Services (DSHS) maintained a page titled, “Maternal Mortality and Morbidity in Texas,” with text suggesting that data was accessible via linked material. Italicized text below was hyperlinked, but clicking the link led to an error page with no content:
Find more information and the latest review committee reports on the Maternal Mortality and Morbidity Review Committee webpage.
On September 14 2022, social media posts claimed that the state of Texas delayed data on maternal mortality until after the November 2022 midterm elections; those figures were anticipated by the public due to the state’s September 2021 near-total ban on abortion. It was true that Texas declined to disclose the data as expected, and further true that the figures would not be released before November 2022.