Women's health has been at the forefront of Texas politics this summer. But with the main focus on abortion, you may have missed an important and troubling fact: women are more likely to die in childbirth than during an abortion.
A study published in the medical journal Obstetrics and Gynecology in February 2012 found that nationally, the pregnancy-associated mortality rate among women giving birth was 8.8 deaths per 100,000 live births while the mortality rate associated with abortion was only 0.6 deaths per 100,000 abortions. In other words, women carrying a baby to term are 14 times more likely to die than a woman who has a legal abortion.
These statistics are even worse in Texas. In 2010, the state's maternal mortality rate was 24.6 maternal deaths per 100,000 live births. Texas has roughly the same maternal mortality rate as Saudi Arabia, and it's worse than Iran and Turkey. That's right–women giving birth in Texas are as likely to die as women giving birth in Saudi Arabia, and are more likely to die than women giving birth in Iran and Turkey.
There are a variety of reasons why maternal mortality has increased in recent years. One reason is the general increased prevalence of chronic health conditions that affect maternal health. For example, rates of obesity and diabetes have steadily increased over the past decade. The prevalence of obesity and diabetes in Texas are both slightly higher than the national average, and obesity is associated with a higher risk of maternal death. Obesity is also linked to socioeconomic and minority status. These problems are also reflected in the maternal mortality rate for minority women in Texas– black women are almost twice as likely to die giving birth than white women.
The healthcare environment created by policies in Texas is also responsible for these dismal health outcomes. Though Texas ranks 9th highest in the nation in poverty, we rank 45th in welfare usage. This may keep our taxes low, but it also means that millions of women and children lack access to resources that could save their lives. 30% of Texas women lack health insurance, compared to 20% of women nationwide. The absence of healthcare coverage means that expectant mothers are unable to access quality pre- and post-natal care, contributing to our increased rates of maternal mortality.
The Texas legislature hasn't completely ignored the problem. During the spring legislative session, the state House and Senate passed the bipartisan HB 1085/SB 495, which mandated the creation of a task force to study maternal mortality and severe maternal morbidity in Texas. Governor Perry signed the bill into law in June. The bill is a good start for improving public health outcomes. A thorough investigation of what exactly is causing Texas's increased maternal mortality rates makes it easier to create policies that can properly address the problem.
But this small step forward for women's health is overshadowed by the giant leap backwards that is HB 2. The draconian measures it imposes endanger the health of Texas women, whether they are seeking abortions or giving birth. The bill's requirement that clinics providing abortions must be licensed ambulatory surgical centers has left many women's health clinics facing closure, as they cannot afford the $1 million-plus necessary to upgrade their facilities. Only five clinics, all in urban centers, currently meet this requirement. This leaves poor, rural women with drastically reduced options to receive a safe abortion, putting their health at risk.
Moreover, fewer women's health clinics means access to contraception and family planning services will decrease. A report by the state Health and Human Services Commission found that state cuts to family planning services will lead to approximately 23,760 additional births in 2014-15 than there would have been had family planning services not been cut. These births would likely be among low-income, rural women whose only access to contraception was through the women's health facilities that are now facing closure. These are the same women who lack health insurance and face the greatest risk of health complications during pregnancy. More births and less access to healthcare among at-risk women will almost certainly increase maternal mortality in Texas.
Texas women are facing deadly risks in pregnancy and childbirth, and our shortsighted politicians are making it worse.