Being pregnant in Texas should not be this dangerous

Texas’ Maternal Mortality and Morbidity Review Committee recently released its report on deaths that occurred during the time from pregnancy through 12 months after pregnancy. The report showed that more than 50 Texans – an unacceptably high number – died for reasons directly related to pregnancy in 2019. Many others experienced severe pregnancy complications that, while not fatal, can lead to long-term maternal health consequences.  

Although the committee found that there were often multiple reasons for a pregnant person’s death, more than half of the contributing factors occurred at the provider, health care facility or health systems level – meaning greater responsibility lies in the systems people interact with than their individual choices. With 90% of these pregnancy-related deaths considered preventable, higher than national reports, state-level policy changes are needed to address these heartbreaking statistics.    

Another key takeaway from the report: Deaths and severe complications occur disproportionately in Texas’ Black communities and among those who lack private insurance.  

As public policy and disparities scholars, we are not surprised by these findings. Research clearly shows the ways that unequal access to quality care and structural racism undermine people’s health and well-being before, during and after pregnancy. 

Texas has the highest rate of uninsured residents because state policymakers have not expanded Medicaid, but Medicaid expansion is supported by most Texans and has been shown to reduce maternal mortality. Comprehensive Medicaid coverage would help people manage health conditions that, if left untreated, can increase their risks of pregnancy complications. Coverage could also provide access to treatment for depression and substance use disorders, which are common causes of pregnancy-related death.