A new review of federal public health data finds that following Texas’ 2021 ban on abortion care, the number of women who died during pregnancy, childbirth or shortly after giving birth soared, far outpacing the slower increase in maternal mortality rates nationwide.
Between 2019 and 2022, maternal mortality rates in Texas rose 56%, compared with just 11% for the national average over the same period, according to an analysis by the Gender Equity Policy Institute. The nonprofit research group reviewed public reports from the Centers for Disease Control and Prevention and provided its analysis exclusively to NBC News.
“There is only one explanation for this shocking disparity in maternal mortality,” said GEPI President Nancy L. Cohen, “and every study points to Texas’ anti-abortion law as the primary cause of this shocking increase.”
“I’m concerned that what’s happening in Texas is a harbinger of what’s going to happen in other states,” she said.
SB 8 Effects
The Texas Legislature in September 2021 banned abortion care after the fifth week of pregnancy, nearly a year before the U.S. Supreme Court in June 2022 overturns Roe v. Wade, which protected the federal right to abortion.
At the time, Republican Texas Governor Greg Abbott praised the bill as a measure that would “guarantee the life of every unborn child.”
Texas law currently bans all abortions except to save the mother’s life.
The passage of Texas Senate Bill 8 provided GEPI researchers with an opportunity to conduct an early study of how a near-total abortion ban, including in cases where the mother’s life is at risk, would affect the health and safety of pregnant women.
Cohen’s team found that the impact of SB 8 was swift and significant: Within a year, maternal mortality rates increased for every racial group studied.
Among Hispanic women, the rate of women dying during pregnancy, childbirth, or shortly after birth increased from 14.5 per 100,000 live births in 2019 to 18.9 in 2022. The rate for white women nearly doubled, from 20 to 39.1 per 100,000. And the rate for Black women, who have historically been more likely to die during pregnancy, childbirth, or shortly after birth, increased from 31.6 to 43.6 per 100,000.
While maternal mortality rates have risen overall during the pandemic, Texas has also seen a consistent increase in women dying during pregnancy and childbirth since its abortion ban, according to the Gender Equality Policy Institute.
“If we deny women access to abortion, more women will become pregnant and more women will be forced to continue their pregnancies,” Cohen said.
Beyond the direct risks to pregnancy and childbirth, there is growing evidence that women who live in states with restrictive abortion laws, like Texas, are much more likely to not receive prenatal care and much less likely to see an obstetrician-gynecologist.
Doctors say there is widespread fear among mothers-to-be.
“Before Senate Bill 8 was passed, fear was something I had never seen in medicine,” said Dr. Leah Tatum, an obstetrician-gynecologist who practices in Austin, Texas. Tatum, who was not involved in the GEPI study, said requests for sterilization among her patients have doubled since the state’s abortion ban.
In other words, women would rather lose the ability to have children than have the possibility of becoming pregnant after SB 8.
“Patients feel cornered,” Tatum says. “Even if they already knew they didn’t want to get pregnant, now they’re scared.”
Tatum said she sees many women in their late 30s and 40s who want to have children but worry they won’t have the option to terminate the pregnancy if the baby isn’t born healthy. “‘What if I have a genetically abnormal fetus?'” Tatum said her patients ask her, worrying that their options are limited.
“They treat you like a criminal”
This unthinkable tragedy happened to Caitlin Kash, 37, of Austin, Texas.
Kash had a typical pregnancy, giving birth to her first child, a healthy boy, in 2018.
“It was really easy at first,” she said. “I never dreamed we’d be on this journey.”
When she fell pregnant again, 13 weeks into her second trimester, she and her husband, Corey, learned that her fetus had severe skeletal dysplasia, a rare genetic disorder that affects the growth of bones and cartilage. The baby’s chances of survival were extremely low.
“We were told that my bones would break in the womb and that I would suffocate during birth,” Kash said. “We thought the doctors would tell us how to take care of the baby and how to stop the pain.”
That was in October 2021, just one month after Texas passed SB 8 abortion law.
“I was told I should get a second opinion, but to make sure it was from outside of Texas,” she said.
At 15 weeks pregnant, Kash had to travel to Kansas to terminate her ill-fated pregnancy, after protesters harassed the grieving mother outside the medical clinic.
“I was treated like a criminal,” she said. “I was not given the dignity I deserved to say goodbye to my child.”
“This is just another example of how heartbreaking it is to practice in Texas,” Tatum said. “These patients are crying out for help, and the state of Texas has failed these women.”
Correction: (Sept. 21, 2024, 8:17 a.m. ET) A previous version of this article incorrectly stated demographic maternal mortality rates as a percentage rather than the number of maternal deaths per 100,000 live births. It has been updated.