Texas Maternal Mortality Task Force Hasn’t Counted Abortion Death Cases for 10 Years

Deaths related to abortion, both provided by doctor and self-directed, have not been part of the task force's analysis (Photo by Maggie Q. Thompson)

Across the country, maternal mortality review committees are tasked with analyzing pregnancy-related deaths and reporting information to their respective states and the CDC.

The 2024 report from the Texas task force will be its first since the Supreme Court overturned Roe v. Wade. It's expected to cover 2020 pregnancy deaths and, later, those from 2021. But as members of the committee have been working through cases sent to them by the Texas Department of State Health Services (DSHS), they were unaware that abortion-related cases have been omitted.

“When asked by many how the Texas [task force] would gauge the impact of recent national and state legislative changes, we were confident when we responded that we review maternal deaths regardless of pregnancy outcome,” said task force Chair Dr. Carla Ortique during the committee’s March 22 public meeting. “We're now aware that that will not be the case.”

Texas’ task force is relatively new. The Legislature created the Maternal Mortality and Morbidity Review Committee in 2013 after a dramatic increase in reported maternal deaths in the early 2010s. Ortique said that a review of the statute that created the committee revealed that, for its entire decade of operation, the task force has not been privy to cases involving abortion.

The 2013 statute that formed the committee states, “This chapter does not apply to disclosure of records pertaining to voluntary or therapeutic termination of pregnancy.” A DSHS spokesperson confirmed the agency has followed the law, omitting abortion-related cases, since it was enacted. So while the committee receives information about almost every death during or 12 months after a pregnancy in Texas – including deaths like those of pregnant women in certain car crashes – cases involving deaths from self-managed abortions have not come before the task force. (The DSHS team of 10 dedicated to reviewing maternal deaths also excludes deaths they determine were accidental, so a car crash case that could have been suicide or homicide will go to the committee, while true car accidents would be excluded.)

It’s unclear how many abortion-related cases the committee has unknowingly skipped since 2014. CDC data directly from death certificates shows at least 20 deaths in Texas that were coded as abortion-related from 2014 to 2020. Researchers predicted an increase in these kinds of deaths due to abortion bans. A 2021 study estimated a blanket ban of abortion would lead to 21% more pregnancy-related deaths overall in the U.S., noting that their projection was a low estimate because it didn’t include potential deaths caused by unsafe, self-managed abortions.

One study found that globally, roughly 68,000 women die from unsafe abortions every year. Another study found that, in the 82 countries with restrictive abortion laws at that time, roughly 2 out of every 100 women had an unsafe abortion. And in 2020, when abortion was still protected by Roe, researchers estimated that more than one in 15 American women would attempt self-managed abortion at some point in their lives.

Doctors in Texas are required to report abortion-related deaths to the state. Passed during the 87th legislative session, Senate Bill 4 mandated that providers report all abortion-related complications, including mortality. “Yet that data is not shared with this committee,” said the task force’s vice-chair, Dr. Patrick Ramsey. Ramsey said that information should be within the committee’s scope going forward.

“It's my hope,” said Chair Ortique, “that members of the public, the media, professional organizations, community organizations, and all that recognize that the preventable death of a mother is unacceptable will hear these updates and understand the importance of engaging in efforts to ensure that the work of this committee is able to continue and will raise their voices.”