Texas’ New Data on Pregnancy Deaths Is Old. As in, Pre-Abortion-Ban Old

Texas has one of the highest maternal mortality rates in the country (image via Getty Images)

Texas is not an easy place to be pregnant. This state’s maternal mortality rate is one of the highest in the nation. Strikingly, the most recent state report on maternal deaths found that roughly 80% of the pregnancy-related deaths analyzed were preventable.

How, exactly, could these losses be prevented? The state’s 2024 report on maternal mortality answers that question in more ways than one. The Department of State Health Services publishes this macabre review every two years, and in addition to laying out statistics about factors that contributed to maternal deaths, the report also includes concrete recommendations for lifesaving policy changes.

But there’s a big problem with the report. The data is old. Pre-abortion-ban old. It looks at deaths in 2020, before Texas’ near-total abortion ban took effect in 2022.

Texas’ Maternal Mortality and Morbidity Review Committee – made up mostly of doctors – takes an in-depth look at almost every death of a pregnant person in a given year. The several-year lag in their analysis, though, could be eliminated or at least reduced, members of the committee told the Chronicle.

“There’s like a three-to-four-year lag,” said committee member Robin Page last year. “And what’s scary about that is the data is telling us what we need to be doing differently. You know, let’s hurry up and do it and save more lives in the meantime.”

The plan for the 2026 report is to skip ahead to 2024 deaths, leaving a gap in analysis from 2021 to 2024. Committee members defended this decision in a public meeting last month, saying timely recommendations are important.

But for a more sustainable solution, new legislation would streamline the data-gathering process.

The point of the committee’s work isn’t to hold specific health care providers accountable but to determine statewide patterns. Partly for that reason, every case is processed to remove identifying details about both the patient and their providers.

“Sometimes right now we will work on cases with more than 2,000 pages. So it’s huge,” said Amy Raines-Milenkov, a member of the state’s maternal mortality committee who also leads the University of North Texas team that redacts cases.

Raines-Milenkov suggests that streamlining the redaction process – so patients’ and hospitals’ names would still be obscured, but other information could be left in – would speed things up. The money and time currently spent on redaction could instead be spent on what’s called abstraction, basically the storytelling part of the process where health care providers turn pages of documents into a summary of each fatal case.

Texas’ cumbersome redaction process is also unique. Maternal mortality committees across the country analyze cases of pregnancy-related deaths, but a Department of State Health Services employee told the Chronicle Texas is the only state that requires this type of redaction in cases given to the maternal mortality committee. (That’s because of the Nursing Practice Act, which includes language that broadly requires nurses to report colleagues’ behavior that poses “risk of harm.”)

State Rep. Donna Howard, D-Austin, heads the Texas Women’s Health Caucus. She’s filed a lot of women’s health bills this session that are self-explanatory: allowing abortions after sexual assaults, expanding Medicaid access, and allowing school absences for students with menstrual disorders, for example.

But one bill that appears far from eye-catching, House Bill 713, would reduce the time-intensive process of redacting cases to go before the maternal mortality committee. The Texas House passed an almost identical bill from Howard last session, but it died in the Senate, having been referred to the Health & Human Services Committee but never taken up.

Howard’s is not the only filed legislation this session that would streamline maternal mortality information processing. Democratic Rep. Lauren Ashley Simmons has filed a bill that includes the same kind of language as Howard’s HB 713.

It’s unclear exactly how much of the data lag could be reduced by streamlining the redaction process, but Howard has described redaction as one of the biggest obstacles to timely processing that maternal mortality committee members describe.

Limiting redaction would also, in some cases, give committee members more information to work with about each death. “We’re not seeing the full actual records,” Page said. “But if I had to pick one issue [with redaction], I would say it’s just the delay.”