Black maternal health advocates call for release of Texas report on maternal mortality

A coalition of organizations advocating for Black maternal health plan to hold a rally at the Texas Capitol on Tuesday to demand the immediate release of the 2022 Texas Maternal Mortality and Morbidity Review Committee (MMMRC) and Department of State Health Services (DSHS) Joint Biennial Report.

 

 

The Maternal Health Equity Collaborative (MHEC), an Austin-based coalition of 6 community-based birthing organizations, is calling on officials to immediately publish the available data to ensure appropriate action is taken to address maternal health and safety.

At the MMMRC’s last meeting in September, outgoing DSHS Commissioner Dr. John Hellerstedt informed the committee that its biennial report, originally scheduled to be released on September 1st, would not be published until summer of next year. 

The delay is due to the emergence of at least 31 additional cases from 2019 provisional data that need to be analyzed and linked to the current report.

Citing the need for the state to make the report an annual one, as is done in other states, rather than every 2 years, Hellerstedt said the release of an accurate report that includes all the data is needed to avoid public confusion and scrutiny over changes to the report.

Opposition to the delay revolves around not having access to the most-current information that guides best practices and reforms. 

The rally is expected to draw vested stakeholders, including state policy organizations, grassroots groups, and medical experts, and call on bipartisan support to address the existing health disparities for women of color that lead to disproportionate maternal deaths. 

State Rep. Shawn Thierry (D – Houston) is expected to speak at the rally. Thierry recently received a letter from DSHS that stated the maternal health data and recommendations would be released in time for the upcoming legislative session but did not provide a specific date. 

In the letter, interim DSHS Commissioner Dr. Jennifer Shuford wrote she plans to attend the MMMRC’s next meeting on December 8th to “provide data and recommendations timely to help inform efforts during the 88th Legislative Session.”

Nakeenya Wilson, the sole community advocate on the review committee and a representative for MHEC, said that while she appreciates the efforts to ensure the work of the committee is not compromised, the reasons for delaying the information and the committee’s recommendations are not relevant to the work of addressing the issue in the upcoming session. 

Saying Black women face significant maternal health disparities, she advocated for a sooner release date of the data to better-inform policy in next year’s session.

“If you’re wanting to be [absolutely] sure about numbers and percentages and stats, then that can be withheld,” Wilson said. “[But] the recommendations and findings can be released. There’s enough external data that’s coming out that people can draw their own conclusions.

I think that anything can be political if we allow it to be. And so the question is, are we allowing public health information to be political and what are the impacts of allowing that to happen?”

One of the members who researches pregnancy-related deaths for the committee, Dr. Amy Raines-Milenkov, was initially opposed to the delay. Speaking to State of Reform on September 30th following the most recent MMMRC meeting, however, Raines-Milenkov said she now supports delaying the report in order to include the full 2019 cohort. 

She detailed the state’s process for reviewing cases of maternal mortality.

“Just to give you an idea of the process, the state requests records once they find a death, and then that will take some time for them to get the medical records, investigative reports, autopsies, [and more],” Raines-Milenkov said.

“Then that information comes to us [for review] and then because of a Nursing Practice Act in Texas, we’re required to redact all the records. That takes a while to redact all the records and then once it’s redacted, then it goes to case abstraction. Case abstraction is where it’s put in a format that’s reviewable by the review committee, then it goes into data entry into the CDC database, then goes back to the state for the committee to review.”

She added:

“On one hand, a good, nice report with the right data is the best thing that you can hope for. But at the same time, there’s this great need for us to have information and those recommendations out to the community.”

Scheduled on Día de los Muertos, the rally is a bipartisan call to action that will hold a special memorial. Organizers will lay marigolds on the steps of the State Capitol as an “ofrenda altar” in honor of the mothers and expectant mothers who lost their lives. 

A recent CDC report found that more than 80% of pregnancy-related deaths in the US are preventable. The leading underlying causes of pregnancy-related deaths among non-Hispanic Black persons were cardiac and coronary conditions, according to the report.  

According to Black Mamas ATX, Black mothers experience maternal death rates 2 to 4 times higher than white women and are at higher risk for developing postpartum depression. Meanwhile, Black children account for 11% of births in Texas, but 30% of pregnancy-related deaths are of Black women.