Complete abortion ban would widen racial gap in maternal mortality rates, study shows

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New analysis shows non-Hispanic Black people will be disproportionately impacted if activists and legislators succeed at banning abortion entirely.

Abortion availability in Texas has plummeted as the state continues to litigate over S.B. 8, its highly restrictive abortion law.

Now a concerning new study shows that maternal mortality rates could increase if abortion becomes completely unavailable, a clear goal of many anti-abortion legislators and activists, impacting the Black community significantly.

In the last several years, Texas has made strides in addressing its overall maternal mortality rate. The state's 2014 rate was the worst in the country, but by 2018 it had fallen to only slightly above the national average. That improvement in overall numbers, however, obscures the fact that vast racial disparities persist.

The most recent data available shows that while Black women represent 11% of live births in the state, they account for 31% of pregnancy-related deaths in Texas.

There's a vast gap too in severe maternal morbidity, outcomes of pregnancy that result in short- or long-term consequences to the mother's health. According to the state's Maternal Mortality and Morbidity Review Committee, if those types of conditions are left untreated, they can result in death, so those indicators are closely tied to maternal mortality.

If Texas were to succeed at banning abortion entirely, the racial gap would likely increase dramatically.

A new study conducted by Amanda Stevenson, a professor of sociology at the University of Colorado Boulder, that examined data at a nationwide level estimates that if a total abortion ban were to pass, there would be a 7% increase in pregnancy-related deaths nationwide in the first year following such a ban, with an increase of 21% in subsequent years.

For Black people, though, there would be a 12% jump in the first year and a 33% increase in later years. Put another way, the risk of death for Black people during pregnancy would jump from 1 in 1,300 to 1 in 1,000.

"Both in terms of the number of additional deaths and in terms of the increase in risk, the additional mortality burden is estimated to be greatest among non-Hispanic Black women," Stevenson writes. "Structural racism is a fundamental cause of maternal health inequity and Black women already experience excessive levels of pregnancy-related mortality."

She adds, "Increasing Black women's exposure to the risk of pregnancy-related mortality because their wanted abortions are denied would exacerbate an existing public health crisis."

Texas-specific estimates are equally grim. A review of data by Dr. David Eisenberg, an abortion provider in Missouri and Illinois, estimates that S.B. 8, though it does not constitute a total ban, could lead to a 15% increase in maternal mortality next year in the state. For Black people, that number is much higher — 33%.

In contrast to the state's vast appetite for abortion restrictions, there has been little attempt to address the maternal mortality gap. Even relatively low-cost proposals such as providing racial bias training for medical personnel and creating a centralized registry for maternal health data have failed to make their way out of the Texas Legislature.

The state did pass a law that increased post-birth Medicaid coverage from 60 days to six months, but experts say that a year of coverage after giving birth is really what is needed. An attempt to pass such a law, extending Medicaid coverage for a year, was opposed by GOP Gov. Greg Abbott and Republicans in the Legislature.

Texas lawmakers said they passed S.B. 8 partly because of its "compelling interest" in protecting women's health, but there's no evidence the law does that at all. Rather, the steep decrease in abortion access caused by the law appears poised to exacerbate the health crisis that pregnant people in the state already face.

Published with permission of The American Independent Foundation.