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More questions than answers in Texas maternal mortality study, lawmakers say

A study published this week in a medical journal revealed that a new state methodology drastically reduced the count of maternal deaths in Texas for 2012. What will that mean for state policy on maternal mortality?

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In the wake of a study that found the state overcounted the number of Texas women who died from pregnancy complications in 2012, state legislators are cautiously moving forward.

They expressed a mixture of surprise, relief, frustration and piqued curiosity after an Obstetrics & Gynecology medical journal study published Monday revealed that a new state methodology for counting and confirming maternal deaths reduced the count of Texas mothers who died in 2012 from 147 to 56.

The study came after nearly two years of Texas garnering national and international scrutiny over the number of women dying from preventable childbirth complications. Despite the lower death rate revealed by the new research, legislators say they plan to continue working to improve maternal health care.

Gov. Greg Abbott said in a Monday tweet that the “maternal mortality rate spike scare was grossly exaggerated ... Nevertheless, Texas remains committed to lowering it even more.”

The study said the state’s 2012 data inflated the number of women 35 and older who were classified as a maternal death and included reporting errors in which a box on death certificates indicating a maternal death was often mischecked for women who had not been pregnant. The study also found black women are still more likely than white and Hispanic women to die from pregnancy complications.

Researchers said they plan to study other years with the new methodology.

State Sen. Lois Kolkhorst, R-Brenham, said in an emailed statement that lawmakers have passed legislation aimed at “doing more to improve maternal health outcomes. Instead of overreacting to sensationalized reports in the media, we directed better data collection in order to develop targeted, evidence-based strategies to more effectively improve the lives and health of mothers in Texas."

State Rep. Four Price, R-Amarillo, chairman of both the House Select Committee on Opioids and Substance Abuse and the House Public Health Committee, said his own committees’ interim charges include looking at how pregnant women are impacted by substance abuse and reviewing the state’s women’s health programs. He said the new 2012 data underscores why the Legislature last year renewed the Task Force on Maternal Mortality and Morbidity, which participated in the study.

“I was a little surprised because [the numbers] were so significantly different than the information we had received in the 85th session,” Price said. “It’s important we receive accurate information to make sound decisions going forward.”

State Rep. Shawn Thierry, D-Houston, said the the new report highlights how maternal health is still being improperly handled in Texas.

Thierry said she’s “glad we did the work and created a spotlight,” but the report shows there’s more work to be done. “We’re still deep in the weeds of this issue and nothing has been reconciled particularly for African-American women, where again we’re still dying at alarming rates.”

When the Legislature reconvenes in January, state Rep. Jessica Farrar, D-Houston, chairwoman of the Texas House Women's Health Caucus, said she hopes legislators will finally agree to expand Medicaid for uninsured Texans, allow mothers to stay in Medicaid longer than 60 days after giving birth and improve access for the state’s women’s health programs.

“What I hope they don’t do is look at one year of getting the accurate statistics and then project that as, ‘We don’t have a problem anymore,’” Farrar said. “I don’t think you can take that from one year of data, I think that we have a long way to go.”

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