#Maternal Mortality

[batboyblog]

Things the Biden-Harris Administration Did This Week #31

August 23-30 2024

The Department of Transportation announced $521 million to help increase the number of electric vehicle charging ports. They money will go to projects in 29 different states, DC, and 8 tribal governments. It'll help build over 9,200 EV charging ports. Since Biden took office publicly available EV chargers has doubled, there are now over 192,000 public EV chargers in the nation with about 1,000 new ones being added every week.

The Department of The Interior announced the first ever lease for off-shore wind power in Oregon. When fully developed the two sites in Southern Oregon will generate 3.1 gigawatts of clean, renewable energy, enough to power a million homes. Under the Biden-Harris administration first of their kind off-shore wind power projects have been approved and started in the Pacific and Gulf of Mexico coasts. In total 13 gigawatts of clean energy from offshore wind projects, enough to power nearly 5 million homes, has been approved.

Secretary of the Interior Deb Haaland finalized the protection of 28 million acres of public lands across Alaska.  In the last days of the Trump Administration protections for these lands were lifted. The Trump Interior Department did not consult with the Alaska natives who depend on these protected lands before lifting the protections. Deb Haaland the first Native American to serve as Secretary of the Interior declared "Tribal consultation must be treated as a requirement – not an option"

The Department of Health and Human Services announced $558 Million for improving maternal health. This is part of the Biden-Harris Administration's effort to address the maternal health crisis, which has been lead by Vice-President Harris. $440 million of the money will help expand a program of home visiting services for maternal, infant, and early childhood. $118 million, through the CDC, will go to 46 states, and six territories, over 5 years to help build the public health infrastructure to better identify and prevent pregnancy-related deaths.

It was announced that Maine will join the IRS' Direct File program for tax year 2025. Maine joins Oregon, New Jersey, Pennsylvania, New Mexico, Connecticut, North Carolina, and Wisconsin along with the original 12 states. The Direct File program, made possible by President Biden's Inflation Reduction Act, allows tax payers to file, for free, simple returns with the IRS. The 140,000 tax payers who used the pilot program in 2024 saved a collective $5.6 million in filing costs. Maine's Revenue Services plans to work with the ISR to allow tax payers to file their state taxes by just transferring the info from the ISR direct file.

[afriblaq]

The crisis facing women who give birth is unacceptable; and for black women it is dramatically more outrageous.

The problem isn’t “can” we solve this - the problem is we aren’t mustering the collective will to do so.

I will continue to lead this fight in Congress with some other determined legislators. We must all be a part of the movement to end the high rates of maternal mortality in America.

"As a Black woman who fought hard for my life for 5 days after having a c-section and suffering postpartum hemorrhaging and perioperative hypothermia, I approve of this message! Also, our rates for them giving us c-sections are doubled that of White women, which could also be a contributing factor in our labor mortality rate."

Meanwhile, the state of Georgia just dismissed all of the members of the maternal mortality committee 🤷🏽‍♀️

@corybooker

[justinspoliticalcorner]

Amanda Marcotte at Salon:

After the Supreme Court ended federal abortion rights in 2022, there was a robust debate between pro- and anti-choice activists over whether or not banning abortion would kill women. Pro-choicers pointed to evidence, from both history and other countries, showing that abortion bans kill women. Anti-choice activists dismissed the record and pointed to toothless "exceptions" in abortion ban laws as "proof" that women could get abortions to save their lives.  The latter argument was frustrating not just because it was wrong but was generally offered in bad faith. Anti-abortion leaders know that abortion bans kill women. They don't care. Or worse, many view dying from pregnancy as a good thing. In some cases, it's viewed as just punishment for "sinful" behavior. Other times, it's romanticized as a noble sacrifice on the altar of maternal duty. But conservatives are aware that this death fetish cuts against their "pro-life" brand. So there was a lot of empty denials and hand-waving about the inevitable — and expected — outcome of women dying. 

We now have another proof point that abortion bans are about misogyny, not "life," as the first deaths from red state abortion bans are being reported. Instead of admitting they were wrong and changing course, Republicans are behaving like guilty liars do everywhere, and destroying the evidence. In the process, they are also erasing data needed to save the lives of pregnant women across the board, whether they give birth or not.  ProPublica has published a series of articles detailing the deaths of women in Georgia and Texas under the two states' draconian abortion bans. They most recently reported the death of Porsha Ngumezi, a 35-year-old mother of two from Texas. Ngumezi suffered a miscarriage at 11 weeks but was left to bleed to death at the hospital, instead of having the failing pregnancy surgically removed. Multiple doctors in Texas confirmed that hospital staff are often afraid to perform this surgery, however, because it's the same one used in elective abortions. Rather than risk criminal charges, doctors frequently stand by and let women suffer — or die.  Ngumezi's youngest son doesn't fully understand that his mother is dead. ProPublica reported that he chases down women he sees in public who have similar hairstyles, calling for his mother. 

A day after this story was published, the Washington Post reported that the Texas maternal mortality board would skip reviewing the deaths of pregnant women in 2022 and 2023 — conveniently, the first two years after the abortion ban went into place. The leadership claims it's about speeding up the review process, but of course, many members pointed out the main effect is that "they would not be reviewing deaths that may have resulted from delays in care caused by Texas’s abortion bans." This is especially noteworthy because it's become standard after one of these reports for anti-abortion activists to blame the victims and/or the doctors, and not the bans. Christian right activist Ingrid Skop, for instance, responded to Nguzemi's death by insisting "physicians can intervene to save women’s lives in pregnancy emergencies" under the Texas law. If she really believed that, however, she would desperately want the state maternal mortality board to review this, and other cases like it, so they could come up with recommendations for hospital staff to treat women without running afoul of the law. Strop, however, is on the Texas maternal mortality board. She was likely part of the decision to refuse to look into whether women like Nguzemi might be saved. 

[...] But despite claims to be "pro-life," anti-abortion activists do not care. Instead, they are on Twitter griping about how comprehensive reproductive health care access "promotes sexual promiscuity." 

Skop also argued last year that abortion bans are justified because "promiscuous behavior declines." It's tempting to point out that all five women whose deaths have been reported by ProPublica were in long-term relationships or marriages. Three of the five planned to bring their pregnancies to term and died because they were denied miscarriage care. But that's the problem with vague terms like "promiscuous." They draw us into debates about how much women are allowed to enjoy sex before their lives are forfeited. Or how many "good girls" should die to punish the "promiscuous" ones. That is the trap of misogyny. It allows women like Lila Rose or Ingrid Skop to pretend that, if you submit to the sexist order and obey all their arbitrary rules, you'll be saved. But these laws punish all women and girls: mothers and non-mothers, wives and single women, women who've had 100 partners and those who were virgins when raped. Abortion bans make crystal clear that, to the Christian right, no woman's life is worth saving. Anyone can be sacrificed, to protect their cruel patriarchal order. 

Want more reason why abortion bans are bad for women? Republicans are working hard to destroy the evidence that abortion bans kill women.

Abortion bans have zip to do with the "sanctity of life", but are a tool for misogyny.

[rapeculturerealities]

Georgia Dismissed All Members of Maternal Mortality Committee After ProPublica’s Report on Amber Thurman, Candi Miller Deaths — ProPublica

Georgia officials have dismissed all members of a state committee charged with investigating deaths of pregnant women. The move came in response to ProPublica having obtained internal reports detailing two deaths.

ProPublica reported in September on the deaths of Amber Thurman and Candi Miller, which the state maternal mortality review committee had determined were preventable. They were the first reported cases of women who died without access to care restricted by a state abortion ban, and they unleashed a torrent of outrage over the fatal consequences of such laws. The women’s stories became a central discussion in the presidential campaign and ballot initiatives involving abortion access in 10 states.

[khizuo]

this statistic for the drc's maternal mortality rate comes from this paper about trends in maternal mortality from 2000 to 2020. the estimates in the paper came from the WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division (if you want to find this statistic, go to Annex 4.)

this paper published by BMC Pregnancy and Childbirth about maternal mortality in the DRC comes to a conclusion of 620 deaths per 100,000 live births. this study was published in 2022, with data collected from between 2015 and 2020.

[pro-birth]

According to the GEPI analysis, maternal mortality in Texas increased from 2019 to 2020 to 2021. For those of you who recall how time works, this is nearly all before the Texas heartbeat law went into effect in September 2021. What happened after the abortion ban? Texas maternal mortality substantially decreased.

Even if we assume that there are no methodological issues with the GEPI analysis, it demostrates precisely the opposite of what NBC’s descriptions and headline suggest. Their headline should more accurately say “A dramatic decrease in maternal deaths after Texas abortion ban.”

Lyman Stone, a demographer and director of research for Demographic Intelligence, took a closer look at the data. He gathered data from the CDC WONDER’s Multiple Mortality Database 2018-2024. He used all deaths related to childbirth and pregnancy to ensure the broadest possible data set.

Again, no “skyrocketing” in maternal deaths in Texas, as compared to other parts of the country, either after the Texas heartbeat law (September 2021) or after Dobbs (June 2022).

[sizzlingsandwichperfection-blog]

dear Mr Intern,

can you try to relate TB to the awesome coffee club as I am wondering if there is a relevance. I hope this will ne a fun challenge for you

The Awesome Coffee Club exists to provide people with the world's best coffee and support efforts to radically reduce maternal and infant mortality in Sierra Leone.

Over 1,500,000 people will die of tuberculosis this year. Many of those people will be pregnant. TB has long been a major cause of non-obstetric maternal death; untreated tuberculosis has a mortality rate of around 40% among pregnant people. And so expanding access to TB treatment (and spreading information about the global tuberculosis pandemic) is central to the work of radically reducing maternal mortality in Sierra Leone and beyond.

[reasonsforhope]

Researchers from Western and Brown University have made groundbreaking progress towards identifying the root cause and potential therapy for preeclampsia.

The pregnancy complication affects up to eight per cent of pregnancies globally and is the leading cause of maternal and fetal mortality due to premature delivery, complications with the placenta and lack of oxygen.

The research, led by Drs. Kun Ping Lu and Xiao Zhen Zhou at Western, and Drs. Surendra Sharma and Sukanta Jash at Brown, has identified a toxic protein, cis P-tau, in the blood and placenta of preeclampsia patients.

According to the study published in Nature Communications, cis P-tau is a central circulating driver of preeclampsia – a “troublemaker” that plays a major role in causing the deadly complication...

“The root cause of preeclampsia has (so far) remained unknown, and without a known cause there has been no cure. Preterm delivery is the only life-saving measure,” said Lu, professor of biochemistry and oncology at  Schulich School of Medicine & Dentistry...

“Our study identifies cis P-tau as a crucial culprit and biomarker for preeclampsia. It can be used for early diagnosis of the complication and is a crucial therapeutic target,” said Sharma...

Until now, cis P-tau was mainly associated with neurological disorders like Alzheimer’s disease, traumatic brain injuries (TBI) and stroke. This association was discovered by Lu and Zhou in 2015 as a result of their decades of research on the role of tau protein in cancer and Alzheimer’s.

An antibody developed by Zhou in 2012 to target only the toxic protein while leaving its healthy counterpart unscathed is currently undergoing clinical trials in human patients suffering from TBI and Alzheimer’s Disease. The antibody has shown promising results in animal models and human cell cultures in treating the brain conditions.

The researchers were curious whether the same antibody could work as a potential treatment for preeclampsia. Upon testing the antibody in mouse models they found astonishing results.

“In this study, we found the cis P-tau antibody efficiently depleted the toxic protein in the blood and placenta, and corrected all features associated with preeclampsia in mice. Clinical features of preeclampsia, like elevated blood pressure, excessive protein in urine and fetal growth restriction, among others, were eliminated and pregnancy was normal,” said Sharma.

Sharma and his team at Brown have been working on developing an assay for early detection of preeclampsia and therapies to treat the condition. He believes the findings of this study have brought them closer to their goal...

“The results have far-reaching implications. This could revolutionize how we understand and treat a range of conditions, from pregnancy-related issues to brain disorders,” said Lu.

-via India Education Diary, September 22, 2023

[thashining]

Judge says: It’s *her* body, *her* choice, not the state’s

@nowthisimpact

[odinsblog]

Rest In Peace, Tori Bowie

While some vehemently deny that structural racism exists and that even individual doctors hold internal biases against Black women, maternal mortality rates do not lie.

👉🏿 https://firstandpen.com/torie-bowie-serena-williams-allyson-felix-pregnancy-black-maternal-health-mortality/

Even though 60% of all childbirth-related deaths in the US are preventable, the "[racial] disparities around maternal health are not improved by access to insurance, access to education," according to double board-certified neonatologist and pediatrician Dr. Terri Maior-Kincade.

"Having a higher socio-economic status for Black women is not protective," Major-Kincade told Insider. "These disparities are related to systemic issues, and they're not going to get better until we provide equitable care. So we have to improve the way we deliver care to Black women so that we can have the full joy of pregnancy."

👉🏿 https://www.insider.com/allyson-felix-near-death-pregnancy-issues-black-moms-face-2022-6

[theivorybilledwoodpecker]

The Texas Maternal Mortality and Morbidity Review Committee revealed this week that it will not be reviewing any cases that occurred over the last two years — which just happen to be the years when Texas's strict anti-abortion law went into effect. The Washington Post reports that the move by the committee is "leaving any potential deaths related to abortion bans during those years uninvestigated."

[afriblaq]

#medicalapartheid warned us years ago, but we don’t read.🥲

"This is why our elders never wanted to go to the hospital. They feared for their lives"

"Thank You too often we are ignored and treated as if we don’t deserve quality care 🖤🖤🖤"

"Have a law that requires a hospital to allow Doulas and birth assistants who are trained is required!"

@dtr360books__

[nando161mando]

Kerala, an Indian region governed by the Communist Party (CPI-M) now has lower maternal mortality than the US. Assam, governned by the neoliberal BJP, has plumetted to dangerous levels.

[killed-by-choice]

FACT: Banning abortion dramatically reduces the rate of abortion— and the number of women dying from abortion

Restrictive state-level abortion policies are associated with not having an abortion at all. Calculated to account for the rate of criminal/illegal abortions.

“Women who lived in a state where abortion access was low were more likely than women living in a state with greater access to use highly effective contraceptives rather than no method” Not only are abortion rates lower where abortions are illegal, but unwanted pregnancy rates too. People are more careful. (From the Guttmacher Institute, former statistics arm of Planned Parenthood.) https://www.guttmacher.org/journals/psrh/2015/05/state-abortion-context-and-us-womens-contraceptive-choices-1995-2010

29% of Medicaid eligible pregnant women who would have an abortion with Medicaid coverage, instead give birth. Calculated to account for the rate of criminal/illegal abortions. https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-019-0775-5

Analysis of statewide data from the three States indicated that following restrictions on State funding of abortions, the proportion of reported pregnancies resulting in births, rather than in abortions, increased in all three States. Calculated to account for the rate of criminal/illegal abortions. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1580169/pdf/pubhealthrep00193-0013.pdf

Approximately one-fourth of women who would have Medicaid-funded abortions instead give birth when this funding is unavailable … Studies have found little evidence that lack of Medicaid funding has resulted in illegal abortions. Calculated to account for the rate of criminal/illegal abortions.

We find that a 100-mile increase in distance to the nearest clinic is associated with 30.7 percent fewer abortions and 3.2 percent more births. Calculated to account for the rate of criminal/illegal abortions.

https://onlinelibrary.wiley.com/doi/10.1002/pam.22263

rate of abortion is found to be lower in states where access to providers is reduced and state policies are restrictive. https://pubmed.ncbi.nlm.nih.gov/9099567/

A wait time as short as 72 hours is enough to start decreasing abortion rates. https://www.sciencedirect.com/science/article/abs/pii/S1049386716300603

Abortion decreased after being restricted: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4050978/

Michigan banned Medicaid from paying for abortion. Abortion rates dropped. https://pubmed.ncbi.nlm.nih.gov/8135922/

The farther away a woman is from an abortion facility, the less likely she is to get one: https://www.jstor.org/stable/2134397?seq=1#page_scan_tab_contents

Some restrictions were enacted in Eastern Europe in the 80s and 90s. The rates of abortion AND pregnancy rates both decreased.

Fetal development information and required waiting periods lead to less abortion:

A study in Louisiana and Maryland found that laws against abortion were effective at stopping abortions

Countries with abortion bans also have dramatically lower maternal mortality compared to other countries in the region with dangerously permissive abortion laws.

“Contrary to the notion proposing a negative impact of restrictive abortion laws on maternal health, the abortion mortality ratio did not increase after the abortion ban in Chile. Rather, it decreased over 96 percent.”

Mexican states that ban and restrict abortion have better MMR than permissive states: “Over the 10-year period, states with less permissive abortion legislation exhibited lower Maternal Mortality Rates than more permissive states.”

Poland bans all abortion except LotM and has the world’s lowest MMR (2/100000). Malta bans almost all abortions and has MMR of 6/100000

It also works in reverse. Multiple countries have seen an increase in MMR after legalizing abortion.

Guyana legalized abortion and achieved the worst MMR on the continent. (Compare that to Chile, which has constitutional protections for the unborn and an MMR that dropped by over 96% AFTER abortion was banned.)

Ethiopia legalized abortion and it made MMR worse: “Although abortion was not legalised on demand, it was legalised on broad socio-economic grounds: the Center for Reproductive Rights place it in the same category as the UK and Finland which, while not strictly allowing abortion on demand, do allow something close to that in practice.” … “Over the period of legalisation, the proportion of women with septic shock more than doubled, with the same result for organ failure. The proportion admitted to intensive care nearly tripled. Between 2008 and 2014, the percentage of women receiving post-abortion care who have severe complications increased by over 50%, from 7% to 11%. During this time, the proportion of women presenting with organ failure quadrupled, the proportion with peritonitis quintupled, and the proportion with shock nearly doubled.”

Ireland’s once-stellar MMR also increased after legalizing abortion. (Compare to Poland and Malta with almost total bans and to the UK where abortion is essentially legal in demand up to the second trimester.)

The pattern repeats in Asia. Nepal, where there is no restriction on abortion, has one of the world’s highest maternal mortality rates. (The lowest in the region is Sri Lanka, with a rate fourteen times lower than Nepal and very good restrictions on abortion.)

In addition, less people are being lured into abortion under the false impression that it’s “safe and legal”. If any of them die of illegal abortion, it’s because they knowingly committed a crime. There will no longer be cases like 17-year-old Roselle Owens, Sarah Dunn, Tonya Reaves and Cree Erwin-Sheppard (to name a few) who were killed by abortion because they were lied to about the risks.

[justinspoliticalcorner]

Amy Yurkanin at ProPublica:

Georgia officials have dismissed all members of a state committee charged with investigating deaths of pregnant women. The move came in response to ProPublica having obtained internal reports detailing two deaths. ProPublica reported in September on the deaths of Amber Thurman and Candi Miller, which the state maternal mortality review committee had determined were preventable. They were the first reported cases of women who died without access to care restricted by a state abortion ban, and they unleashed a torrent of outrage over the fatal consequences of such laws. The women’s stories became a central discussion in the presidential campaign and ballot initiatives involving abortion access in 10 states.

“Confidential information provided to the Maternal Mortality Review Committee was inappropriately shared with outside individuals,” Dr. Kathleen Toomey, commissioner of the state Department of Public Health, wrote in a letter dated Nov. 8 and addressed to members of the committee. “Even though this disclosure was investigated, the investigation was unable to uncover which individual(s) disclosed confidential information.

“Therefore, effective immediately the current MMRC is disbanded, and all member seats will be filled through a new application process.” A health department spokesperson declined to comment on the decision to dismiss the committee, saying that the letter, which the department provided to ProPublica, “speaks for itself.” Georgia Gov. Brian Kemp’s office also declined to comment, referring questions to the health department.

Under Georgia law, the work of the maternal mortality review committee is confidential, and members must sign confidentiality agreements. Those members see only summaries of medical records stripped of personal details, and their findings on individual cases are not supposed to be shared with the public — not even with hospitals or with family members of women who died. The health department’s letter states that there could be new steps to keep the board’s deliberations from public view. The letter said officials might change “other procedures for on-boarding committee members better ensuring confidentiality, committee oversight and MMRC organizational structure.” Maternal mortality review committees exist in every state. They are tasked with examining deaths of women during a pregnancy or up to a year after and determining whether they could have been prevented. Georgia’s had 32 standing members from a variety of backgrounds, including OB-GYNs, cardiologists, mental health care providers, a medical examiner, health policy experts and community advocates. They are volunteer positions that pay a small honorarium.

[...] Reproductive rights advocates say Georgia’s decision to dismiss and restructure its committee also could have a chilling effect on the committee’s work, potentially dissuading its members from delving as deeply as they have into the circumstances of pregnant women’s deaths if it could be politically sensitive.

After ProPublica reported on the deaths of two Georgia women as a result of the state’s stringent abortion ban, the state government made the politically-motivated move to shutter the Maternal Mortality Review Committee.