Sunday, September 26

‘It’s easy to dismiss black women’s lives’: Texas drags its feet into maternal mortality crisis | Texas

When the medical staff prepared Shawn Thierry for an emergency cesarean section, she knew something was seriously wrong. After an epidural, excruciating pain ran through her legs. Soon, he could barely breathe.

“I felt like my heart was going to jump out of my chest and that I might die,” he said.

She yelled for her doctor to put her under anesthesia, which turned out to be the solution. The epidural, Thierry later discovered, was administered too high up her spine, causing her to paralyze that slowly progressed to her heart.

“I was an attorney who had full private health coverage and I almost died,” Thierry said of her daughter’s birth in 2012. “I can’t imagine what the outcome would be for the thousands of other African-American women without health insurance. “

Years later, as a member of the Texas House of Representatives, Thierry was “stunned” to learn of the maternal mortality crisis.

The United States has the higher maternal mortality rate among developed countries similarly and is the only industrialized nation where such deaths are growing. But according to data from the federation Centers for Disease Control and PreventionIn Texas, the maternal mortality rate is above the United States average, with 18.5 deaths per 100,000 live births.

Black women in the state are “disproportionately” affected, accounting for 11% of live births, but 31% of maternal deaths. Large racial and ethical disparities They exist nationwide as well.

“I was surprised that black mothers like me are three times more likely to die than our white counterparts,” Thierry said. “And no one in the legislature was really talking about it.”

He has repeatedly introduced laws to combat the glaring problem. Their proposals included racial bias training for medical professionals and a bill to address a “severe” backlog of maternal health data by creating a centralized registry.

They did not advance in 2019, nor in the current legislature that ends this weekend. Focused on restricting the right to abortion, the male and Republican-dominated state legislature has lagged on maternal mortality.

Health advocates were cautiously optimistic that in 2021 Texas lawmakers would at least usher in a proposal to extend Medicaid care to a year after birth.

Lawmakers took action. A proposal was sent to Governor Greg Abbott on Friday. But it failed to provide the full expansion of Medicaid.

‘A great racial disparity’

A state committee for the review of maternal mortality and morbidity he found that of the pregnancy-related deaths in Texas in 2013, about a third occurred between 43 days and a year after the end of pregnancy. It also found that almost 90% of those deaths were preventable. Among the leading underlying causes of death most likely to be preventable are infections, bleeding, pre-eclampsia, and cardiovascular conditions.

“It was really amazing,” said Dr. Amy Raines-Milenkov, a professor at the University of North Texas Health Sciences Center and a member of the review committee. “We found that most of these deaths could have been prevented, but the system is simply not set up to prevent them. And we find a great racial disparity, which is a reflection of how we in society value women, especially African American women. “

Since 2016, the committee Recommendation No1 Helping save lives has been extending postpartum Medicaid coverage for low-income mothers to one year. Texas currently expels new moms from Medicaid after 60 days, leading to later and less preventive care. The American Medical Association and the American College of Obstetricians and Gynecologists Support longer postpartum care.

“So many health problems can develop in this really delicate time frame, so it’s critical that new moms get that full year of extended coverage,” Raines-Milenkov said. “Thinking that new mothers can identify problems, get timely appointments and follow up with their doctors in as little as two months after having a baby is unrealistic. Anything less than 12 months is really insufficient. “

The Biden Administration recently initiated incentives for states to extend postpartum coverage to 12 months. Illinois was the first to have its extension approved and other states including Florida and Virginia hope to implement measures soon.

Toni Rose, a representative from Dallas, joined Thierry at the presentation HB 133, to do just that in Texas. The Republican-dominated House passed the bill with rare bipartisan approval and nearly 70 groups, from the Texas Medical Association to the right-wing Texas Public Policy Foundation, expressed support.

However, the ultra-conservative Texas Senate, which passed extremist anti-abortion bills in March, did not pass the bill until the final minutes of its session. Even then, the legislation was not what was proposed. Without explanation, Republican Lois Kolkhorst of Brenham cut the coverage year to six months.

Rose called the legislation a “victory” but said it still “falls short.” Thierry expressed his dismay.

“The data is clear that women are still at risk for maternal mortality and pregnancy-related complications for up to a year after delivery,” she said. “While the six months negotiated by the Texas Senate is better than the status quo, many new mothers will still be deprived of quality health care at a time when they are most vulnerable.

“Since this is a subject in which I have both personal and professional experience, I am disappointed. When it comes to saving the lives of Texas mothers, ‘splitting the difference’ is not appropriate. “

Marsha Jones, executive director of the Afiya Center, a Dallas group that supports black women with reproductive health care, said the lack of substantial progress was in part a reflection of the legislature’s misguided priorities and lack of diversity.

Protesters march in front of the Texas State Capitol in Austin.
Protesters march in front of the Texas State Capitol in Austin. Photograph: Sergio Flores / Getty Images

The Texas Legislature is made up mainly of white men: 61% of legislators in the House and Senate are white, even though white Texans make up only 41% of the population. Women are vastly outnumbered by men.

“Black women are dying at an alarming rate for preventable reasons and our state leaders cut back on the main proposal that a state-appointed committee recommended to help them, why would that happen?” Jones said. “I think it’s because it’s so easy to dismiss the lives of black women.”

The legislature invested time and energy in restricting access to abortion, including passing one of the most extreme bans in the country, which allows any citizen to sue an abortion provider, as well as a Invoice “trigger” prohibiting the procedure in the case of Roe v Wade, the 1973 ruling that safeguards the right to abortion, is annulled by the Supreme Court of the United States.

Both measures were “top legislative prioritiesFor Senate Leader Lt. Governor Dan Patrick, who did not make maternal mortality a priority on the list.

“It seems like the only time we want to stand up and worry about a life is when it’s in the womb,” Rose said. He said Republicans in the House of Representatives in May.

‘Women are obviously choosing a life’

In an ideological quest to punish abortion affiliates, Republicans have decimated the Texas Reproductive Health Safety Net by preventing low-income Medicaid patients from receiving life-saving preventive care at Planned Parenthood, a measure resulting in reducing access to contraception and increasing Medicaid birth rates, according to the Texas Policy Assessment Project.

A recent study in the medical journal Contraception showed a correlation between high maternal mortality rates and states that overcome abortion barriers.

“We have a maternal health crisis and conservative lawmakers once again made anti-choice bills a priority,” Thierry said. “They don’t realize that all women threatened by maternal death are obviously choosing life; they shouldn’t have to do it in exchange for their own. “

Lawmakers did not make significant progress for Medicaid overall. Texas is home to the largest number of uninsured residents in the U.S., as well as the largest percentage of uninsured women of childbearing age, but has refused to expand Medicaid under the Affordable Care Act and Republicans blocked Legislative efforts to help extend health coverage for the working poor.

Texas has one of the steepest Medicaid Eligibility Requirements in the U.S. Of the 1.4 million Texans who would benefit from Medicaid expansion, 75% are people of color.

“Once again, we are kicking the road with many of these solutions,” Thierry said. “It is absolutely imperative that we continue to work to reduce maternal mortality. One death is too much, especially when it can be prevented. “

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