Rising U.S. Mortality Rate For Mothers Is Highest In Texas

The maternal mortality rate in Texas doubled from 2010 to 2014. Dr. Lisa Hollier of Texas' Maternal Mortality and Morbidity Task Force tells NPR's Scott Simon it's a complex problem.

SCOTT SIMON, HOST:

Texas has some of the best medical care facilities in the world, but a study in the Obstetrics and Gynecology Medical Journal singles out Texas for concern because its maternal mortality rate has doubled. From 2010 to 2014, the mortality rate for mothers dying from complications of childbirth has risen in the U.S. generally over a decade, but that increase has been sharpest in Texas where more than 600 women died between 2010 and 2014 while they were pregnant or within six weeks of giving birth.

Dr. Lisa Hollier heads Texas's Maternal Mortality and Morbidity Task Force. She joins us from the studios of KPFT in Houston. Thanks so much for being with us, Doctor.

LISA HOLLIER: It's a pleasure. Thank you for having me.

SIMON: And why does Texas have such troubling numbers?

HOLLIER: We are very concerned about the numbers that we see here in Texas. In fact, Texas established the Maternal Mortality Review Task Force in 2013 to further investigate the potential causes for the rising maternal mortality rate, and we have recently published our report.

SIMON: And?

HOLLIER: We find that African-American women are bearing the greatest risk for maternal death. In fact, their rate of maternal death is about three times higher than it is for women of other races and ethnicities. In the years 2011 to 2012, African-American women accounted for 11 percent of the births but accounted for 28 percent of the maternal deaths.

SIMON: And why this circumstance, do you think, Dr. Hollier?

HOLLIER: We are studying this very closely. Some of the things that we found - that the most common cause of maternal mortality was cardiac events or heart problems. The second most common explanation was an overdose with prescription drugs. And the third was hypertensive disorders of pregnancy. Those are things like preeclampsia, eclampsia, you may have heard of it as toxemia of pregnancy.

SIMON: I've got to point out, as I'm sure some people have, that there are other states that have these same kind of afflictions and problems with opioid addiction that certain communities in Texas have had. Why do you think the maternal mortality rate, though, has been so much higher in Texas?

HOLLIER: We know that there are several things that were more commonly seen among women who died than in those who did not. And those complications include things like obesity, high blood pressure, diabetes, cesarean delivery and late prenatal care.

SIMON: Could this increase in maternal mortality have something to do with the cuts the Texas legislature made during this time, that, according to what we read, caused more than 80 family planning clinics, which provided many medical services to pregnant women, to shut down?

HOLLIER: Well, I don't believe that there is any single cause that is contributing to this rise. Maternal mortality is a very, very complex problem, and there are many different things that are involved.

SIMON: So when medical clinics have to close - you know, to cite an example that I think of as apocryphal but maybe not just apocryphal - if a woman is pregnant in Nacogdoches used to be able to go to a clinic that was 20 miles from home and now she has to go to one that's 180 miles from home, that could make a difference, right?

HOLLIER: Again, I think that access to health care across a woman's lifespan is incredibly important, and things that we can do to permit that access are very important.

SIMON: Dr. Lisa Hollier is director of the Texas Maternal Mortality and Morbidity Task Force. Thanks so much for being with us.

HOLLIER: Thank you.

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