Maternal death and illness persist as a serious health issue for Texans, prompting Gov. Greg Abbot to declare Saturday, Jan. 23, as Maternal Health Awareness Day.
“It’s unacceptable that maternal mortality and morbidity statistics remain at alarming levels for Texas mothers,” Governor Abbott said in his declaration.
Texas’ maternal mortality rate of 18.5 per 100,000 live births in 2018 – the latest year for which data is available – was slightly above the U.S. rate of 17.4 per 100,000, according to the National Center for Health Statistics, a branch of the U.S. Centers for Disease Control and Prevention.
But the U.S. rate is high compared with most other wealthy, industrialized countries. For instance, Canada’s 2018 maternal death rate was 8.3 deaths per 100,000 live births, according to Statistics Canada, the country’s national statistics office.
The Texas Medical Association has worked hard to find policy and clinical solutions to the problems causing maternal illness and death. TMA’s five maternal health priorities for this session of the Texas Legislature focus mostly on preserving and expanding health care services for women of childbearing age.
TMA also has pushed for federal legislation that would provide Medicaid coverage for 12 months postpartum for the mothers who lose services. For instance, the U.S. House of Representatives in September unanimously adopted House Resolution 4996, which allows states to extend one-year postpartum coverage under Medicaid or the Children's Health Insurance Program. TMA strongly supported the bill.
Pregnancy-related Medicaid coverage, which provides comprehensive health care benefits, ends 60 days postpartum for most women.
Two 2020 reports on maternal death and illness from Texas’ top health agencies – the Department of State Health Services (DSHS) and the Health and Human Services Commission (HHSC) – highlighted the need for improved health care coverage for Texas women.
“Medicaid covers 4.3 million Texans, and 33 percent are in the 15-64 age groups that include women of childbearing ages,” the HHSC report said. It added that Medicaid pays for 53% of Texas births and plays a critical role in reducing rates of maternal mortality and morbidity.
The DSHS report called for increased “access to comprehensive health services during pregnancy, the year after pregnancy, and throughout the preconception and interpregnancy periods.”
Many pregnancy-related deaths occur after 60 days, the current Medicaid coverage limit, and more than 60% of those deaths are preventable, according to a CDC a survey of maternal health research.
Since 2018, Texas’ main clinical tool against maternal death and illness has been a collection of best practices advanced by the Alliance for Innovation on Maternal Health (AIM). These best practices are designed to help physicians and other health care professionals recognize and treat problems that can threaten the health of women during and after deliveries.
So far, 219 Texas hospitals, representing more than 98% of the state’s total with obstetric services, have begun implementing the AlM “bundles” of best practices, the HHSC report said.
With support from TMA, DSHS launched the TexasAIM Initiative in 2018 to encourage all Texas hospitals offering delivery services to voluntarily adopt the AIM bundles. Research shows that programs like TexasAIM have succeeded in reducing maternal death and illness.
Find more information, tools, and resources on TMA’s Maternal Mortality and Morbidity webpage.