Texas’ maternal mortality committee faces backlash for not reviewing deaths from first two years post-Dobbs

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At times speaking through tears, mothers, health care providers and community advocates implored Texas’ maternal mortality committee to fully review deaths from the first two years since the state banned nearly all abortions.

At a public meeting Friday, members of the committee defended the decision to skip from 2021 to 2024 as a necessary step to offer more timely recommendations.

“I know that we've always talked about how we want to be as contemporary as possible,” Nakeenya Wilson, a former member of the committee, testified. “What I am concerned about is the fact that the two years that we were skipping are the most crucial years of reproductive health in this country's history.”

Texas banned most abortions after about six weeks of pregnancy in September 2021, and in summer 2022, expanded that ban to all abortions from the moment of conception, except to save the life of the pregnant patient.

There have since been countless stories of doctors delaying or denying pregnancy care due to fear and confusion about how the law would be applied. At least three women have died, ProPublica has reported, due to delayed or mismanaged miscarriage care. Doctors found to have violated the law face up to life in prison, fines of at least $100,000 and the loss of their medical license.

Texas’ maternal mortality committee, responsible for reviewing maternal deaths and near-misses, has come under increased scrutiny since these laws went into effect. Some of the criticisms lay at the feet of the Legislature, which created the committee in 2013. The original statute prohibits the review of abortion-related deaths, a caveat that even committee members were not aware of until a few months ago.

The Legislature also allocated money last year with the intent of cutting Texas out of the federal maternal death tracking system, despite committee members’ concerns. Lawmakers also expanded the committee, replacing the single community advocate position with two community member roles, one representing urban areas and one for rural areas.

This change pushed Wilson, a Black woman who experienced a traumatic birth, off the committee. She was replaced by two doctors; the rural position went to an anti-abortion OB/GYN from San Antonio.

The committee’s last report, released in September, showed that maternal deaths surged in 2020 and 2021, even with COVID deaths excluded. Black women remain far more likely to die than anyone else, although every group except white women saw their odds of dying increase.

That same month, the committee announced its next report would look at deaths from 2024. The committee, which often works on a several year delay, has previously skipped certain years to try to catch up. At Friday’s meeting, Dr. Carla Ortique, a Houston OB/GYN and committee chair, rejected the implication of political influence and said the fact that the committee was skipping the first two years of the abortion ban was a “coincidence.”

“There was no input from the executive or any other branch of our state government regarding our plans for cohort review,” she said. “It is imperative that we become more contemporary in our review process.”

Ortique didn’t discuss the recently reported Texas deaths, but did address the fallout from similar reporting in Georgia. After ProPublica reported on two pregnancy-related deaths the Georgia maternal mortality committee deemed preventable, the state dismissed all members of the committee.

Ortique reminded members of Texas’ committee that they signed confidentiality agreements, and said that “regardless of personal belief and opinion,” members must respect the integrity of the process.

“The work that we do is for the greater good,” she said. “It is critical that none of us act individually in a way that threatens the ability to continue the work assigned to this committee.”

She also said the committee would be dropping its request that the state health agency not redact personal information from the files they review. The committee has long argued that the redaction process was an unnecessary delay since their work is confidential. Ortique attributed this change of position to a new feature in the state’s data collection system that can automatically redact information more quickly.

These announcements were met with frustration from the community members who filled the room to testify. Judy Ward, of Richardson, north of Dallas, testified as a concerned citizen, and said there was a growing sense that the committee’s work was becoming politicized.

“I suggest that this committee needs to bend over backwards to avoid such an interpretation,” she said. “Please, don't be afraid to look at all the data and prove those of us who are skeptical of the motives of some of the committee members, prove us wrong.”

Serita Fontanesi, with the advocacy group United for Reproductive and Gender Equity, spoke as a Black woman preparing to start a family. She said she was worried about the high risk of maternal mortality or morbidity in Texas, and whether her doctors would be able to provide the full spectrum of care.

“Furthermore, should I or my child not make it, I am not confident that my state and this committee would do their due diligence to ensure that it doesn’t happen to someone else, to investigate what went wrong,” she said.

She urged the committee to rethink their decision to not fully review the 2022 and 2023 deaths.

“Too many birthing people and their children whose lives were lost, perhaps for preventable reasons, will go unheard, unseen, unremembered,” she said. “Their deaths will be in vain.”