A puzzle wrapped in an enigma
August 22, 2016 9:33 PM Subscribe
Texas has highest maternal mortality rate in developed world, study finds. The rate of Texas women who died from complications related to pregnancy doubled from 2010 to 2014, a new study has found, for an estimated maternal mortality rate that is unmatched in any other state and the rest of the developed world.
This is really shameful. But I doubt any of the legislators who voted and continue to vote for bills that "protect" women and "save" babies are capable of recognizing that feeling.
Please stop protecting and saving us to death.
posted by rtha at 10:58 PM on August 22, 2016 [37 favorites]
Please stop protecting and saving us to death.
posted by rtha at 10:58 PM on August 22, 2016 [37 favorites]
The global picture is much more hopeful: 'around 303,000 women died of complications during pregnancy or up to six weeks after giving birth in 2015 - down from 532,000 in 1990.' (Source)
There's a statistic to remember when the news gets depressing.
posted by Busy Old Fool at 11:39 PM on August 22, 2016 [11 favorites]
There's a statistic to remember when the news gets depressing.
posted by Busy Old Fool at 11:39 PM on August 22, 2016 [11 favorites]
Yes, it’s worth noting that while this is a particularly acute problem in Texas, the US rates overall went up, while across the developed and developing world, they went down.
posted by wilful at 11:42 PM on August 22, 2016 [10 favorites]
posted by wilful at 11:42 PM on August 22, 2016 [10 favorites]
This makes me sick. It's what happens when you base health care decisions on feelings and not facts. The Republicans in Texas have the blood of their people on their hands.
posted by Joey Michaels at 11:45 PM on August 22, 2016 [13 favorites]
posted by Joey Michaels at 11:45 PM on August 22, 2016 [13 favorites]
"Pro-life."
posted by entropone at 4:24 AM on August 23, 2016 [21 favorites]
posted by entropone at 4:24 AM on August 23, 2016 [21 favorites]
Well, I guess that's one way to make the female vote not a factor in elections.
:-(
posted by prepmonkey at 5:20 AM on August 23, 2016 [4 favorites]
:-(
posted by prepmonkey at 5:20 AM on August 23, 2016 [4 favorites]
Texas: protecting the unborn, extremely keen on killing adults. (Not to mention learning impaired/low-IQ ethnic minorities who were mostly in the wrong place at the wrong time and had a public defender.)
posted by cstross at 5:32 AM on August 23, 2016 [10 favorites]
posted by cstross at 5:32 AM on August 23, 2016 [10 favorites]
This seems like its just the start of a larger story. As the local paper noted, the spike cannot be entirely explained by policy changes. So then, what?
posted by lownote at 5:45 AM on August 23, 2016
posted by lownote at 5:45 AM on August 23, 2016
From the Houston Chronicle: Report: Black women in Texas face the greatest risk from pregnancy related death. The article also links to the Maternal Mortality and Morbidity Task Force and Department of State Health Services Joint Biennial Report (Scribd).
From that report's Summary of Findings: "Based on analysis of maternal death data from calendar years 2011-2012, the task force found that 1) Black women bear the greatest risk for maternal death; 2) cardiac events, overdose by licit or illicit prescription drugs, and hypertensive disorders are the leading causes of maternal death; 3) a majority of maternal deaths occur more than 42 days after delivery; and 4) data quality issues related to the death certificate make it difficult to identify a maternal or “obstetric” death."
posted by MonkeyToes at 6:09 AM on August 23, 2016 [4 favorites]
From that report's Summary of Findings: "Based on analysis of maternal death data from calendar years 2011-2012, the task force found that 1) Black women bear the greatest risk for maternal death; 2) cardiac events, overdose by licit or illicit prescription drugs, and hypertensive disorders are the leading causes of maternal death; 3) a majority of maternal deaths occur more than 42 days after delivery; and 4) data quality issues related to the death certificate make it difficult to identify a maternal or “obstetric” death."
posted by MonkeyToes at 6:09 AM on August 23, 2016 [4 favorites]
As the local paper noted, the spike cannot be entirely explained by policy changes. So then, what?
The local paper seems to have taken things somewhat out of context. From the FPP, emphasis mine:
The local paper seems to have taken things somewhat out of context. From the FPP, emphasis mine:
In the wake of the report, reproductive health advocates are blaming the increase on Republican-led budget cuts that decimated the ranks of Texas’s reproductive healthcare clinics. In 2011, just as the spike began, the Texas state legislature cut $73.6m from the state’s family planning budget of $111.5m. The two-thirds cut forced more than 80 family planning clinics to shut down across the state. The remaining clinics managed to provide services – such as low-cost or free birth control, cancer screenings and well-woman exams – to only half as many women as before.posted by fraula at 6:13 AM on August 23, 2016 [12 favorites]
At the same time, Texas eliminated all Planned Parenthood clinics – whether or not they provided abortion services – from the state program that provides poor women with preventive healthcare. Previously, Planned Parenthood clinics in Texas offered cancer screenings and contraception to more than 130,000 women.
In 2013, Texas restored funding for the family planning budget to original levels. But the healthcare providers who survived the initial cuts reported struggles to restore services to their original levels.
Indeed, the report said it was “puzzling” that Texas’s maternal mortality rate rose only modestly from 2000 to 2010 before doubling between 2011 and 2012. The researchers, hailing from the University of Maryland, Boston University’s school of public health and Stanford University’s medical school, called for further study. But they noted that starting in 2011, Texas drastically reduced the number of women’s health clinics within its borders.
Also, this has got to represent an increase in all the other problems that used to be dealt with by family planning clinics and Planned Parenthood. I bet there will be (if there isn't already) an uptick in the number of gynecological cancers that only get caught later, dysplasia that develops into cancer where it would normally have been treated, menstrual problems, untreated endo, declines in prenatal health, etc.
It really is like deaths from police brutality - relatively few in an absolute sense (still too many, but hundreds rather than thousands) and an indicator of a whole pyramid of police abuse beneath them.
posted by Frowner at 6:16 AM on August 23, 2016 [21 favorites]
It really is like deaths from police brutality - relatively few in an absolute sense (still too many, but hundreds rather than thousands) and an indicator of a whole pyramid of police abuse beneath them.
posted by Frowner at 6:16 AM on August 23, 2016 [21 favorites]
Calling it now: nothing will be done because it's mostly brown people affected. "Pro-life" orgs will be silent, even though children absolutely suffer when their mothers get sick and die. The Republicans will, if asked, blame "lifestyle choices" and wash their hands of any responsibility.
Until we get enough Democrats into the Texas legislature, no one with the power to do anything will give a flying fuck.
posted by emjaybee at 6:40 AM on August 23, 2016 [9 favorites]
Until we get enough Democrats into the Texas legislature, no one with the power to do anything will give a flying fuck.
posted by emjaybee at 6:40 AM on August 23, 2016 [9 favorites]
Fraula: I read that. Those thoughts are from reproductive rights advocates, not the researchers, who were paraphrased by the Chronicle.
To be clear, I support those advocates, but I wonder if there are other issues we haven't entirely identified yet. Perhaps its a combination of the health care reduction and the findings from the Houston Chronicle article posted above.
posted by lownote at 6:47 AM on August 23, 2016
To be clear, I support those advocates, but I wonder if there are other issues we haven't entirely identified yet. Perhaps its a combination of the health care reduction and the findings from the Houston Chronicle article posted above.
posted by lownote at 6:47 AM on August 23, 2016
It will be interesting to see later numbers on this, since in 2014 Obamacare started taking effect and could help reverse the trend. Of course, Texas is one of those states that is fighting tooth and nail to keep poor people from getting healthcare, so any positive effect will be smaller than it could have been.
posted by TedW at 6:56 AM on August 23, 2016 [1 favorite]
posted by TedW at 6:56 AM on August 23, 2016 [1 favorite]
Not that it's news to anyone here, but worth noting that Cecile Richards, current president of Planned Parenthood, is the daughter of former Texas governor Ann Richards.
posted by mikeh at 6:59 AM on August 23, 2016 [3 favorites]
posted by mikeh at 6:59 AM on August 23, 2016 [3 favorites]
There's an old saying: "Texas is hard on horses and women."
posted by Pirate-Bartender-Zombie-Monkey at 7:21 AM on August 23, 2016 [4 favorites]
posted by Pirate-Bartender-Zombie-Monkey at 7:21 AM on August 23, 2016 [4 favorites]
As the local paper noted, the spike cannot be entirely explained by policy changes. So then, what?
The local paper seems to have taken things somewhat out of context.
I think this is a misunderstanding of what "accounted for" means in the context of an academic paper. All that stuff said by activists explains why we would expect an increase in mortality rates. But to "entirely explain" it in the academic sense would mean that once you control for these variables in your statistical models (number of planned parenthoods per state, funding per planned parenthood location, family planning budget, percent of family planning budget that goes to healthcare etc. etc.), then the difference goes away (i.e. controlling for those things there is no increase in maternal mortality). So all these changes might "explain" the increase in the lay sense, and probably partially explain it in the models, but they do not "entirely explain" (i.e. account for all the variance) in the statistical models.
posted by If only I had a penguin... at 7:26 AM on August 23, 2016 [7 favorites]
The local paper seems to have taken things somewhat out of context.
I think this is a misunderstanding of what "accounted for" means in the context of an academic paper. All that stuff said by activists explains why we would expect an increase in mortality rates. But to "entirely explain" it in the academic sense would mean that once you control for these variables in your statistical models (number of planned parenthoods per state, funding per planned parenthood location, family planning budget, percent of family planning budget that goes to healthcare etc. etc.), then the difference goes away (i.e. controlling for those things there is no increase in maternal mortality). So all these changes might "explain" the increase in the lay sense, and probably partially explain it in the models, but they do not "entirely explain" (i.e. account for all the variance) in the statistical models.
posted by If only I had a penguin... at 7:26 AM on August 23, 2016 [7 favorites]
If this is not what Jesus desires, then dozens of churches and millions of Christians are bitterly misguided; if it is what Jesus desires, then He is unworthy of worship.
Does anyone have a name for this dilemma? It seems like it must be a very old idea, but it occurs to me afresh every time something terrible happens to those that an evangelical God is supposed to be keeping a sharp eye on.
It gives me no joy, either. I'm not from Texas, but I'm from the Bible Belt and I'm sick of seeing the governments there piss their own pants out of spite.
posted by Countess Elena at 7:28 AM on August 23, 2016 [12 favorites]
Does anyone have a name for this dilemma? It seems like it must be a very old idea, but it occurs to me afresh every time something terrible happens to those that an evangelical God is supposed to be keeping a sharp eye on.
It gives me no joy, either. I'm not from Texas, but I'm from the Bible Belt and I'm sick of seeing the governments there piss their own pants out of spite.
posted by Countess Elena at 7:28 AM on August 23, 2016 [12 favorites]
Does anyone have a name for this dilemma?
Cognitive dissonance.
posted by blue_beetle at 7:42 AM on August 23, 2016 [6 favorites]
Cognitive dissonance.
posted by blue_beetle at 7:42 AM on August 23, 2016 [6 favorites]
> It will be interesting to see later numbers on this, since in 2014 Obamacare started taking effect and could help reverse the trend. Of course, Texas is one of those states that is fighting tooth and nail to keep poor people from getting healthcare, so any positive effect will be smaller than it could have been.
Yeah, Texas has chosen to not expand Medicaid coverage. While its Medicaid/CHIP coverage for pregnant women and children isn't the worst in the country, if there are an insufficient number of clinics available to those eligible for coverage, well...
posted by rtha at 7:49 AM on August 23, 2016 [2 favorites]
Yeah, Texas has chosen to not expand Medicaid coverage. While its Medicaid/CHIP coverage for pregnant women and children isn't the worst in the country, if there are an insufficient number of clinics available to those eligible for coverage, well...
posted by rtha at 7:49 AM on August 23, 2016 [2 favorites]
Yes, it’s worth noting that while this is a particularly acute problem in Texas, the US rates overall went up, while across the developed and developing world, they went down.
There's a couple possible explanations for this. First and most importantly, anti-woman legislation like this has been passed in other states, not just Texas. Similar laws have been enacted in Arizona, Florida, Indiana (by no less than the GOP's "moderate" VP candidate Mike Pence), Michigan, Missouri, Ohio, Pennsylvania, Tennessee, and Virginia (and potentially several more). The common thread is, rather predictably, conservative lawmakers and executives with legislative supermajorities and/or control of all three branches of state government. There's also the problems coming from poor maternal health due to existing chronic illness, although that can also largely be attributed to the decimation of women's health programs at federal, state, and local levels.
The Republicans in Texas have the blood of their people on their hands.
It's not just Texas. Hell, it's not even just the states I mentioned above. It's across the whole country, and at the federal level, it's even affecting what one would normally think of as common-sense legislation. For example, one of the many stupid and bigoted reasons anti-Zika funding is currently held up in the US Congress (the others are Confederate flags, Obamacare, and dangerous chemical deregulation, because of course) is that the GOP has en masse decided that getting rid of the providers of maternal, fetal, and natal health services is worth holding bills hostage for. Never mind those are the exact populations most at risk from Zika, the the prion disease that has infected the whole party (h/t Charlie Pierce) has seemingly destroyed the logic and empathy centers of their brains,
posted by zombieflanders at 7:50 AM on August 23, 2016 [8 favorites]
There's a couple possible explanations for this. First and most importantly, anti-woman legislation like this has been passed in other states, not just Texas. Similar laws have been enacted in Arizona, Florida, Indiana (by no less than the GOP's "moderate" VP candidate Mike Pence), Michigan, Missouri, Ohio, Pennsylvania, Tennessee, and Virginia (and potentially several more). The common thread is, rather predictably, conservative lawmakers and executives with legislative supermajorities and/or control of all three branches of state government. There's also the problems coming from poor maternal health due to existing chronic illness, although that can also largely be attributed to the decimation of women's health programs at federal, state, and local levels.
The Republicans in Texas have the blood of their people on their hands.
It's not just Texas. Hell, it's not even just the states I mentioned above. It's across the whole country, and at the federal level, it's even affecting what one would normally think of as common-sense legislation. For example, one of the many stupid and bigoted reasons anti-Zika funding is currently held up in the US Congress (the others are Confederate flags, Obamacare, and dangerous chemical deregulation, because of course) is that the GOP has en masse decided that getting rid of the providers of maternal, fetal, and natal health services is worth holding bills hostage for. Never mind those are the exact populations most at risk from Zika, the the prion disease that has infected the whole party (h/t Charlie Pierce) has seemingly destroyed the logic and empathy centers of their brains,
posted by zombieflanders at 7:50 AM on August 23, 2016 [8 favorites]
Again we've got absolute, undeniable, empirical, proof that the so-called "pro-life" movement doesn't actually care about children, and is actively hostile towards women.
We on the left need to stop pussyfooting around and letting them define terms. They aren't "pro-life", they're for forced birth.
Getting into the weeds about whether or not any one particular forced birther (usually someone brings up their mom or grandmother) really is motivated by misogyny or love of embryos is a giant red herring that is intensely appealing to us on the left because we on the left love nothing more than second guessing ourselves, on the other handing things, and declaring that everything is shades of gray rather than actually confronting real problems.
It doesn't matter if your grandmother loves embryos or if she's a howling misogynist.
What matters is that she's voting for people and policies that undeniably, empirically, both hurt women and increase the rate of abortions.
What matters is that they are killing and maiming women and we can't let them keep pretending they aren't.
We've been playing defense ever since Roe. We let that decision trick us into thinking the fight was won so we could go off into the moral gray area back and forth bickering we on the left would rather engage in than just about anything else, and we let the right define terms and fight essentially unchallenged for decades.
We've got to go back on the offense here. We've got to be not just standing neutral in states where we have a majority, but pushing back, expanding sex ed, abortion access, birth control access, and general women's health access. We've got to be able to show a sharp line between what works (our position) and what doesn't (their's) so that granny can maybe be persuaded by glaring facts.
In part my fellow Texans have been able to be so awful because voters in California, New York, and other liberal leaning states have not drawn a sharp enough contrast, have not made abortion, sex ed, and contraception so much more accessible in their states that it shames Texas into proper action.
Note that it was Colorado, not California, not New York, that was at the tip of the spear on free and reduced cost contraception for teens.
posted by sotonohito at 9:43 AM on August 23, 2016 [22 favorites]
We on the left need to stop pussyfooting around and letting them define terms. They aren't "pro-life", they're for forced birth.
Getting into the weeds about whether or not any one particular forced birther (usually someone brings up their mom or grandmother) really is motivated by misogyny or love of embryos is a giant red herring that is intensely appealing to us on the left because we on the left love nothing more than second guessing ourselves, on the other handing things, and declaring that everything is shades of gray rather than actually confronting real problems.
It doesn't matter if your grandmother loves embryos or if she's a howling misogynist.
What matters is that she's voting for people and policies that undeniably, empirically, both hurt women and increase the rate of abortions.
What matters is that they are killing and maiming women and we can't let them keep pretending they aren't.
We've been playing defense ever since Roe. We let that decision trick us into thinking the fight was won so we could go off into the moral gray area back and forth bickering we on the left would rather engage in than just about anything else, and we let the right define terms and fight essentially unchallenged for decades.
We've got to go back on the offense here. We've got to be not just standing neutral in states where we have a majority, but pushing back, expanding sex ed, abortion access, birth control access, and general women's health access. We've got to be able to show a sharp line between what works (our position) and what doesn't (their's) so that granny can maybe be persuaded by glaring facts.
In part my fellow Texans have been able to be so awful because voters in California, New York, and other liberal leaning states have not drawn a sharp enough contrast, have not made abortion, sex ed, and contraception so much more accessible in their states that it shames Texas into proper action.
Note that it was Colorado, not California, not New York, that was at the tip of the spear on free and reduced cost contraception for teens.
posted by sotonohito at 9:43 AM on August 23, 2016 [22 favorites]
@SeanMcElwee: Cato's new "freedom in the states" index includes cousin marriage, prostitution, MMA and raw milk but not abortion.
posted by zombieflanders at 11:08 AM on August 23, 2016 [6 favorites]
posted by zombieflanders at 11:08 AM on August 23, 2016 [6 favorites]
Secession is going to work so well for Texans. I'm not sure if I should be madder at redneck voters or the religio-fascist politicians who manipulate them.
posted by Abehammerb Lincoln at 11:40 AM on August 23, 2016
posted by Abehammerb Lincoln at 11:40 AM on August 23, 2016
In related news, terrorism works in Wisconsin: When a Planned Parenthood Clinic Closes, This Happens. A fire is more than a symbolic act.
posted by homunculus at 12:33 PM on August 23, 2016 [3 favorites]
posted by homunculus at 12:33 PM on August 23, 2016 [3 favorites]
This makes me sick. It's what happens when you base health care decisions on feelingsreligious dogma and not facts.
ftfy
posted by Thorzdad at 3:11 PM on August 23, 2016 [4 favorites]
ftfy
posted by Thorzdad at 3:11 PM on August 23, 2016 [4 favorites]
Does anyone have a name for this dilemma? It seems like it must be a very old idea, but it occurs to me afresh every time something terrible happens to those that an evangelical God is supposed to be keeping a sharp eye on.
Epicureanism, or the Problem of Evil?
Is God willing to prevent evil, but not able? Then He is not omnipotent. Is He able, but not willing? Then He is malevolent. Is He both able and willing? Then whence cometh evil? Is He neither able nor willing? Then why call Him God?
Epicurus (c. 341 - c. 270 BC)
I'm reminded of some conclusion that functioning social democracies tend to get less religious because people aren't suffering as much and therefore don't need religion.
Ah, here:
Why Atheism Replaces Religion In Developed Countries
Meanwhile in the US: Americans May Be Too Religious To Embrace Socialism (538)
posted by sebastienbailard at 3:27 AM on August 24, 2016 [2 favorites]
Epicureanism, or the Problem of Evil?
Is God willing to prevent evil, but not able? Then He is not omnipotent. Is He able, but not willing? Then He is malevolent. Is He both able and willing? Then whence cometh evil? Is He neither able nor willing? Then why call Him God?
Epicurus (c. 341 - c. 270 BC)
I'm reminded of some conclusion that functioning social democracies tend to get less religious because people aren't suffering as much and therefore don't need religion.
Ah, here:
Why Atheism Replaces Religion In Developed Countries
Meanwhile in the US: Americans May Be Too Religious To Embrace Socialism (538)
posted by sebastienbailard at 3:27 AM on August 24, 2016 [2 favorites]
I have to periodically remind myself that there are indeed people who are both deeply religious and deeply compassionate and I shouldn't be too cynical about this.
posted by sebastienbailard at 3:27 AM on August 24, 2016
posted by sebastienbailard at 3:27 AM on August 24, 2016
Thorzdad: Got into a long argument recently with an atheist libertarian about how an embryo's liberty is something to be protected at the expense of the person carrying. It's not just dogma you're fighting here.
posted by Jilder at 4:31 AM on August 24, 2016
posted by Jilder at 4:31 AM on August 24, 2016
Thorzdad: Got into a long argument recently with an atheist libertarian about how an embryo's liberty is something to be protected at the expense of the person carrying. It's not just dogma you're fighting here.
How is that not dogma? Not all dogma is religious.
posted by If only I had a penguin... at 5:34 AM on August 24, 2016 [3 favorites]
How is that not dogma? Not all dogma is religious.
posted by If only I had a penguin... at 5:34 AM on August 24, 2016 [3 favorites]
We on the left need to stop pussyfooting around and letting them define terms. They aren't "pro-life", they're for forced birth.
Exactly. Contraceptives are a proven way to lower abortion rates. If you truly believe abortion is murder, you should be pushing contraceptives as hard as you can. Free condoms mailed to every household! Funding for birth control research! It's worth it if even one life is saved. So why isn't this a focus of the pro-life movement?
posted by panic at 3:33 PM on August 24, 2016 [4 favorites]
Exactly. Contraceptives are a proven way to lower abortion rates. If you truly believe abortion is murder, you should be pushing contraceptives as hard as you can. Free condoms mailed to every household! Funding for birth control research! It's worth it if even one life is saved. So why isn't this a focus of the pro-life movement?
posted by panic at 3:33 PM on August 24, 2016 [4 favorites]
Dr. Katharine Morrison's response: "Your editorial passed over the real reason behind the unconscionable rise in deaths among childbearing women in the United States -- American obstetric practices."
posted by sutureselves at 10:21 AM on September 8, 2016
posted by sutureselves at 10:21 AM on September 8, 2016
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