Some of the state’s leading physicians vetted ideas this weekend to reduce the deaths of women while pregnant or shortly after giving birth.
One of the biggest challenges addressed at the Maternal Health Congress was access to health care. Dr. Carlos Cardenas, president of the Texas Medical Association, said the problem starts with family planning.
“Since the Legislature vastly reduced funding for family planning in 2011, we have seen a 27 percent increase in unplanned pregnancies,” he said. “Unplanned pregnancies are more likely to result in maternal and infant complications perhaps because [the mothers'] pre-pregnancy health wasn’t ideal.”
Others pointed out that Medicaid also isn’t serving enough Texas women. The state didn’t expand Medicaid under the Affordable Care Act, so many women are not getting health care before they’re pregnant.
Dr. Ryan Van Ramshorst, chairman of the TMA’s Select Committee on Medicaid, CHIP, and the Uninsured, said women are also kicked out of the state’s Medicaid program just 60 days after giving birth.
“Medicaid is key to improving women’s health and addressing our alarmingly high rate of maternal mortality and morbidity,” he said. “And we know that Medicaid provides preventive, prenatal and postpartum care.”
Physicians also discussed how to tackle substance abuse and opioid overdoses among pregnant women in the state. Opioid deaths are one of the big drivers of maternal deaths that aren’t solely linked to pregnancy.
During the meeting, members also talked about efforts to improve data collection. Getting good data from death certificates has been an ongoing problem. Last session, lawmakers passed a bill aimed at improving death certificate data. Doctors at the conference said, however, more may need to be done.
There was also discussion about why black women in Texas are dying at higher rates than white women while pregnant or after giving birth. Dr. Carla Ortique, vice chair of the Texas Maternal Mortality and Morbidity Task Force, said individual and institutionalized racism are to blame.
“Until we address these issues, the inequities will persist,” she said. “But why should we care? Aside from the ethical and moral reasons that we as physicians are pledged to, it’s economically imperative to address these issues.”
Ortique said research shows racial inequities cost Americans hundreds of millions dollars a year.
In a private session, doctors discussed dozens of ideas to change the problems facing pregnant women in the state. Among them is an effort to expand Medicaid coverage to up to a year after a woman gives birth; other proposals suggest improving data collection and training at hospitals.