Dear Chairman Price and the Committee on House Public Health,
On behalf of the Texas District of the American Congress of Obstetricians and Gynecologists (ACOG) and the Texas Association of Obstetricians and Gynecologists (TAOG), representing more than 3,700 ob/gyns in the state, thank you for the opportunity to present this written testimony in support of HB 2403 by Representative Thierry.
Texas is facing a crisis in maternal mortality and morbidity. According to a 2016 study published in Obstetrics and Gynecology, the rate of Texas maternal deaths following birth more than doubled from 18 per 100,000 live births to 38 per 100,000 live births between 2010 and 2012.
In 2013, the Texas Maternal Mortality and Morbidity Task Force was created and began analyzing maternal deaths in Texas. For the examination of the statewide trends presented in the Task Force’s biennial report to this legislature, maternal deaths in 2011-2012 were identified by linking the mothers’ information from their birth/fetal death record with information from their own death record occurring within one year of the end of a pregnancy. This analysis of confirmed maternal deaths identified that black women bear the greatest risk. Though only 11.4% of all births in Texas were to black women, they accounted for 28.8% of all maternal deaths.
Leading causes for maternal mortality in Texas are cardiac disease; behavioral-health disorders, including opioid overdose and suicide; and hypertension. While multiple factors contribute to maternal mortality and morbidity, including genetics and socioeconomics, lack of access to care is a key driver. HB 2403 would direct the Maternal Mortality and Morbidity Task Force to study and evaluate the health conditions disproportionately affecting the African American population. Taking a closer look at these disparities and at maternal deaths of black women, could help us develop recommendations to address said disparities, and improve maternal health.
Racial and ethnic disparities in obstetric and gynecological outcomes and care are prevalent and persistent. In order to provide the best care possible for all women, ob/gyns must be keenly aware of the existence of and contributors to health disparities and be willing to work toward their elimination. ACOG and TAOG are committed to providing the highest level of care for all women of Texas. We will continue to advocate for our patients and for the resources needed to provide the best care for our patients.
We thank Representative Thierry for filing this important legislation and look forward to working with her and the Task Force on this important cause.
Tony Dunn, MD, FACOG
Chair, Texas District American Congress of Obstetricians and Gynecologists
President, Texas Association of Obstetricians and Gynecologists