AUSTIN – It’s no secret that Texas has a serious health crisis on its hands with the alarming number of women dying due to issues related to pregnancy within a year after giving birth, and state leaders haven’t yet come to a consensus on finding the best policy path forward.
But some women’s health experts and state legislators agree one of the first steps is making sure Texas mothers have continuous access to health care before, during and after childbirth.
“I think we could have made some changes last (legislative) session,” said Rep. Donna Howard, D-Austin. “We already knew that access to care was one of the leading problems, and yet we still refuse to do what’s necessary to make sure we have more women getting this access to care.”
On Thursday, Howard gathered alongside other state lawmakers, health care experts and Texas care providers for a daylong health care policy conference at the University of Texas at Austin for a slew of panels on topics ranging from strategies to manage the opioid crisis to addressing maternal health in Texas. Most of the panels, regardless of topic, touched on maternal mortality at some point.
Howard said the first step in tackling the state’s maternal mortality issue is developing policy to ensure women have` continuous health care coverage without any breaks or gaps, so that they get the prenatal and wellness care they need through postpartum under the same program. Under current state law, women are eligible for Medicaid coverage up until 60 days after delivery before they’re kicked off.
“That would go a long way to making sure women are going to afford themselves of the care that they need to stay healthy before, during and after the pregnancy,” Howard said.
The Maternal Mortality and Morbidity Task Force, an agency under the Department of State Health Services, reported in 2016 that 189 mothers died within a year after of giving birth in 2011-2012. The problem has only worsened, with the state’s maternal mortality rate nearly doubling since 2011, making the state the worst in the country, according to 2016 research published in a national medical journal, though a recent study has cast doubt on those numbers. Most of the mothers in the study died from heart disease, drug overdose (particularly prescription drugs), hypertension or hemorrhaging.
“As a mom, I will tell you it’s a miracle to have a healthy baby,” said Anne Rote, president and CEO of Molina Healthcare of Texas. “There’s so many things that can go wrong.”
Addressing the issue
The state task force report made several recommendations on how legislators could examine and address the problem. These included increasing access to care up until a year after birth; increasing screening for mental and behavioral health issues (especially postpartum depression); and improving the quality of death certificate data.
According to a recent study, there’s a direct link between the lack of quality data and women dying during pregnancy, in childbirth or the 42 days thereafter. It found that the state’s death rate is not as high as previously found, but it’s still worse than other states throughout the country.
Some legislators at the panels said the Legislature needs to look at addressing how death certificates are written and signed to clean up some of the data problems.
“We need to be sure there’s good integrity around the data,” said Rep. John Zerwas, R-Richmond, and a candidate for speaker of the House of Representatives. “We don’t want to try to create solutions for something that the data doesn’t really support.”