| Perspectives on Texas

During the past few years, claims of high maternal mortality rates in Texas have been a key talking point for Planned Parenthood supporters. However, new research just out in the journal Obstetrics & Gynecology finds the actual maternal mortality rate in Texas is far lower than what was previously reported. This new study shows that data coding errors in previous research misclassified a number of deceased women as pregnant, and therefore, the actual maternal mortality rate in Texas is less than half of what previous reports indicated. This study has been covered by a number of mainstream media outlets including The Washington Post, Fortune, and The Chicago Tribune.

The original claim of a sharp increase in the Texas maternal mortality rate came from a study that was published in Obstetrics & Gynecology in September 2016. The primary author was Marian MacDorman of the Maryland Population Research Center. The original MacDorman study received a great deal of attention. It has been cited over 300 times by online news sources and by approximately 70 scholarly research articles. More importantly, these purported increases in the maternal mortality rate have been emphasized by several prominent Planned Parenthood supporters including Hillary Clinton and Wendy Davis.

While it has been heartening to see the media correct the record, reporting of this new research has left a lot to be desired. The reporters have allowed the authors of the original Obstetrics & Gynecology article to save face. Several articles about this new study quote MacDorman, who points out that the new research presents corrected data for only one year. She also states that certain demographic groups in Texas still have high rates of maternal mortality. More importantly, not one media outlet has engaged the debate about Planned Parenthood funding. When MacDorman’s study was first released in 2016, many in the media were quick to blame Planned Parenthood funding cuts for the purported increase in the maternal mortality rate. Now that good evidence shows the maternal mortality rate in Texas is far lower, not one mainstream media outlet has bothered to revisit this question.

MacDorman’s original article should not have been published in the first place, as explained by  James Studnicki and John Fisher of the Charlotte Lozier Institute in a recent letter published by Obstetrics & Gynecology. Studnicki and Fisher looked at the original data that was used in the MacDorman study. They found that MacDorman and her coauthors analyzed data from 2000 to 2015, but mathematically adjusted their data only for the years between 2000 and 2005. If this mathematical adjustment is removed, the data indicate that the proportionally largest increase in maternal mortality occurred between 2004 and 2006 – not in 2010. Additionally, the Texas Legislature established an investigative panel in 2013 that produced results that were inconsistent with the MacDorman paper three months before it was published. MacDorman had time to become aware of the inaccuracy of her calculations.

All in all, the argument that Planned Parenthood cuts led to sharp increases in the Texas maternal mortality rate was never strong. MacDorman and her coauthors were guarded about their original conclusions, stating that “In the absence of war, natural disaster, or severe economic upheaval, the doubling of a mortality rate within a two-year period … seems unlikely.” If the original study was taken at face value, Texas would have a similar maternal mortality rate to Washington, D.C. — an area with a much higher poverty rate and much worse public health metrics. The reported increase in maternal mortality in the original Obstetrics & Gynecology article occurred before the cuts to Planned Parenthood actually took effect. 

That said, ever since the Texas Legislature eliminated state funding to Planned Parenthood, the mainstream media have worked tirelessly to create the narrative of a public health crisis in Texas. Among other things, they have claimed significant increases in unintended pregnancies, teen births and the maternal mortality rate. However, most of what has been reported has been misleading, or, in this case, false. The previous research has given many the wrong impression that Planned Parenthood cuts resulted in skyrocketing maternal mortality rates. The damage will not be easily undone, but it’s time to begin the effort.