Maternal health advocates are in the dark as Texas withholds data.

That experience is partly what led Wilson to serve on the Texas Maternal Mortality and Morbidity Review Committee, investigating the causes of pregnancy-related deaths and finding ways to stop them. And that’s why she was heartbroken this month to find out. Texas health officials are pushing for his release. The first major death toll in the state in nine years.

deep Texas delayed publishing maternal mortality data until after the midterm elections.

“Every day, every month, issues for people whose lives are at stake in a very significant reproductive justice shift,” Wilson said, adding that she and others were on the edge of their seats to get this information. “

Health officials said they need more time to complete the work and now expect to release the findings next year, after midterms and possibly after the Texas Legislature meets for its biannual session. Under state law, the state Department of Health Services, which covers pregnancy-related deaths in 2019, was required to issue a report on the review by Sept. 1.

Instead, lawmakers will convene in January on the same outdated data that has been in place for almost a decade since 2013. Texas has one of the ten highest rates of maternal mortality. National estimates Monitoring the results during pregnancy or within one year of birth.

The last-minute delay has angered mothers who have been pushing for the state to update its slow data review process by maternal health experts. Members of the committee, some of which meet more than 12 times each year, said they were given no advance warning of the announcement, which is unusual given that the report takes months to draft.

Focus of the issue: American Heart Association panel discusses Texas’ maternal mortality crisis.

And some lawmakers were persuaded by an explanation from Texas Health Services Commissioner Dr. John Hellerstedt that resources were tight and the review could only be released after all pregnancy-related deaths were investigated. The agency regularly issues reports with preliminary data to inform public health responses more quickly.

Census for 2019, By early September, it had completed 118 out of 149 reviews. In the year In 2013, out of 175 possible cases, 70 were determined to be related to pregnancy.

Neither Hellerstedt nor the agency fully explained the decision to shelve the report for a year, other than to say the state wants to align itself with others on data collection and build a more comprehensive report.

“Reviewing and publishing data throughout the year is standard practice in public health and allows state leadership and the public to have a complete picture of maternal mortality in Texas,” Hellerstedt told Gov. Greg Abbott explains his decision.

Examining the deaths before each case is considered by committee members is a time-consuming process that requires revisions to thousands of medical records. But the Legislature has added millions to the review committee’s work in recent years, and in 2019 the agency got 3 million dollars in federal aid to dig up pregnancy-related deaths that year. Under the terms of the grant, the state was required to complete assessments within two years of each death.

That’s why I’m confused by Representative Armando Valle, a Houston Democrat and one of several lawmakers who helped renew the Maternal Mortality Committee’s charter in 2017. The state currently has contracts with about a dozen students who attend North University. Texas Health Science Center for Recipients.

“I understand UNT’s job is tough, but again, we knew that going in,” he said. “Wealth was never a problem.”

Health agency spokesman Chris Van Deusen said funding was not the only problem.

“The purpose of[the grant]is to provide states with a reliable source of funding for maternal mortality assessments and to support the work they are doing now, not to speed up assessments,” he said.

Unlike the data collected by the Centers for Disease Control and Prevention, state review committees can drill down, examine medical and non-medical contributors to death, and recommend targeted solutions. And many states look at the longer period from pregnancy to one year after giving birth, unlike the CDC, which only tests up to 42 days after birth.

Marsha Jones, executive director of the North Texas Reproductive Justice Organization, said past Texas reports have helped her group get support for expanded Medicaid coverage for new mothers and other interventions. The group focuses on black women, who are three times more likely to die from pregnancy-related causes than non-black women.

“We couldn’t just say, ‘Hey, this is happening, black women are dying,’ but we had data to back up these stories,” Jones said. “He brought value to what we were saying. It’s allowed us to have these productive conversations with legislators that we can influence.

Unsuccessful attempts at a new model

Texas has a long review process for pregnancy-related deaths, partly in response to a 2016 miscalculation based on inaccurate state data and an inflated count of maternal deaths. That finding was later revised, but still shows a higher risk of dying during or after pregnancy for black women.

To avoid conflicts with state law, DSHS will update the records of all provider names prior to the committee’s review.”

UNT students spend an average of 46 hours per case. More than a third of the funds allocated for the 2019 assessment will go to rehabilitation, the health agency said.

The extensive revisions are a big reason why the current assessments are only for 2013 — the agency hasn’t carried over to subsequent years. In the year The 2019 grant was intended to push the state forward in understanding the current state of maternal health.

That same year, state Rep. Shawn Thierry, D-Houston, introduced the Centralized Death Registry Act, which would have required hospitals across the state to upload compiled records. It won’t be as granular as current assessments, but it will help the state know who is dying each year and help policymakers understand why.

In response to pushback that creating the registry in two years would be difficult, Thierry watered down the bill to establish a task force to study the creation of the registry. He failed to get a vote in the Republican-controlled House. In the year She introduced a similar bill in 2021, but House members said they ran out of time to pass it in the final hours of the session. Thierry plans to try again in January.

“It cleans up a significant part of the process,” Thierry said, pointing to California as an example.

California Since 2018, she has used an online database, sifting through vital statistics and patient-level data to link pregnancy and death, some of which will be scrutinized by a review committee. Dr. Connie Mitchell, deputy director of the Center for Family Health at the California Department of Public Health, said having more up-to-date information has allowed the state to focus its public health response on targeted areas, such as high blood pressure.

Since 2006, the state has dramatically reduced its maternal mortality rate.

“Getting as much information as we can, making sure to identify all the people who died, getting information out to people who are concerned about this and getting them involved to help us was critical to our success,” Mitchell said.

Thierry, a lawyer who has experienced her own perils, said she would prepare a letter to Hellerstedt in the coming days demanding the report be made public. The agency is limited by law to release it, she said.

Hellerstedt will retire at the end of the month.

Wilson, on the other hand, continues to discover new information, guided by her nightmarish experiences.

Six years ago, nurses forced her to give birth to her second child. Her unborn child was stuck in her pelvis, a condition known as shoulder dystocia, and hospital staff took drastic measures to retrieve him.

When he came out, he wasn’t breathing and Wilson was bleeding. The situation worsened, she said, because of the disorganized response of the nurses, they could not give her proper care immediately. The child recovered quickly and was finally released. She was hospitalized to recover from her newborn baby.

When she found out about her third pregnancy, “it wasn’t joy,” Wilson said. “Because I was afraid to die.”

julian.gill@chron.com

jeremy.blackman@chron.com