Opinion: How abortion bans like Missouri's drive maternal mortality (2024)

Rylea Luckfield

Maternal mortality rates are rising in the United States, part of the myriad consequences from state abortion bans and, to a lesser extent, the impact of the shrinking maternal health workforce. Across the U.S., these issues are interconnected. Missouri is no different.

Maternal health outcomes worsen without access to comprehensive reproductive health services. Maternal health providers are wary of working in abortion-restrictive states where they cannot provide adequate care for their patients, a reality that exacerbates the workforce shortage.

In Missouri, 70 people on average die annually while pregnant or within one year of pregnancy, and the majority of these deaths are preventable.

In December, Gov. Mike Parson announced that the Missouri Department of Health and Senior Services would invest $4.3 million in new funds to reduce maternal mortality and increase access of health services provided to people during pregnancy and postpartum. These funds will support Missouri’s maternal quality care protocols; development of standardized trainings to maternal care providers; creation of a standardized assessment for mental health; the creation of the Maternal Health Access Project; and improved collection of maternal health data.

While this is a positive first step toward tackling the maternal health crisis in our state, more must be done to address the lack of access to reproductive health services.

Many Missourians have limited access to prenatal and maternity care and a very high vulnerability to adverse outcomes due to the availability of reproductive health care services. Lack of access to high-quality maternal care contributes to negative maternal health outcomes, such as premature birth, low-birth weight, maternal mortality and severe maternal morbidity, and increased risk of postpartum depression.

Nearly half of Missouri’s counties lack maternity care services. There are several reasons, including but not limited to lack of funding for mental health services, particularly for pregnant and postpartum people; hospital closures over the last 10 years, which have left 50 rural counties without a hospital; low reimbursem*nt from Medicaid; and maternal health workforce shortages.

To make matters worse, Missouri bans nearly all abortions. While there is an exception for medical emergencies, there are no exceptions for rape or incest.

States with abortion bans have fewer maternity care providers, more counties without maternity care services and higher rates of maternal mortality and severe maternal morbidity.

Since the overturn of Roe v. Wade in 2022, medical students going into obstetrics and gynecology reported being less likely to apply for residency in states with abortion restrictions.

Additionally, our maternal health crisis does not affect all pregnant and postpartum people equally. Black women in Missouri are three times more likely to die from a pregnancy-related cause than white women. This is due to the fact that Black, Indigenous and people of color often face structural racism and bias in health care settings. In the U.S., the perinatal workforce does not reflect the diverse racial and ethnic identities of the birthing population.

Such a crisis calls for decisive action. Missouri lawmakers should consider enhancing the obstetric workforce by expanding Medicaid coverage to doula and midwifery services, which leads to improved health outcomes and patient experience, as well as may potentially reduce costs.

One promising measure moving through the Missouri House proposed by Missouri Rep. Wendy Hausman, R-St. Peters, would do just that by allowing doulas registered with the state to be reimbursed by health insurance. While the bill has made it out of committee, it has not yet come to the floor for a vote. Lawmakers must prioritize getting this legislation through the chambers and to Gov. Parson’s desk for signature.

Registered Missouri voters should also keep their eye out for the Missourians for Constitutional Freedom abortion rights coalition, which is gathering signatures through the end of April to bring abortion to the Missouri ballot later this year. If successful, this campaign would amend the Missouri constitution so that the state government cannot interfere with a person’s right to reproductive freedom.

Access to comprehensive reproductive health services, including abortion, is crucial for improving maternal health in Missouri.

Information about Missouri’s pending reproductive rights ballot initiative, including scheduled upcoming petition signing events, is available at moconstitutionalfreedom.org.

Luckfield is a Master of Public Health candidate at George Washington University and a University of Missouri alum with a background in maternal and reproductive health.

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Opinion: How abortion bans like Missouri's drive maternal mortality (2024)


Opinion: How abortion bans like Missouri's drive maternal mortality? ›

Opinion: How abortion bans like Missouri's drive maternal mortality. Maternal mortality rates are rising in the United States, part of the myriad consequences from state abortion bans and, to a lesser extent, the impact of the shrinking maternal health workforce. Across the U.S., these issues are interconnected.

Why does Missouri have a high maternal mortality rate? ›

Mental health conditions, including substance abuse disorder, were the leading cause of pregnancy-related deaths, followed by cardiovascular disease and then homicides. From the previous report, covering 2017 to 2019, the number of suicides doubled, corresponding with an increase in firearm deaths.

Which state has the highest maternal mortality rate? ›

Mississippi had the highest maternal mortality rate in 2021, with 82.5 deaths per 100,000 births, followed by New Mexico (79.5 deaths per 100,000 births). In contrast, California had the lowest maternal mortality rate (9.7), and Massachusetts had the second-lowest (17.4). But data is not available for all states.

What is the meaning of maternal mortality? ›

Definition: The annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy.

What is the maternal mortality rate for the Commonwealth Fund? ›

New international data show the maternal mortality rate in the U.S. continues to exceed the rate in other high-income countries. In 2020, the maternal mortality rate in the U.S. was 24 deaths per 100,000 live births — more than three times the rate in most other high-income countries.

What is the No 1 cause of maternal mortality? ›

The major complications that account for nearly 75% of all maternal deaths are (2): severe bleeding (mostly bleeding after childbirth); infections (usually after childbirth); high blood pressure during pregnancy (pre-eclampsia and eclampsia);

What are the top 3 causes of maternal deaths in the US? ›

Cardiovascular conditions, obstetric hemorrhage, and self-harm or unintentional harm are important causes of pregnancy-related deaths; significant inequities exist between non-Hispanic black and non-Hispanic white women. The majority of pregnancy-related deaths are preventable.

What is the maternal mortality rate in Missouri? ›

An average of 70 Missouri women died while pregnant or within one year of pregnancy each year, with the highest number recorded in 2020 (85 deaths). ➢ The pregnancy-related mortality ratio (PRMR) was 32 deaths per 100,000 live births, up from 25.2 deaths in the last multi-year report.

What are the top 5 causes of maternal mortality in the United States? ›

The leading underlying causes of pregnancy-related death include:
  • Mental health conditions (including deaths to suicide and overdose/poisoning related to substance use disorder) (23%)
  • Excessive bleeding (hemorrhage) (14%)
  • Cardiac and coronary conditions (relating to the heart) (13%)
  • Infection (9%)
Sep 19, 2022

Which US state has the lowest maternal mortality rate? ›

  • California. California has the lowest maternal mortality rate of 4.0 deaths per 100,000 births. ...
  • Massachusetts. Massachusetts's maternal mortality rate of 8.4 per 100,000 births makes it the state with the second-lowest maternal mortality rate in the United States. ...
  • Nevada. ...
  • Connecticut. ...
  • Colorado. ...
  • Louisiana. ...
  • Georgia. ...
  • Indiana.

How many babies can a woman have in her lifetime? ›

One study estimated a woman can have around 15 pregnancies in a lifetime. And depending on how many babies she births for each pregnancy, she'd probably have around 15-30 children. But the "most prolific mother ever," according to Guinness World Records, was Mrs.

Is maternal mortality an issue? ›

The CDC's National Center for Health Statistics' most recent report put the U.S. maternal mortality rate at a whopping 32.9 deaths per 100,000 births. That number garnered a great deal of attention, including being covered by NPR and other news outlets.

How can maternal mortality be prevented? ›

It is important for all women of reproductive age to adopt healthy lifestyles (e.g., maintain a healthy diet and weight, be physically active, quit all substance use, prevent injuries) and address any health problems before getting pregnant.

Which group has the highest maternal mortality rate? ›

At the national level, US MMRs (or maternal deaths per 100 000 live births) are 2 to 4 times higher in the non-Hispanic Black (hereafter referred to as Black) population than in the non-Hispanic White (hereafter referred to as White) population.

Which country has the lowest maternal mortality rate? ›

The lowest maternal mortality ratios were in Norway (2.7, 95% confidence interval 1.2 to 5.4) and Denmark (3.4, 1.6 to 6.2) and the highest in the UK (9.6, 8.4 to 11.0) and Slovakia (10.9, 7.4 to 15.5), all per 100 000 live births, with a maximum absolute difference of 8.2 (3.9 to 12.5) per 100 000 live births.

Why is the black maternal mortality rate higher? ›

Black women are three times more likely to die from a pregnancy-related cause than White women. Multiple factors contribute to these disparities, such as variation in quality healthcare, underlying chronic conditions, structural racism, and implicit bias.

What is the black maternal mortality in Missouri? ›

➢ The PRMR for Black women was 87.6 per 100,000 live births which is more than 4 times greater than the rate for White women (21.9). ➢ Eighty-two percent of pregnancy-related deaths were determined to be preventable. ➢ A majority (63%) of pregnancy-related deaths occurred between 43 days and one year after pregnancy.

Where is maternal mortality the worst? ›

Maternal mortality tends to be especially high in sub-Saharan Africa, South America, and South and South-East Asia.

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