By: Kalani Phillips, MPH, CPH
Georgia’s Department of Public Health chose to disband its Maternal Mortality Review committee earlier this year in November. This was done after the unauthorized release of internal information on two preventable maternal deaths following the Dobbs decision in June of 2022. The two cases, or rather, the preventable deaths of Amber Thurman and Candi Miller, highlight the detrimental impacts of restrictive abortion policies on maternal health, and expose the fatal implications of these laws.
The two cases of maternal death underscore systemic failures of governmental institutions to care for pregnant individuals, and highlight the broader issues in Georgia’s healthcare system. The investigation by ProPublica showed that the deaths of Amber Thurman and Candi Miller were the first reported cases of death from abortion bans. These abortion bans restricted access to critical care that these individuals needed, causing them to die from preventable and treatable complications. In fact, providers chose not to intervene in one of the cases because of the restrictive abortion laws, despite knowing that the patient could die. This shows that Georgia’s restrictive legal landscape created chilling effects, resulting in delays in healthcare that were fatal. Had these individuals received the life-saving abortion care they needed in a timely manner, Amber Thurman and Candi Miller could still be here today. These horrible tragedies illustrate how political determinants of health impact our lives, and how the consequences of abortion bans cause maternal deaths.
Research shows that restrictive state abortion laws are associated with increased maternal mortality rates. For example, The Commonwealth Fund found that states with stricter abortion laws have a 62% increased rate of maternal mortality, compared to states with less strict policies. Even in life-threatening situations, these restrictive abortion laws spur fear among providers wanting to avoid legal repercussions, causing potentially fatal delays in care.
While these restrictive policies impact all pregnant people, abortion bans disproportionately impact minoritized groups, such as young people, low income people, and people of color. For instance, Black individuals have the highest maternal mortality rate compared to any other racial and ethnic group. In fact, Black individuals are three times more likely to die from a pregnancy-related cause than White mothers. This holds true no matter the socioeconomic level of educational attainment of the mother, highlighting the impacts of systemic racism and socioeconomic barriers. Other groups like young people also face many structural barriers in accessing abortions, including legal, financial, and logistical barriers. And abortion bans exacerbate the multitude of barriers that these vulnerable populations face.
The disbandment of Georgia’s Maternal Mortality Review Committee reflects a disheartening trend across the country. Many states have chosen to undermine public health research by preventing access to necessary, safe, and effective reproductive healthcare like abortions, making Maternal Mortality Review Committees even more important. These committees play a crucial role in investigating maternal deaths in order to identify solutions to prevent them. Without them, there is no accountability for the failure of governmental and healthcare institutions when they cause the death of a pregnant person. Moreover, states with restrictive abortion policies tend to also have less resources for maternal and infant health. For instance, Georgia has done little to invest in maternal health despite having the third highest maternal mortality rate in the nation, leaving many individuals without access to prenatal and postnatal care, which likely further exacerbates the problem.
Access to reproductive healthcare is crucial. The deaths of Amber Thurman and Candi Miller illustrate the consequences of these abortion bans. The dismissal of Georgia’s Maternal Mortality Review Committee was disheartening, however, there were still some positive outcomes for abortion rights in November, including in Arizona, Colorado, Maryland, Missouri, Montana, Nevada, and New York. Additionally, Idaho, which previously disbanded their Maternal Mortality Review Committee in 2023, reassembled their committee in November of this year. They are now working on a report on preventing maternal deaths for 2025. These ongoing efforts highlight the importance of continued advocacy work in this field.
References:
Burris, H. H., & Hacker, M. R. (2017). Birth outcome racial disparities: A result of intersecting social and environmental factors. Seminars in Perinatology, 41(6), 360–366. https://doi.org/10.1053/j.semperi.2017.07.002
CDC. (n.d.). About Maternal Mortality Review Committees. CDC: Maternal Mortality Prevention. https://www.cdc.gov/maternal-mortality/php/mmrc/index.html#:~:text=Maternal%20mortality%20review%20committees%20(MMRCs,of%20the%20end%20of%20pregnancy.
Declercq, E., Barnard-Mayers, R., Zephyrin, L. C., & Johnson, K. (2022). The U.S. Maternal Health Divide: The Limited Maternal Health Services and Worse Outcomes of States Proposing New Abortion Restrictions. https://www.commonwealthfund.org/publications/issue-briefs/2022/dec/us-maternal-health-divide-limited-services-worse-outcomes
Declercq, E., & Zephyrin, L. (2020). Maternal Mortality in the United States: A Primer. https://doi.org/10.26099/TA1Q-MW24
Fishman, S. H., Hummer, R. A., Sierra, G., Hargrove, T., Powers, D. A., & Rogers, R. G. (2021). Race/ethnicity, maternal educational attainment, and infant mortality in the United States. Biodemography and Social Biology, 66(1), 1–26. https://doi.org/10.1080/19485565.2020.1793659
Hill, L., Artiga, S., & Ranji, U. (2022). Racial Disparities in Maternal and Infant Health: Current Status and Efforts to Address Them. KFF. https://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-in-maternal-and-infant-health-current-status-and-efforts-to-address-them/
Hoopes, A. J., Maslowsky, J., Baca, M. A., Goldberg, J., Harrison, M. E., Hwang, L. Y., Romano, M., Tebb, K., Tyson, N., & Grubb, L. K. (2022). Elevating the Needs of Minor Adolescents in a Landscape of Reduced Abortion Access in the United States. Journal of Adolescent Health, 71(5), 530–532. https://doi.org/10.1016/j.jadohealth.2022.08.007
KFF. (2024, November 6). Ballot Tracker: Outcome of Abortion-Related State Constitutional Amendment Measures in the 2024 Election. KFF. https://www.kff.org/womens-health-policy/dashboard/ballot-tracker-status-of-abortion-related-state-constitutional-amendment-measures/
KFF. (2024, November 6). Ballot Tracker: Outcome of Abortion-Related State Constitutional Amendment Measures in the 2024 Election. KFF. https://www.kff.org/womens-health-policy/dashboard/ballot-tracker-status-of-abortion-related-state-constitutional-amendment-measures/
Pfannenstiel, K. (2024, November 27). For a year, Idaho pregnant moms’ deaths weren’t analyzed by this panel. But new report is coming. Idaho Capital Sun. https://idahocapitalsun.com/2024/11/27/for-a-year-idaho-pregnant-moms-deaths-werent-analyzed-by-this-panel-but-new-report-is-coming/#:~:text=In%20summer%202023%2C%20Idaho%20became,disband%20by%20not%20renewing%20it.
Yurkanin, A. (2024, November 21). Georgia Dismissed All Members of Maternal Mortality Committee After ProPublica Obtained Internal Details of Two Deaths. ProPublica. https://www.propublica.org/article/georgia-dismisses-maternal-mortality-committee-amber-thurman-candi-miller
Comments