Texas mother: The extent of the state’s maternal mortality rate is sobering

Texas mothers are dying at a rate that's difficult to explain “in the absence of war, natural disaster, or severe economic upheaval." During a months-long investigation, The Texas Tribune found the state’s maternal mortality rate, especially for women of color, is increasing, mostly due to underlying health problems. Our investigation looked into how the Texas Legislature has missed opportunities to improve women's health programs in the state.

On Jan. 19, The Texas Tribune hosted a live Reddit discussion with Evans and Syreeta Lazarus, a Houston mother of two who experienced complications during childbirth. They discussed with our readers why Texas mothers are at a disadvantage when it comes to accessing prenatal care, postpartum care and health insurance.

Read the highlights of the discussion below, or view the full conversation on Reddit.

What are the changes that need to be made to address these problems and who in Texas is working on it? – Twitter User  

Evans: “Addressing maternal mortality in Texas is going to take multiple solutions.

Some big themes I heard during my interviews with advocates and health experts include: Educating moms about what signs to look for on their bodies during and after pregnancy so they can get help right away; increasing access to health insurance for Texas women so they can properly get prenatal and postpartum care; expanding Medicaid so more uninsured women are covered; increasing access to substance abuse/mental health services; increasing access to affordable birth control (whether it's the pill or an IUD, birth control can be expensive over time, particularly for low-income women).”

I first want to say I'm so thankful that your pregnancy ended up successful and your children are healthy! In a recent article, Serena Williams pointed out how she had done research and made specific requests (for a CT scan and a blood thinner) that were initially denied by the nurse. What do you feel black women in Texas should do to try and prevent possible complications until this crisis has been addressed? – PimpNinjaMan

Lazarus: “In general, ALL women should receive prenatal care and NEVER underestimate or doubt self if you don't feel 'right'...

For me, I was a 'regular' to the 'Triage Department.' I attended ALL of my prenatal care appointments and my husband and I took week long prenatal care classes in advance. We stayed informed and came prepared with questions to appointments….

Within the medical community, I do believe that a resource and/or tool that is shared, which highlights more uncommon complications and symptoms, need to be circulated. Classes, webinars, doctors, nurses and families need to be informed of (perhaps) 5-10 complications, factors ... and what to do if you are concerned.”

Can you explain how expecting mothers can lack insurance or healthcare in the state, despite the Affordable Care Act being in existence? –Judi

Evans: “On paper, the Affordable Care Act (aka Obamacare) was supposed to help almost everyone access health insurance. The idea was that if everyone was insured and able to get care for "essential health benefits" like lab tests, maternity/newborn care, drugs, mental health, etc, then less people would need to go to the hospital for primary care...

BUT even with Medicaid expansion in 32 states right now, many women are still not able to be in the program because they still make "too much money" despite still being considered low-income. Essentially, they're poor but not "poor enough" if that makes sense.

Now, for Texas, we have not expanded Medicaid because legislators say it'll add costs to the state and it's not enough of a guarantee.

Keep in mind 19 percent of Texas women are uninsured, so many of these women are likely paying a lot of money out of pocket for care OR not getting care at all. This is a huge problem because by being uninsured, not having access to a doctor to pay for care, they're forgoing help for things like diabetes, heart disease, high blood pressure, etc. All very big deals that can cause serious pregnancy complications.”

Were you surprised to learn these findings in the Tribune’s reporting? Or did you already have a sense that this was a problem in Texas? – Quinn

 Lazarus: “I was astounded. I thought that, to some extent, I was an anomaly. (To the extent that I had 3 preeclampsia episodes ALL AFTER delivering my babies, I was.) However, to know that there are so many post delivery complications in Texas … and the U.S. … is sobering.”