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The CDC hasn’t asked states to track deaths linked to abortion bans By Kavitha Surana, Robin Fields and Ziva Branstetter This story was originally published by ProPublica. ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox. Series: Life of the Mother: How Abortion Bans Lead to Preventable Deaths After the Supreme Court overturned the constitutional right to abortion in 2022, President Joe Biden issued an executive order tasking the federal government with assessing the “devastating implications for women’s health“ of new state abortion bans. Experts were warning that these bans would interfere with critical medical care and lead to preventable deaths. And the states that passed the laws had little incentive to track their consequences. Biden directed the secretary of Health and Human Services to make sure federal agencies were “accurately measuring the effect of access to reproductive healthcare on maternal health outcomes.” He called on the National Institutes of Health and the Centers for Disease Control and Prevention to drive targeted research and data-collection efforts. But the Biden administration has missed a critical opportunity to illuminate how abortion bans are interfering with maternal health care, leading to deaths and irreversible injuries: The CDC has not pushed state committees that review maternal deaths to examine the role these new laws have played. The CDC leads the
nation’s work to track and reduce maternal mortality, spending nearly $90 million over the last five years to fund state panels made up of health experts who analyze fatalities to spot trends and recommend reforms. While it cannot require states to collect or report certain data, the CDC gives committees detailed guidance for assessing whether deaths were preventable and which factors contributed to them. Following this guidance, committees consider factors including obesity, mental health issues, substance use, homicide and suicide. In 2020, the CDC added a checkbox to its model case review form for committees to indicate whether discrimination played a role. Yet the agency has issued no guidance to address the recent rollback of reproductive rights or to direct committees to consider how abortion bans factor into deaths. Some state officials point to this silence as a reason their committees haven’t made any changes to their process. “The committee must follow national guidelines in maternal mortality review committee death investigations,” said a spokesperson for Oklahoma’s health department, which oversees the committee in the state. Researchers say that this can obscure the impact of abortion bans. “It’s pushing it under
the rug in a way — like we don’t want to count it, we don’t want to know what’s happening,” said Maeve Wallace, an epidemiologist at the University of Arizona who has published studies on the intersection of intimate partner violence and maternal deaths, including one that found a rise in maternal homicides in places with increased abortion restrictions. When asked about this, the CDC said the information submitted by states is sufficient to understand any effects from abortion bans. “Maternal mortality review committees already comprehensively review all deaths that occur during pregnancy and through the year after the end of pregnancy, including abortionrelated deaths,” said David Goodman, lead health scientist with the CDC’s Maternal Mortality Prevention Team. “The current process includes documenting and understanding contributing factors.” But experts said that the CDC’s current guidance gives committees no standard way to consider the role abortion bans played in maternal deaths, which makes it harder to study deaths related to the restrictions and create an evidence base to inform recommendations. Georgia’s maternal mortality review committee blamed the state’s abortion
| Photo by risingthermals CC BY-NC 2.0
ban as a factor in one of the deaths examined by ProPublica, that of Candi Miller. The 41-year-old mother of three ordered abortion medication online and suffered complications, but did not visit a doctor “due to the current legislation,” her family told the coroner, who documented the statement. Committee members told ProPublica
that the explicit mention in the records indicated the law created a barrier to care. The case of Amber Thurman wasn’t as clearcut; she had taken abortion medication at home and she sought care in a Georgia hospital for complications similar to Miller’s. Records showed doctors discussed, but did not provide, a dilation and curettage
procedure to clear her uterus of infected tissue as she suffered for 20 hours with sepsis. Any impact the law may have had on the doctors’ decisionmaking was not noted in records the committee reviewed. The committee concluded that one of the factors in her preventable death was See Abortion Page 03