In the three years since the Supreme Court overturned Roe v. Wade and states enacted their trigger abortion bans, dire predictions from researchers, doctors, and maternal health advocates have come true: Outlawing abortion has caused more people to die or suffer severe illness during pregnancy—especially Black pregnant people.

The overall U.S. maternal mortality rate rose for Black women from 2022 to 2023, while decreasing for other demographics. Following widely read reports of women dying because they did not get lifesaving treatment for complications of at-home abortion or miscarriage, some states are now trying, with varying success, to clarify the medical exception to their abortion bans, including Texas, Tennessee, and Kentucky.

But task forces that are supposed to help local and state governments combat this growing maternal mortality crisis are being undermined, distorted, or even erased by officials and legislators with political agendas.

Preventable deaths in Texas and Georgia

In Texas—which banned abortion in September 2021, before the overturn of Roe—dozens more pregnant and postpartum people in the state have died than in the years prior to the COVID-19 pandemic, according to ProPublica, which used pre-pandemic numbers as a baseline to avoid COVID-related anomalies. Georgia’s maternal mortality rate, too, has spiked.

At least six of these deaths are directly attributable to those states’ strict six-week abortion bans, according to the investigative outlet ProPublica. Throughout the Fall of 2024, ProPublica published explosive reporting about the deaths of Amber Thurman, Candi Miller, Josseli Barnica, Nevaeh Crain, and Porsha Ngumezi, women from Texas and Georgia who died after their states’ abortion bans prevented them from getting necessary medical treatment after complications from miscarriage or at-home abortions.

States already have a system in place to review and try to prevent such deaths. As of publication, all 50 states, in addition to Washington, D.C., New York City, Philadelphia, and Puerto Rico, have maternal mortality review committees. These panels, mostly made up of medical professionals who review pregnancy-related deaths, are tasked with issuing recommendations for a local or state response to maternal mortality. The committees vary state by state in their structure, scope of work, handling of information, frequency of publishing reports, and whether they review maternal morbidity rates, or health conditions that arise from pregnancy or birth.

Now, they vary in their ability to do their jobs, too. In both Texas and Georgia, maternal mortality committees have been undermined in recent years by political forces.

Texas’ maternal mortality review committee announced in December that it will be skipping over maternal mortality data from 2022 through 2023, and will only review data from 2024 onward. Data showing the immediate aftermath of the state’s abortion ban won’t be available. Georgia Public Health Commissioner Dr. Kathleen Toomey dismissed all its maternal mortality committee members in November 2024 after Miller and Thurman’s deaths became public, saying whoever released the information did so illegally and in violation of a confidentiality agreement, the Associated Press reported. It has since relaunched the committee with new members but will not disclose their identities.

Texas and Georgia are not the only states to weaken their state’s maternal mortality review committees since federal abortion protections ended in 2022: In July 2023, Idaho’s legislature allowed the law that created its maternal mortality review committee to lapse, which, according to Boise State Public Radio, made it the only state in the country without one at the time. Lawmakers subsequently reinstated the committee in July 2024, and it met for the first time since its disbanding in November 2024.

Maternal health advocates warn that eliminating and distorting the professional apolitical nature of maternal mortality review committees in this way will exacerbate the already high rates of maternal mortality and morbidity in abortion-ban states. This is especially for Black people and other marginalized groups, who are already more likely to die during pregnancy and in childbirth.

“The people who are going to be harmed the most are those who are already harmed the most,” said Marsha Jones, a doula and the founding executive director of the Afiya Center, a Dallas-based sexual and reproductive justice organization.

‘Everyone needs this data’

According to the Texas maternal mortality review committee’s most recent report, the state’s 2020 pregnancy-related maternal mortality rate was 23.1 deaths per 100,000 live births. Black and Latine Texans had a maternal mortality rate of 39 and 22.2 deaths per 100,000 live births, respectively. Other research has found similar high rates of maternal mortality in 2020 as well—before the Supreme Court’s overturn of federal abortion rights. More infants have died in Texas since 2022 as well.

According to the Centers for Disease Control and Prevention—which cites heart conditions, mental health issues, hemorrhage, blood clots, infection, and cardiomyopathy as some of the leading causes of maternal mortality—more than 80 percent of pregnancy-related deaths are preventable.

Jones told RNG the Texas maternal mortality review committee needs to review all the maternal deaths from 2022 to 2023 and release the information about the deaths.

“These are not just statistics and numbers, these are people,” Jones said.

Angela Aina, MPH, co-founder and executive director of Black Mamas Matter Alliance, a network of Black women-led organizations that provide reproductive programs and services including abortion care and support after miscarriage or stillbirth, said it is disheartening that maternal mortality review committees are not reviewing this kind of data anymore.

“Not collecting data is not only dangerous, but also contributes to erasure,” Aina said.

Aina added that the fight to prevent and end maternal deaths had always been political. Black Mamas Matter Alliance began organizing around improving Black maternal health and increasing awareness about Black maternal deaths following a 2010 report by Amnesty International about the high risk of people dying during pregnancy in the U.S. that showed Black women were four times more likely than white women to face pregnancy-related deaths.

When states conceal their maternal mortality data, Aina said, it suggests “we are headed back to that time of being in the dark and pretending that maternal mortality data doesn’t exist in this country.”

That could have wide-ranging public health consequences. Policymakers use the data and recommendations provided by state-level maternal mortality review boards to inform sound policymaking that aims to combat maternal mortality.

“For the people who provide the care and those who enact continuous quality improvement in our health-care systems on how care is even delivered, they need this data too,” Aina said. “Everyone needs this data.”

Areas of improvement for maternal mortality review committees

Jones has other suggestions to improve how maternal mortality review committees operate, including by diversifying the makeup of their membership to include more people who are not medical professionals.

“There should be more than one community member … someone who had boots on the ground and could bring a more human perspective,” Jones said of Texas’ 23-member committee.

Doulas, she felt, would bring important experience to the job.

“A full-spectrum doula works with the family throughout the entirety of the pregnancy,” Jones said. “They can bring to the conversation about the birthing complications they see in their work.”

Texas’ committee has just one nurse midwife. For six years, it had a non-medical community member on its committee—Nakeenya Wilson, a Black mother and doula who nearly died because of one of her pregnancies. But Wilson was booted from the committee in 2024—the Texas legislature in 2023 altered the definition of “community member” on the maternal mortality review committee from a “community advocate in a relevant field” to a person in a relevant health-care field serving either a rural or urban population. That spot was recently filled by Dr. Ingrid Skop, an anti-abortion doctor from Texas who sued to revoke the Food and Drug Administration’s approval of mifepristone. (In 2024, the Supreme Court dismissed the case on standing, but sent the case back to lower courts.)

Jones said Skop’s appointment shows that “the needs of the people [the state] is supposed to be serving and speaking for is not as important as the ideology that they are committed to.”

Only four states and Washington, D.C. require their committees to include a patient or family member impacted by maternal mortality or near maternal mortality. Just three states and New York City require a doula to sit on their committees.

Maternal mortality review committees could also benefit from diversifying the kind of data they collect, according to Aina of the Black Mamas Matter Alliance. Between 2020 and 2022, the group released four briefs recommending improvements to maternal mortality review committees based on listening sessions with community members and advocates, according to Aina. Among other changes, the briefs recommend collecting data beyond “cause of death” in order to evaluate quality of maternal health care, such as health conditions that result from pregnancy and “near misses.” They also suggested listening to and centering community members’ experiences and expertise while meaningfully engaging with impacted communities.

Both Aina and Jones said that a birth justice approach to care is necessary not only to improve maternal mortality review committees, but also to prevent more deaths during pregnancy and the first year after childbirth.

Aina said that the deaths of Thurman, Miller, Barnica, and Ngumezi, were “a birth injustice, Black maternal health inequity, and clearly preventable.”

As the post-Roe data shows, taking away access to abortion care doesn’t diminish their need for it.

“Criminalizing people’s birth choices … will lead to people taking more risks,” Jones said. “That means more people will die and have adverse effects.”

“People are not supposed to die from a miscarriage,” Jones added. “All people who are pregnant have a desire to live after their pregnancies.”