Trends in Severe Maternal Morbidity resulting from Pregnancy Loss

Project Summary/Abstract Poor maternal health in the United States is a cause of increasing alarm. The rate of severe maternal morbidity is high and has been increasing. However, the research into severe maternal morbidity does not consider morbidity related to pregnancy loss. Pregnancy loss (ectopic pregnancy, miscarriage, or stillbirth) can be a serious medical event, and adequate medical care during loss is essential to the health and wellbeing of pregnant people. However, abortion bans may impact treatment and health outcomes for people experiencing pregnancy loss. Since the Supreme Court overturned Roe v Wade with the Dobbs v Jackson decision in June 2022, 14 states, including Texas, have banned abortion with limited exceptions. Denials of and delays in providing pregnancy loss care have been reported in states with abortion bans, jeopardizing women's health. In addition to a total abortion ban implemented August 25th, 2022, Texas implemented SB8 on September 1st, 2021, banning abortion after the detection of fetal cardiac activity. I will use de-identified inpatient, outpatient, and emergency department data from Texas hospitals and surgery centers for 2017 through 2024 to quantify severe pregnancy loss morbidity generally, and disparities by race and ethnicity, maternal age, and insurance payer. Measuring severe pregnancy loss morbidity will reveal opportunities to improve previously invisible aspects of pregnancy health. I will then assess changes in the volume of pregnancy loss cases at Texas facilities and severe pregnancy loss morbidity after implementation of restrictive abortion policies. I will disaggregate the data by subgroups to identify differential impacts of the policies by race, insurance payer, and maternal age. Assessing the impact of abortion bans on pregnancy loss case volume and morbidity provides policy relevant information on how reproductive health and abortion policies affect women’s health.