The Texas abortion study on maternal mortality has several holes

Written by: Ana Maria Dumitru, new national chair for Medical Students for Life

Maternal mortality rates are up in Texas, and according to abortion advocates, it’s the fault of pro-lifers who slashed family planning budgets. Before getting swept away in the current of modern liberal thought and reasoning (or lack thereof), there are several key points about this study by Marian F MacDorman and colleagues. and about the coverage their study has received.

For starters, maternal mortality ratios and maternal mortality rates are not the same thing. The problems start in the introduction where MacDorman and colleagues state that “the United Nations’ Millennium Development Goal 5a was to reduce the maternal mortality rate by 75% from 1990 to 2015.” (emphasis added)

In fact, the UN Goal 5a was to reduce maternal mortality ratios, not rates. The difference, as defined by the World Health Organization (WHO) is that the maternal mortality ratios are obtained by dividing the number of maternal deaths in a population 787px-Texas_flag_map.svgfor a given time interval by the number of live births occurring in the same population at that time.

Maternal morality ratios give an idea of the risk of death once a woman becomes pregnant, which can then lead to determining the quality of the healthcare system that the woman is in.

The maternal mortality rate is calculated by dividing the average annual maternal deaths in a population by the average number of women of reproductive age who are alive during the specified time interval in that population. As a result, the maternal mortality rate also factors in the fertility of the population, and both direct and indirect causes of death for a pregnant woman (for instance, pre-existing medical conditions).

Another major issue, as the authors acknowledge, is that the United States has not reported national maternal mortality data since 2007. Part of the problem is that before 2000, there was very little standardization for reporting the cause of death on death certificates. Between 2000 and 2014, most states gradually adopted a revised death certificate which included a pregnancy status question. During this time, as some states changed over sooner than others, maternal death data were confusing at best, making national calculations increasingly difficult to perform. What MacDorman and colleagues thus attempt to do is to take state-by-state maternal mortality data and create their own adjustments in order to facilitate comparisons over that time period.

This is where Texas comes in to play. When the authors analyzed their data, Texas stood out like a sore thumb. Specifically, the authors found that while Texas tracked similarly with the national maternal mortality data between 2000-2010, the calculated data after 2010 showed a doubling in adjusted maternal mortality rates. In their discussion, the authors then speculated as to what could be driving the changes they calculated, and they mentioned that Texas did have “some changes in the provisions of women’s health services” between 2011-2015.

Here the authors reference two sources, both of which are quite problematic in and of themselves. One is a New York Times article covering the Supreme Court’s hearing of oral arguments on this year’s Texas abortion case. By citing this article, perhaps the authors are implying potential restrictions to abortion access, although it ought to be noted that the Supreme Court struck down the intended law before it went into effect, so no restrictions were actually put into place. Therefore the purported changes to women’s health services were not due to changes in access to abortion in Texas during this time interval.

The second reference is a study by Amanda Stevenson and colleagues, and it evaluates changes in Planned Parenthood in Texas after state-wide cuts in funding for family planning services. Texas slashed its general state funding for family planning services by 66% in 2011, but Planned Parenthood was not the organization most negatively affected by this cut. Two-thirds of the clinics that closed after these funding cuts in fact were not affiliated with Planned Parenthood. Furthermore, Texas provided transition funding through 2012, which means that the cuts only kicked in during fiscal year 2013.

What’s truly remarkable is that the MacDorman study cited this as evidence of changes that could have contributed to the maternal mortality doubling of 2011, even though the changes wouldn’t have gone into effect until 2013, at which point their calculated maternal mortality in Texas has begun to go down again.

Even aside from all of these issues, there’s still one more obvious problem. According to the Houston Department of Health and Human Services, “from 2001 through 2006, the MMRatio for Texas was higher than that of the United States.” Which means that Texas was already aware that it had this problem, and it was a problem well before any changes were made to any kind of purported changes to access of family planning services. Also, between 2005-2006, Texas Planned Parenthood’s budget was cut by 31.2%, causing some closings of clinics – and according to the Macdorman article, during that time and the four subsequent years, there were no increases in maternal mortality (in fact some slight decreases).

There’s more that could be said about this article, but the bottom line is that while political ideology is getting busy misrepresenting facts, women in the United States are losing. It’s time for us as a nation to get our act together. We need to collect uniform data about maternal mortality so we can know where we actually stand, and then we need to mobilize to decrease our MMRatios – in Texas, and also from sea to shining sea.

New Study Confirms Post-Abortive Women Have Increased Risk of Mental Health Disorders

A new study published in July of 2016 confirms that abortion is consistently associated with increased risk of mental health disorders and substance abuse in late adolescence and early adulthood. Dr. D. Paul Sullins of the Catholic University of America released the results of an analysis conducted on data collected from 8,005 women in the United States who were followed over the course of thirteen years. The article was published in Sage Open Medicine, a peer-reviewed open-access journal, and can be accessed for free here.

Abortion activists have repeatedly denounced attempts to link abortion with any adverse events. In medical schools across the country, students are taught that there are no long-term consequences of abortion, and that abortion is a safe procedure. However, these statements are misleading at best. One of the major problems with abortion statistics in the United States is that each state sets its own reporting laws, which means that some states, like California for instance, don’t require any public reporting of abortion statistics. So for starters, we don’t know what we don’t know. Additionally, of the states that do report abortion statistics to the CDC, not all of those states report the same amount of information. Furthermore, the private pro-abortion Guttmacher Institute has consistently reported much higher (as much as 30% higher) abortion rates than those listed in the CDC reports, which calls into question the reliability of state reporting. Another major issue is that only 16 states require reporting information on abortion complications, and only 8 of these states actually publish abortion complications in their public abortion reports. Only 4 states inquire about maternal mortality post-abortion, and only one state inquires about any follow-up care provided to post-abortive mothers.

If your head is spinning with these numbers, that’s understandable, because the conclusion is that it’s shockingly difficult to get any straight answers on nationwide abortion statistics. Why are we being taught that there are no long-term consequences of abortion if we don’t have reliable reporting systems with which to track this information?

Here’s what you need to know about the Sullins study:

  • The Sullins study followed 8,005 women and tracked them across three average age time points: age 15, age 22, and age 28. All 8,005 of these women were examined at all three time points (the initial study had about a 20% dropout rate, but Sullins only included the women who completed all of the evaluations).
  • These data were from the National Longitudinal Study of Adolescent to Adult Health (ADD Health), which was funded by 18 federal agencies and was initiated in 1994 with the intent of being “the largest and most extensive study of the health-related behaviors of U.S. adolescents during the transition to adulthood.”
  • Extensive adjustments for possible confounding variables were made, including adjustments for age, race, region of origin, childhood family conditions, socioeconomic status, educational status of participant and of participant’s parents, history of abuse, and preexisting mental health conditions.
  • It’s not the first longitudinal study to conclude that there’s a significant link between abortion and mental health disorders. Two examples of similar studies were Fergusson and colleagues’ New Zealand study (link) and Pedersen’s Norway study (link), both of which followed cohorts of women from adolescence into their late 20s. Both of those studies also concluded that there was a clear connection between abortion and “affective and addictive disorders, including depression, anxiety, suicidal ideation, and abuse of marijuana, alcohol, or other illicit drugs.”
  • The conclusions of the Sullins study are that even after adjusting for over twenty demographic variables and covariates, there is still a clear, significantly increased relative risk of mental health disorders for women who have abortions.
  • Importantly, the Sullins study compares across all pregnancy outcomes too (abortion, live birth, or unintended pregnancy loss). Even when comparing a woman who chooses abortion to a woman who loses a pregnancy for any other reason, the relative risks of mental health disorders are higher in post-abortive women.
  • Table 5 from the Sullins study is shown below and lists the relative risks associated by category:


Abortion, Substance Abuse and Mental Health in Early Adulthood: Thirteen-Year Longitudinal Evidence from the United States. D. Paul Sullins, 2016, Sage Open Medicine.

Texas Pro-life Bill Seeks More Accountability from Abortion Providers

baby-wombTighter regulations on abortion providers and ending abortion at 20 weeks are some of the highlights of Senate Bill 5 (SB5) in the Texas legislature. Last week, pro-abortion Senator Wendy Davis filibustered SB5 for 13 hours, which contributed to the bill not being passed before the midnight deadline. Because there are stringent restrictions on filibustering, such as not using the restroom during the filibuster, Senator Davis resorted to using a catheter she had inserted prior to her floor speech. This action shows the desperation that exists among pro-abortion advocates to protect their right to kill innocent babies in the womb. As a result, Governor Rick Perry has reconvened the legislature for a special session to take up SB 5 again.

Here are the Facts: Senate Bill 5 will raise standards of care for women who are pregnant and protect the lives of the preborn who feel pain, by banning abortions at 20 weeks. SB 5 also requires the same health and safety regulations as an ambulatory surgical center, requires a doctor providing abortions to secure admitting privileges at a nearby hospital within 30 miles and requires a doctor to personally administer abortion-inducing drugs to the patient.

While SB 5  is not perfect legislation because it still allows for abortions up to 20 weeks and has an exception for rape and incest, it still represents the most restrictive piece of legislation offered by any state.

If you would like to have your voice heard on SB 5, please join us for an on-line tweetfest on Tuesday at 12PM EST. #Stand4Life

An Emerging Threat to Religious Liberty

WACatholicHospitalsA trend is developing across the country of secular hospitals merging with Catholic hospitals, as the New York Times recently reported. The latest state to see a wave of completed and proposed mergers is Washington, one of the most pro-abortion states in America. Abortion activists there are up in arms because of what they see as a threat to abortion access, especially in rural areas of the state. If the abortion lobby gets its way, we could see a new threat to religious liberty in the form of litigation or legislation forcing Catholic hospitals to perform abortions and other life-destroying practices.

Catholic hospitals, which operate under the direction of their local bishops and serve one out of every six patients in America, must adhere to Ethical and Religious Directives for Catholic Healthcare Services put forth by the United States Conference of Catholic Bishops. This prohibits any practice that violates Catholic teaching, including abortion, sterilization, contraceptives, and assisted suicide.

In today’s healthcare industry, most hospitals are faced with utilitarian decisions about whose life is more valuable, a development accelerated due to the impending implementation of Obamacare. We’re moving into a culture of death where healthcare for the elderly will be rationed to save costs and the abortion and infanticide of disabled babies will be promoted as the humane way to reduce healthcare costs. The quality of life ethic is being pushed by the medical community wherein the value of human life lies in its functionality. But in a Catholic hospital, all life is valuable.

Catholic hospitals are unique because they unite traditional healthcare services with the church’s mission to serve the poor and promote the sanctity of all human life. Because of their commitment to serving every human being, they are able to go into poor and rural areas where secular and public hospitals do not operate. This is evident from the very fact that such hospitals are merging with their Catholic partners in these regions.

But for Catholic hospitals to continue to operate in such a way, they must be allowed to freely practice their faith. To force Catholic hospitals to provide abortions would be like forcing mosques to serve pork, or Quakers to enlist in the military.

The first amendment guarantees the right of every American to the “free exercise” of his or her religion, but we have seen that ignored before by the Obama administration. And Congress has upheld that right in the Hyde–Weldon Conscience Protection Amendment, which protects physicians, nurses, hospitals and health insurance companies from being forced to commit, fund, cover or refer for abortions by the federal or any state government.

However, that amendment has to be approved every year and it will only take one pro-abortion Congressional majority to end it. We must be proactive in educating our friends, our neighbors and our fellow parishioners on the basic fact that abortion and assisted suicide are not healthcare. In fact, they are the antithesis of healthcare.

The Catholic Church is not going to back down on its commitment to the dignity and sanctity of all human life. The hospitals will be shut down, or risk losing the financial benefit of affiliation with the Church, before that happens. Then, in those rural areas that are served exclusively by Catholic hospitals, there will be no healthcare at all. There will be nothing for those patients who need immediate, true emergency care. All because of the obstinacy of abortion advocates who value the destruction of life over the saving of it.

Dr. Marguerite Duane Lectures on our Live Webcast Today!

Dr. Duane

Dr. Duane

Dr. Duane will be speaking live at the University of Illinois-Chicago Medical Campus. Click here to watch live at 1:30pm EST or 12:30pm CST. 

As part of our Medical Students for Life 2013  Spring Tour, Dr. Duane is speaking on Modern Fertility Awareness as an alternative to prescribing birth control pills.

Our belief in the sanctity of life extends into family planning. Delivering medically accurate information on reproductive health plays a huge role in caring for both the mother and preborn baby as a patient. Women who consistently use birth control pills for a 10-15 year time period seriously increase their chances of developing cancer and problem pregnancies. Dr. Duane is providing information on natural methods to  increase or decrease the likelihood of pregnancy without using chemicals to do so.

Dr. Duane is speaking at the following schools this week.

April 11th University of Illinois College of Medicine- Dr. Duane (LIVE WEBCAST)
  • Topic: Modern Fertility Awareness Based Methods of Family Planning
  • 12:30pm CST
  • 1853 West Polk Street, Room 130 Chicago, IL 60612
 April 11th The Medical College of Wisconsin- Dr. Duane
  • Topic: Modern Fertility Awareness Based Methods of Family Planning
  • 5pm
  • 9200 W Wisconsin Ave Milwaukee, WI
April 12th Northwestern Feinburg School of Medicine – Dr. Duane
  • Topic: Modern Fertility Awareness Based Methods of Family Planning
  • 12pm
  • 420 East Superior Street Chicago, IL 60611

You can watch video recordings of Dr. Duane’s lecture and many more from our tour. Click here.

About Dr. Marguerite Duane

Dr. Marguerite Duane, a board certified family physician and Adjunct Associate Professor at Georgetown University, is co-founder and Executive Team Leader of FACTS – the Fertility Appreciation Collaborative to Teach the Systems.   Dr. Duane formerly served as the medical director of the Spanish Catholic Center of Catholic Charities of the Archdiocese of Washington, DC and the Family Medicine Clerkship Director at Georgetown University.  She received her M.D. degree with recognition in primary care from the State University of New York at Stony Brook and completed her Family Medicine residency at Lancaster General Hospital in Lancaster, PA. Dr. Duane received a Bachelor of Science with Honors degree and a Master of Health Administration degree from Cornell University in 1992 and 1994, respectively. She is also trained as a Creighton Medical consultant and a TeenSTAR educator.  Dr. Duane has been recognized for her leadership efforts by the American Board of Family Medicine which named her as a 1998 Pisacano Scholar, and by the American Academy of Family Physicians which awarded her the AAFP Bristol Meyers Squibb Graduate Medical Education Award in 2002. Dr. Duane balances her career as a teacher and Family Physician, with her role as a mother and wife.

2012 Fall Tour Video: Dr. Calhoun Lectures on Perinatal Hospice at Wayne State Univ.

During our Fall 2012 Medical Students for Life tour, we were privileged to facilitate a lecture  at Wayne State University School of Medicine. Dr. Byron Calhoun, the pioneer of perinatal hospice spoke on the issue of perinatal hospice. Well over 70 medical students attended the lecture. Dr. Byron C. Calhoun, MD, FACOG, FACS, MBA is a diplomat of the American Board of Obstetrics and Gynecology and is board certified in general Obstetrics/Gynecology and the sub-specialty of Maternal-Fetal Medicine. Here is the lecture in it’s entirety:


Dr. Calhoun has authored 60+ peer review articles in the obstetric and gynecologic literature, presented 100+ scientific papers, participated in 40+ research projects, and published several articles on perinatal hospice. He is an original author of the perinatal hospice concept, which provides a multidisciplinary care to families with a lethal prenatal diagnosis.

Dr. Calhoun serves as Professor and Vice-Chair in the Department of Obstetrics and Gynecology at West Virginia University-Charleston. He is also the National Medical Advisor for NIFLA, National Institute of Family and Life Advocates.