Report: Sepsis, maternal deaths surged in Texas following abortion bans

There’s been ample evidence over the past few years that abortion bans lead to death and major health risks for pregnant people and babies. Now, a groundbreaking analysis by ProPublica shows just how dire the situation has become in Texas since the state implemented a six-week abortion ban in 2021, followed by an even more draconian, near-total ban after the Supreme Court overruled Roe v. Wade in 2022.

According to ProPublica, dozens more pregnant and postpartum women have died in Texas hospitals since those bans were implemented, compared with maternal deaths in the state immediately before the pandemic. A total of 79 maternal hospital deaths were reported in the state in 2018 and 2019, versus 120 hospital deaths in 2022 and 2023, ProPublica reports. Jonas Swartz, an assistant professor of obstetrics and gynecology at Duke University, told the outlet that the 2022-23 figure was likely “an underestimation of the number of people who died.”

ProPublica notes that not all deaths of pregnant women and new mothers occur in hospitals; the Texas hospital data used in the analysis also don’t provide the causes of women’s deaths. But other data confirms there has been a sharp rise in maternal deaths in the state since the abortion bans. Centers for Disease Control and Prevention data, for example, shows that the rate of maternal deaths in the state rose 33 percent from 2019 through 2023—making Texas an outlier, given that the national maternal mortality rate decreased by 7.5 percent over the same time frame, ProPublica notes.

ProPublica also found that for women who were hospitalized when they lost their pregnancies in the second trimester, the number of women suffering from sepsis shot up more than 50 percent—from 147 women in the period before the implementation of the six-week ban, also known as SB8, to 213 women after. Sepsis is a life-threatening condition that can lead to septic shock and is caused by the body’s improper response to an infection. According to the ProPublica analysis, rates of sepsis were found to be particularly high in patients whose fetuses still had detectable cardiac activity when the patient was admitted to the hospital.

ProPublica notes its analysis of sepsis rates is conservative “and likely missed some cases” given that it does not, for example, reflect miscarrying patients who were turned away from emergency rooms.

At the time Texas enacted its six-week abortion ban, in 2021, it was the most restrictive law in the country, allowing private citizens to sue anyone who “aids and abets” an abortion for $10,000. The following year, Texas enacted a post-Dobbs trigger ban that prohibits almost all abortions and threatens anyone providing one with criminal charges and $100,000 fine. While both bills claim to offer exceptions for medical emergencies and life-threatening physical complications, respectively, they have had a chilling effect on doctors who have wound up delaying necessary abortion care to people experiencing pregnancy complications—sometimes, until it’s too late—for fear of breaking the law.

Last year, ProPublica reported on two Texas women—Josseli Barnica and Neveah Crain—who died of sepsis in 2021 and 2023, respectively, after doctors delayed in intervening while they were miscarrying. (The outlet also reported on two women in Georgia, Amber Nicole Thurman and Candi Miller, who died after experiencing rare complications from abortion pills; their deaths could have prevented by a routine procedure—a dilation and curettage, or D&C, which is functionally the same as an abortion—to clear unexpelled fetal tissue from their uteruses, if performed in time.)

Following ProPublica‘s publication of Barnica’s and Crain’s stories, more than 100 Texas doctors sent a letter to state legislators demanding that the near-total ban be amended to reduce the risk of future maternal deaths. Several bills have been introduced in the current legislative session to amend the law.

ProPublica says it conducted its analysis by purchasing and analyzing Texas hospital discharge data from 2017 to 2023. More than a dozen maternal health specialists reviewed the findings and characterized them as more evidence that abortion restrictions lead to poor health outcomes and dangerous delays in care for pregnant people. Many of the experts told ProPublica that the abortion bans were the only reason they could see for the dramatic rise in sepsis rates.

Other recent analyses have also shown the devastating health impacts of abortion bans—in Texas, and beyond.

A paper by the Journal of the American Medical Association, published online last week, analyzed US national vital statistics data from 2012 through 2023 and found that infant mortality rates were 5.6 percent higher in 14 states—including Texas—after they adopted six-week or near-total abortion bans. The researchers found Black infants, those with serious birth defects, and those born in Southern states faced disproportionately larger increases in mortality. (“Texas had a dominant influence on the overall result,” the paper notes.)

Another new analysis—presented at the Society for Maternal-Fetal Medicine conference last month—found that adverse maternal outcomes, and particularly sepsis, increased in Texas following the implementation of SB8. (A link to the full paper was not immediately available.)

So far, abortion opponents have been largely unmoved by evidence suggesting that abortion bans lead to negative health outcomes. Miller’s and Thurman’s deaths were not enough to make Senate Republicans back a resolution to guarantee abortion access to protect a pregnant person’s life, as I wrote last year. Meanwhile, some lawmakers in Texas are trying to restrict abortion even further, introducing legislation to reclassify abortion pills as “controlled substances” and allow Texas women who obtain abortions to be charged with homicide, potentially allowing them to face the death penalty.