Missouri continues to fail new mothers as it focuses on ending abortion rights

Missouri keeps passing abortion restrictions while ignoring a real crisis in its midst: a Black maternal mortality rate that is shockingly high. 

The state just released its most recent review of pregnancy-related deaths, covering the year ending in 2018. 

The review found that Missouri had one of the country’s overall worst maternal mortality rates. (The state defines a pregnancy-related death as death during childbirth or within one year of pregnancy.)

What that overall rate doesn’t show, though, is that Black women are four times as likely to die a pregnancy-related death as their white counterparts, a statistic that hasn’t improved from the previous year’s report.

The state determined that the vast majority — 82% — of these pregnancy-related deaths were preventable. In this context, “preventable” means the death could have been prevented if a change had happened somewhere in “the facility, the system, the provider, or the community.”

Black reproductive health advocates point out that institutional racism in the medical field is one factor that drives the disparate health results for Black and white people.

Missouri’s initial refusal to accept the Medicaid expansion has also possibly contributed to those disparate outcomes. Without Medicaid coverage after delivery, postpartum care is out of reach of many individuals with lower incomes. Since the poverty rate in Black households in Missouri is double that of white households, far more Black mothers fall into that gap.

Though Missouri refused to implement the Medicaid expansion, a new court decision changes that. Earlier this month, the Missouri Supreme Court held that the state must adhere to a 2020 ballot initiative where Missouri citizens voted to expand Medicaid. Given that the U.S.  Department of Health and Human Services is now piloting a program to have Medicaid cover people for a full year post-birth, such a change could drastically improve the lives of pregnant people in Missouri. 

However, the possibility of expanded Medicaid won’t likely change Missouri’s zeal for abortion restrictions, nor the fact that the state doesn’t mandate sick leave or family leave.

Missouri already has some of the most restrictive abortion laws in the country, including mandated counseling, a required waiting period, restrictions on when private insurance companies can cover abortions, a ban on telemedicine abortions, a parental consent requirement, and more. 

Missouri’s anti-choice legislators suffered a mild setback earlier this year when a federal court of appeals upheld a lower court’s block of the state’s eight-week abortion ban. Almost immediately afterward, though, the full Eighth Circuit Court of Appeals decided to rehear the case, which abortion advocates say does not bode well. The state’s hardline anti-abortion Republican attorney general, Eric Schmitt, has also asked the U.S.  Supreme Court to take up the ban and explicitly stated that the court should use the Missouri case to decide whether to overturn Roe v. Wade. 

If Missouri’s legislators were to bring their zeal for banning abortions to bear on helping people, particularly Black people, during and after childbirth, that could make a big difference in health outcomes. Instead, private citizens had to take matters into their own hands and sue the state to force it to honor voters’ wishes.