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Maternal Sepsis More Than Triple After Texas Abortion Ban

The fallout from Texas’s near-total ban on abortion continues as rates of maternal sepsis soar. Those rates have more than tripled since 2021.

Maternal sepsis is a life-threatening condition where the body’s own immune system starts to attack organs, resulting in damage or failure. The most common cause is the previable premature rupture of membranes (PROM), which exposes the pregnant person’s uterus to the outside environment, causing infection and the immune response. This is the reason that once a pregnant person’s “water breaks” they have to deliver within hours of the rupture.

Emily Fahl, MD, a resident physician at McGovern Medical School at UTHealth Houston, compared cohorts before and after the passage of Senate Bill 8, the “bounty hunter” law that let Texas residents sue pregnant people who received abortions after six weeks gestation as well as the people who helped them obtain the abortion. According to Fahl, maternal sepsis rates rose from 9.4 percent pre-S.B. 8 to a whopping 29.2 percent.

The data was pulled from three Houston hospitals from January 2018 through March 2023, but excluded incidences during Spring 2020 due to COVID potentially skewing the results. All the patients experienced PROM at or before 22 weeks gestation. Notably, this did not include pregnancies that suffered an intrauterine demise or premature labor.

Before S.B. 8, more than half of pregnant people with PROM chose termination. After S.B. 8, only 8 percent did. The drop in terminations was not met with a significant rise in neonatal survival rates, though there was some small increase.

Fahl presented these findings to the Society for Maternal-Fetal Medicine (SMFM) annual meeting, asking for the Texas Legislature to clarify PROM as a life-threatening condition necessitating abortion to treat.

Since the prohibition against abortion began in Texas there have been increasingly common and gruesome stories of reproductive health mishaps. The current law on abortion does make exceptions for abortion to preserve the life of the pregnant person, but what that means remains vague and undefined. As such, many doctors in Texas will not perform an abortion until a patient is literally dying in front of them.

Many pregnant people have been forced to leave the state for healthcare when their doctors refused to abort dead fetuses for fear of legal reprisal.  A group of women and doctors have sued the State of Texas over the wording of the law and its dangers, and the case is still making its way toward the U.S. Supreme Court. In the meantime, the all-Republican Texas Supreme Court rejected claims that the law was a danger to pregnant Texans.  

Even when pregnancies are carried to term, the abortion ban is causing tragedy. Fatal infant abandonment has also skyrocketed in the state since the ban went into place. The number of infants left out to die has doubled in the state in recent years. In fact, infant mortality is up across the board as Texans who would have previously aborted go without natal or maternal care following unwanted pregnancies.

Jef Rouner
Jef Rouner
Jef Rouner is an award-winning freelance journalist, the author of The Rook Circle, and a member of The Black Math Experiment. He lives in Houston where he spends most of his time investigating corruption and strange happenings. Jef has written for Houston Press, Free Press Houston, and Houston Chronicle.

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