Washington, D.C. — Late yesterday, on behalf of the Society for Maternal-Fetal Medicine (SMFM)—a national organization comprised of more 5,500 maternal-fetal medicine (“MFM”) subspecialists, 442 of whom practice in Texas—Democracy Forward sent a letter to the Texas Department of State Health Services (“DSHS”) and the Maternal Mortality and Morbidity Review Committee (“MMMRC”) to request they comply with Texas law by releasing the Joint Report containing the MMMRC’s findings and recommendations to address the state’s maternal health crisis as soon as possible and no later than November 10, 2022. Should the state continue to withhold the report in violation of Texas law, the letter informs the state that “SMFM will consider all available options, including seeking legal remedies” to compel its release.

SMFM and its members are on the front lines of addressing the maternal mortality crisis and work to ensure that all medically appropriate and evidence-based treatment options are available for individuals experiencing a high-risk pregnancy. Central to SMFM’s work is addressing racial inequities in maternal health outcomes, and in doing so SMFM relies on the data and recommendations of the MMMRC.

“The United States has the highest rate of maternal death among developed nations with significant racial disparities and large differences in rates between states,” said Kerri Wade, Chief Public Affairs Officer for the Society for Maternal-Fetal Medicine. “When a pregnant person or new mother dies, it is a heartbreaking loss for their family, community, and clinical team charged with their care. State-based Maternal Mortality Review Committees are critical to understanding why each maternal death happened and how to prevent future deaths. Pregnancy experts, like members of SMFM, rely on the information and recommendations contained in the reports of these committees to advance equitable care for pregnant and postpartum people.”

By law, the report was required to be released on September 1, 2022. By refusing to release this joint report, the state has been in violation of the law for more than two months.

“Texas law is clear: the state does not have discretion to indiscriminately withhold this Joint Report beyond its statutorily required deadline,” said Skye Perryman, CEO & President of Democracy Forward. “Every day that passes without the release of the Joint Report and the information it contains is not only a further hindrance to the ability of lawmakers, advocates, and clinicians to address the state’s maternal health crisis, it’s unlawful. State leadership asserting to care about the health of women and families need to comply with the law, or the law will be used to compel compliance.”

Members of the Texas legislature previously asked DSHS to reconsider its decision to delay the release of the Joint Report. In response, DSHS again did not commit to a date certain by which it will remedy its ongoing violation of Texas law. Instead, they indicated only that DSHS would discuss its continued withholding of this critical maternal health data at the MMMRC’s December 8, 2022 meeting and that it intends “to provide data and recommendations timely to help inform efforts during the 88th Legislative Session.”    

Texas faces a maternal health crisis and has one of the ten highest rates of maternal mortality in the country. What’s more, pregnant Black women in Texas die at around three times the rate of other women, according to existing state data. MMMRC, an advisory body administered by DSHS and composed of medical and public health experts and other maternal health advocates, meets at least quarterly and studies and reviews cases of pregnancy-related deaths in Texas, as well as “trends, rates, or disparities in pregnancy-related deaths and severe maternal morbidity.” 

By law, DSHS must release the MMMRC’s findings and recommendations in a joint report, which must be sent to state officials and appropriate committees of the Legislature, disseminated to specified healthcare organizations and made available to the public. On September 13, the Houston Chronicle reported that the report would be delayed until summer of 2023, after the midterms and the next biennial legislative session. 

In September and October, Democracy Forward sought records and communications regarding the report’s delay from DSHS, MMMRC, and Governor Greg Abbott. On November 1, 2022 the Office of Gov. Abbott informed Democracy Forward it would invoke all exceptions to the Texas Public Information Act and sought an advisory opinion from Texas Attorney General Paxton to endorse its decision to withhold documents. Just a day later, DSHS informed Democracy Forward it was following suit. After six weeks, DSHS has provided no documents and no estimate of when, if ever, it will.