In Philly, maternal mortality, health care disparities take center stage at abortion access hearings

At a joint hearing in Philadelphia on Tuesday, Democratic lawmakers from the House and Senate heard from doctors, providers, public officials and advocates about the “far-reaching” impact of the recent Roe v. Wade ruling in Pennsylvania.

The session, the second in a SERIES of meetings about reproductive health care in Pennsylvania, focused on the impact abortion bans would have on maternal mortality rates in Pennsylvania and the implications for OB-GYN physicians, as well as how advocates and providers are coping with an influx of out-of-state patients .

“It is critical that we not limit access to abortion,” Aasta Mehta, chief medical officer of Women’s Health for the Philadelphia Department of Public Health, told members of the House and Senate Democratic Policy Committees. “Denying access to abortion results in poor health, financial and family outcomes for women and people who give birth.”

Mehta also said limiting abortion care in Pennsylvania would exacerbate disparities in medicine, particularly in reproductive health care.

Aasta Mehta, chief medical officer of women’s health at the Philadelphia Department of Public Health, testifies before lawmakers at a Democratic Policy hearing in Philadelphia on Tuesday, July 26, 2022 (Capital-Star screen capture).

“Studies show that carrying a pregnancy to term is significantly riskier than a safe abortion with the risk of stillbirth approximately 14 times higher than that of abortion,” Mehta told the panel. “Between 2013-2018, the city [Philadelphia] suffered 110 pregnancy-related deaths.”

Mehta said 52 percent of pregnancy-related deaths in the city occurred among women under the age of 30. In addition, Mehta said 75 percent of women with pregnancy-related deaths were known to be Medicaid beneficiaries.

“Black women accounted for 58 percent of pregnancy-related deaths, despite accounting for only 43 percent of births,” Mehta said. And black women in the city are four times more likely to die from pregnancy-related causes than white women.

A nationwide abortion ban would “codify” those inequalities and lead to more pregnancy-related deaths, Mehta warned.

Ceshia Elmore, a community organizer for New Voices for Reproductive Justice, a national advocacy group, echoed Mehta’s concerns about a rising maternal mortality rate.

“The US has the highest maternal mortality rate in the world,” Elmore said. “This does not demonstrate a pro-life agenda.”

State Sen. Amanda Cappelletti, D-Montgomery, said a possible increase in maternal mortality rates in Pennsylvania is “absolutely unacceptable.”

Elmore also testified about the impact abortion bans will have on black families and communities.

“We know that individuals of color will be the most affected by this upheaval,” Elmore said. “It reinforces the agenda to dismantle black family structures, perpetuate generational poverty and cause division in our communities.”

Elmore also commented on SB106, a constitutional amendment package advanced in a late-night session last month to give voters the right to abortion care in Pennsylvania.

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So said Elmore SB106 would compromise the basic human rights of people who give birth and warned against any attempts by lawmakers to criminalize abortion.

“Denying bodily autonomy and criminalizing abortion is just another tactic to limit people’s power,” Elmore said. “If abortion becomes a criminal offense, we know what criminals can’t do in most states — vote.”

Sarah Gutman, an OB-GYN and complex family medicine specialist at UPenn Medicine told the committee that she worries that confusion over state-level abortion laws will affect doctors’ abilities to make life-saving decisions. She said she also fears the bans will criminalize providers trying to do what is medically best for their patients.

“If Pennsylvania legislators restrict access to abortion care, they are making deeply personal decisions on behalf of their constituents who do not have the medical expertise to make them,” Gutman said. “We must pass legislation that protects the ability of our providers to care for these patients. We need to build our clinical capacity, knowing that the demand for our clinics, support staff and medical staff will increase.”

Gutman told the committee that she is concerned that people, fearing the possible consequences, will stop seeking care.

“I really worry that people will stop seeking care,” Gutman said, adding that in Texas, where abortion is prohibited after six weeks, “Individuals who had a complication, such as their water breaking , before 22 weeks of pregnancy were denied standard medical care and forced to wait until they became ill before receiving treatment.

“In this group, the risk of maternal morbidity nearly doubled after abortion bans were enacted, without any improvement in fetal outcomes,” Gutman said. “In this world, nobody wins. People will get sick. People will die.”

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