Idaho abandons panel investigating pregnancy-related deaths
August 23, 2023 12:30 AM   Subscribe

Idaho Legislature’s decision to disband board came as two hospitals that serve rural areas announced they would stop providing services for expectant mothers From the Idaho Capital Sun
The committee will disband despite a high rate of maternal mortality in the United States that exceeds those of other high-income countries. The U.S. recorded 23.8 maternal deaths per 100,000 live births in 2020, compared with 8.4 in Canada and 3.6 in Germany, according to the Organization for Economic Cooperation and the Centers for Disease Control and Prevention.

And the U.S. rate is sharply rising. In March, a few weeks before Idaho lawmakers adjourned their 2023 session, the CDC released data that showed the maternal mortality rate in the U.S. climbed in 2021 to 32.9 deaths per 100,000 live births.

Idaho has a particularly acute problem. Its pregnancy-related mortality ratio was 41.8 pregnancy-related deaths per 100,000 live births in 2020, according to the Maternal Mortality Review Committee report from that year.
The Guardian has this: No OB-GYNs left in town: what came after Idaho’s assault on abortion
“Nobody knows if their pregnancy is going to be uncomplicated or complicated. Nobody sets out to have a complicated pregnancy. Things happen, some of which can be predicted, and some of which cannot. So you have a little bit of a component of Russian roulette,” she says. “Being pregnant is always more dangerous than not being pregnant.”
And a reminder from Politico: The Religious Right and the Abortion Myth
The history of that movement, however, is more complicated. White evangelicals in the 1970s did not mobilize against Roe v. Wade, which they considered a Catholic issue. They organized instead to defend racial segregation in evangelical institutions, including Bob Jones University.
posted by mumimor (35 comments total) 28 users marked this as a favorite
 
Ah, Idaho. I visited family this summer and learned of the messed-up OB-GYN situation in Sandpoint and the challenges facing student health clinic workers at the University.

More Idaho flavor seasoning this reactionary stew from the Grauniad: millionaire warlords and aspirational theocrats. The whole "American Redoubt" is a scary development that negatively colors any trip "home" for me these days, and makes me ashamed of what has become of this place when I share it with my daughter.
posted by St. Oops at 1:24 AM on August 23, 2023 [11 favorites]


Wow, those last two articles seemed like straight out of some dystopic fiction or video game. I guess that in “with strong leadership committed to family and culture”, "family" means "no queers" and culture means "no coloured folks"?
posted by Harald74 at 2:32 AM on August 23, 2023 [20 favorites]


The maternal death rate is jaw dropping.
posted by warriorqueen at 4:21 AM on August 23, 2023 [16 favorites]


I’ll also note Canada’s is high in part because of lack of care in northern, remote, and rural communities, so already very bad.
posted by warriorqueen at 4:23 AM on August 23, 2023 [13 favorites]


Yeah, I looked up the numbers here in Denmark, just to have an idea of what is reasonable...
posted by mumimor at 4:32 AM on August 23, 2023 [10 favorites]


The GOP war on facts (war on knowledge?) continues.
posted by TedW at 4:58 AM on August 23, 2023 [3 favorites]


The lobbying group Idaho Freedom Foundation celebrated the end of the committee, contending it was a “vehicle to promote more government intervention in health care,” and citing the group’s recommendation to extend Medicaid coverage to mothers for 12 months postpartum.

Reprehensible. Also how exactly opposite of the truth.

I hope that lobbying group and the people involved in ending the program are treated with the care and respect they deserve
posted by Baethan at 5:25 AM on August 23, 2023 [6 favorites]


On the one hand - hurrah - Darwinian results

On the other - poor women - Darwinian effects
posted by Barbara Spitzer at 5:39 AM on August 23, 2023


The GOP war on facts (war on knowledge?) continues.

Women. War on Women. They've institutionalized slut-shaming by acting and proclaiming that any woman who may wish to end a pregnancy is of loose morals.

The same with the war on the LGBTQIA+ community - we don't fit their worldview (or secretly arouse them) and they see us as a threat to "good morals".

Knowledge that disagrees with what they "know in their hearts"? Also immoral.

Of course, let's also note how many of them act in an unbiblical manner.

They have the Theocratic Bible; they inhabit that, and anything outside it is the Enemy and must be destroyed.
posted by mephron at 5:56 AM on August 23, 2023 [31 favorites]


Wow, those last two articles seemed like straight out of some dystopic fiction or video game. I guess that in “with strong leadership committed to family and culture”, "family" means "no queers" and culture means "no coloured folks"?

It's all about Real Families and Real Culture. You know, the right kinds of each. They used to be more subtle about this stuff but these days it is increasingly right there in the open.
posted by Dip Flash at 6:02 AM on August 23, 2023 [1 favorite]


This is awful. And from the article they cheered that they shut the program down. They want this result. One of the worst effects will be how it builds on itself - without studies, you don’t have verified mortality numbers. Without verified numbers, you can effectively say that there aren’t any. As with anything governments want to obfuscate or get away with, “none reported in the state” of any statistic doesn’t mean none; it means none officially reported - but it sure sounds like a net positive. Which means things can get significantly worse and no one has to know it’s happening at all.
posted by Mchelly at 6:19 AM on August 23, 2023 [20 favorites]


It's all about Real Families and Real Culture. You know, the right kinds of each. They used to be more subtle about this stuff but these days it is increasingly right there in the open.
It is all about Real People. People who aren't Real People are to be punished and removed from society, or reduced to a a service class.

Who is Real? White cis male landowners. Everyone else either serves them or is a problem to be dealt with.

This isn't new. This is America, Great Again.
posted by NotAYakk at 6:57 AM on August 23, 2023 [2 favorites]


Women. War on Women. They've institutionalized slut-shaming by acting and proclaiming that any woman who may wish to end a pregnancy is of loose morals.

Conservatives have been able to convince themselves that abortion is only about sex outside marriages, for several reasons, mainly that they didn't have to discuss real life issues as long as Roe vs. Wade stood. But the truth is that it is about reproductive health for everyone. That huge maternal mortality number is from before the ban on abortion! People who have been raped, people carrying a fetus that cannot live outside the womb for months. People who are in mortal danger for any number of reasons. In the old days, and still today in developing countries, people died from pregnancy-related illness in huge numbers.
The stories that prove that are going to come out in large numbers, I think to a degree where it can't be kept down, not by closing the board. Everyone is going to know someone who died, or nearly died.
Before WW2, where OB/GYN practice wasn't as developed as today, and many women still died in childbirth, or during or after pregnancy, it might have been easier to write off those deaths. But today, where a doctor knows that she can save almost every woman's life, it is cruel and unusual to prohibit that care.

In a way, the conservative movement is getting caught up in their own hypocrisy. Abortion was a great wedge issue as long as it was a right. Now that the states can decide, conservative women and their daughters are feeling the consequences on their own bodies, and even dying from those consequences. How does that feel, dying because of a lie you told in order to get votes and get conservative judges elected?
posted by mumimor at 7:05 AM on August 23, 2023 [22 favorites]


patriarchy is a death cult and misogyny is its praxis. we are losing OB's in Louisiana too. why risk prosecution for doing your job?

But we in Louisiana are less visible to our Senators, because many of the mothers affected are of color.

What I learned by the pandemic, things don't happen for public health in the USA until

--football / basketball season is affected
--the AMA goes on strike
posted by eustatic at 7:30 AM on August 23, 2023 [13 favorites]


Now that the states can decide, conservative women and their daughters are feeling the consequences on their own bodies, and even dying from those consequences. How does that feel, dying because of a lie you told in order to get votes and get conservative judges elected?

Without detracting from your point, which I overall agree with, the impacts are more targeted than that and are intended to hurt poorer women most of all. Anyone* with more resources can cross state lines and go get modern reproductive health care there (likely partially subsidized by the taxpayers in the more liberal state, also). Don't forget that the median income of Trump voters was higher than you would guess based on all of the "working class base" attention, and that poverty is more concentrated in minority populations.

* "Anyone" meaning people over 18 with supportive family or resources of their own -- lots of women/girls in abusive situations, or under the age of majority, or otherwise disempowered won't be able to access this. But again, this is a feature, not a bug, to the supporters of this stuff.
posted by Dip Flash at 7:40 AM on August 23, 2023 [8 favorites]


They organized instead to defend racial segregation in evangelical institutions

That's how Jerry Falwell got started, running a segregation academy. In fact, his Liberty Christian Academy (the L in LCA was originally Lynchburg) still exists.

Note: Although Lynchburg may sound ironically appropriate for a white supremacist organization, the name comes from the town, named after John Lynch. The term lynching, however, likely comes from another guy with the same surname, Charles Lynch.
posted by CheeseDigestsAll at 7:42 AM on August 23, 2023 [2 favorites]


I know this isn't, like, a helpful comment or whatever, but what the fuck is wrong with this country? I don't know, I've like reached my limit.
posted by rhymedirective at 7:48 AM on August 23, 2023 [29 favorites]


The history of that movement, however, is more complicated. White evangelicals in the 1970s did not mobilize against Roe v. Wade, which they considered a Catholic issue. They organized instead to defend racial segregation in evangelical institutions, including Bob Jones University.

If memory serves me correctly, the liberal evangelical blogger known as Slacktivist has pointed out that the religious right took up abortion as a way of regaining the moral high ground after opposing civil rights -- after all, who wouldn't be against "murdering babies"?
posted by Gelatin at 8:20 AM on August 23, 2023 [6 favorites]


Improvements to maternity care have been so successful that a sizable chunk of people seem to be completely unaware of all the ways things can go tragically wrong. They think every fetus is going to result in a beautiful healthy baby. Ignoring the complexities of the real world they can proclaim that every abortion is a murder and legislate it, not believing or understanding that they are actually outlawing the very medicine that enabled our prosperity.
posted by interogative mood at 8:31 AM on August 23, 2023 [14 favorites]


muminor, did Danemark had a medical/care breakthrough? Stopped collecting stats?

0 for a few years seems incredible! I mean, that's the goal, you absolutely don't want pregnancies to end in death, especially ones you know how to prevent, but shit happens and medical science isn't all-powerful, I'm really surprised this can be brought to zero. It's a pleasant surprise for sure, but I'd like to know how they did it.
posted by WaterAndPixels at 8:46 AM on August 23, 2023 [2 favorites]


To put the Danish numbers in perspective I looked up which US state is closest in population to Denmark, and found that it is Colorado. Here is CO’s maternal health equity report. One thing I found noteworthy is that 72% of CO births had a physician attending and 100% of Danish births did.
posted by cali at 9:05 AM on August 23, 2023 [6 favorites]


After my initial thought of ████ those ███████ █████ and their ████████ misguided, idiotic, hateful, deadly self-righteous egocentric ████████, ███████. I just cried.
I mean, why? Just why?
I can only hope that if there is heaven, that upon their arrival, they are met by St. Peter going, "Yeah, let's talk about that dogma you blindly clung to, at the cost of countless lives, and then I'll show you how to get to the down escalator."
posted by BigHeartedGuy at 9:30 AM on August 23, 2023 [5 favorites]



muminor, did Danemark had a medical/care breakthrough? Stopped collecting stats?

I think it was more of a management breakthrough. Getting a razor-sharp focus on at-risk pregnancies, and monitoring those carefully and consistently from very early on. Most Danish deliveries happen at the hospital, and if they happen at home, Danish midwives are closer to medical doctors in education than in the US and will flag any problems they can't handle early on. (Which might go to explain the claim of a 100% physician rate, which I don't think is entirely true, except if one describes the midwives as physicians, which would not be wrong). About 2000 births a year are planned home births, always with a midwife present, but if you are at any form of risk, you will be strongly encouraged to go to the hospital. So strongly that everyone complies.

We also have universal healthcare and a broad accept of reproductive rights, so vulnerable mothers-to-be are given the same level of care as more middle class people. That includes full access to reproductive care for teenagers, homeless people, and people with substance abuse issues.

There is all the racism in Denmark, don't imagine this is a fairy-tale kingdom of progress, but we don't have the weird US situation where people of color are in greater risk of maternal or infant mortality. I have no idea what that is about. It looks like the maternal mortality rate in Greenland is also 0.

There have been a couple of population-sized research projects about maternal and infant health over the last three decades, so maybe they know better what to look for, but tbh, I think the management decisions are more important in this case.

BTW, I'm mumimor, the Danish word for Moominmamma, because that is who I am. My eldest is Moomin. Literally. The little one is Piglet. I know, it's weird, but it makes sense here.
posted by mumimor at 9:40 AM on August 23, 2023 [23 favorites]


The "Pro-Life" Party also happens to be the "Pro-Dead Mothers" Party. What a shit-hole state in the shit-hole country we've become.
posted by Saxon Kane at 9:50 AM on August 23, 2023 [4 favorites]


One thing I found noteworthy is that 72% of CO births had a physician attending and 100% of Danish births did.

If you break the stats out by race it becomes more horrifying too.

In the US, there's the also the more extreme wellness/natural birth community - a community where one of its major magazines put an AIDS denier on the cover in 2001 and which also is part of the heart of the anti-vax community. They're anti doctor and anti hospital birth, preferring midwives.

(If you're in Canada or other parts of the world, don't confuse US midwives with your professionals. Also not the American Certified Nurse Midwives.)

A Certified Professional Midwife qualifies with:
- a high school diploma
- some courses
- assisting (in various capacities) at 55 births. 55 births is NOTHING for seeing complications etc. (Thread on r/medicine)

I can't say how much statistically that's contributing because I think the number of homebirths remains small (CPMs don't have hospital privileges), but that the CPM designation is recognized in over 30 states is frankly kind of appalling.

It's a big thing in the fundamentalist/homeschooling Christian communities because it's a role a young woman can have that's "feminine" and she can practice without having to ever go to a university. I suspect that community influences a lot of the idiotic narrowness of this kind of policy-making - the idea that a woman (re: a white Christian woman) will be fine because "her body knows what to do."
posted by warriorqueen at 9:51 AM on August 23, 2023 [11 favorites]


BTW, I'm mumimor, the Danish word for Moominmamma, because that is who I am. My eldest is Moomin. Literally. The little one is Piglet. I know, it's weird, but it makes sense here.


And this is why I usually copy/paste names!!! Argh, my sincere apologies. At least I didn't write Numenor.

We also have universal healthcare and a broad accept of reproductive rights, so vulnerable mothers-to-be are given the same level of care as more middle class people. That includes full access to reproductive care for teenagers, homeless people, and people with substance abuse issues.

I'm Canada, so that kinda applies here and we don't have numbers this good. Well it applies in theory, I wouldn't say homeless people have easy access to care but it's not outright denied. And as mentioned in thread, our more isolated communities can face some challenge with access.
posted by WaterAndPixels at 10:06 AM on August 23, 2023 [3 favorites]


Argh, my sincere apologies. At least I didn't write Numenor.

No bad at all, I usually don't comment when people get it wrong, but I thought it was relevant here to explain my handle. I'm a mum. I wan't my kids and grandkids to have excellent reproductive care, and all the other kids too.

I think it is a huge priority of our current and former government, our PM has tried to brand herself as the minister of the children. You are not going to be a happy child if your mother died. Hence the management/government perspective, rather than the research/medical development.

Thinking about this, I wonder if COVID had an effect on maternal mortality as well. Denmark was seriously entirely locked down, and the general mortality rate actually went down. My eldest grandson was born during lockdown, and obviously visits were very restricted and all the safety protocols were at max. They were hospitalized for a while because of complications and the whole atmosphere at the hospital was very safe and tranquil.
posted by mumimor at 10:21 AM on August 23, 2023 [6 favorites]


Oughta send a nice "Congratulations!! You killed {name}!" card to each of these politicians every time a pregnant woman dies in their state. Maybe do some annual wrap-up for them as well. I have some less savory remarks which I'll skip.
posted by aramaic at 10:59 AM on August 23, 2023 [9 favorites]


Oughta send a nice "Congratulations!! You killed {name}!" card to each of these politicians every time a pregnant woman dies in their state.

This is an excellent idea. They'll never see it, but maybe it'll give the staffer opening the mail pause.
posted by rhymedirective at 11:18 AM on August 23, 2023 [5 favorites]


Or go "well, good, another parasite on society down!"

I believe they are all sociopaths with zero empathy.
posted by mephron at 11:34 AM on August 23, 2023 [4 favorites]


and citing the group’s recommendation to extend Medicaid coverage to mothers for 12 months postpartum.

The GALL of providing a little boost to infants and their mum's.
posted by 922257033c4a0f3cecdbd819a46d626999d1af4a at 11:48 AM on August 23, 2023 [4 favorites]


Every time something like this happens I find myself thinking it's finally going to be a bridge too far for the (let's be honest, white) women who have been voting for these mustache-twirling villains, and they'll either vote for someone else or just not vote. But every time that hope runs aground on the shores of, "That won't happen to me or my daughter" and they still pull the lever for whichever Heydrich-of-the-day the Republicans trot out.
posted by slkinsey at 12:05 PM on August 23, 2023 [2 favorites]


Re: that Politico piece. I see that sometime in the last year and a half or so it's become common knowledge that the anti-abortion movement was basically made up as a stalking horse for racist political agendas. Good of the legacy media to admit that out loud, now that talking about it can no longer possibly make a difference in political outcomes. Excellent work there, political editors.

I mean, really, I glanced at that politico piece and went off to find the original Dirty Fucking Hippie journalism that pieced this story together like 20 years ago probably, and couldn't find it. Every query I could think of was swamped with results from 2022-23 about "OMG the anti-abortion movement was always really a racist scam!" I can't even remember who wrote it, off the top of my head. He (pretty sure it was a he) certainly didn't get cited by the guy who wrote the Politico piece. Surely if I had that name I could track it down.
posted by Aardvark Cheeselog at 12:38 PM on August 23, 2023 [1 favorite]


I'm Canada, so that kinda applies here and we don't have numbers this good. Well it applies in theory, I wouldn't say homeless people have easy access to care but it's not outright denied. And as mentioned in thread, our more isolated communities can face some challenge with access.

Not only are lots of people 12-48 hours travel (weather permitting) from a hospital in Canada our social safety net has a lot of holes to fall through especially in the earlier months of pregnancy. Many people lack a primary healthcare provider depending on ad hoc delivery by clinics and urgent/emergency care.

And though the percentage is a lot smaller than the states we have plenty of antivax, anti science, or alternative medicine woo believers who think child birth is natural and therefore everything will just work out who won't seek effective prenatal care.
Also a dash of controlling domestic abusers who won't let women in their influence seek appropriate levels of care or resist basic reproductive education and access for teenagers and others.
posted by Mitheral at 2:04 PM on August 23, 2023


The part which really gets me is preventing the data from being collected: you only do that if you know it’s going to make your policy look bad, so it’s basically proof of premeditated intent which will, like pretty much all of this, be unmentioned by most journalists due to fear of death threats.
posted by adamsc at 2:19 PM on August 23, 2023 [12 favorites]


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