A new report shows the number of Hoosier women dying in childbirth, or within one year of delivery, remained stubbornly high in 2021 — even before Indiana's near-total abortion ban took effect last year, potentially compelling up to 8,000 additional women each year to carry their pregnancies to term.
Detailed data recently released by the Indiana Maternal Mortality Review Committee shows 80 pregnant and postpartum women died in connection with the nearly 80,000 live births in Indiana during 2021, a 13% decrease from the state's 92 maternal deaths in 2020, but still well above the 63 maternal deaths identified by the committee for 2019 and 60 maternal deaths tallied in 2018.
More than 7 in 10 maternal deaths recorded in Indiana for 2021 were preventable, the committee found.
According to the report, 14 of the 80 deaths (18%) were directly related to medical issues associated with pregnancy, and mostly occurred shortly before, during or within six weeks of giving birth.
Of the remaining 66 deaths, drug overdoses were the leading cause and accounted for 28% of pregnancy-associated deaths, followed by motor vehicle crashes, gunshot wounds, cancer and COVID-19, the report said.
Data show black women had the highest rate of maternal mortality in 2021 with 156.3 maternal deaths per 100,000 live births.
That was 72% higher than the maternal mortality rate of white women in Indiana, 90.7 per 100,000 births, and also well above the rate for Hispanic women, 79.4 per 100,000, according to the report.
The state's overall 2021 maternal mortality rate of 100.1 deaths per 100,000 live births is down from the 117.1 maternal deaths per 100,000 births recorded in 2020, but up from the 74.2 per 100,000 rate of 2019 as well as the 2018 rate of 77.2 per 100,000, the report said.
Dr. Lindsay Weaver, the state health commissioner, said despite the tireless work of the review committee to identify and confirm Indiana maternal deaths, she acknowledged the process "does not take away any pain felt by family and friends who lost loved ones."
"The Maternal Mortality Review Committee members share their knowledge and time in hope that fewer Hoosiers will experience the pain of a maternal loss. The Indiana Department of Health is committed to learning from the review process and implementing preventative recommendations through partnerships with state and local agencies," Weaver said.
To that end, Weaver noted in September 2022 the U.S. Centers for Medicare and Medicaid Services approved a request by Indiana's Family and Social Services Administration to extend postpartum Medicaid coverage for a full year following a Medicaid-covered birth, instead of the prior limit of 60 days.
Indiana initially extended its postpartum Medicaid coverage to one year beginning in April 2022 using funding provided to the state through the American Rescue Plan. The policy change ensures the extended Medicaid health coverage remains available for an estimated 12,000 Indiana women and their newborn children through at least March 31, 2027.
"This coverage is vital to improving the health of mothers of Indiana through increasing access to necessary medical care and medication," Weaver said.
Weaver also pointed to a recently launched state program aimed at connecting women with opioid use disorder to drug treatment early in their pregnancies and other initiatives to bolster the safety and health of pregnant women as key preventative measures she hopes will reduce Indiana's maternal mortality rate in future years.
A big unknown, however, and unacknowledged by Weaver, is how Indiana's near-total abortion ban, which took effect Aug. 21, 2023, will impact its maternal mortality and infant mortality rates, as many women who might previously have obtained an abortion in Indiana are forced to instead carry their pregnancies to term and give birth.
Under Senate Enrolled Act 1 (2022), abortion is prohibited in Indiana from the moment of conception — except within 10 weeks of fertilization for pregnancies caused by rape or incest, or 20 weeks if necessary to prevent serious physical impairment or the death of a pregnant woman, or because of a lethal fetal anomaly.
Records show women obtained just 46 abortions in Indiana during the October-December 2023 period when the new abortion restrictions were in effect.
According to the Indiana Department of Health, zero Hoosier women died in connection with the 8,414 abortions performed in the state during 2021.
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