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The evidence is clear: The loss of abortion access will be devastating for Kentucky

Maternal mortality is higher in states with more restrictive abortion policies

June 30, 2022
Opinion Contributor: Melissa Eggen, Program Manager at Center for Health Organization Transformation; Senior Policy Analyst at Commonwealth Institute of Kentucky; PhD Student, Department of Health Management and Systems Sciences

Melissa Eggen

Opinions and perceptions may vary but the evidence remains clear: The loss of access to abortion, an essential component of reproductive healthcare, will be devastating for Kentucky.

At 40.8 deaths per 100,000 live births, Kentucky’s maternal mortality rate is far higher than the national average (17.4) and among the highest in the nation. Black women are more than two times as likely as white women to die during pregnancy and childbirth. Credible research has found that maternal mortality is higher in states with more restrictive abortion policy. We may yet see our maternal death rate increase in the coming years. High rates of maternal mortality in Kentucky are direct results of structural and systemic factors like racism, lack of access to quality healthcare, and poverty (15% of Kentuckians live in poverty). At the same time, Kentucky is experiencing an increasing behavioral health crisis with females, individuals with lower incomes and people of color bearing the heaviest burden. Our rising rates of substance use are an indicator of the behavioral health crisis we are experiencing. In 2017, 46% of maternal deaths in Kentucky were related to substance use disorder. With adequate availability and coordination of evidence-based treatment options and an overall stronger safety net, many of those deaths could have been prevented.

Kentucky has now enforced a near total ban on abortion, including no exceptions for rape or incest. At the same time, we know that forcing birth on people is detrimental to their physical and mental health and, ultimately, outcomes for babies and children who are parented by those individuals. Once again, Kentucky leads the nation in child abuse rates, at nearly double the national rate. We also rank in the top 10 among all states for cesarean rates (34% of all births in Kentucky), which has been associated with maternal mortality and severe maternal morbidities like excessive bleeding during childbirth. Our vaginal birth after cesarean (VBAC) rates, a key strategy for reducing overall cesareans, are abysmal at 10%.

Many argue that women should use contraception if they don’t want to get pregnant. This argument fails to understand many things, including the male role in unintended pregnancy, that no contraception is 100% effective, and that contraceptive use requires decision-making within the context of a consensual and respectful relationship. Access to effective contraception is not available to all, especially among those living in rural areas, low-income individuals, teens, those who lack health insurance, or cannot afford to take time off work to see a doctor. An estimated 300,000 women in Kentucky meet these criteria.

Kentucky, we can do better, and we must do better, to address and improve outcomes for women, infants, and families, particularly considering the abortion restrictions that are now in place. We, as a nation, have spent mounds of dollars, time, resources, and energy on making abortion illegal. This is time that could have been spent on policies and practices to improve the circumstances in which we all live. Quality improvement to lower cesarean rates, implicit bias training for health care providers, group prenatal care, improving access to safe housing, expanding our social welfare workforce to adequately address needs, and on and on.

It’s past time for Kentucky’s elected politicians to, first, listen to us. A recent poll showed that 59% of Kentuckian’s believe abortion should be legal. Now is the time for elected officials, government, organizations, academic institutions, insurers, health care providers, and individuals, to step up and show our support for women and infants by investing our money and efforts in building a more robust safety net and ensuring access to high quality healthcare that includes the full range of reproductive healthcare services, including abortion.

Article was originally published in the Courier-Journal on June 30, 2022


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