After Democratic wins, Texas could more closely review deaths related to the abortion ban

With a power shift imminent at the Texas Capitol, advocates are more hopeful than ever that incoming elected officials will finally empower the state’s beleaguered maternal mortality committee to review abortion-related deaths.

State law and decisions by the Legislature in recent years have hamstrung the Texas Maternal Mortality and Morbidity Review Committee’s work by restricting the data it is allowed to review and stopping the committee from sharing its detailed data with the federal government.

“It was a review committee — it felt like — in name only,” said state Rep. Lauren Ashley Simmons, a Houston Democrat who sits on the House Public Health Committee. But with Democrats capturing the governorship, lieutenant governorship and control of the state House, Simmons said the maternal mortality committee will finally be empowered to do its job.

Among the first changes advocates are pushing for is to release the committee’s biennial maternal mortality report, which was supposed to be published Sept. 1. This year, the Department of State Health Services opted to delay the report until Dec. 1 to fine-tune findings and recommendations. 

Women’s health advocates allege the delay was designed to avoid publicizing potentially alarming findings linking the state’s near-total abortion ban to an uptick in maternal deaths ahead of November’s midterm election. The highly anticipated report examines cases from 2021 and 2024, making it the state’s first comprehensive look at maternal mortality and morbidity since the ban went into effect in 2022.

State Rep. Donna Howard, an Austin Democrat who previously authored a law speeding up the committee’s review process, said she has spoken with DSHS Interim Commissioner Imelda Garcia, who told her there would be a meeting to discuss the report on Monday. Howard is expecting the report as soon as this week.

On Monday, DSHS emphasized that the report will be released by Dec. 1, but declined to name a specific date.

Beyond having the report released soon, maternal health advocate Nakeenya Wilson, a former member of the committee, has high expectations for the committee moving forward.

“We have a Democratic leadership that typically supports full reproductive rights,” Wilson said of the slate of Democrats elected last week. “I think that’s even further strengthened by the fact that this leadership is now female.” If Houston Rep. Senfronia Thompson claims the House speaker in January — as she is poised to do — she, Lt. Gov.-elect Vikki Goodwin and Gov.-elect Gina Hinojosa would become Texas’ first female “Big Three.”

While Democrats aren’t likely to repeal the abortion ban, they’ve already signaled they’ll interpret and implement the ban less rigidly moving forward — Attorney General-elect Nathan Johnson has already said he won’t use his office to sue out-of-state doctors for providing abortion pills.

Democrats can also give the maternal mortality committee more tools to explore the ban’s negative impact and appoint more of their allies to the committee.

Created in 2013 to review maternal deaths and near-misses, the committee has been overshadowed by controversy in recent years. The original statute establishing the committee bars it from reviewing abortion-related deaths, and state Republicans have resisted efforts to amend its scope. Advocates on both sides of the abortion debate have called for the committee to review such cases, albeit for very different reasons.

Abortion opponents want to learn more about cases where women died by abortions. Abortion advocates are also interested in that information, especially in cases where the ban drove women to seek out medically unsupervised abortions. 

Wilson said the committee already reviews cases of women who died because they weren’t given an abortion; this year’s report will be the first to show the impact of the state’s abortion ban on this category.

If lawmakers expand the committee’s scope to review deaths caused by an abortion, anti-abortion advocates expect it will illuminate the potential dangers of the procedure and reinforce the need for an abortion ban. 

“Texas Alliance for Life would like the Legislature to remove a prohibition against examining deaths that are associated with abortion,” said Amy O’Donnell, the organization’s executive director. “We cannot have that full picture without knowing what the abortion-related death numbers are.”

In addition to delayed reports, the committee has also faced criticism for adding an outspoken anti-abortion advocate to its lineup, and not doing enough to review Black maternal outcomes — according to the committee’s last report, Black women in Texas are about 2.5 times more likely to die from pregnancy and childbirth than white women.

Democrats already filed legislation related to the committee on Monday, the first day of filing for the Legislature’s upcoming sessions. State Rep. Charlene Ward Johnson, D-Houston, submitted a bill calling for a separate study on Black maternal health in the state, similar to a bill she filed in the 2025 session. That bill passed the House but not the Senate.

The committee previously faced backlash for jumping from 2021 to 2024 data, skipping 2022 and 2023, the first two years after the U.S. Supreme Court’s ruling in Dobbs v. Jackson and Texas’ implementation of its current abortion ban. Advocates and legislators now hope that the committee will expand its reviews to include the missing years.

But Dr. Carla Ortique, the committee’s presiding officer, warned that despite interest in such retroactive review on the committee, whether it will be able to do it depends on its resources, which are scarce; the committee is currently composed entirely of volunteers.

“We’re already reviewing two years at a time. I think it would be extremely difficult to try to review four years during that time frame,” Ortique said. Such an undertaking would require at least three additional full-time employees, she added.

While some reforms require legislation, other reforms can be accomplished without, including the retroactive review of 2022 and 2023, as well as changing who sits on the committee.

In 2023, lawmakers changed the committee’s composition, as laid out by state law, to replace the community advocate position held by Wilson with two community member positions. Both of those seats are currently occupied by doctors, leaving the committee with no pure advocates.

As governor, Hinojosa will be empowered to appoint the DSHS commissioner, who in turn makes appointments to the committee from an applicant pool.

“I absolutely want to see people who understand that abortion is not just a social culture war issue, that this is a medical procedure,” Simmons, who previously introduced a bill that would add two committee spots for doulas, said. The bill didn’t make it out of committee.

Although discussion has now turned to tapping the committee’s potential, just a few weeks ago, there was still doubt whether the committee would continue to exist at all. With DSHS up for Sunset review, Ortique and Wilson expressed concerns the committee might be eliminated entirely. Last week, the Sunset Staff Report found a “continuing need” for the committee and recommended the state improve its data sharing “with internal and external public health partners.” The Sunset Advisory Commission will make a final determination in 2027.

In 2024, Texas pulled out of the national Maternal Mortality Review Information Application, run by the Centers for Disease Control and Prevention, which facilitated maternal death tracking in Texas and across the country.

Maternal mortality data, both from Texas and other states, helps inform maternal health care, said Dr. Kimberly Pilkinton, president of the Texas Association of Obstetricians and Gynecologists. In the past, data analysis has led to improvements in treatment of maternal mental health and postpartum hemorrhage. Aggregated country-wide data can also lead to insights state data alone cannot provide, she said.

“Maternal morbidity and mortality crosses party lines,” Pilkinton said. “One preventable maternal death is worth every bit of resource put into it.”