The following is a transcript of an interview with Dr. Henning Tiemeier of Harvard University that aired Sunday, July 3, 2022, on “Face the Nation.”
MARGARET BRENNAN: According to the Gates Foundation, the maternal mortality rate is higher here than in any other developed country, and the elimination of federal protection for abortion rights only underscores that reality and the risks ahead. Dr. Henning Tiemeier is the director of the Maternal Health Task Force at Harvard University, and he joins us now. Good morning to you, doctor.
DR. HENNING TIEMEIER: Hello, Margaret, and good morning.
MARGARET BRENNAN: Morning- I think this is incredibly important, because I want to put the issue of abortion itself aside for a moment and talk about pregnancy in America, as these states rewrite these laws. So, how is it possible that in the richest country in the world, we have the highest maternal mortality rate, and how do we stop it from getting worse?
DR. TIEMEIER: Well, I have to say two things to that. First of all, there seems to be an issue with the data; we think it’s higher than in other developed countries, so it is higher. But, some of the uptick we’ve seen recently is partly due to poor data collection. So, that has been corrected, but it is higher. So why is it higher? We think that has to do with the general health of women in America, so it is a background risk. And, it is partly due to poverty to poor health care during pregnancy, and importantly, poor care after pregnancy, after delivering.
MARGARET BRENNAN: It- the mortality rate among Black mothers is three times higher than white women. Why?
DR. TIEMEIER: That is correct, it is much higher, it is substantially higher. And it is – you must understand that there’s about 700 women dying, during or after labor, or in the first month after delivering 700 per year, and we know that most of these deaths are preventable. And, they indeed occur in minorities more often, and in particular, in Black women. And why that is, is essentially one of the biggest challenges of public health. And, we see that as a top of the iceberg of poor health in women and poor health in Black women. And, there are several reasons there seems to go from poverty to discrimination to poor care for this group of women.
MARGARET BRENNAN: So according to the CDC, nearly 40% of all abortions performed in this country happened among Black women. So in laying out what you did, I would base the assumption that you are projecting that the death rate for these mothers will also climb?
DR. TIEMEIER: I don’t think we have good projections in numbers at the moment, because that will depend on many of the issues, actually, that you’ve touched on before on the legal issues, on the access to abortion in other states. But, we know that abortion occurs and people of poverty and minorities much more often. We know that they have difficulties to access abortion outside the state, so we think it will impact their physical and mental health. How many deaths? Nobody knows. It is very hard. It will- It will- it’s- I wouldn’t want to quantify that. I haven’t put a number. It depends on so many other things, um yeah.
MARGARET BRENNAN: So, you know we looked at Medicaid coverage in this country, it covers about 40% of all births in the country, and the federal government’s trying to get states to take more money to extend maternal health care. So it’s not just cut off at two months, but it goes for longer. So, women can get pelvic exams and they can get other things after they give birth. States like Mississippi aren’t doing that. What’s the consequence if you don’t have access to health care after two months?
DR. TIEMEIER: So, what you’re pointing out now is one of the big issues, and one of the things that could be addressed quickly. There are numerous states, Mississippi is one of them, but don’t forget, Texas is another one and that counts in big numbers that have not expanded, as we say, Medicaid. They have not accepted the Affordable Care Act offer to expand health care to women in the first year, and I would actually say it should go further than that in the first year after delivery. That means that you have very little right and very little coverage. So, only the very, very poor in these states are covered. But a big number of poor women have relatively poor low-income women. Women that struggle to make the time and the money to be insured are not covered for things like mental health, physical checkups, even so, they will not have the pelvic examinations that are needed. You’re right.
MARGARET BRENNAN: So America looks a lot different now than it did in 1973. Brookings says about 40% of U.S. households have women as the prime breadwinner. So I want to ask you how important it is, in your view, from a medical perspective, that women be able to take recovery time after childbirth. Because of course, as you know, in this country, there is no federal guarantee of paid family leave. So if these women have to work to support their family, their jobs in question, essentially, or at least being paid for it.
DR. TIEMEIER: I think this is such an important issue. It’s in a way under-recognized. I know that the Vice President addressed some of this, but it is very important to see that we need many measures to improve maternal health. One of them would be to improve the prenatal care and the other is indeed to improve postnatal care, but also to support families, and in particular, poor, disadvantaged families, buying them time. So, giving them leave; paid leave is very important because having a child is a stress on the system. Imagine you have three children, you have a fourth one, then you need, you know, you’re making a minimum, though you will not manage to- to make your ends meet, you will not find the time to breastfeed. We see that breastfeeding is- is not going up as we wished it would because of this. So I —
MARGARET BRENNAN: –Doctor–
DR. TIEMEIER: –argue yes, and many of my colleagues that we need time.
MARGARET BRENNAN: And we will continue to cover your research. Thank you. We’ll cover those issues on this program as well. I have to leave it there though. So we’ll be back in a moment.
