Rising U.S. maternal mortality rates were a major story in 2019. As AJN reported, the number of women dying during or after pregnancy has been increasing for at least two decades; the United States today has the highest maternal mortality rate compared with other high-income countries. Pregnancy is especially dangerous for women of color; in an analysis of maternal deaths between 2013 and 2017, black women were three times more likely to die from pregnancy-related complications than white women, according to the Centers for Disease Control and Prevention, which also concluded that 60% of the deaths were preventable. The Joint Commission is releasing new standards, effective July 1, to address the maternal mortality crisis. Accredited hospitals will be required to implement 13 policies to reduce the likelihood of hemorrhage and severe hypertension in pregnant patients.
The past year also saw several states pass legislation that would significantly curtail women's access to abortion services. Nine states passed "gestational" bans, which outlaw abortion past a certain point in pregnancy, such as once a fetal heartbeat is detected. To date, lower courts have blocked these "heartbeat" bans, some of which outlaw abortion as early as six weeks after conception. The strictest was Alabama's, which would permit abortion only to save a woman's life and criminalize it for any other reason, with prison sentences of up to 99 years. A federal judge blocked the Alabama law last October.
Despite the lower court actions, states such as Pennsylvania and South Carolina are considering similarly restrictive legislation. And Alabama and other states whose abortion laws have been blocked are intent on advancing their cases to the Supreme Court in order to challenge precedents, including the landmark 1973 case, Roe v. Wade, which prohibited restrictions on abortion before fetal viability.
The Supreme Court has agreed to hear the case of a Louisiana law requiring abortion providers to have admitting privileges at local hospitals. If enacted, the law could make Louisiana the first state without legal abortion access because only two abortion providers have the required admitting privileges, and neither is likely to remain in practice if the law is upheld, according to news reports. Critics of the Louisiana law also worry that more states will pass such regulations, which don't directly challenge abortion rights but do effectively limit access, especially in rural areas.
Meanwhile, Arkansas, Idaho, Kentucky, Nebraska, North Dakota, Oklahoma, Utah, and, most recently, Ohio, are considering bills that would require physicians to counsel women thinking of using medication to induce an abortion about so-called "reversal" treatment, which consists of varying doses of progesterone. Many medical experts say there's no evidence that progesterone does anything to reverse chemical abortion, and the procedure has faced criticism from the American College of Obstetricians and Gynecologists, the American Medical Association, and the American Civil Liberties Union.-Amy M. Collins, managing editor