Dr. Carla Ortique, chair of Texas’ maternal mortality review committee, speaking at The Texas Tribune Festival in Austin on Sept. 29, 2018. Credit: Thomas Meredith for The Texas Tribune
June 26, 2024 Story by: Editor
The chair of Texas’ maternal mortality review committee voiced concerns Tuesday regarding recent changes to the committee’s structure. Notable changes include the removal of the community advocate position by the Legislature and the recent appointment of an anti-abortion doctor by the Department of State Health Services commissioner. During Tuesday’s meeting, members expressed appreciation for the work of Nakeenya Wilson, the former community advocate, and discussed the potential implications of these changes.
“As I sat and listened to the roll call today, it was abundantly apparent that greater than 90% of our members now hold doctoral-level degrees,” said Dr. Carla Ortique, the committee chair. “This is a cause for concern.”
Ortique emphasized the importance of having community representation in maternal mortality discussions, stating, “It is rarely possible for those who sit in positions of privilege to truly be the voice of at-risk communities. We can and should at all times be voices that support and attempt to foster positive change. We can be trusted allies. However, we cannot truly be their voice.”
She urged the committee to find ways to include the experiences of Black women, uninsured women, and others with limited access to maternal health care. Dr. Carey Eppes, a maternal-fetal medicine specialist, praised Wilson’s contributions, saying, “Her contributions have been invaluable and I have learned a lot from working with her.”
Ortique reminded the committee that the Legislature and the commissioner of the Department of State Health Services determine the committee’s composition. She stressed the importance of respecting the appointment process despite personal beliefs.
Ortique also expressed concerns about Texas potentially withdrawing from a federal maternal death data system. Currently, Texas, like most states, uses the CDC’s Maternal Mortality Review Information Application (MMRIA) system. However, the Legislature has allocated nearly $6 million to develop a state-level program, which could lead to Texas leaving the federal system. Ortique highlighted the benefits of national collaboration, noting, “Participating in the national system allows Texas to efficiently and effectively review cases and contribute to the national conversation about maternal deaths.”
Despite widespread attention on the appointment of Dr. Ingrid Skop, an anti-abortion OB/GYN, only one person commented during the public session. Midwife Dinah Waranch criticized the committee for its perceived timidity, saying, “It seems the committee is both imprisoned by its insider perspective and at the mercy of cruel political forces. Partisanship, the politics of abortion, and institutional rigidity are anathema to bringing the changes that must happen to save lives.”
Dr. Ingrid Skop, appointed last month, serves as vice president and medical director at the Charlotte Lozier Institute, an anti-abortion advocacy group. Her appointment has raised concerns about bias in the committee’s work. Ortique reassured that the committee’s focus remains on addressing maternal health disparities, especially for Black women, through science and public health standards.
Ortique emphasized the committee’s commitment to maintaining a diverse and unbiased review process, saying, “We will continue to strive for standardization of the review process and application of a public health equity lens to guide our deliberations.”
The committee has expanded from 15 to 23 members, replacing the community advocate position with two new roles for community members with healthcare experience, representing urban and rural areas. Nakeenya Wilson, the former community advocate, applied for the new urban position but was not selected. Instead, Dr. Meenakshi Awasthi, a pediatric emergency medicine fellow, and Dr. Ingrid Skop were appointed.
The committee’s future remains uncertain as it navigates these structural changes and the potential shift away from federal maternal health data systems. Source: The Texas Tribune
