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Tags health care issues , maternal mortality , Texas issues , Texas politics

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Old 20th August 2016, 01:31 PM   #1
Tony Stark
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Texas has highest maternal mortality rate in developed world, study finds

No way does that have anything to do with the Republican trash that run the state. They are the pro life party!


Quote:

The rate of Texas women who died from complications related to pregnancy doubled from 2010 to 2014, a new study has found, for an estimated maternal mortality rate that is unmatched in any other state and the rest of the developed world.

The finding comes from a report, appearing in the September issue of the journal Obstetrics and Gynecology, that the maternal mortality rate in the United States increased between 2000 and 2014, even while the rest of the world succeeded in reducing its rate. Excluding California, where maternal mortality declined, and Texas, where it surged, the estimated number of maternal deaths per 100,000 births rose to 23.8 in 2014 from 18.8 in 2000 – or about 27%.

...

In the wake of the report, reproductive health advocates are blaming the increase on Republican-led budget cuts that decimated the ranks of Texas’s reproductive healthcare clinics. In 2011, just as the spike began, the Texas state legislature cut $73.6m from the state’s family planning budget of $111.5m. The two-thirds cut forced more than 80 family planning clinics to shut down across the state. The remaining clinics managed to provide services – such as low-cost or free birth control, cancer screenings and well-woman exams – to only half as many women as before.
http://www.theguardian.com/us-news/2...linics-funding

Last edited by Tony Stark; 20th August 2016 at 01:32 PM.
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Old 20th August 2016, 01:35 PM   #2
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Did they establish a causal link between prenatal care and maternal mortality?
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Old 20th August 2016, 01:39 PM   #3
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Old 20th August 2016, 01:40 PM   #4
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Originally Posted by marplots View Post
Did they establish a causal link between prenatal care and maternal mortality?
It is just a total coincidence that the Republican scum slashed the budget for prenatal care and the maternal deaths skyrocketed!
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Old 20th August 2016, 01:48 PM   #5
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Originally Posted by Tony Stark View Post
It is just a total coincidence that the Republican scum slashed the budget for prenatal care and the maternal deaths skyrocketed!
Mortality rates have been trending upwards since 2000 according to the linked article. How does this align with the policies?
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Old 20th August 2016, 01:51 PM   #6
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Originally Posted by marplots View Post
Mortality rates have been trending upwards since 2000 according to the linked article. How does this align with the policies?
You do agree that the explanation is plausible enough to warrant investigation, correct?
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Old 20th August 2016, 01:51 PM   #7
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Originally Posted by marplots View Post
Mortality rates have been trending upwards since 2000 according to the linked article. How does this align with the policies?
The Republican human garbage keep becoming even huger scumbags every year.
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Old 20th August 2016, 01:56 PM   #8
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Originally Posted by tyr_13 View Post
You do agree that the explanation is plausible enough to warrant investigation, correct?
I'm not even sure what the explanation is yet. That's why I was asking for a causal chain.

Originally Posted by Tony Stark View Post
The Republican human garbage keep becoming even huger scumbags every year.
Aha. I made a beginner's error. I didn't note where the thread was posted. It isn't in Science at all, but Social Issues.

My instinct to discuss the science is misplaced in a thread with the sole function of virtue signalling. I shall try harder.

Texas, what a bunch of primitive mother-killers they are! Once again, idealism-driven Republican policies ignore the real world consequences in pursuit of their crazy religious narrative. The power of prayer, my ass!

Better?
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Old 20th August 2016, 01:58 PM   #9
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Originally Posted by marplots View Post
Aha. I made a beginner's error. I didn't note where the thread was posted. It isn't in Science at all, but Social Issues.

My instinct to discuss the science is misplaced in a thread with the sole function of virtue signalling. I shall try harder.

Texas, what a bunch of primitive mother-killers they are! Once again, idealism-driven Republican policies ignore the real world consequences in pursuit of their crazy religious narrative. The power of prayer, my ass!

Better?
That's how it really is.
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Old 20th August 2016, 04:57 PM   #10
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Originally Posted by marplots View Post
I'm not even sure what the explanation is yet. That's why I was asking for a causal chain.



Aha. I made a beginner's error. I didn't note where the thread was posted. It isn't in Science at all, but Social Issues.

My instinct to discuss the science is misplaced in a thread with the sole function of virtue signalling. I shall try harder.

Texas, what a bunch of primitive mother-killers they are! Once again, idealism-driven Republican policies ignore the real world consequences in pursuit of their crazy religious narrative. The power of prayer, my ass!

Better?
This metric is one of the basic measures of how well a health system is functioning. It's like taking a person's temperature. You don't have to know why to know something is wrong.
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Old 20th August 2016, 05:07 PM   #11
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hmmm, any other demographics involved?

I suspect Texas has the highest number of illegals of all the place compared to in the OP. Illegals in fear of being deported not going to the doc? How is the economy for illegals in Texas? Bigger influx of Undocumented coming north for Obamacare?
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Old 20th August 2016, 07:58 PM   #12
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Originally Posted by casebro View Post
hmmm, any other demographics involved?

I suspect Texas has the highest number of illegals of all the place compared to in the OP. Illegals in fear of being deported not going to the doc? How is the economy for illegals in Texas? Bigger influx of Undocumented coming north for Obamacare?
That would make it better? More acceptable?
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Old 20th August 2016, 08:02 PM   #13
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Originally Posted by casebro View Post
hmmm, any other demographics involved?

I suspect Texas has the highest number of illegals of all the place compared to in the OP. Illegals in fear of being deported not going to the doc? How is the economy for illegals in Texas? Bigger influx of Undocumented coming north for Obamacare?
If "illegals" was the cause, then your state would be right up there. California has almost double the number of illegal immigrants as Texas. Yet the maternal mortality rate in CA actually went down over the same period as Texas' skyrocketed.

Hmmm? If only there was some other correlation? El Nino? Continental drift?

It's really rather pathetic. Thailand has no national health program to speak of but because they attacked infant mortality a couple of decades ago, along with that comes "maternal mortality". Thailand has a lower rate of maternal mortality than Texas does.

Guys..... Guys!!!! We are the third world over here.
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Old 20th August 2016, 08:39 PM   #14
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Texas leads the world in something else too: the largest number of stupid *********** yahoos who think that Jeebus is coming back any day now to crush everyone who doesn't believe in him exactly as they do. There is a connection.
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Old 21st August 2016, 03:26 AM   #15
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Originally Posted by a_unique_person View Post
This metric is one of the basic measures of how well a health system is functioning. It's like taking a person's temperature. You don't have to know why to know something is wrong.
There are a few problems with this the research would have to address. First, is it appropriate to separate out Texas (and Texas policies) when the trend is nationwide? Second, how reasonable is it to pull out one aspect of medical care and treat it as a separate, significant entity?

It reminds me a bit of trying to extract climate from weather. They are certainly related, but there are plenty of complex interactions and unknowns. Naturally, without reading the paper, I can't have specific criticisms, just general cautions.
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Old 21st August 2016, 05:43 PM   #16
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Originally Posted by Babbylonian View Post
That would make it better? More acceptable?
Gotta keep the latino population from growing too quickly and since abortions, sexual education and contraceptives aren't acceptable this is the only way.
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Old 21st August 2016, 10:25 PM   #17
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Originally Posted by Tony Stark View Post
Texas has highest maternal mortality rate in developed world, study finds
So?
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Old 21st August 2016, 10:41 PM   #18
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Originally Posted by Cain View Post
So?
I just intercepted an email from the Texas Congressional Bible Thumping White Boy Caucus. It reads,

"It's working!"
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Old 21st August 2016, 11:14 PM   #19
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Originally Posted by marplots View Post
There are a few problems with this the research would have to address. First, is it appropriate to separate out Texas (and Texas policies) when the trend is nationwide? Second, how reasonable is it to pull out one aspect of medical care and treat it as a separate, significant entity?

It reminds me a bit of trying to extract climate from weather. They are certainly related, but there are plenty of complex interactions and unknowns. Naturally, without reading the paper, I can't have specific criticisms, just general cautions.
They separated texas because it *surged* there instead of merely increasing.
To take up your analogy with climate and weather, It is like they excluding measuring station placed on the roof of a coal plant. The surge seem to be correlated with the closing of many many women's clinic in texas. In fact, if I google closing women's clinic, guess which states comes at the top ? The thing is, women which would be bound to have complication and may have chosen an abortion, have less chance (especially if poor) to get an abortion. That alone is a good candidate for a causation.
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Old 21st August 2016, 11:15 PM   #20
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Originally Posted by marplots View Post
Did they establish a causal link between prenatal care and maternal mortality?
What they found is that the (a) the maternal mortality doubled in the space of 4 years, and (b) that this coincided with the closure of many women's health care clinics in the state. Also (c) no other state showed a comparable increase.

Quote:
From 2000 to the end of 2010, Texas’s estimated maternal mortality rate hovered between 17.7 and 18.6 per 100,000 births. But after 2010, that rate had leaped to 33 deaths per 100,000, and in 2014 it was 35.8. Between 2010 and 2014, more than 600 women died for reasons related to their pregnancies.

No other state saw a comparable increase.
Quote:
In 2011, just as the spike began, the Texas state legislature cut $73.6m from the state’s family planning budget of $111.5m. The two-thirds cut forced more than 80 family planning clinics to shut down across the state. The remaining clinics managed to provide services – such as low-cost or free birth control, cancer screenings and well-woman exams – to only half as many women as before.
Quote:
Indeed, the report said it was “puzzling” that Texas’s maternal mortality rate rose only modestly from 2000 to 2010 before doubling between 2011 and 2012. The researchers, hailing from the University of Maryland, Boston University’s school of public health and Stanford University’s medical school, called for further study. But they noted that starting in 2011, Texas drastically reduced the number of women’s health clinics within its borders.
So that's my take on the science. Does this prove causation? Well, I am not a scientist, but the rate doubling would seem to be a statistical outlier. Anyone know how to calculate the number of sigmas for that? And it coincided with the closure of enough health care clinics that the number of patients served statewide was cut in half. And no other state saw a comparable increase.
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Old 22nd August 2016, 01:54 AM   #21
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And this is the same state that tried to introduce bogus laws to restrict access to safe and legal abortion services to "protect women", attempting to hold facilities providing terminations to higher standard than those providing childbirth facilities.
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Old 22nd August 2016, 06:07 AM   #22
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Originally Posted by Puppycow View Post
What they found is that the (a) the maternal mortality doubled in the space of 4 years, and (b) that this coincided with the closure of many women's health care clinics in the state. Also (c) no other state showed a comparable increase.

Quote:
From 2000 to the end of 2010, Texas’s estimated maternal mortality rate hovered between 17.7 and 18.6 per 100,000 births. But after 2010, that rate had leaped to 33 deaths per 100,000, and in 2014 it was 35.8. Between 2010 and 2014, more than 600 women died for reasons related to their pregnancies.

No other state saw a comparable increase.
Quote:
In 2011, just as the spike began, the Texas state legislature cut $73.6m from the state’s family planning budget of $111.5m. The two-thirds cut forced more than 80 family planning clinics to shut down across the state. The remaining clinics managed to provide services – such as low-cost or free birth control, cancer screenings and well-woman exams – to only half as many women as before.
Quote:
Indeed, the report said it was “puzzling” that Texas’s maternal mortality rate rose only modestly from 2000 to 2010 before doubling between 2011 and 2012. The researchers, hailing from the University of Maryland, Boston University’s school of public health and Stanford University’s medical school, called for further study. But they noted that starting in 2011, Texas drastically reduced the number of women’s health clinics within its borders.
So that's my take on the science. Does this prove causation? Well, I am not a scientist, but the rate doubling would seem to be a statistical outlier. Anyone know how to calculate the number of sigmas for that? And it coincided with the closure of enough health care clinics that the number of patients served statewide was cut in half. And no other state saw a comparable increase.
Here are a few things missing from the analysis:
1) Were the deaths preferentially among women who did not receive prenatal care?
2) What is the background rate for maternal mortality?
3) What other measures would we expect to "spike" besides maternal mortality? (Based on other services that were offered.)
4) Were the deaths of a type that prenatal care is known to prevent/lessen? [Same as #8]
5) What else happened in 2010 which might explain the data?
6) Does the "spike" align with a 9-month delay between clinic closure and giving birth?
7) Was there a concomitant rise in states which also lessened prenatal care services (for whatever reason)? (Apparently the pattern didn't show up elsewhere, suggesting that no other states lowered prenatal care availability, is that true?)
8) What are the known connections between prenatal care and maternal mortality? Do those align with what we see?
9) What infant morbidity statistics would we also expect to see with a drop in prenatal care and do we see those too? (Such as spina bifida from a lack of folic acid supplementation.)

#1 is probably the most important for establishing a cause and effect. #5 can be as simple as changing diagnostic criteria and subsequent data categorization - although I doubt the researchers were that sloppy.

Is the actual paper available to look at yet? I have not read it, so my cautions may be unwarranted.

Last edited by marplots; 22nd August 2016 at 06:12 AM.
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Old 22nd August 2016, 06:23 AM   #23
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Originally Posted by marplots View Post
Here are a few things missing from the analysis:
1) Were the deaths preferentially among women who did not receive prenatal care?
2) What is the background rate for maternal mortality?
3) What other measures would we expect to "spike" besides maternal mortality? (Based on other services that were offered.)
4) Were the deaths of a type that prenatal care is known to prevent/lessen? [Same as #8]
5) What else happened in 2010 which might explain the data?
6) Does the "spike" align with a 9-month delay between clinic closure and giving birth?
7) Was there a concomitant rise in states which also lessened prenatal care services (for whatever reason)? (Apparently the pattern didn't show up elsewhere, suggesting that no other states lowered prenatal care availability, is that true?)
8) What are the known connections between prenatal care and maternal mortality? Do those align with what we see?
9) What infant morbidity statistics would we also expect to see with a drop in prenatal care and do we see those too? (Such as spina bifida from a lack of folic acid supplementation.)

#1 is probably the most important for establishing a cause and effect. #5 can be as simple as changing diagnostic criteria and subsequent data categorization - although I doubt the researchers were that sloppy.

Is the actual paper available to look at yet? I have not read it, so my cautions may be unwarranted.

Causation may not be established, but the correlation seems strong enough that increased, even prioritized investigation into that cause as a possibility appears warranted.

Not least because this possibility may be a direct effect of conservative ideology and the pandering to pro-life segments of the electorate by less than honest politicians who cheerfully fabricate obviously false justifications to make such a problem even worse.

Do you disagree than the evidence at hand should be sufficient to prioritize such an investigation?
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Old 22nd August 2016, 06:49 AM   #24
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Originally Posted by quadraginta View Post
Do you disagree than the evidence at hand should be sufficient to prioritize such an investigation?
I don't know. I still haven't seen the evidence at hand - presumably some of what I mentioned previously is available already, it's just not part of the news reports. I haven't read the paper either.

For example, if I find that the doubling is within expected statistical variation within this pool, or I find out that other states which reduced prenatal services did not show a spike, then suddenly the issue, qua issue, evaporates.

If "further investigation" means other researchers taking a look, I'm all for it. If "further investigation" is meant to address a perceived problem, then I'd want to be reassured there is a problem first. Merely citing a rise in some metric isn't enough, is it?

If we want to promote decreased maternal mortality in Texas, I'm all for it. But framing the issue is an important aspect because it's going to drive the solution set sought.

Suppose, for instance, we find out (using existing data) that the rise is caused in part (say 50%) by an uptick in undiagnosed/untreated gestational diabetes. And, to make it stronger, we can credit clinics which do prenatal services with the change. They aren't detecting the disease so it goes untreated. (All this from existing data.) Texas might address this by authorizing some program delivered through hospitals without reconstituting clinic networks. Does all that count as further investigation and a reasonable response?

My point is that we don't have to approach this as dialing back to the status quo ante. Texas wants to reduce abortions. Presumably, Texas doesn't want to kill mothers either. The question is whether a compromise exists between those two objectives and how much the answer we seek depends on the abortion issue, rather than women's health overall.

We have been told that having an abortion is safer than having a baby. Assuming that's so, and Texas still doesn't want abortions, shouldn't we support lessening the risks associated with bringing a fetus to term? I do not favor making women hostages in this game at all, by either side.

The anti-abortion crowd could use the same statistics to show how great the situation is, and I'd reject that as well. They could say something like, X more babies survived (weren't aborted) and only Y more mothers died. Hence, on balance, more lives were saved than lost. The biased framing seems obvious when the side of the issue I am against uses it - it's much harder to detect when the side I support (abortion on demand) does it.

Last edited by marplots; 22nd August 2016 at 06:59 AM.
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Old 22nd August 2016, 09:08 AM   #25
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Originally Posted by marplots View Post
Here are a few things missing from the analysis:
1) Were the deaths preferentially among women who did not receive prenatal care?
2) What is the background rate for maternal mortality?
3) What other measures would we expect to "spike" besides maternal mortality? (Based on other services that were offered.)
4) Were the deaths of a type that prenatal care is known to prevent/lessen? [Same as #8]
5) What else happened in 2010 which might explain the data?
6) Does the "spike" align with a 9-month delay between clinic closure and giving birth?
7) Was there a concomitant rise in states which also lessened prenatal care services (for whatever reason)? (Apparently the pattern didn't show up elsewhere, suggesting that no other states lowered prenatal care availability, is that true?)
8) What are the known connections between prenatal care and maternal mortality? Do those align with what we see?
9) What infant morbidity statistics would we also expect to see with a drop in prenatal care and do we see those too? (Such as spina bifida from a lack of folic acid supplementation.)

#1 is probably the most important for establishing a cause and effect. #5 can be as simple as changing diagnostic criteria and subsequent data categorization - although I doubt the researchers were that sloppy.

Is the actual paper available to look at yet? I have not read it, so my cautions may be unwarranted.
I was unable to find the paper itself so all I could find is various articles in the lay press about the paper. I think you would need to be a subscriber to read the article itself. According to this one however, the mortality rate actually doubled in 2 years which exactly coincides with the closure of 80 clinics:
https://www.texastribune.org/2016/08...lated-deaths-/
Quote:
In 2012, 148 women in Texas died from pregnancy-related complications, including excessive bleeding, obesity-related heart problems and infection. Two years before, 72 women died from those causes.
Quote:
The study mentioned “changes to the provision of women’s health services” — a reference to cuts made by state lawmakers in 2011 that stripped funding from Planned Parenthood and other women’s health and family planning services — but the researchers stopped short of saying whether that policy change had any effect on the numbers.
So in 2010, 72 women died during childbirth, in 2011 the state cut funding by two thirds and 80 clinics closed, and in 2012, 148 women died, more than double.
You just don't see spikes that large in a span of 2 years. It's way out of the norm. So even without all those things, the magnitude of the change and the fact that it corresponds exactly with these huge budget cuts and clinic closures seems to be very compelling evidence all by itself.
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Old 22nd August 2016, 09:46 AM   #26
marplots
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Originally Posted by Puppycow View Post

Quote:
In 2012, 148 women in Texas died from pregnancy-related complications, including excessive bleeding, obesity-related heart problems and infection. Two years before, 72 women died from those causes.
You just don't see spikes that large in a span of 2 years. It's way out of the norm. So even without all those things, the magnitude of the change and the fact that it corresponds exactly with these huge budget cuts and clinic closures seems to be very compelling evidence all by itself.
You have to be careful. Is the spike significant on it's own? Depends on the base rate and other factors - I'll bow to the statisticians here to inform us better.

Causation, however, is trickier. Suppose this wasn't Texas but Florida. And we see a sudden spike in malformed babies - triple or more the base rate. If that spike coincided with legislation affecting prenatal care, we'd be asking the same question - unless we knew about Zika.

That's why you want to know if the clinics closed actually prevented the conditions credited with the uptick: "excessive bleeding, obesity-related heart problems and infection."

If they do, then the case is much stronger.
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Old 22nd August 2016, 10:22 AM   #27
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Why all of the sudden does anyone care about evil, Republican scum mothers in Texas? Surely having an abortion is much safer. Just another thread to bash all Republicans, as if all Republicans think, act, believe and live exactly the same. Meh.
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Old 22nd August 2016, 10:37 AM   #28
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Originally Posted by bytewizard View Post
Why all of the sudden does anyone care about evil, Republican scum mothers in Texas? Surely having an abortion is much safer. Just another thread to bash all Republicans, as if all Republicans think, act, believe and live exactly the same. Meh.
It's a type of Anger Management. Ymmv
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Old 22nd August 2016, 12:36 PM   #29
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Originally Posted by marplots View Post
....
7) Was there a concomitant rise in states which also lessened prenatal care services (for whatever reason)? (Apparently the pattern didn't show up elsewhere, suggesting that no other states lowered prenatal care availability, is that true?)
8) What are the known connections between prenatal care and maternal mortality? Do those align with what we see?
.....

Other states instituted Obamacare about then, should have seen the rate fall. Did they?

Did Obamacare in Texas attract more problem pregnancies?

(eta- could it be related to drug use among the mothers? More crack/meth/alcohol babies? Meantime, the US rate went up 5% )

And FSM, an increase if 76 maternal deaths, out of a 400,000 (???) ? Is that earthshaking to anyone but a Republican basher?
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Old 22nd August 2016, 01:02 PM   #30
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Originally Posted by casebro View Post
Other states instituted Obamacare about then, should have seen the rate fall. Did they?

Did Obamacare in Texas attract more problem pregnancies?

(eta- could it be related to drug use among the mothers? More crack/meth/alcohol babies? Meantime, the US rate went up 5% )

And FSM, an increase if 76 maternal deaths, out of a 400,000 (???) ? Is that earthshaking to anyone but a Republican basher?
Funny who much killing 76 people will be treated as a big deal when they are killed for a political agenda you don't support. Like how people treat less than a dozen cops getting killed as if it were a big deal and a great reason to stop caring about police abusing their authority.

If prenatal care is so pointless why does any insurance company cover it? It clearly has no effect on anything.
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Old 22nd August 2016, 01:53 PM   #31
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Originally Posted by ponderingturtle View Post
Funny who much killing 76 people will be treated as a big deal when they are killed for a political agenda you don't support. Like how people treat less than a dozen cops getting killed as if it were a big deal and a great reason to stop caring about police abusing their authority.

If prenatal care is so pointless why does any insurance company cover it? It clearly has no effect on anything.
Oh yeah, well you are one too- or didn't you want to notice that YOU are blaming MY politics for My opinion? Pot/kettle/black?
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Old 22nd August 2016, 07:24 PM   #32
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Tony, where do you live?
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Old 23rd August 2016, 02:22 AM   #33
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Curious how the jump in maternal mortality coincided with the state pf Texas slashing health care funding for women; women's health advocates (rightly) blame the Republican-led state legislature that gutted Texas' family-planning funding (it was cut by two-thirds, US$73.6M out of US$111.5M in 2011)
The funding cuts forced eighty women's health clinics which had previously provided birth control, cancer screenings, and other services.
But hey it cut spending and they're only women...
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Old 23rd August 2016, 03:20 AM   #34
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Originally Posted by casebro View Post
Oh yeah, well you are one too- or didn't you want to notice that YOU are blaming MY politics for My opinion? Pot/kettle/black?
We can all agree that some people clearly matter and their deaths are important and some simply don't. And apparently most healthcare is a total scam.
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Old 23rd August 2016, 03:24 AM   #35
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Originally Posted by bytewizard View Post
Why all of the sudden does anyone care about evil, Republican scum mothers in Texas? Surely having an abortion is much safer. Just another thread to bash all Republicans, as if all Republicans think, act, believe and live exactly the same. Meh.
Wow, how did you build such a large straw-man?

The thread is about the possible connection between Republican policies and mortality.
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Old 23rd August 2016, 03:44 AM   #36
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Originally Posted by marplots View Post
You have to be careful. Is the spike significant on it's own? Depends on the base rate and other factors - I'll bow to the statisticians here to inform us better.
Yes. If it was a random spike, you could calculate the significance on its own (there are formal out there) but far more importantely, the doubling stayed constant after 2012 e.g. in 2012,2013,2014,2015 you had the double of prior 2011. Naturally if I take my null that the rate should be roughly around 70 with a standard deviation of 20, then the p significance that the null is broken not by accident seem to be less than p=0.0001 (used an unpaired t test).

Quote:
Causation, however, is trickier. Suppose this wasn't Texas but Florida. And we see a sudden spike in malformed babies - triple or more the base rate. If that spike coincided with legislation affecting prenatal care, we'd be asking the same question - unless we knew about Zika.
But in this case we know from historical experience than lack of access to women's clinic lead to increased mother's mortality and increased access lead to some pregnant women at risk choosing abortion. The simple cause effect the reverse way is that a lot of mother which would otherwise abort, don't due to lack of access. It is not as if it was a new causality. (and I would add : FFS it is not new).

Quote:
That's why you want to know if the clinics closed actually prevented the conditions credited with the uptick: "excessive bleeding, obesity-related heart problems and infection."

If they do, then the case is much stronger.
See above.

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Old 23rd August 2016, 03:57 AM   #37
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"Prenatal care can help keep you and your baby healthy. Babies of mothers who do not get prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do get care."

http://womenshealth.gov/publications...atal-care.html

So that would seem to give some indication that prenatal care like what Texas massively cut does have an effect on maternal mortality. Of course I expect to see arguments that this is all government lies next.
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Old 23rd August 2016, 07:26 AM   #38
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Originally Posted by ponderingturtle View Post
"Prenatal care can help keep you and your baby healthy. Babies of mothers who do not get prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do get care."

http://womenshealth.gov/publications...atal-care.html

So that would seem to give some indication that prenatal care like what Texas massively cut does have an effect on maternal mortality. Of course I expect to see arguments that this is all government lies next.
Two different stats - mom v. baby. But I'm surprised the reports haven't been about increased infant mortality or morbidity. Those are stats I would expect to jump up without proper prenatal care. It could be the data was harder to track or just wasn't part of the study.
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Old 23rd August 2016, 08:00 AM   #39
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Originally Posted by marplots View Post
Two different stats - mom v. baby. But I'm surprised the reports haven't been about increased infant mortality or morbidity. Those are stats I would expect to jump up without proper prenatal care. It could be the data was harder to track or just wasn't part of the study.
Well the idiots at the World health organization seem to think that health care can reduce maternal morality rates, but that is all lies I am sure.

http://www.who.int/mediacentre/factsheets/fs348/en/

The trick is stopping thinking of texas as part of the developed world. It really is a pretty decent third world nation.
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Old 23rd August 2016, 08:45 AM   #40
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Originally Posted by marplots View Post
You have to be careful. Is the spike significant on it's own? Depends on the base rate and other factors - I'll bow to the statisticians here to inform us better.

Causation, however, is trickier.
Indeed. From the article:

"At the same time, Texas eliminated all Planned Parenthood clinics – whether or not they provided abortion services – from the state program that provides poor women with preventive healthcare. Previously, Planned Parenthood clinics in Texas offered cancer screenings and contraception to more than 130,000 women."

Cancer screenings and contraception. Neither of these things is prenatal care. Why would they significantly impact maternal mortality rates? The women at most risk of cancer are older, and not likely to be pregnant, so that impact should be negligible. A lack of contraception may increase pregnancy rates among vulnerable populations, but in order to double the mortality rate, you would have to more than double the pregnancy rate among such a population. That would be quite remarkable, and I would expect evidence of such an increased pregnancy rate to be easy to find if it's responsible. So did such a rise occur?

A doubling of the maternal mortality rate is definitely something to be concerned about, but without evidence for the cause (and this study doesn't provide any), it's illogical to simply try to blame your political opponents. Not only is that unfair, but if something else is responsible (like the spread of an infectious disease), then attacking the wrong cause can get people killed.
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