Pregnancy Is Not a Benign Event

Late last week, researchers announced that the already high maternal mortality rate in the U.S. hit its highest level since 1965. The number of people who died during or shortly after pregnancy increased a staggering 40 percent from 2020 to 2021, marking the third year in a row the maternal mortality rate had increased in this country. And that was before the Supreme Court overturned Roe v. Wade—though abortion was effectively banned in Texas for the last four months of 2021.

I was already thinking about these dire numbers, and how more forced pregnancies will mean more women dying, when I read the story of Krystina Pacheco, a Texas woman who had her hands and feet amputated due to a life-threatening infection she developed after a C-section.

Pacheco, 29, didn’t have a miscarriage and wasn’t denied an abortion—she had what she called an “uneventful” C-section in late October 2022. But she started feeling feverish two days later, the day she was discharged, and a nurse gave her ibuprofen. She kept feeling sick and saw a doctor, who sent her to the ER. From there she was airlifted to a different hospital where doctors diagnosed her with septic shock. That’s the most dangerous stage of sepsis, in which the body has an extreme reaction to an infection, and it can lead to tissue damage, organ failure, and death. Sepsis is the second leading cause of pregnancy-related death, according to the Centers for Disease Control and Prevention.

She stayed in the ICU for two weeks and was put on an ECMO machine to let her heart and lungs heal. Doctors said she had a 20 percent chance of surviving and she miraculously did, but ECMO can reduce blood flow to the limbs and it damaged her hands and feet so badly that she needed all four of her extremities amputated. After three months in the hospital, multiple skin grafts, and several weeks in a rehabilitation center, Pacheco only recently went home to her husband and two children.

What was left out of much of the coverage about these mortality rates was that severe complications from birth—people who almost die—vastly outnumber actual deaths. The CDC has noted for years that for every person who dies from pregnancy, another 70 women come close. In previous years, that’s meant about 50,000 people. But in 2021, when more than 1,200 women died, that means about 84,000 women almost died. (And the CDC doesn’t count homicide when it tallies the maternal mortality rate, even though homicide—often at the hands of a partner—is the leading cause of pregnancy-related deaths, moreso than any health problems.)

The experiences of women like Pacheco underscore that pregnancy is not a benign event. As Erin Gloria Ryan recently wrote in Jezebel, “Pregnancy is cool and miraculous, and it’s fantastic that our bodies can do it—but carrying a pregnancy to term is also something that could literally kill you and at the very least will change your body permanently.” Thousands of pregnant people will experience serious medical complications and will try to recover, all while facing massive medical bills.

What happened to Pacheco is rare, yes, but sepsis and other complications can happen to any birthing person. And while I don’t know anything about Pacheco’s views on abortion, these are the kinds of health risks that six Supreme Court justices and countless lawmakers are forcibly subjecting people to.

Weeks after the fall of Roe, Nisha Verma, an OB/GYN in Georgia and a fellow with Physicians for Reproductive Health, shared her concerns about more people having to stay pregnant in a country where pregnancy already harms and kills so many. “We are going to see people die and have terrible outcomes from this,” Verma told Jezebel in July. “More people carrying pregnancies to term and delivering…there’s risk in that.”

It’s one thing to take these risks if you want children, but it’s entirely another if you were forced to continue a pregnancy. “If someone chooses to continue their pregnancy, knowing they have a high-risk condition [like high blood pressure], that is completely fine and we are all there to support them and to optimize their health,” Verma said. But many people can’t access abortion, so in “many cases, it’s not even a choice. And that’s just going to get worse and worse.”