Texas Has the Highest Maternal Mortality Rate in the Developed World. Why?

I've seen this story reported roughly a bajillion times, with very little context.

(1) The study chose to adjust official numbers for Texas (and other states) rates because death certificates didn't inquire about pregnancy for a full year previous to death. This isn't necessarily wrong, but it is a guess.

(2) There were 15-20 maternal deaths per 100,000 live births in Texas each year 2000-2010. Then the rate almost doubled by 2012. [1] Something very interesting (whether in methodology or reality) happened in that time, but most news outlets just want to tell the narrative without the details.

(3) Texas has 400k births per year. [2] Twenty deaths per 100k births is 80 deaths. Statistically, p=0.05 is going to give you something like +-50% on that number. Do this for fifty states, and you've got some serious reporting bias.

(4) But even using the adjusted numbers for Texas, this is 1% of 1% for cause of death. My wife gives birth next month (in the U.S., not in Texas); I'm nervous about it. But there's a lot of other things to worry about.

[1] http://www.politifact.com/texas/statements/2017/jun/29/shawn...

[2] https://www.dshs.texas.gov/chs/vstat/vs14/t09.aspx

I think the main problem is the medical guild exterminated midwifery in the early 20th century and "medicalized" women's normal pregnancy experiences. Doctors are doing better taking care of pregnant women in the modern era (more female doctors, etc), but I think they're still 'missing the forest for the trees'.

This was my comment on this general topic from a month ago: https://news.ycombinator.com/item?id=14708472

Violence is never the answer, statistics is.