Transcript: Dr. Henning Tiemeier on “Face the Nation”, July 3, 2022

The following is a transcript of an interview with Dr. Henning Tiemeier of Harvard University which aired on “Face the Nation” on Sunday, July 3, 2022.

MARGARET BRENNAN: According to the Gates Foundation, the maternal death rate here is higher than in any other developed country, and the abolition of federal protections for abortion rights only underscores that reality and the risks that lie ahead. dr. Henning Tiemeier is the director of the Maternal Health Task Force at Harvard University, and he’s joining us now. Good morning, doctor.

Dr. HENNING TIEMEIER: Hello Margaret, and good morning.

MARGARET BRENNAN: Morning- I think this is incredibly important because I want to put the issue of abortion itself aside for a moment and talk about pregnancy in America as these states are rewriting these laws. So, how is it possible that we have the highest maternal mortality rate in the richest country in the world, and how do we keep it from getting worse?

Dr. TIEMEIER: Well, I must say two things to that. First of all, there seems to be a problem with the data; we think it’s higher than other developed countries, so it’s higher. But part of the increase we’ve seen recently is partly due to poor data collection. So that has been corrected, but it is higher. So why is it higher? We think that has to do with the general health of women in America, so it’s a background risk. And it’s partly due to poverty from poor health care during pregnancy, and more importantly, poor care after pregnancy, after childbirth.

MARGARET BRENNAN: The death rate among black mothers is three times higher than among white women. Why?

Dr. TIEMEIER: That’s right, it’s much higher, it’s considerably higher. And it’s — you have to understand that about 700 women die, either during or after childbirth, or in the first month after delivery, 700 a year, and we know that most of these deaths are preventable. And they are indeed more common among minorities, especially black women. And why that is is essentially one of the greatest public health challenges. And we see that as the tip of the iceberg of ill health in women and ill health in black women. And there are several reasons why there seems to be a shift from poverty to discrimination to poor care for this group of women.

MARGARET BRENNAN: So according to the CDC, nearly 40% of all abortions in this country were among black women. So in explaining what you did, I would base the assumption that you are projecting that the death rate for these mothers will also rise?

Dr. TIEMEIER: I don’t think we have good forecasts in numbers right now, because that depends on a lot of the issues that you’ve touched on before about the legal issues, about access to abortion in other states. But we know that abortion is much more common and people from poverty and minorities. We know they have difficulties accessing out-of-state abortion, so we think it will have an impact on their physical and mental health. How many dead? Nobody knows. It is very difficult. It will- It will- it’s- I wouldn’t quantify that. I didn’t put a number. It depends on so many other things, uh yeah.

MARGARET BRENNAN: So, you know, we looked at Medicaid coverage in this country, it covers about 40% of all births in the country, and the federal government is trying to get states to take more money to fund maternal health care. expand. So it’s not only cut off from two months, but it lasts longer. So women can get pelvic exams and they can get other things after they give birth. States like Mississippi don’t. What happens if you don’t have access to healthcare after two months?

Dr. TIEMEIER: So what you’re pointing out now is one of the big problems and one of the things that can be addressed quickly. There are countless states, Mississippi is one of them, but remember, Texas is another and that counts in great numbers that have not expanded, as we say, Medicaid. They have not accepted the Affordable Care Act’s offer to expand health care for women in the first year, and I would actually say it should go beyond that in the first year after childbirth. That means you have very little entitlement and very little coverage. So only the very, very poor in these states are covered. But a large number of poor women have relatively poor, low-income women. Women who struggle to earn the time and money to be insured aren’t covered for things like mental health, physical checkups, and yet they won’t have the pelvic exams needed. You’re right.

MARGARET BRENNAN: So America looks a lot different now than it did in 1973. Brookings says about 40% of American households have women as the primary breadwinner. That is why I would like to ask you how important you think it is medically that women can recover after childbirth. Because of course, as you know, there is no federal guarantee for paid family leave in this country. So if these women have to work to essentially support their family, their job in question, or at least get paid for it.

Dr. TIEMEIER: I think this is such an important issue. It is somehow underrecognized. I know the Vice President has said something about this, but it’s very important to see that we need a lot of measures to improve maternal health. One would be to improve prenatal care and the other is indeed to improve postnatal care, but also to support families, especially poor, disadvantaged families, by giving them time. So, give them leave; Paid leave is very important because having a child is a burden on the system. Imagine you have three kids, you have a fourth, then you know, you earn a minimum, though you can’t make ends meet, you won’t find time to breastfeed. We see that breastfeeding is not going the way we would like. So I —


Dr. TIEMEIER: — yes, and many of my colleagues argue that we need time.

MARGARET BRENNAN: And we will continue to deal with your inquiry. Thank you. We will also address those issues in this program. However, I have to leave it at that. So we’ll be right back.