Table 4.
Weighted rates of severe maternal morbidity and mortality among Medicaid-paid pregnancy-related hospitalizations in 43 states from 2000–2011, overall and stratified by state Medicaid coverage of medically necessary abortion
| Severe maternal morbidity | Overall | State with Coverage of Medically Necessary Abortion | State without Coverage of Medically Necessary Abortion | |||
|---|---|---|---|---|---|---|
| Weighted n | rate per 10,000 (95% CI) | Weighted n | rate per 10,000 (95% CI) | Weighted n | rate per 10,000 (95% CI) | |
| Diagnosis Codes | ||||||
| Disseminated intravascular coagulation | 30,670 | 19.5 (18.0,21.0) | 10,859 | 17.4 (15.9,18.7) | 19,811 | 20.9 (18.7,23.2) |
| Heart failure during procedure or surgery | 29,178 | 18.6 (16.9,20.2) | 11,004 | 17.6 (15.9,19.3) | 18,174 | 19.2 (16.8,21.6) |
| Eclampsia | 16,262 | 10.4 (9.7,11.0) | 5,749 | 9.2 (8.5,9.9) | 10,513 | 11.1 (10.1,12.1) |
| Adult respiratory distress syndrome | 10,235 | 6.5 (6.1,6.9) | 3,661 | 5.9 (5.3,6.4) | 6,574 | 6.9 (6.4,7.5) |
| Acute renal failure | 6,829 | 4.3 (4.0,4.7) | 2,613 | 4.2 (3.7,4.7) | 4,216 | 4.5 (4.0,4.9) |
| Sepsis | 5,870 | 3.7 (3.5,4.0) | 2,400 | 3.8 (3.5,4.2) | 3,470 | 3.7 (3.3,4.0) |
| Puerperal cardiovascular disorders | 4,928 | 3.1 (2.9,3.4) | 2,014 | 3.2 (2.9,3.6) | 2,914 | 3.1 (2.7,3.4) |
| Shock | 4,623 | 2.9 (2.7,3.2) | 2,066 | 3.3 (2.9,3.7) | 2,557 | 2.7 (2.4,3.0) |
| Severe anesthesia complications | 2,985 | 1.9 (1.7,2.0) | 1,308 | 2.1 (1.8,2.4) | 1,677 | 1.8 (1.6,1.9) |
| Thrombotic embolism | 2,951 | 1.9 (1.7,2.1) | 1,156 | 1.9 (1.6,2.2) | 1,795 | 1.9 (1.6,2.1) |
| Pulmonary edema | 2,659 | 1.7 (1.4,2.0) | 1,023 | 1.6 (1.1,2.2) | 1,636 | 1.7 (1.5,1.9) |
| Sickle cell anemia with crisis | 2,145 | 1.4 (1.1,1.6) | 756 | 1.2 (0.9,1.5) | 1,389 | 1.5 (1.1,1.9) |
| Internal injuries of thorax, abdomen, and pelvis | 1,405 | 0.9 (0.7,1.0) | 445 | 0.7 (0.5,0.9) | 960 | 1.0 (0.8,1.2) |
| Cardiac arrest or ventricular fibrillation | 1,164 | 0.7 (0.6,0.8) | 401 | 0.6 (0.5,.07) | 763 | 0.8 (0.7,0.9) |
| Amniotic fluid embolism | 668 | 0.4 (0.4,0.5) | 281 | 0.5 (0.3,0.6) | 387 | 0.4 (0.3,0.5) |
| Acute myocardial infarction | 373 | 0.2 (0.2,0.3) | 169 | 0.3 (0.2,0.4) | 204 | 0.2 (0.1,0.3) |
| Aneurysm | 210 | 0.1 (0.01,0.2) | 81 | 0.1 (0.01,0.2) | 129 | 0.1 (0.01,0.2) |
| Intracranial injuries | 211 | 0.1 (0.01,0.2) | 45 | 0.1 (0.01,0.1) | 166 | 0.2 (0.01,0.2) |
| Procedure Codes | ||||||
| Hysterectomy | 11,986 | 7.7 (7.1,8.2) | 4,942 | 7.9 (7.0,8.8) | 7,044 | 7.4 (6.6,8.2) |
| Ventilation | 11,030 | 7.0 (6.6,7.4) | 4,483 | 7.2 (6.6,7.8) | 6,546 | 6.9 (6.4,7.5) |
| Operations on heart and pericardium | 10,322 | 6.6 (6.1,7.1) | 3,664 | 5.9 (5.2,6.5) | 6,658 | 7.0 (6.5,7.7) |
| Cardio monitoring | 7,549 | 4.8 (1.4,8.2) | 4,321 | 6.9 (1.7,12.1) | 3,228 | 3.4 (1.0,7.8) |
| Conversion of cardiac rhythm | 1,169 | 0.7 (0.6,0.8) | 519 | 0.8 (0.7,1.0) | 650 | 0.7 (0.5,0.8) |
| Temporary tracheostomy | 409 | 0.2 (0.2,0.2) | 120 | 0.2 (0.1,0.2) | 289 | 0.3 (0.2,0.4) |
| Any severe maternal morbidity | 104,550 | 66.6 (62.3,70.8) | 38,902 | 62.4 (56.7,68.0) | 65,648 | 69.3 (63.4,75.2) |
| In-hospital mortality | 1,423 | 0.9 (0.8,1.0) | 584 | 0.9 (0.8,1.0) | 839 | 0.9 (0.7,1.0) |
| Any morbidity or mortality | 105,260 | 67.0 (62.8,71.2) | 39,228 | 62.9 (57.2,68.6) | 66,033 | 69.7 (63.8,75.6) |
Notes: Severe maternal morbidity defined by the presence of ICD-9-CM diagnosis or procedure codes recorded in the hospitalization record. States with Medicaid coverage of medically necessary abortion are: AK, CA, CT, HI, IL MA, MD, MT, NJ, NM, NY, OR, VT. States without Medicaid coverage of medically necessary abortion are: AR, AZ, CO, FL, GA, IA, IN, KS, KY, LA, ME, MI, MO, MS, NC, NE, NH, NV, OK, PA, RI, SC, SD, TN, TX, UT, VA, WI, WY.