The number of women in Texas who died while pregnant, during labor or soon after childbirth skyrocketed following the state’s 2021 ban on abortion care — far outpacing a slower rise in maternal mortality across the nation, a new investigation of federal public health data finds.

From 2019 to 2022, the rate of maternal mortality cases in Texas rose by 56%, compared with just 11% nationwide during the same time period, according to an analysis by the Gender Equity Policy Institute. The nonprofit research group scoured publicly available reports from the Centers for Disease Control and Prevention and shared the analysis exclusively with NBC News.

“There’s only one explanation for this staggering difference in maternal mortality,” said Nancy L. Cohen, president of the GEPI. “All the research points to Texas’ abortion ban as the primary driver of this alarming increase.”

“Texas, I fear, is a harbinger of what’s to come in other states,” she said.

The SB 8 effect

The Texas Legislature banned abortion care as early as five weeks into pregnancy in September 2021, nearly a year before the U.S. Supreme Court overturned Roe v. Wade — the case that protected a federal right to abortion — in June 2022.

At the time, Texas Gov. Greg Abbott, a Republican, lauded the bill as a measure that “ensures the life of every unborn child.”

Texas law now prohibits all abortion except to save the life of the mother.

The passage of Texas’ Senate Bill 8 gave GEPI researchers the opportunity to take an early look at how near-total bans on abortion — including cases in which the mother’s life was in danger — affected the health and safety of pregnant women.

The SB 8 effect, Cohen’s team found, was swift and stark. Within a year, maternal mortality rose in all racial groups studied.

Among Hispanic women, the rate of women dying while pregnant, during childbirth or soon after increased from 14.5 maternal deaths per 100,000 live births in 2019 to 18.9 in 2022. Rates among white women nearly doubled — from 20 per 100,000 to 39.1. And Black women, who historically have higher chances of dying while pregnant, during childbirth or soon after, saw their rates go from 31.6 to 43.6 per 100,000 live births.

While maternal mortality spiked overall during the pandemic, women dying while pregnant or during childbirth rose consistently in Texas following the state’s ban on abortion, according to the Gender Equity Policy Institute.

“If you deny women abortions, more women are going to be pregnant, and more women are going to be forced to carry a pregnancy to term,” Cohen said.

Beyond the immediate dangers of pregnancy and childbirth, there is growing evidence that women living in states with strict abortion laws, such as Texas, are far more likely to go without prenatal care and much less likely to find an appointment with an OB-GYN.

Doctors say the feeling among would-be moms is fear.

“Fear is something I’d never seen in practice prior to Senate Bill 8,” said Dr. Leah Tatum, an OB-GYN in private practice in Austin, Texas. Tatum, who was not involved with the GEPI study, said that requests for sterilization procedures among her patients doubled after the state’s abortion ban.

That is, women prefer to lose their ability to ever have children over the chance that they might become pregnant following SB 8.

“Patients feel like they’re backed into a corner,” Tatum said. “If they already knew that they didn’t want to pursue pregnancy, now they’re terrified.”

Tatum said she’s seeing many women in their late 30s and 40s who, even though they’d like to have a child, worry they wouldn’t have an option to end the pregnancy if it turned out that the baby wouldn’t be born healthy. “‘What happens if I end up with a genetically abnormal fetus?’” Tatum said her patients have asked her. They worry their options are limited, she said.

‘Treated like a criminal’

That unthinkable tragedy happened to Kaitlyn Kash, 37, of Austin, Texas.

Kash had a textbook pregnancy with her first child, a healthy little boy, born in 2018.

“It’d been so easy the first time,” she said. “Never in my wildest dreams did I think we would go down the journey that we went down.”

When she became pregnant again, it wasn’t until Kash’s second trimester, at 13 weeks, that she and her husband, Cory, discovered that their fetus had severe skeletal dysplasia, a rare genetic disorder affecting bone and cartilage growth. It was highly unlikely the baby would survive.

“We were told that his bones would break in utero and he would suffocate at birth,” Kash said. “We were expecting our doctor to tell us how we were going to care for our baby, how we were going to end his pain.”

It was October 2021, just a month after Texas passed the SB 8 abortion law.

“We were told that we should get a second opinion, but make sure that it was outside of Texas,” she said.

At 15 weeks, Kash had to travel to Kansas to terminate her doomed pregnancy. Outside the medical clinic, protesters harassed the grief-stricken mom.

“I was being treated like a criminal,” she said. “I didn’t get the dignity that I deserved to say goodbye to my child.”

“It’s just another example of how it’s heartbreaking to practice in the state of Texas,” Tatum said. “These patients are asking for help. The state of Texas has failed women.”