ProPublica’s most recent attempt to blame pro-life laws for pregnancy complications points to an alleged increase in the sepsis rate among Texas women who experienced pregnancy loss in the second trimester, following the enactment of the state’s Heartbeat Act in 2021. To build the report, four article authors at ProPublica claim they purchased and analyzed seven years of discharge data from Texas hospitals, but failed to share their sources or raw data with readers.
The report leaves numerous unanswered questions about what may have actually caused a spike in sepsis rates connected to pregnancy loss.
In its report, ProPublica claimed that sepsis was more “pronounced” in women whose preborn babies still had heartbeats when they arrived at the hospital. Though several doctors told ProPublica that the “only explanation” could be the state’s pro-life law, this is unlikely.
At a Glance:
- ProPublica was not transparent with the data, failing to link to it or share the methodology it used so that the data could be properly analyzed.
- The report ignored additional factors that could cause an increase — or even the appearance of an increase — in sepsis cases.
- Rising sepsis rates are occurring across the nation. It is not a problem exclusive to Texas or other pro-life states.
- The abortion pill comes with a black box sepsis warning and women who take it in pro-life states are advised to lie to emergency room doctors saying they are experiencing a natural miscarriage when they have complications from the abortion pill.
- The Modern Early Warning System has helped doctors identify and diagnose sepsis more quickly and more often than in previous years, leading to an increase in the number of sepsis cases and a decrease in sepsis-related deaths. Texas began to implement the warning system in late 2019.
Lack of transparency
Sepsis is the body’s extreme response to an infection and can cause shock, organ failure, and death if it is not treated immediately. Maternal sepsis is a nationwide problem and is a leading cause of death for pregnant women — even in states without abortion restrictions — accounting for 261,000 deaths annually. According to the Centers for Disease Control and Prevention (CDC), sepsis caused almost 13% of pregnancy-related deaths in the U.S. between 2011 and 2013. So, while ProPublica focused its efforts on Texas, sepsis is not a problem exclusive to Texas.
According to the Sepsis Alliance, “The number of cases of maternal sepsis is increasing. One study of the National Inpatient Sample, a national database, reported a 10% annual increase in cases of maternal severe sepsis and sepsis-related deaths in the U.S. between 1998 and 2008.”
ProPublica claimed that in “a first-of-its-kind data analysis,” it found that after the Heartbeat Act went into effect in Texas, the “rate of sepsis shot up more than 50% for women hospitalized when they lost their pregnancies in the second trimester.” To determine this, the outlet claims to have purchased and reviewed hospital discharge data and identified the hospitalizations that included miscarriages, abortions, and births from 13 weeks through 22 weeks gestation. However, it was not transparent with the data, failing to link to it or share the methodology it used so that the data could be properly analyzed.
As Charlotte Lozier scholar Michael New wrote on X, “It purportedly shows that pro-life policies have led to an increase in sepsis cases. There is less here than meets the eye.”
(1/8) Pro-life friends, here are some comments on the @propublica piece.
It purportedly shows that pro-life policies have led to an increase in Sepsis cases.
There is less here than meets the eye.
— Michael New (@Michael_J_New) February 20, 2025
‘There is no enormous surge in sepsis’
According to ProPublica’s analysis, in Texas, sepsis rates rose dramatically for pregnant women whose preborn babies had not already died upon admission to the hospital. It wrote, “In 2021, 67 patients who lost a pregnancy in the second trimester were diagnosed with sepsis — as in the previous years, they accounted for about 3% of the hospitalizations. In 2022, that number jumped to 90. The following year, it climbed to 99.”
These 99 allegedly accounted for 4.9% of hospitalizations involving pregnancy loss between 13 weeks and 22 weeks. But, New noted that hospitalizations involving pregnancy “actually fell by 9.3% after the pro-life laws took effect. This positive health outcome is ignored [by ProPublica].”
He added, “Taking their data at face value, since the TX Heartbeat Act took effect, the average annual increase in sepsis cases [involving pregnancy loss] was 28,” said New. “Sepsis is a serious issue. But there has not been an enormous surge in sepsis cases involving pregnancy loss.”
He added, “[T]here are nearly 400,000 babies born in Texas every year. As such, about 1 in every 14,000 pregnancies involve sepsis.”
ProPublica ignored additional factors
If sepsis rates did rise in Texas, there are several other possible explanations for any increase in sepsis among pregnant women, regardless of a state’s pro-life laws.
Live Action Research Fellow Carole Novielli explained, “Correlation does not equal causation, and a review of the data, the individual cases, as well as the way in which each physician and hospital handled them, should be reviewed — but trusting ProPublica to conduct that review would be irresponsible as they are on a crusade to undo all protections in the state of Texas.”
ProPublica has admitted that in collecting and analyzing data, it has an agenda — to discredit and blame pro-life laws for maternal injuries and deaths. So far, it has utilized questionable tactics to make its claims; for example, it has chosen to only look for pregnancy-related deaths and injuries in states with abortion restrictions, without comparing them to states without abortion restrictions.
Likewise, Dr. Ingrid Skop, board-certified Texas OB/GYN and Senior Fellow and Director of Medical Affairs for Charlotte Lozier Institute, explained in a thread on X:
Texas law clearly allows intervention to protect the life of a mother in a pregnancy emergency.
When a woman is suffering from an incomplete or inevitable second trimester miscarriage, as discussed in ProPublica’s article, there is an increased risk of sepsis if delays in delivery occur, which is a serious complication.
The Texas Supreme Court has affirmed that the threat need not be “immediate” nor the diagnosis “certain” before a doctor can act. The Texas Medical Board also reiterated the point about “imminence” in guidance provided to physicians in July 2024.
To assert otherwise implies a lack of obstetric understanding or pro-abortion motivation. The physicians interviewed by ProPublica made it clear their goal isn’t to prevent confusion, but rather, to overturn these laws so women have the “option to terminate pregnancies for health considerations, regardless of whether it’s an emergency.”
Texas law does not prevent physicians from acting quickly to prevent sepsis in women experiencing a miscarriage.
Allow me to explain: https://t.co/sryUuVnfzE
— Ingrid Skop MD (@docskop) February 21, 2025
In addition, New Mexico malpractice attorney Mike Seibel explained to Live Action News, “The data [presented in ProPublica’s article] just does not support the conclusion that this is related to pro-life laws. There are a variety of other factors which could increase the number of sepsis cases in the maternal population. We have seen a long term increase in sepsis cases nationally since 2016 among all populations. Furthermore, the Modern Early Obstetric Warning Systems has assisted in identifying and diagnosing sepsis more often in hospital systems. All of these factors make the ProPublica article mere speculation.”
Increased rates of sepsis are occurring across the nation
Maternal sepsis is a nationwide problem, not a pro-life state problem. According to a report by the Agency for Healthcare Research and Quality, the number of sepsis-related maternal hospital stays increased 60.9% between 2016 and 2021 while the in-hospital mortality rate for maternal sepsis hospitalizations decreased from 3.4 per 100 in 2016 to 1.6 per 100 in 2019 before increasing 4.2 per 100 in 2021.
The increases are found even in pro-abortion states with wide access to abortion, such as California. According to the California Maternal Quality Care Collaborative, “Obstetric sepsis is now the second-leading cause of maternal mortality” in the state and “the primary cause of severe maternal morbidity during both the antepartum and postpartum periods, and the third-leading cause at delivery.” Data from the California Pregnancy Associated Mortality Review Committee revealed that 63% of maternal deaths from sepsis in the state had a good to strong chance of being prevented.
“Severe septic shock might be easy to diagnose in an emergency room, but some patients with the infection show up only reporting weakness or that they’re ‘just not feeling right,'” said Dr. David Larson, medical director of the emergency department at Ridgeview Medical Center in Waconia, Minnesota. “You need to have that urgency that these patients could have severe sepsis.”
Unregulated abortion pill use
ProPublica made it known that it looked at sepsis from “terminations” as well as natural miscarriages (though it only analyzed data beyond the first trimester of pregnancy). A serious issue not mentioned by ProPublica is the increased and unregulated use of the abortion pill, which carries a black box warning for sepsis. ProPublica itself previously reported on two women in Georgia who developed sepsis after taking the abortion pill they obtained elsewhere — one from an out-of-state abortion pill prescriber and one from an online abortion pill dispensary. ProPublica blamed the state’s pro-life laws for their deaths.
Though the abortion pill is only FDA-approved for the first 10 weeks of pregnancy, it is now commonly prescribed to women beyond this point, including to women who have not received a proper medical examination to actually determine the gestational age of the child. The risk of complications such as incomplete abortion — which can lead to infection, and therefore, sepsis — increases as the child’s gestational age increases.
Telemed abortion pill dispensing means that women in Texas have received the abortion pill from abortionists in New York or from other locations, via the internet. Abortion industry leaders have advised women taking the abortion pill to lie to emergency room doctors and claim they are miscarrying if they experience complications from the abortion pill requiring emergency care (though these women in pro-life states risk no prosecution for abortion). Women who are in their second trimester could be taking the abortion pill, which they obtained through the mail, suffering significant complications, and reporting them as natural miscarriages to hospital doctors. This, in turn, makes it appear that something other than the abortion pill is responsible for such complications.
“If we were to speculate in the same way [as ProPublica does], using their methodology, we could say that an increase in the number of sepsis cases is directly correlated to mail-order abortions flooding into Texas, causing women to present to the ER,” said Novielli. But, she added, there is no proof of this — just as there is no proof that the state’s pro-life law led to an increase in sepsis cases.
Improved methods of detecting sepsis
According to the CDC, “Sepsis can develop quickly from initial infection and progress to septic shock in as little as 12 to 24 hours.”
In recent years, advances and training have led to better detection, which could make it appear as though the rate of sepsis is rising. One review of the nationwide sepsis data concluded (emphasis added), “Numerous studies have suggested that sepsis incidence is increasing over time and mortality rates are declining. These estimates are biased, however, by increasing clinical awareness of sepsis, more screening, decreasing diagnostic thresholds, and more diligent coding practices. The net effect of these many sources of bias is misleading impressions of rising sepsis incidence and decreasing sepsis mortality rates.”
The Modern Early Warning Systems has helped doctors to identify and diagnose sepsis more quickly and more often than in previous years, leading to an increase in the number of sepsis cases and a decrease in sepsis-related deaths, thanks to this early warning system.
In fact, in late 2019, Texas initiated the first implementation of the Maternal Early Warning System Quality Improvement Initiative in certain hospitals, the number of which grew over time. Infection was the leading cause of pregnancy-related deaths from 2016-2020 with sepsis or septic shock being the second most common underlying condition, second only to COVID-19. The implementation of that early warning system may have led to an increase in sepsis diagnosis.
“The reported rate of sepsis increased when systems were implemented to improve the diagnosis of sepsis,” explained Dr. Ingrid Skop.
In a thread on X, she further explained, “[ProPublica] authors fail to acknowledge a recent emphasis to train physicians to diagnose sepsis earlier. The increase in cases of sepsis diagnosed may reflect increased early detection.”
Other considerations
Pro-life laws prevent preborn children from being killed in the womb, which leads to more full-term pregnancies and more births. With more full-term pregnancies come more opportunities for complications that must be treated. According to New, “Recent research also shows that Hispanic women and African American women have become more likely to carry pregnancies to term as the result of pro-life laws. These are also demographics that have a higher incidence of sepsis.”
Another possible factor not considered by ProPublica is the increase in chronic health conditions such as kidney disease, liver disease, and congestive heart failure among pregnant women, according to research.
Yet another consideration is that insurance companies are denying or delaying coverage for pregnancy complications unless there is an immediate, life-threatening condition. Even before the fall of Roe v. Wade, insurance companies have been delaying care for maternal complications. Research from 2023 found that “coverage denial is associated with significant delays in care, providing practical implications for effective perinatal care.”
A pro-abortion agenda
ProPublica is admittedly on a mission to blame pro-life laws for pregnancy complications and pregnancy-related deaths. The pro-abortion outlet has enlisted pro-abortion doctors to weaponize reporting on maternal complications and deaths, focusing only on cases that have occurred within states with pro-life laws and ignoring similar maternal complications and deaths in pro-abortion states. In doing so, ProPublica is building a false narrative that pro-life laws kill women.
Editor’s Note: Special thanks to Live Action Research Fellow Carole Novielli for her assistance with this article.
