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Minnesota Rep. Keith Ellison, the number two official in the Democratic National Committee and the first Muslim elected to Congress, stepped in it with the right wing this weekend after excerpts of a Friday speech he gave to a candidate training by the Progressive Campaign Change Committee (PCCC) were posted on his Twitter account.

From the speech:

Did you know that in Missouri and in Texas and maybe other places, maternal mortality has risen. Women are dying because we are losing elections. We don’t have the right to lose a damn election. We have to win. We have to win.

We can take over the state legislature, the city council, the school board and Congress. And we can have universal single-payer Medicare for All, and we can have free college, and we can have a society that is truly democratic and reflects the priorities of the American people.

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Predictably, conservative media pounced on Ellison’s comments. “Are you kidding me? Is this how you plan to win elections, Mr. Ellison?” Tomi Lahren wrote for Fox News. “By blaming the Republican Party and President Trump for the rate of pregnancy-related deaths among women? That’s so outrageous, I doubt even the Democrats believe it.”

Breitbart, in a post on Ellison’s comments, linked to a Kansas City Star article from 2016 about Missouri’s high maternal mortality rate, saying “most of the women die from cardiac issues and blood clots...Due to the high rate of women in the state who smoke or are obese, many of these women increase their risk of developing diabetes or heart problems.”

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Here’s what comes immediately after that part of the Star piece, which Breitbart didn’t mention (emphasis mine):

All of those risks are compounded when pregnant women don’t see a doctor regularly. A report released by Williams’ agency in May found that 17.5 percent of Missouri women received no prenatal care in the first trimester of pregnancy.

That’s partly an issue of access. Williams said 67 Missouri counties don’t have a single OB/GYN. He’s decided to spend one Saturday a month working in a clinic in Springfield, in addition to running the health department. “We need all hands on deck,” Williams said.

Cost is also a factor. Maulik said women should ideally start seeing a physician when they’re considering trying to get pregnant, so doctors can look for underlying medical conditions and advise them to take supplements like folic acid. But the state report found that 26 percent of Missouri women were uninsured in the months before they got pregnant.

Most of those women qualify for Medicaid once they’re pregnant, but for those who aren’t covered, Maulik said government-subsidized places like Truman might be their only option for miles.

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It’s not just Missouri or Texas, either. As NPR and ProPublica found last year, the United States has the highest rate of maternal mortality in the developed world, and it’s rising. As Nina Martin reported:

American women are more than three times as likely as Canadian women to die in the maternal period (defined by the Centers for Disease Control as the start of pregnancy to one year after delivery or termination), six times as likely to die as Scandinavians. In every other wealthy country, and many less affluent ones, maternal mortality rates have been falling; in Great Britain, the journal Lancet recently noted, the rate has declined so dramatically that “a man is more likely to die while his partner is pregnant than she is.” But in the U.S., maternal deaths increased from 2000 to 2014. In a recent analysis by the CDC Foundation, nearly 60 percent of such deaths were preventable.

Like everything else in America, this crisis affects people of color disproportionately. From the New York Times:

Black women are three to four times as likely to die from pregnancy-related causes as their white counterparts, according to the C.D.C. — a disproportionate rate that is higher than that of Mexico, where nearly half the population lives in poverty.

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One common denominator between all of these wealthy countries whose maternal mortality rates are in deep decline is that they all have universal healthcare systems; the United States does not. And Missouri, by the way, opted out of Medicaid expansion under the Affordable Care Act. According to a November 2017 report by the nonprofit Kaiser Family Foundation, 199,000 more Missourians would have had been eligible for Medicaid had the state legislature expanded it.

Considering the stated position of the mainstream Republican Party is that abortion should be illegal, Ellison’s point was even more salient. Before Roe v. Wade, illegal abortions—those that were reported, at least—accounted for 17 percent of all childbirth- and pregnancy-related deaths in the United States, according to the Guttmacher Institute.

This doesn’t even begin to scratch the surface on the multitude of other ways that a conservative and reactionary agenda actively harms all poor people, people of color, and workers, not to mention people in other countries whose interests don’t align with those of U.S. imperialism, suffering which the Democratic Party has more often than not been a willing partner to.

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But at the very least, it’s a fact that inequality is a disaster for women’s health. And given that the Republican agenda only serves to perpetuate inequality even further, it’s far from out of line to say that when Republicans have power, more women die.