May 15, 2019

Dear Members of the Ways and Means Committee:

It has come to my attention that witness testimony submitted to the Committee regarding
a relationship between contraception and maternal mortality relies heavily on references to a
deeply flawed study published by Dr. Marian MacDorman et al. in September 2016 in Ob-Gyn.
The MacDorman study has been heralded by pro-abortion politicians such as Wendy Davis,
Hillary Clinton, and Keith Ellison.
However, as Charlotte Lozier Institute scholars Dr. Jim Studnicki and Dr. John Fisher
demonstrated in the attached letter published by the journal Ob-Gyn, the MacDorman study on
maternal mortality comparing Texas to California and drawing adverse conclusions was
methodologically wrong from the start. The maternal mortality rate in Texas did not spike after
the legislative actions mentioned in the study.
As Ob-Gyn admitted after a Texas commission reviewed case-level information, total
maternal deaths in Texas were less than half what MacDorman concluded in her heralded study –
56 deaths, rather than 147. Moreover, Texas had experienced a spike in maternal deaths almost a
decade earlier, and California had experienced an even larger one, facts MacDorman’s study had
obscured because of its failure to apply a mathematical adjustment to historical data across the
board.
It is disappointing that any witness would submit testimony that relies on the deeply
flawed MacDorman study whose weaknesses have been widely and publicly acknowledged.
Sincerely,

Chuck Donovan
President