Mississippi has one of the worst maternal health care infrastructures in a developed country — with record-high maternaland infantmortality rates — according to a new policy paper from the ACLU of Mississippi. The paper, published in early November, focused on maternal and reproductive health care in the state.
Mississippi’s maternal mortality rate is twice as high as the national average, and for Black mothers, it’s even higher. More than half of the state’s counties also qualify as maternity deserts, which means more than a million residents don’t have close access to a hospital or a birthing center — or an abortion clinic.
The report points to factors like inadequate Medicaidcoverage, abortionbans and a large number of people living in poverty.
Vara Lyons, a lawyer for the ACLU of Mississippi, authored the paper. Lyons specializes in reproductive justice and said she started putting the report together after Mississippi officials began to create committees that will lead research on maternal care in the state.
Lyons noticed that legislators and government officials were adamant about not speaking on abortion in conversations on reproductive access. She recently sat with Maya Miller of The Gulf States Newsroom to talk about what she found in her research and what she’s anticipating ahead of the next legislative session.
The following transcription has been edited and condensed for clarity.
Miller: How did you end up working at the ACLU of Mississippi?
Lyons: I graduated from law school in 2015 in D.C., and then I worked for the Brooklyn District Attorney's Office for about four years. I was in the human trafficking unit there, and I then went into private practice litigating sexual abuse claims under New York's Child Victims Act. I've prosecuted sex trafficking investigations, and I've also litigated cases involving sex trafficking victims on a civil basis. My career had a feminist angle dealing with a lot of female victims, and I ended up at the ACLU in September 2021, moved back to Mississippi and was interested in getting involved in a job that let me work in reproductive justice.
Why did you come back to Mississippi?
I'm from Mississippi originally, and I had planned on moving to London with a firm that I was working for that ended up falling through. I had done the New York thing for six years. When I came back after leaving at 16, now returning in my 30s, I met a lot of progressive and trusting people who are really bent on making Mississippi, and Jackson in particular, a better place. I found that a lot of the difficulties fitting in culturally that I had as a teenager and in my childhood have actually gotten a lot better. I found more of a community here, and I realized that this is why I want to work towards making Mississippi a better place, because I'm seeing spots of it in the community and people doing this work and succeeding. I wanted to be a part of that.
Tell me a little bit about the process of you starting this policy paper. What was it like diving into the research and looking at maternal data across the state?
When I took the ACLU position, I did a lot of reading, a lot of research about the legal scholarship behind Roe v. Wade, what led up to the cases that led after it and followed the Dobbs decision really heavily. Once the arguments were heard and [I saw] how the court was stacked, I kind of had a premonition as to how Dobbs was going to turn out. I don't think we could be prepared for how devastating it has been. As much as I appreciate Lt. Gov. [Delbert] Hosemann’s deputy chief of staff calling me to talk about the committee, it concerned me that they were adamant they were not going to talk about the abortion exceptions. They thought it was too political. I had a long conversation with her about that, and I think that's really something you can't avoid. I think the ability to get an abortion, to decide when and if you want to become pregnant is inextricably linked to the health of women and children in our state. I think avoiding that is putting your head in the sand.
So while looking at trends in the data and getting all of this information together, what stood out to you as far as maternal care in the state?
Something that really stuck out for me was I was talking to an OB-GYN in Jackson, and she told me that what a lot of these lawmakers don't understand is that being pregnant is an inherent medical risk. I think that sometimes pregnancy is portrayed as this beautiful, feminine thing. While it can be that, it puts a lot of stress on someone's body. I think a lot of these lawmakers don't understand that when you're forcing somebody to go through with an unwanted pregnancy, or maybe even carrying a [nonviable] fetus to term, you're putting their life at risk.
In your report, you talk about reproductive justice. You talk about maternal mortality, but you also make it a point to mention teen pregnancy. Why do you think it's important to talk about teenagers and teen pregnancy when talking about maternal mortality and reproductive health care in the state?
Having grown up in Mississippi, I didn't go to a public school. I went to a private school, so they were kind of free to do what they wanted to do in terms of sex education. But even then, I don't remember really getting a comprehensive sex education, because you grew up in this culture of evangelical beliefs. We don't talk about sex before marriage, and I think that's really detrimental. I feel that we really fail to prevent people from getting pregnant in the first place, and then once they get pregnant, we don't offer them any options.
What are you anticipating as we go into the 2023 session?
I am concerned that we're having a lot of talk from legislators about how they want to create this pro-life culture. [State Attorney General] Lynn Fitch’s whole campaign overturning Roe v. Wade was to empower women and empower life, and I just don't see it happening. This past session, we had bipartisan support to expand postpartum Medicaid, which is something I talk about in the report about how we simply do not have enough Medicaid coverage to help women, especially if they're facing postpartum depression or other medical complications after pregnancy. I know there's going to be a push for that again, and I hope it gets passed, but [State House] Speaker Philip Gunn refused to bring the bill to a vote, and I don't think his position has changed.
We also know that from interviews he's given that he is OK with a 12-year-old child being forced to take a pregnancy to term, even if she's a victim of incest. I am concerned that we will see attacks on bodily autonomy. Alliance Defending Freedom — which is the group that helped draft the 15-week ban that ultimately helped overturn Roe v. Wade for Mississippi — they believe that personhood begins at fertilization. They are against birth control that prevents the implantation of a fertilized egg. So scientifically, the acceptable definition of a pregnancy is when that fertilized egg implants. Groups like Alliance Defending Freedom and Pro-Life Mississippi see the beginning of a pregnancy as when the egg is fertilized. They are against using birth control or IUDs or Plan B, which interferes with the implantation of that fertilized egg. I think we're going to be on the defense against bills like that.
Recently Speaker Gunn went on a radio show saying that he intends to expand tax credits for crisis pregnancy centers. Currently, the budget is at $3.5 million, but he wants to expand that to $10 million. What do you think about that?
I think it's a slap in the face to women because these so-called crisis pregnancy centers, they're not health care facilities. We are in a state where many of the rural hospitals are at risk of closing. I talk about that in the paper where there are women who are in Greenwood who are going to have to drive 45 minutes to give birth. These crisis pregnancy centers, they're not going to provide that. They're not going to be there when a mother has an ectopic pregnancy. They're not going to be there when somebody has been raped and doesn't necessarily feel comfortable reporting it to the police, because that's the exception. You have to report that rape to the police. We know that many sexual assault survivors do not come forward immediately to go to the police. I cannot tell you how many sexual assaults were reported to me for the first time, weeks and months later, because I came in as a female presenting assistant district attorney, and they felt comfortable enough talking to me over a male presenting young rookie cop. The timeline to report is going to make that increasingly difficult for women to get abortion care. I think it's really a Band-Aid for a hemorrhaging wound. I think it's really unfortunate that the speaker thinks this is what is going to fix the problem because it's not.
I think that politicians have to start putting their money where their mouth is. I think we can't keep saying that we're not going to expand Medicaid when 60% of births in Mississippi are covered by Medicaid. We are actively choosing not to support life when we are not putting funds into supporting these pregnancies. We can't use crisis pregnancy centers to fix a problem that is largely medical and financial in terms of people having access to resources and child care. I think we have to start getting realistic, and we can't skirt around the topic of abortion because it's “too political” because having equitable access to abortion care is what makes women healthier.
Well, Vara. Thank you so much for joining me today.
Thank you. Thanks for having me. I've really enjoyed it.
This story was produced by the Gulf States Newsroom, a collaboration among Mississippi Public Broadcasting, WBHM in Alabama and WWNO and WRKF in Louisiana and NPR. Support for reproductive health coverage comes from the Commonwealth Fund.
