Slide 1 of 3 · The Baseline
The car was already old.
The U.S. obstetrical care system was breaking down before the current crisis. Worst maternal mortality in the wealthy world. Homicide as #1 cause of pregnancy death.
17.9 per 100K maternal deaths · worst in the developed world · 55% of U.S. counties had no OB-GYN · Homicide as #1 cause of pregnancy death
Key Baseline Conditions
- WORST IN THE WEALTHY WORLD — U.S. maternal mortality of 17.9 per 100,000. Sweden: 4. Norway: 2. Two to six times worse than peer nations.
- RACIAL DISPARITY DEFINING — Black women dying at 3.5× the white rate. Native women at 4.9×. Disparity persistent across every income, every education level.
- HOMICIDE AS #1 — Leading cause of pregnancy-associated death — 3.62 per 100K. 68% involve firearms. Killer almost always a male intimate partner.
- WORKFORCE COLLAPSE BUILT IN — 37% of OB-GYNs over 55. 55% of counties with no OB-GYN at all. The pipeline was already shrinking before any policy changed.
Takeaway
This is the car before anyone touched it. Then someone forgot the oil change. Then the transmission blew. The compounding starts from a baseline that was already among the worst in the developed world.
Slide 2 of 3 · The Four Phases
How they took it apart.
Trump 1 lit the fuse. COVID broke the system. Dobbs blew the transmission. Trump 2 is stripping the car for parts. Each phase compounded the last.
The Compounding Decline
- TRUMP 1 (2017–2020) · LIT THE FUSE — Three Supreme Court appointments — Gorsuch, Kavanaugh, Barrett. The court that would overturn Roe was assembled in four years.
- COVID (2020–2022) · SYSTEM BROKE — Maternal mortality spiked to 32.9 per 100K, the highest in modern American history. Black mortality hit 69.9.
- DOBBS (2022–2024) · TRANSMISSION BLEW — Texas maternal mortality up 56%. White women up 95%, Black women 38%, Hispanic women 30%. 264 women turned in to law enforcement by their own doctors.
- TRUMP 2 (2025–NOW) · STRIPPING FOR PARTS — PRAMS team fired before the 2023 data could be released. $900B Medicaid cut. EMTALA rescinded. 2,300+ NIH grants canceled, $4B ordered reversed by federal court.
The proof it was manufactured: In Texas, white women's maternal mortality rose 95% post-ban — more than Black or Hispanic women. The ban states are killing the women who voted for the bans. The policy itself is driving the deaths. That is how you know it is policy, not biology.
Slide 3 of 3 · How to Use This Briefing
What to do with this.
This briefing is for collaborators amplifying the work — producers, editors, advocates, fellow physicians, doulas. The argument is yours to use.
For Different Audiences
- FOR PRODUCERS — Pitch a segment on Texas's white-women-up-95% finding. The "ban states killing the women who voted for the bans" angle is the producer-friendly hook that crosses partisan lines.
- FOR EDITORS — The four-phase spine (car already old → fuse → break → transmission → stripping) is the structure of a 4,000-word essay. Lift it.
- FOR ADVOCATES — The lever: every advance in maternal/child health came from Congress. Medicaid (1965) through Pregnant Workers Fairness Act (2023). Whoever sits in Congress in January 2027 decides whether this gets rebuilt or finished off.
- FOR PHYSICIANS / BIRTH WORKERS — Use the Five Buckets resource sheet with patients. Use the One-Pager in your professional society newsletter. Use the Quote Cards on your social.
Take this and use it
- The full intelligence brief is at manufactured.laboracollective.com/one-pager — republish in full or excerpt with attribution
- The animated 1:52 explainer is at manufactured.laboracollective.com/explainer/ — embed it
- The downloadable quote cards are at manufactured.laboracollective.com/quote-cards — post to your feed
- For a longer version of any finding, an interview with Dr. Connor, or to coordinate placement: lcresearch@diosara.com
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The full Republican Manufactured Healthcare Crisis package