AUSTIN (KXAN) — A new mother suffering from high blood pressure after giving birth was afraid to go to sleep because she wasn’t sure if she would wake back up. Another mom spent 10 days in a coma after her twins were born, while another suddenly started having heart attacks.

Those are just a few of the women KXAN spoke with during a five-month investigation into pregnancy-related deaths and near-deaths. We got in touch with the moms mentioned in our investigation with the help of ProPublica, which through its own “Lost Mothers” investigation identified more than 100 women who died of pregnancy-related complications in 2016. 

ProPublica has extensively covered the U.S.’ maternal mortality crisis. We wanted to take a look at the issue in Austin and across the state. We reached out to communities all over Texas through a crowdsourcing initiative that allows other mothers, or those who knew women who died after giving birth, to share their experiences.

We wanted to know how their stories can help shape future research into maternal disease, so we created an online form for people to upload their deadly or near-death birth experiences. That form was shared with 12 other Nexstar TV stations and garnered responses from across the state.

A screenshot of KXAN’s “Mothers | Send Us Your Stories” upload form.

We took those viewer videos and created a gallery featuring each one of their unique situations. Their stories will help educate the public, lawmakers and medical officials about mothers dying or nearly dying every year due to pregnancy complications.

Our investigation found that because some women survived life-threatening pregnancy complications, their experiences aren’t being tracked as part of Texas’ maternal mortality and morbidity statistics. And, we discovered, even when women die from health problems directly related to their pregnancies, their deaths aren’t always included in official maternal mortality rates in Texas and around the U.S.

We first began investigating how the state’s maternal mortality rate is calculated last fall after the Maternal Mortality and Morbidity Task Force released a report saying the number of women dying after giving birth isn’t nearly as high as previously reported.

Still, our investigation found, the state is years behind when it comes to maternal mortality data. Texas says its most accurate maternal mortality rate is for 2012 – seven years ago. But, even those numbers discount certain women who the state says would be included in had they died sooner.

Using different methodology, the state says there were only 56 maternal deaths in 2012 – not the 147 deaths reported by researchers in an Obstetrics & Gynecology journal article. The women who died from pregnancy complications, but who weren’t included in the total, were left out because they died more than 42 days after giving birth, the World Health Organization’s standard for labeling a maternal death.

The Mothers Erased team, from left: Josh Hinkle, Arezow Doost, Sarah Rafique, Chris Nelson

But KXAN found many experts say the 42-day cutoff is arbitrary, which is why the task force is looking into deaths that occur up to one year after the woman gives birth. Still, with most of Texas’ maternal deaths occurring after 42 days, could not including those women in the maternal mortality rate interfere with solutions to this public health crisis, and can the state truly understand the magnitude of the issue?

We also wanted to know how Texas’ numbers compare to other states and found methods for tracking how many people die due to pregnancy complications is so unreliable across the U.S. that the Centers for Disease Control and Prevention stopped publishing maternal mortality rates in 2007.

We spoke with state and federal officials who admit flaws with how maternal mortality is tracked as well as lawmakers looking to implement measures aimed at improving the quality of the state’s data.

Our investigation ultimately found there are still many unanswered questions and shortfalls in the system. More research and better tracking of information are needed to accurately know how many women die of pregnancy complications every year in Texas, because without that, as one researcher said, how can you prevent it?