Georgia’s Maternal Mortality Committee Identifies 2nd Woman Killed by State’s Abortion Ban

In a Wednesday report, ProPublica identified a second maternal death in Georgia that the state’s maternal mortality committee deemed “preventable,” caused by Georgia’s near-total abortion ban. 

Candi Miller, a 41-year-old Black woman and mother of two, suffered from lupus, hypertension, and diabetes when she learned she was pregnant in the fall of 2022. Georgia’s abortion ban had taken effect just months earlier. Doctors told Miller that her pregnancy “was going to be more painful and her body may not be able to withstand it,” Miller’s sister, Turiya Tomlin-Randall, told ProPublica. But Georgia’s ban only allows exceptions for imminent threats to the pregnant person’s life and doesn’t account for chronic conditions that can make pregnancies high-risk. 

Consequently, Miller bought abortion pills online. Medication abortion is highly safe and rarely results in complications. Still, complications do arise, and can be treated by simple in-clinic abortion procedures. But abortion bans have changed that.

After Miller took the pills, some fetal tissue remained in her uterus, which requires a dilation and curettage procedure to prevent life-threatening infections like sepsis. But under Georgia law, D&C procedures are a felony punishable with prison time. As a result, Miller spent several days sick and bedridden until, on November 12, 2022, her husband found her unresponsive in bed alongside her three-year-old daughter.

Per ProPublica, doctors found a “lethal combination of painkillers, including the dangerous opioid fentanyl” in Miller’s system. Her medical records show no history of drug use, and Miller’s family members told the outlet they’re unsure if she was trying to manage her pain from the complications she was experiencing, complete her abortion, or end her life. Georgia’s maternal mortality committee determined that Miller’s death hadn’t been caused by medication abortion but severely high doses of diphenhydramine and acetaminophen. And, of course, Miller wasn’t able to receive medical help because of Georgia’s abortion ban, her family said, telling a coroner she wouldn’t go to the hospital “due to the current legislation on pregnancies and abortions.”

ProPublica obtained a summary of Georgia’s maternal mortality committee’s findings about Miller’s death. Doctors deemed it “preventable” and blamed the state’s abortion ban. “The fact that she felt that she had to make these decisions, that she didn’t have adequate choices here in Georgia, we felt that definitely influenced her case,” one unnamed committee member told ProPublica. “She’s absolutely responding to this legislation.”

Georgia’s abortion ban forced Candi Miller to fend for herself. When she had complications after taking abortion medications for a high-risk pregnancy, not being able to seek care, she self-medicated and died, leaving behind her husband and 3 children. She was 41 years old. https://t.co/mlDrMhUNha pic.twitter.com/i7nT1da3jw

— Arghavan Salles, MD, PhD (@arghavan_salles) September 18, 2024

Even if Miller had wanted to be pregnant, her pregnancy would have been high-risk. According to the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, lupus, diabetes, and hypertension can all be exacerbated by pregnancy. These conditions also render miscarriage and premature birth more likely, or can require a c-section, which is a major surgery that can be especially difficult for patients like Miller to recover from.

On Monday, ProPublica first reported the case of Amber Nicole Thurman, a 28-year-old single mother who Georgia’s maternal mortality committee deemed the first woman to die a preventable death from a post-Dobbs v. Jackson Women’s Health abortion ban. Like Miller, Thurman had a medication abortion, but tissue remained in her uterus, resulting in sepsis. Because doctors weren’t sure when they could act to save her life due to the ambiguity of the abortion ban’s supposed emergency exception, a hospital waited 20 hours to perform a medically necessary D&C on Thurman; she died during the operation, leaving behind a six-year-old son. Georgia’s maternal mortality committee deemed Thurman’s a “preventable death,” concluding there’s a “good chance” she would have lived if the hospital provided the D&C earlier, per ProPublica.

“Candi Miller should be alive right now, and the reason she is not is because of Donald Trump, [Georgia Gov.] Brian Kemp, and every single Republican politician who helped put Georgia’s ban in place,” Reproductive Freedom for All [formerly NARAL] President Mini Timmaraju said in a statement shared with Jezebel. Timmaraju added that she “grieves the loss of Candi, Amber, and the many others who have lost their lives because of abortion bans whose stories have not yet come to light.”

As medical experts have long warned, these exceptions neglect to consider the urgent, time-sensitive reality of pregnancy-related complications. Similarly, as Miller’s case shows, exceptions fail to account for the complexity of people’s health situations and the innate danger of pregnancy itself. Earlier this month, the research organization ANSIRH (Advancing New Standards in Reproductive Health) of the University of California, San Francisco published a study of dozens of anecdotes from physicians about how abortion bans have impeded their ability to provide standard medical care. The study detailed the case of a woman who learned she was pregnant after being diagnosed with breast cancer, and was told she couldn’t start chemotherapy until she had an abortion—but abortion was banned in her state.

Miller and Thurman’s identities as Black women are an inextricable factor in their deaths. Georgia has one of the highest maternal mortality rates in the nation and Black patients are three times more likely to die from pregnancy-related complications than white patients. In the first year after Roe v. Wade was decided, the availability of D&C procedures reduced the rate of maternal deaths for women of color by a staggering 40%. The same ANSIRH study found that patients of color, who are more likely to receive substandard medical care in general, were disproportionately represented.

ProPublica notes that most state maternal mortality committees, which operate on a two-year lag, are only now beginning to work on maternal deaths that took place after Dobbs—which is why Georgia’s maternal mortality review’s findings arrive about two years after Miller and Thurman’s tragic, preventable deaths. Their stories are likely just the beginning.

In 2022, attorneys representing the state of Georgia in defending the state’s abortion ban called medical experts’ warnings about the dangers of abortion bans “hyperbolic fear mongering.” Two years later, at least two preventable deaths caused by their ban have been confirmed.