I HAD BEEN ASSURED THAT THE SCIENCE WAS SETTLED: The horrifying maternal mortality rate in Texas turned out to be wrong, but that’s not the biggest issue.

Though we only now realize how flawed the data were, this isn’t entirely a recent revelation. Experts suspected that something was wrong with the data, they just weren’t sure what. The authors of that original study noted that “in the absence of war, natural disaster, or severe economic upheaval, the doubling of a mortality rate within a 2-year period in a state with almost 400,000 annual births seems unlikely.” Their suspicions turned out to be right. Instead of roughly 36 deaths per 100,000 births, the mortality rate was more like 14.6 deaths per 100,000 births.

Texas is, in fact, a cautionary tale, just not in the way we all thought. It’s been collecting data poorly for years now, and they’re not alone—maternal mortality rates could be wrong all over the U.S. Ever since some states introduced a checkbox to their death certificates asking about pregnancy back in 2003, the stats on maternal mortality have been skewed. A 2017 study concluded that this addition “appears to be the main driver of the increases in [maternal mortality rates] during the last decade.” States with and without the checkbox differ so much in reported data that we haven’t published an official national maternal mortality rate since 2007. The data just haven’t been good enough.

It makes you wonder what other data aren’t being collected, or are being improperly or incompletely collected.