There is a moment every family imagines the first cry and the joy of welcoming a child into the world. Childbirth should be a blessing, wrapped in faith, hope and new beginnings, not fear and uncertainty. Yet for thousands of mothers across Texas, bringing life into the world has become a frightening gamble, determined not by choice, but by geography.
Today, nearly half of Texas counties (46.5%) are considered maternity care deserts, places with no obstetric providers and no OB-GYNs to safely deliver babies. Between 2010 and 2020, Texas lost twenty-six rural hospitals, many of which closed their labor and delivery units long before shutting down completely. When hospitals disappear, communities lose more than health care. They lose stability, jobs and the confidence that families can grow safely in places they call home.
Texas already ranks near the bottom nationally for maternal health outcomes. Maternal mortality rose from about 18 deaths per 100,000 live births in 2013 to over 24 in 2020, remaining above 23 in 2021, according to Texas health data.
The burden is not shared equally. Black women in Texas are more than twice as likely to die from pregnancy-related causes as white women. These are not just statistics. They are daughters, wives, mothers and sisters. They are families torn apart and children growing without their mothers.
Opinion
These disparities are rooted in systematic failures like delayed care, inconsistent prenatal services, limited postpartum support and a health care system that many families no longer trust. For women in rural and low-resource communities, especially communities of color, pregnancy becomes a journey of uncertainty instead of joy.
Texas has made meaningful progress. In 2023, lawmakers extended postpartum Medicaid coverage to 12 months. Telemedicine has helped some rural mothers reach specialists, community doulas and birth workers are providing culturally grounded care that builds trust and comfort. But progress means little if a mother cannot reach a hospital in time.
Insurance coverage does not save lives when the nearest provider is hours away. Distance becomes a barrier. Delays become dangerous. Preventable complications become fatal.
Last year, lawmakers introduced House Bill 514, the Maternal Healthcare Workforce Campaign, a bipartisan effort to expand the maternal care workforce in regions that need it most. The bill aimed to recruit OB-GYNs, midwives, family physicians and doulas; invest in rural hospital infrastructure; strengthen cultural competency; and expand telehealth. It could have been a lifeline, but it failed to pass.
Reviving and strengthening this legislation could change the trajectory of maternal health in Texas. Lawmakers should also consider including rural-service loan-forgiveness, competitive salary incentives to retain clinicians, funding to reopen shuttered birthing units, and support for hospitals serving uninsured families. These are not luxuries. They are life-saving necessities.
Maternal health is not just a woman’s issue. It is a family issue, a faith issue, a workforce issue and an economic issue. Communities thrive when mothers survive. Texas has the data and resources. What we need now is the will to act. Childbirth should be safe for every mother whether she lives in Dallas, Houston, the Panhandle or the smallest town on the map.
No mother’s birth story should depend on the distance to the nearest hospital, no family should pray their way through a two-hour drive in the middle of labor, and no birth in Texas should ever feel like gambling.
Priscilla Tetteh is a graduate student in public health and a GIS analyst at UNT Health Fort Worth.