The Issue:

Central Texas has the fourth highest maternal death rate in Texas and the worst maternal death rate among Black women. Moreover, most maternal deaths were potentially preventable, with behavioral health challenges leading to many deaths. Nearly half of births in Texas are to women on Medicaid for Pregnant Women, coverage that ends 60 days postpartum, before many behavioral health challenges are identified.

Summary of Key Findings (Excerpt):

Key findings from research in Central Texas, which are explained in greater detail in Part 3 of this report, include the following:

Central Texas has significant maternal health challenges

• Central Texas has the fourth highest maternal death rate in the state and high rates of other concerning birth outcomes.
• In Central Texas, overdose is a relatively less common cause of maternal deaths compared to other regions, but postpartum behavioral health challenges affect many new mothers and undermine their health and their babies’ health.

Central Texas must address the particular challenges that the region’s Black women and other women of color face as a result of the current and historical factors described in this report:

• Central Texas has the state’s worst maternal death rate among Black women and high rates of disproportionality in other adverse birth outcomes, underscoring the need to address disparities in the region.
• The fear of Child Protective Services (CPS) prevents some mothers in the region, particularly women of color, from seeking and receiving the postpartum care they need

Key barriers limit access to maternal health support in Central Texas:

• Lack of insurance coverage is a significant barrier to postpartum behavioral health care for mothers in Central Texas.
• Behavioral health providers for uninsured mothers in Central Texas often lack capacity both in terms of available slots and adequate staff training.
• Transportation to medical appointments is a significant barrier in Central Texas and may lead to new mothers missing appointments or forgoing health care during a critical time.

There are underutilized opportunities to support maternal health in the region:

• Mothers and maternal health professionals in Central Texas have limited knowledge regarding the Healthy Texas Women program.
• Health professionals in Central Texas often lack the expertise and confidence to screen and refer clients for behavioral health challenges.
• Co-location of medical and behavioral health services for mothers is effective but rarely implemented in Central Texas.
• Doulas, community health workers, and other labor and postpartum supports are beneficial for new mothers, especially women of color, but availability in Central Texas is limited due to limited funding.