Report: Central TX Must Address Maternal Health

For Immediate Release
Contact: Peter Clark, 512-473-2274,

New report highlights ways to improve behavioral health support for mothers during the year after pregnancy



Austin – A new report released today found that untreated behavioral health challenges — such as maternal depression and substance use disorders — affect many new mothers in the region during the first year after childbirth and undermine their health and their babies’ health. The report by the non-profit organization Texans Care for Children also identifies ways that community leaders — including local officials, health care providers, philanthropic foundations, and others — can improve support for local mothers during the first year after childbirth in Austin, Round Rock, Manor, Bastrop, San Marcos, and other Central Texas communities.

“If we want kids and moms to thrive in Central Texas, then we need to help local moms stay healthy,” said Adriana Kohler, Senior Health Policy Associate at Texans Care for Children. “In many ways, the health of moms can affect entire families, communities, and economies. When communities provide effective support, parents can often manage behavioral health challenges, stay healthy, and provide a strong foundation for the rest of a child’s life.”

The report shows that Central Texas must confront many of the serious maternal health challenges that the state is facing. Across Texas, drug overdose is the leading cause of maternal death up to one year after childbirth, suicide is the fifth leading cause of maternal death, and many more mothers face pregnancy complications that may have long-term health consequences for mothers and babies. The report found that the Central Texas region has the fourth highest maternal death rate out of the state’s eight health regions. The region also has higher rates of drinking and smoking during pregnancy compared to the rest of the state, highlighting the potential need for early screenings and follow-up to prevent pregnancy complications, maternal deaths, and harmful effects for babies.

The report identifies a range of policies and structural factors — both past and present — that contribute to racial disparities and disproportionality in maternal health outcomes in Central Texas and statewide. Implicit biases in our health care system can affect the quality of health provided, decision making, and how health programs are carried out. The physical toll of ongoing stress can affect mothers of all backgrounds but is particularly harmful to birth outcomes for Black families. Social determinants of health — such as housing, food scarcity, and education, among others — are affected by past and present discrimination. Finally, Black families in Texas have less access to health insurance compared to White families.

The report highlights that Central Texas must address the particular challenges that the region’s Black women and other women of color face. The region has the worst maternal death rate among Black women compared to the other seven health regions in the state. By many measures, Central Texas has worse birth outcomes for Black families compared to other families in the area. Black women in Central Texas were much more likely to report maternal depression compared to White and Hispanic women, underscoring the need for screening and referral to follow-up care to treat symptoms before they get worse. Seventeen percent of Black women in the region reported maternal depression symptoms compared to 10 percent for White and Hispanic women. Additionally, in Central Texas 14 percent of Black infants were born with low birth weight in 2015 compared to 7 percent of White and Hispanic infants in the region. Infant mortality rates were also higher for the region’s Black families compared to other local families. The report notes that the fear of Child Protective Services (CPS) prevents some mothers in Central Texas, particularly women of color, from seeking the postpartum care they need for mental health and other behavioral health challenges. 

The research by Texans Care for Children identified other barriers to postpartum maternal health support in Central Texas, including the lack of insurance coverage; behavioral health providers’ waitlists and limited capacity to serve low-income mothers; and the lack of transportation to medical appointments. The report notes that Texas has the highest uninsured rate in the nation for women of childbearing age, 25 percent, and cuts off Medicaid health insurance for mothers about 60 days after childbirth. During the recent state legislative session, the Texas House passed legislation to extend that coverage to 12 months after childbirth, reflecting the first recommendation in the 2018 report from the Texas Maternal Mortality and Morbidity Task Force, but the Texas Senate did not take up the legislation. The Legislature did pass targeted legislation to improve telehealth options for maternity care and improve transportation options for mothers traveling to medical appointments with small children.

The report also identifies underutilized opportunities to support maternal health in the region. Mothers and maternal health professionals in Central Texas report limited knowledge regarding the Healthy Texas Women program, a state program that offers critical well-woman care and may be the only available source for preventive care after pregnancy. Our research found that health professionals in Central Texas have limited knowledge regarding maternal depression and often lack the expertise and confidence to screen and refer clients for behavioral health challenges. Integrating medical and behavioral health services in a single setting is effective for mothers but rarely implemented in Central Texas. Finally, 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.

“This new research shows that it’s going to take some work to ensure that Texas moms have the support they need to be healthy during that first year after childbirth, but there are clear steps that community leaders can start taking now,” said Ms. Kohler. “While there is no silver bullet, we can make real progress if health systems, community leaders, and state policymakers all get to work on supporting healthy moms.”

Action steps identified in the report include:

  • Expanding access to health care,
  • Investing in community-based behavioral health providers to serve more mothers, 
  • Improving training for maternal health professionals about screening and how to help mothers connect with local resources, 
  • Promoting effective practices in health care settings that integrate medical and behavioral health for new mothers, and 
  • Expanding and investing in effective local programs, including community health workers and labor and postpartum supports. 

In the development of this report, Texans Care for Children analyzed statewide and Central Texas data, researched existing local programs and the network of health and behavioral health providers, and gathered information through almost 40 interviews and several listening sessions with families and maternal health professionals.

This report was supported by a generous grant by the St. David’s Foundation.