Strengthening Maternal Care Access: Tools & Global Insights for Texas Practitioners

Helping Moms Thrive in Every Texas County

Why Maternal Care Access Is Breaking Down

Improving maternal outcomes begins with improving access to care in the first weeks of pregnancy.

Across Texas, pregnant and postpartum mothers are experiencing increasing difficulty accessing timely prenatal and delivery care. While these challenges are often attributed to insurance coverage, global comparisons suggest that the structure of maternity care systems—particularly in early pregnancy—plays a critical role in access.

Global Perspectives on Maternal Care Access

In Texas, maternity care deserts continue to expand due to hospital closures, workforce shortages, and uneven provider distribution. Providers in many regions are stretched across large geographic areas, limiting timely access to early prenatal care.

Canada

Canada provides universal coverage for prenatal care, yet access challenges persist. Research highlights fragmented early pregnancy care, with many patients experiencing delays in securing a prenatal provider and navigating multiple disconnected entry points into the system.

In some regions, limited integration of midwifery and primary care contributes to gaps in timely access, particularly in underserved communities.

Key Takeaway for Providers

Coverage alone does not ensure access—clear entry pathways and workforce integration are essential.

The Netherlands

The Netherlands has structured its maternity system around midwife-led entry into care, ensuring that nearly all pregnant patients have a clear and timely first point of contact.

Community midwives provide primary care for low-risk pregnancies, with referral to obstetricians when needed, creating a coordinated, tiered system

Key Takeaway for Providers

Early access improves when systems establish a default entry point into prenatal care.

What This Means for Providers in Texas

These comparisons highlight a consistent pattern:

Access challenges are driven not only by geography or insurance but also by how patients enter and move through the maternity care system.

Providers play a critical role in strengthening access by helping create clearer pathways into care, particularly during the first trimester.

How Save Texas Moms Supports Providers

  • Connecting mothers to local resources

  • Supporting navigation into care

  • Mapping access gaps across Texas

  • Partnering with clinics, academia, and public health and community organizations

Texas physicians—from rural family medicine clinics to urban OB-GYN practices—consistently go above and beyond for pregnant and postpartum mothers.

At Save Texas Moms, we recognize that today’s environment, with its rapidly shifting legal constraints, places extraordinary pressure on physicians who seek to provide evidence-based and compassionate care to patients.

We honor your commitment and seek to support you with up-to-date tools, evidence-based guidance, and practical resources so no mother—regardless of ZIP code or county—suffers for lack of timely care.

The Reality: Clinical Judgment Under Constraint

Many Texas physicians have shared that they feel their clinical judgment—especially in obstetric emergencies—is increasingly constrained by legal uncertainty. While the medical standard of care has not changed, the risk environment around treatment decisions has changed significantly.

This environment can delay care in time-sensitive emergencies such as sepsis, hemorrhage, preeclampsia, and complications of pregnancy loss—conditions where minutes matter. These delays do not reflect clinicians' intentions; they reflect the reality of practicing within unclear or high-risk legal boundaries.

The Compounding Challenge: Racial & Systemic Inequities

At the same time, we know from the Texas Maternal Mortality and Morbidity Review Committee (MMMRC)—and national data—that longstanding equities continue to shape outcomes.

Black mothers in Texas are twice as likely to die from pregnancy-related causes, and Hispanic mothers face higher rates of severe maternal morbidity, especially in rural regions.

These disparities are not necessarily the result of individual physician actions—they also reflect larger systemic forces: delayed access to care, gaps in coverage, mistrust of the health system, transportation barriers, lack of specialty services, and the uneven distribution of hospitals in our state.

When emergency care is delayed because of legal uncertainty, these systemic inequities become even more severe.

A Shared Path Forward

Save Texas Moms is committed to supporting physicians and hospitals as they navigate this challenging landscape. Our work focuses on:

  • Reducing preventable complications by improving early education and navigation

  • Supporting rural and low-access counties where clinicians are overextended

  • Strengthening communications and trust between mothers and providers

  • Bringing lived-experience data back to the clinical community

  • Elevating evidence-based maternal health policies that protect both mothers and clinicians

We believe Texas physicians should have the clarity and support to practice timely, patient-centered care, especially in emergencies. And we believe that no mother, regardless of race, religion, insurance status, or hospital proximity, should face preventable harm.

Doctor using a stethoscope on a pregnant woman in hospital gown

Maternity Care Deserts make it harder for pregnant and postpartum mothers to access reliable, evidence-based guidance—especially when broadband is unavailable, or devices are limited. The Mama Library is a bilingual (English/Spanish) educational station offering prenatal safety guides, postpartum support, infant-feeding information, mental-health resources, and local referrals.

All materials are reviewed and vetted by healthcare professionals.

Clinic-Based Support: The Mama Library

Informational flyer titled "Save Texas Moms" showing a white Mamá Library with educational resources and a purple background with text about maternal healthcare disparities in Texas, key problems, and services provided in a bilingual format.

Best Practices for Strengthening Maternal Healthcare Access and Birth Equity

Providers play a critical role in improving access to maternal healthcare services and advancing birth equity across Texas. The following actions can help strengthen care delivery, particularly during early pregnancy and in underserved communities.

Improve Early Access to Care

Ensure patients can enter prenatal care as early as possible.

  • Offer or prioritize first prenatal visits within the first trimester

  • Establish clear referral pathways for patients without a provider

  • Collaborate with community partners (WIC, libraries, nonprofits) to help connect mothers to care

Address Implicit Bias in Clinical Care

Understand how implicit bias can affect patient interactions, diagnosis, and treatment decisions.

  • Participate in evidence-based bias training

  • Implement standardized clinical protocols to reduce variation in care

  • Foster a practice environment that supports respectful, patient-centered communication

Strengthen Rural and Underserved Care Networks

Support access to care in communities with limited maternal health services.

  • Partner with rural clinics, Federally Qualified Health Centers (FQHCs), and community providers

  • Explore telehealth and hybrid care models where appropriate

  • Coordinate care across regions to reduce gaps in services

Engage in Continuing Education

Stay current on best practices in maternal healthcare.

  • Participate in continuing medical education (CME) on patient safety, maternal mental health, and obstetric emergencies

  • Seek training on care coordination and social determinants of health

  • Incorporate updated clinical guidelines into practice

Participate in Maternal Health Review and Quality Initiatives

Contribute to system-level improvements in maternal outcomes.

  • Engage with Maternal Mortality and Morbidity Review Committees (MMRCs)

  • Participate in hospital or regional quality improvement initiatives

  • Support data-informed approaches to improving care delivery

Advocate for Policies That Improve Access to Care

Providers play an important role in shaping policies that impact maternal health outcomes.

  • Support policies that expand access to prenatal and postpartum care

  • Advocate for sustainable reimbursement models, including telehealth and hybrid care

  • Promote standardized, transparent data collection to identify and address disparities

Support Medicaid Expansion and Continuous Coverage

Advocate for policies that expand Medicaid coverage and ensure continuous access to care throughout pregnancy and the postpartum period.

  • Support 12-month postpartum Medicaid coverage and continuity of care

  • Reduce coverage gaps that delay or interrupt prenatal and postpartum services

  • Promote payment models that enable providers to deliver timely, comprehensive care

Gaps in insurance coverage are associated with delayed prenatal care and missed postpartum follow-up, particularly in underserved communities.

Consistent coverage is strongly associated with earlier entry into prenatal care, improved continuity of care, and better maternal health outcomes.

Support for All Texas Mothers

This page brings together evidence-based, peer-reviewed resources to help providers address the social and economic factors that impact maternal and infant health.

It is designed to support practitioners caring for diverse patient populations, including mothers facing financial barriers, limited access to care, and other social challenges.

Illustration of a helping hand with a heart drawing

Bundles, toolkits, and other resources

According to a 2023 national report by the Policy Center for Maternal Mental Health, the vast majority of U.S. counties lack sufficient maternal mental health resources, and nearly all women of childbearing age live in areas with provider shortages.

In Texas, counties such as Jasper, Lamar, and Tyler rank among those with the highest risk for maternal mental health disorders, while highly populated counties, including Harris and Dallas, face some of the largest gaps in available providers.

Nationally, the report found:

  • 96% of U.S. women live in maternal mental health shortage areas

  • 70% of counties lack sufficient resources

The Policy Center now maintains a national, county-level mapping tool to track maternal mental health risk and provider availability—highlighting the urgent need for improved access to care across both rural and urban communities.

More Texas Resources

Read the latest Texas Maternal Mortality and Morbidity Review Committee (MMMRC) and Department of State Health Services Joint Biennial Report, which estimates 80 percent of the pregnancy-related deaths in Texas were preventable.

The Texas State Health Plan examines the factors affecting health equity in Texas. It makes recommendations concerning access to care, rural health, teleservices and technology, and the state’s mental health and behavioral healthcare workforce.

The March of Dimes reports offer a comprehensive overview of maternal and infant health in Texas. They provide comprehensive data and illustrate where resources are needed to reduce the complications of pregnancy during delivery and postpartum.

Physicians and community organizations share the same goal: Healthy mothers, healthy babies, and safe, timely access to care. By working together—and by listening deeply to both clinicians and the mothers they serve—we can reduce preventable complications and rebuild trust across Texas.

Thank you for the lifesaving work you do every day.