Texas stands at a crossroads. Once a leader in rural health care innovation, the state now finds itself grappling with a burgeoning maternal health crisis. Alarmingly, nearly half of Texas counties are classified as “maternity care deserts.” This lack of access to essential health care services puts the lives of many women and their children at risk, particularly in rural areas. The solution lies in swift legislative action to implement a rural maternal health rescue initiative. Without it, the health and economic vitality of Texas’ rural communities may be irreparably compromised.
The statistics paint a bleak picture. Over 47% of Texas counties lack obstetrical care services entirely, far exceeding the national average of 33%. The consequences of this are stark: rural mothers face higher rates of inadequate prenatal care, long travel times to maternity facilities, and poorer health outcomes for both mothers and infants.
Additionally, the financial strain on existing hospitals is unsustainable. Most rural hospitals do not provide obstetrical services and of those that do, 59% lose money on labor and delivery services. These alarming trends demand immediate attention.
The history of rural health care in Texas underscores the urgency. In the 1990s, the state faced a similar crisis, marked by hospital closures and the exodus of OB care providers. Lawmakers responded with the Rural Health Rescue Act, stabilizing and strengthening our rural health care system. Today, Texas needs a similarly bold approach to prevent history from repeating itself. The Rural Texas Maternal Health Assembly has proposed a comprehensive plan to address these challenges and secure the future of rural maternal health care.
At the heart of the problem is access — or rather, the lack of it. Women in rural areas often live more than 30 minutes from the nearest maternity care facility, a barrier that disproportionately affects low-income and uninsured women. This distance exacerbates the risks of complications during pregnancy and childbirth, and it underscores the broader inequities in health care access between urban and rural populations.
This issue is not just about health; it’s about economics. Rural communities generate more than $20 billion annually for the state’s economy, but their long-term viability hinges on their ability to attract and retain young families. Who would choose to start a family and raise children in a place without adequate maternal health care? Without investment in these areas, Texas risks not only the well-being of its citizens but also the economic stability of its rural heartland.
The proposed rescue initiative offers a roadmap for change. It calls for targeting investments in Texas’ rural health care infrastructure, strengthening access to maternal health services in Medicaid, and expanding incentives to attract and retain obstetric care providers in underserved areas. These measures are not only morally imperative but also fiscally prudent.
One of the most pressing needs is ensuring postpartum care, as 25% of maternal deaths occur within a year of delivery. By improving postpartum services in Medicaid, Texas can prevent avoidable deaths and improve the quality of life for mothers and their families. Furthermore, investments in preventive care — such as cancer screenings and contraceptive services — will lead to healthier communities overall.
Texas has always prided itself on resilience and innovation. Our state’s leaders must now channel these qualities to resolve our maternal health crisis. The stakes are too high to delay. A modern rural maternal health rescue plan is not just a policy priority. It is critical to ensuring Texas’ economic miracle continues. Healthy mothers and babies are the foundation of strong families and thriving communities. By investing in their future, Texas invests in its own.
It’s time for lawmakers to act boldly and decisively. The lives of rural mothers and their children depend on it.
John Henderson is the CEO and president of the Texas Organization of Rural and Community Hospitals.
Tom Banning is the CEO and executive vice president of the Texas Academy of Family Physicians.