The Rural Texas Maternal Health Assembly says the state is teetering on a crisis in maternal health, as 47% of Texas counties are considered maternity-care deserts.
Only 70 rural hospitals in the state now provide obstetrics care to expectant mothers.
Dr. Jacquelyn Alvarado, maternal fetal focus program manager with the Texas A&M Rural and Community Health Institute, said some pregnant people can travel up to three or four hours for a routine checkup and are missing out of wrap-around services.
"So, they may have a WIC opportunity, but they don’t have a grocery store available, so they’re stuck eating very processed foods," said Alvarado. "And behavioral health services and postpartum lactation – these women want to breastfeed, but they don’t have access to that support."
Among hospitals still providing labor and delivery services, 59% report financial losses for each service.
Medical experts say without access to local preventive and primary care, women living in rural communities are more likely to miss important cancer screenings, postpartum care and contraceptive services. Alvarado said telehealth appointments are helpful in bridging the gap.
"That’s a great care model which allows those women to receive some point of care throughout their pregnancy," said Alvarado. "But also getting creative with it – if they don’t have great Internet access at home, let’s bring them to the local rural health clinic."
Alvarado said the majority of maternal deaths in the U.S. are considered preventable, and thinks rural areas should receive comparable funding, training and services as urban areas.
"It’s financial, but geography shouldn’t determine whether you deserve that care or not," said Alvarado. "I feel like, in a country with so many resources and expertise, where a woman lives, it really shouldn’t determine whether she survives her pregnancy or not."
She said she’s hopeful the Rural Health Transformation Program, which provides states with federal funding to improve rural health care systems, will improve maternal health services in the state. Texas is receiving $1.4 billion over five years as part of the program.