Report: Almost 47% of Texas counties are 'maternity care deserts'
AUSTIN (KXAN) -- A new report by the charity March of Dimes and healthcare insurer Amerigroup Foundation claims that 46.5% of Texas counties are "maternity care deserts" that lack adequate health care for those who can become or are pregnant.
The report, titled "Where you Live Matters: Maternity Care in Texas" categorized the state's counties by looking at the following:
- How many hospitals and/or birth centers offer obstetric care;
- How many obstetric care providers work there; and,
- Proportion of women between the ages of 18-64 lack health insurance.
A breakdown of how the counties were evaluated for each category:
"More than 2 million women of childbearing age live in maternity care deserts, areas without access to birthing facilities or maternity care providers," the report's introduction reads. "Access to maternity care is essential for preventing poor health outcomes and eliminating health disparities."
To put Texas into a national context, the report states that 32.6% of counties in the U.S. are maternity care deserts. The national situation has improved slightly from March of Dimes' 2022 report (34.9%).
"All women deserve health care which is safe, effective, timely, efficient and equitable," the report concludes. "Consistent and equitable access to maternity care helps women maintain optimal health as well as reduce the risk of experiencing complications during pregnancy and the postpartum period."
The report also examined Texans' distance to maternity care, the availability of family planning services, disparities in prenatal care, and chronic health conditions and preterm births.
Texans have shorter drives to the hospital
A longer drive to a birth center or hospital leads to worse outcomes for an infant and higher risk of maternal death.
In a Texas maternal care desert, that distance is 4.5 times farther, the report claims. On average, maternity care is farther than 30 miles for someone in a maternity care desert. Limited access averages 17 miles to care, and full access is around 6.7 miles.
Still, Texans have a shorter drive than the national average: 8.2 miles in Texas is 1.5 miles closer than the national average.
Lack of family planning increases risk statewide
"Access to family planning services allows for people to achieve their goals around having children, including the timing of and spacing between pregnancies," the report states. "An unexpected pregnancy or too little time between pregnancies can lead to serious health
consequences, including preterm birth, depression, and anxiety."
This category suggests a lack of such services has a dire impact on Texans, claiming that 94% of counties have a high or very high vulnerability to adverse outcomes.
The counties nearest to Austin, Dallas/Fort Worth and Houston all have the highest concentrations of family planning services.
Black Texans have greatest disparity in prenatal care
Prenatal care, or the health care prior to a child's birth, lowers the risk of complications and adverse postnatal outcomes, according to the report. But 20.4% of Texas women do not receive adequate care (14.8% nationwide), and access to that care is not equal.
In areas defined as high vulnerability, more than 20% of Texans do not have adequate prenatal care. That deficit is greater for Black and Hispanic people in those areas.
Black people in less vulnerable areas receive inadequate prenatal care at the highest rate for those areas. The statewide average for lower vulnerability areas is around 15%
KXAN has requested specific numbers from March of Dimes by category to better examine the disparities.
Most counties see premature births due to chronic health conditions
The final category in the report looked at how chronic health conditions relate to the risk of a premature birth (PTB). It specifically looked at pre-pregnancy hypertension and diabetes, smoking, and being underweight or obese before pregnancy, and calls the impact of such conditions "the burden of chronic health conditions" (CHB).
For CHB, Texas women were below the national average (35.7% to 37.8%), but had a higher PTB rate (11.4% to 10.5%). Women in Texas with at least one condition had a 43% higher chance of a PTB than those without.
"Access to healthcare before, during, and after pregnancy is important for appropriate management of chronic health conditions. At the time of birth, women with chronic conditions and their babies may need access to higher-level care, such as specialized providers, hospitals with the ability to perform a Cesarean birth, or hospitals with NICUs," the report states.