Texas lawmakers hope to advance a series of bills addressing maternal and postpartum health care when they return to Austin on Tuesday.
Some of these bills, like doula services and more up-to-date maternal mortality data, had support during the last legislative session in 2021 but didn’t get signed into law. State Rep. Shawn Thierry, D-Houston, said she feels cautiously optimistic this session.
“This is an issue that we have to continue to address,” Thierry said. “I hope people don’t take their eyes off the prize and say we’ve already solved maternal mortality and morbidity in Texas — we absolutely have not.”
Thierry has introduced a number of bills this session seeking to address the high rates of maternal mortality in Texas, including House Bill 663, which would create a maternal mortality and morbidity data registry.
Other bills would require cultural competency education for physicians (HB 1162 and HB 1165), and the creation of a pilot program for doula services to be covered by Medicaid (HB 465).
“Healthy moms equal healthy babies,” Thierry said. “Reducing maternal mortality is going to reduce infant mortality. All of the measures are directly correlated to improving the health and well-being of babies, and so the issues go hand in hand.”
Another bill recommends adding more community representatives to the Texas Maternal Mortality and Morbidity Review Committee. The committee’s long-delayed report, released in December, showed continued racial disparities in maternal mortality in Texas, where Black pregnant people were twice as likely to die than their white counterparts.
“Black people should not just be a footnote in the report, we are the report,” Thierry said.
The contributing factors for maternal mortality are complex: everything from mental health conditions to underlying medical issues to discrimination by health professionals.
“It’s not just one single event that causes this tragic death, it’s a whole confluence of events,” said Jen Biundo, senior director of policy and research for Healthy Futures of Texas. “It really shows the need for structural change in a number of areas.”
Extending pregnancy Medicaid coverage
One way to address these disparities, and lower maternal mortality rates overall is extending pregnancy Medicaid coverage for 12 months after giving birth, Biundo said.
Texas lawmakers passed a bill in 2021 that provided six months of Medicaid after giving birth, but current coverage only extends two months postpartum. Multiple bills proposing an extension to a year have also been introduced this session.
“A large number of pregnancy-related deaths occur several months after delivery, related to mental health like postpartum depression, and so there’s a real need to continue that medical coverage,” Biundo said.
Biundo feels hopeful about expanding pregnancy Medicaid coverage, but “it’s always a little bit wait and see in the legislature.”
“You don’t know what you’ll get until the session gavel’s in,” she said.
Other health policy issues, like mental health services for youth across Texas, access to gender-affirming care for trans youth, and expanding access and coverage for contraceptives, are also on deck for the 2023 legislative session.
The session begins Tuesday.
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