Texas lawmakers push bills to tackle maternal deaths in 2023

Texas lawmakers are hoping to introduce a range of bills related to maternal and postpartum health care when they return to Austin on Tuesday.

Some of these bills, such as doula services and more recent data on maternal deaths, received support during the last legislative session in 2021 but were not signed into law. State Rep. Sean Thierry of Houston said she is cautiously optimistic in this session.

“This is a problem that we must continue to address,” Thierry said. “I hope people don’t take their eyes off the prize and say that we have already solved the problem of maternal mortality and morbidity in Texas – we have absolutely failed.”

In this session, Thierry introduced a number of bills to address the high maternal mortality rate in Texas, including House Bill 663, which would create a Maternal Mortality and Morbidity Data Registry.

Other bills require cultural training for physicians (HB 1162 and HB 1165) and the creation of a pilot program for Medicaid-covered doula services (HB 465).

“Healthy moms mean healthy babies,” said Rep. Thierry. “A decrease in maternal mortality will lead to a decrease in infant mortality. All measures are directly related to improving the health and well-being of children, so the questions go hand in hand.”

Another bill recommends adding more community representatives to the Texas Maternal Mortality and Morbidity Review Committee. The committee’s long-awaited report, released in December, revealed persistent racial disparities in maternal mortality in Texas, where black pregnant women are twice as likely to die as their white counterparts.

“Black people shouldn’t just be a footnote in the report, we are the report,” Rep. Thierry said.

The factors that contribute to maternal mortality are complex, ranging from mental illness to underlying medical problems and discrimination by healthcare professionals.

“It’s not just one event that causes this tragic death, it’s a confluence of events,” said Jen Bundo, senior director of policy and research at Healthy Futures of Texas. “It really shows the need for structural change in a number of areas.”

Pregnancy extension Medicaid coverage

One way to address these discrepancies and reduce maternal mortality overall, Bundo said, is to extend Medicaid coverage for pregnancy to 12 months postpartum.

In 2021, Texas legislators passed a law providing Medicaid for 6 months after childbirth, but current coverage only extends to two months after childbirth. This session also saw the introduction of several bills proposing an extension of up to a year.

“A large number of pregnancy-related deaths occur months after childbirth related to mental health, such as postpartum depression, and so there is a real need to continue this health coverage,” Bundo said.

Bundo hopes to expand Medicaid coverage for pregnant women, but “you always have to wait and see in the legislature.”

“You don’t know what you’ll get until you put the hammer in,” she said.

Other health policy issues, such as mental health services for youth across Texas, access to gender-affirming care for trans youth, and expanding access to and coverage of contraceptives, will also be considered in the 2023 legislative session.

The session starts on Tuesday.

Any advice? Email Elena Rivera at [email protected] You can follow Elena on Twitter @elenaiswriting.

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