“If we want kids, moms, and communities to thrive in Texas, then we need to help local moms stay healthy.”

            — Adriana Kohler, Senior Health Policy Associate, Texans Care for Children

A new report, Healthy Moms Raising Healthy Babies: Central Texas and Statewide Challenges and Opportunities to Support Maternal Behavioral Health During the First Year After Childbirth, paints a clear picture of why supporting maternal behavioral health during the fourth trimester is vital to ensuring that Texas’ moms, kids, and their families are able to thrive in life.

First a little background. Across Texas, drug overdose is the leading cause of maternal death up to one year after childbirth, suicide is the fifth leading cause of maternal death, and many more mothers face pregnancy complications that too often have long-term health consequences for mothers and babies. The report notes that Texas has the highest uninsured rate in the nation for women of childbearing age (25 percent) and cuts off Medicaid health insurance for mothers about 60 days after childbirth.

This new report from Texans Care for Children found that the Central Texas region has the fourth highest maternal death rate out of the state’s eight health regions.  It details how untreated behavioral health conditions — such as maternal depression and substance use disorders — affect many new mothers in the region during the first year after childbirth and undermine their health and their babies’ health. And while treatment works, the authors found that for a few key reasons, treatment is often out of reach for many moms. The report authors found that women of color in Austin and the surrounding communities, understandably fear the consequences of admitting they need help.

The report also identifies ways that community leaders — including local officials, health care providers, philanthropic foundations, and others — can improve support for local mothers during the first year after childbirth. While the report has a special focus on Central Texas, the data, findings, and action steps have implications for all Texas communities and beyond.

Key findings include:

• Central Texas has significant maternal health challenges.
• Central Texas must address the particular challenges that the region’s Black women and other women of color face as a result of the current and historical factors described in this report.
• Key barriers limit access to maternal health support in Central Texas, including a lack of insurance coverage for postpartum behavioral health care for mothers, a lack of transportation to medical appointments, and too few trained behavioral health providers available to meet the needs of uninsured mothers.
• There are underutilized opportunities to support maternal health in the region, including: raising awareness of the Healthy Texas Women program, increasing confidence to screen and refer clients for behavioral health challenges among Central Texas health professionals, co-locating medical and behavioral health services for mothers, and improving the availability and funding for doulas, perinatal community health workers, and other labor and postpartum supports beneficial for new mothers.

To address these barriers, the report makes several recommendations, including:

• Maximize existing state programs by leveraging Medicaid to increase access to labor and other postpartum support, such as trained doulas, and promoting implementation of initiatives that remove obstacles in the Medicaid medical transportation program to connect more mothers with the care they need.
• Improve training opportunities and support awareness campaigns, such as outreach and education activities to help more mothers and maternal health professionals to understand the process for requesting rides to health appointments through the medical transportation program or their Medicaid health plan.
• Promote positive practice and health system changes, such as tele-health visits and initiatives, especially for new mothers without transportation or child care options, coupled with efforts to ensure insurance reimbursement parity between in-person and virtual visits.
• Expand and support effective local programs, such as local substance use disorder treatment providers, case managers, other behavioral health specialists, and community mental health centers that serve Texans regardless of insurance or ability to pay.

Report co-author Adriana Kohler explains that “it’s going to take some work to ensure that Texas moms have the support they need to be healthy during that first year after childbirth but there are clear steps that community leaders can start taking now.”

Please read the full report here.