Texas’ urban cities can offer women a deluxe birthing suite, equipped with high-tech monitoring for mom and the baby, spacious rooms and a full team to handle any emergency.
That isn’t the case in the Panhandle, where just eight hospitals are scattered in the 26,000 square mile region. Instead of high-tech monitoring, women are hooked up to the most basic medical equipment in a cramped and outdated room. There is no emergency team in the face of risks or complications, except in Amarillo.
“Your small town hospitals may have the staff and some stirrups to handle a delivery,” said Lisa Dillard, director of Maternal Child Health for March of Dimes in Lubbock. “And just like a paramedic on the roadside, they will do the delivery.”
This medical desert lies in the backyard of Amarillo, where the long battle over abortion access has found a new front. Anti-abortion activists, led by Mark Lee Dickson, director of East Texas Right to Life, has pressured the city to approve an ordinance outlawing the use of city roads and highways for an abortion outside of Texas. Amarillo was chosen due to its proximity to states that offer abortion services.
On Tuesday, the conservative City Council rejected the ordinance — delivering a major loss for the so-called sanctuary city movement. Now, a group of residents who successfully petitioned the council to consider the proposal must decide whether to ask voters in November to override the council’s decision. They are likely to do so.
The largest city near the top of the state — population 201,000 — serves as a medical hub for the rest of the 26 counties in the northern Panhandle, essentially an oasis in a maternal care desert. Women’s health advocates say the neverending fight over abortion access is ignoring the more pressing matters of expanding health care access to more than 122,000 girls and women between the ages of 10-54 in the Panhandle. Those women lack access to quality OB-GYNs, maternal health support, and insurance providers.
The picture is grim. At best, women can have their babies delivered safely in one of eight rural hospitals scattered in the vast region. At worst, a person with a high-risk pregnancy or an emergency is traveling to one of Amarillo’s two hospitals, regardless of how far it is from home.
These advocates argue that the health care profession is already stressed due to bad policies, workforce shortages and tight budgets.
“The infrastructure is not in place for women to access the health care they need,” said Lindsay London, co-founder of the Amarillo Reproductive Freedom Alliance. “It all comes down to the bootstrap mentality of, ‘Figure it out.’”
Texas women face countless challenges to their reproductive health. And in a state with the highest numbers of maternal deaths in the nation, women in rural areas fare worse. Maternal access is stretched thin in the Texas Panhandle — only eight hospitals, including those in Amarillo, have labor and delivery services for the upper 26 counties. And, it’s a national issue. The Commonwealth Fund’s research shows nearly 7 million women in the U.S. live in counties without hospitals or birth centers.
What a maternal health care desert looks like
Spread out over 85% of the state’s geography are 3.1 million Texans who live in small communities few and far between. The rural landscape offers an idyllic lifestyle for some, including vibrant sunsets, tranquil nights, and wide open spaces full of fresh air.
The peace and quiet comes at a price though, and part of it is losing critical resources, including labor and delivery services.
Health care deserts don’t happen overnight in rural Texas. In most cases, the decline is caused by a single factor — an EMS service runs out of funding, a clinic loses providers, a hospital locks its doors for the last time.
According to the Texas Organization of Rural and Community Hospitals, 28 rural Texas hospitals have closed since 2010, the most in the nation. This leaves underserved communities vulnerable, as any need for medical care could turn into a long drive.
And even in these dire circumstances, pregnant women and new moms are more vulnerable during a significant time in their life. Only 64 of the remaining 158 rural hospitals in Texas still provide obstetrical and delivery services.
“Labor and delivery services are one of the first to go when hospitals need to tighten belts,” said Erika Ramirez, senior director of the Texas Hospital Association’s policy team.
Hospitals can face financial loss when a patient uses Medicaid to give birth. The federal program covers nearly half of all births in Texas, but hospital officials say the Medicaid payout rate is low. This can lead to financial loss for hospitals trying to be paid for services, along with trouble retaining physicians and recruiting new ones.
Ramirez said for years, maternal care in Texas has been limited for women seeking care before, during and after pregnancy. The hurdles are reflected by the state’s maternal mortality numbers.
According to a March of Dimes report card for Texas, an average of 28 women die from causes related to pregnancy or postpartum per 100,000 births in the state, compared to 23.5 deaths on average in the U.S. Women in rural areas have a 9% higher chance of maternal mortality than those in urban areas.
The same report gave Texas a D- and found that nearly 47% of counties are a maternity care desert. The Texas Maternal Mortality and Morbidity Review Committee also recommends increasing access as the top recommendation to prevent maternal death and illness.
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Democrats are dropping ads that could literally double as a documentary at this point.
