The recent election may have concluded, but the effort to hold Texas officials accountable is only beginning. The focus now shifts towards uncovering the truth surrounding maternal health in the state.
A newly released report from Texas’ maternal mortality committee reveals that the rate of women dying from pregnancy or childbirth has returned to pre-pandemic levels. However, it also highlights a troubling trend: mental health issues have emerged as the leading cause of maternal deaths, with Black mothers experiencing disproportionately high mortality rates.
Initially scheduled for release on September 1, the biennial report was delayed until after the midterm elections. This document provides the first thorough examination of maternal mortality rates since the state imposed a near-total ban on abortions in 2021.
The report analyzes maternal deaths from 2021 and 2024, omitting reviews from 2022 and 2023. In 2024, the maternal mortality ratio in Texas stood at 20.5 deaths per 100,000 births, a decrease from 23.5 in 2021, which excludes deaths related to COVID-19, and slightly higher than the rates recorded in 2019.
More than 75% of maternal deaths in both 2021 and 2024 were deemed preventable, although this figure reflects a slight decline from 80% reported previously. The mortality rate among Black women was the highest across all racial and ethnic groups, being 2.4 times that of non-Hispanic white women.
Severe maternal morbidity rates, which can lead to both short- and long-term health complications, increased from 80.4 to 83.5. These rates also vary significantly among different racial and ethnic groups, with Black women in 2024 suffering from severe maternal morbidity at a rate of 146.2 per 100,000 births—more than double that of their white counterparts.
State Representative Donna Howard, D-Austin, who has championed enhancements to the committee’s data collection efforts over the years, expressed concern over the high maternal death rates among women utilizing Medicaid health insurance. “I am glad the Department has finally decided to release the MMMRC’s 2026 report, but it remains unacceptable that they delayed its release by more than two months,” she stated via text message.
The leading cause of pregnancy-related deaths identified in 2021 was infections, while mental health issues took precedence in 2024. The circumstances surrounding these deaths shifted considerably over the years; for instance, incidents of violence, including suicide and homicide, quadrupled as contributing factors, rising from 5% to 19%. Conversely, the role of obesity in these cases was cut by half, from 63% to 29%, while other significant factors like chronic health conditions, mental disorders, and substance abuse nearly doubled.
In both 2021 and 2024, over half of the pregnancy-related deaths involved women on Medicaid, although this figure saw a slight decline from 57% to 53%. Additionally, 22% of deaths in both years were attributed to women who paid for medical care out of pocket.
The committee’s report does not provide insights into the years 2022 and 2023, which could have shed light on deaths occurring after the implementation of the abortion ban. Notably, the report does not mention abortion or the legal changes affecting it.
Officials from the Texas Department of State Health Services, which oversees the Maternal Mortality and Morbidity Review Committee, dismissed claims that the abortion ban influenced the omission of those years. “The committee was completing 2021 reviews and decided to move next to 2024, the most recent full year available at the time, to ensure the data would not continue to lag,” explained Chris Van Deusen, a DSHS spokesperson. He added that the decision was made without dissent at the commissioner’s request and with the chair’s encouragement.
Agency officials also refuted the idea that the upcoming elections contributed to the report’s delay, citing a state law enacted in 2025 that allows agencies greater flexibility in submitting reports to the governor.
Women’s health advocates have criticized the delay as politically motivated, arguing it limits lawmakers’ ability to draft relevant legislation ahead of the upcoming Texas legislative session, which commences in January. Bill filing began on Monday.
Despite this setback, the recent shift in Texas’ political landscape, which has placed Republicans in the minority, may lead to increased support for the maternal mortality committee. Democrats have already introduced legislation pertaining to the committee. State Representative Charlene Ward Johnson, D-Houston, has filed a bill advocating for a distinct study on Black maternal health in the state, echoing a proposal she made in the 2025 session, which passed the House but not the Senate.
While many of the report’s 11 recommendations for enhancing maternal health outcomes in Texas mirror those from the 2024 report, new suggestions emphasize the importance of ensuring access to critical resources, such as clinical trials, and improving education and healthcare coordination for individuals with chronic or high-risk medical conditions.
Updated recommendations from last year’s report continue to focus on engaging Black communities to tackle healthcare disparities and enhancing access to mental health services. Notably, the report stresses the need for increased education and behavioral health treatment for women experiencing pregnancy loss and those with substance abuse disorders.
