Maternal healthcare deserts in West Texas

Objective: Hospital and obstetric unit closures in U.S. counties often lead to expansion of maternal healthcare deserts, defined as counties without a birth center offering obstetric care. This study describes the maternal demographic profile and geographic scarcity of obstetric care across the large and sparsely populated west Texas region. Materials and Methods: Aggregate population data are obtained from the U.S. Census and American Community Survey. Maternal healthcare centers for 107 counties across west Texas, defined here as public health regions 1, 2, 9, and 10, are identified using data from the Texas Collaborative for Healthy Mothers and Babies. Results: Across west Texas, 76 of 107 counties are maternal healthcare deserts, with no available obstetric care. Approximately 82,000 women of childbearing age live in these counties, with about 5,000 reporting having given birth in the past 12 months. Level II or higher obstetric care is available in just 12 (about 11%) of west Texas counties. Conclusion: A majority of rural counties across the large geographic area of west Texas lack labor and delivery services, leading expectant mothers to travel to neighboring counties for obstetric care, or further for high-risk care. Greater coordination between higher level maternal care centers and rural hospitals and providers, as well as telehealth and community health worker outreach, may provide some level of connection to obstetric services for women in rural areas.