The rate of women dying from pregnancy or childbirth in Texas has fallen to pre-pandemic levels, with mental health conditions now the leading cause of pregnancy-related deaths, according to a long-delayed state report released Friday. The biennial report from the Texas Maternal Mortality and Morbidity Review Committee also found that Black mothers continue to die at disproportionately high rates.
State officials were supposed to release the report by September 1 but delayed it until after the midterm elections. The report reviews maternal deaths that occurred in 2021 and 2024, skipping 2022 and 2023 individual case reviews. In 2024, the maternal mortality ratio, the number of maternal deaths per 100,000 births, was 20.5, down from 23.5 in 2021 (excluding COVID-related deaths) and slightly above the 2019 rate.
More than three-quarters of deaths were deemed preventable in both years. Pregnancy-related mortality among Black women was 2.4 times higher than among non-Hispanic white women. Severe maternal morbidity rates increased from 80.4 to 83.5, with Black women experiencing them at a rate of 146.2 per 100,000 births, more than double that of white women.
For deaths researchers determined were related to pregnancy, infection was the leading cause in 2021 and mental health in 2024. Contributing circumstances shifted significantly: the number of cases where violence such as suicide or homicide was a factor quadrupled, from 5% to 19%. Obesity as a factor halved from 63% to 29%. Chronic health conditions, mental disorders and substance abuse all nearly doubled. More than half of pregnancy-related deaths in both years were among women on Medicaid (57% in 2021, 53% in 2024), and 22% in both years were among women who paid out of pocket.
The committee’s report omits 2022 and 2023 from individual case reviews, which could have provided additional information on deaths after Texas’s near-total abortion ban. The report makes no mention of abortion or changes to state law. The Texas Department of State Health Services rejected the notion that the abortion ban was the reason those years were skipped, saying: “The committee was completing 2021 reviews and decided to move next to 2024 (the most recent full year available at the time) so the data wouldn’t continue to get farther and farther behind,” said spokesperson Chris Van Deusen. “The committee made the decision with no dissent at the commissioner’s request and encouraged by the chair.”
Women’s health advocates said the delay was politically motivated and gave lawmakers less time to craft bills based on the report before the legislative session beginning in January. State Rep. Donna Howard, D-Austin, said in a text message: “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 2 months.”
As Texas enters a historic power shift with Republicans in the minority, Democrats have already filed legislation. State Rep. Charlene Ward Johnson, D-Houston, filed a bill calling for a separate study on Black maternal health, similar to one that passed the House but not the Senate in 2025.
The report’s 11 recommendations are largely unchanged from 2024, but new ones include prioritizing access to critical resources, including clinical trials, and improving education and healthcare coordination for women with chronic or high-risk conditions. Recommendations carried over and updated from last year include engaging Black communities and improving access to mental health services. For those services, the report added a note to increase education and behavioral health treatment for women who experience pregnancy loss and women with substance abuse disorders.
Analysis
Why This Matters
- Maternal mortality in Texas, a state with one of the highest rates in the country, remains a critical public health issue, with significant racial disparities.
- The shift to mental health as the leading cause and the quadrupling of violence-related deaths highlight new challenges for healthcare providers and policymakers.
- The report’s delay and the omission of 2022-2023 data may affect legislative priorities in the upcoming session, where Democrats now have more influence.
Background
Texas has long struggled with high maternal mortality rates, particularly among Black women. In 2021, the state banned nearly all abortions, a policy that some researchers and advocates have linked to maternal health outcomes, though the report makes no mention of it. The Texas Maternal Mortality and Morbidity Review Committee, created to study and recommend improvements, releases a biennial report. Friday’s report was originally due September 1 but was delayed for what the state agency said were administrative reasons.
Key Perspectives
- State Rep. Donna Howard (D-Austin): said she was glad the report was finally released but called the two-month delay “unacceptable.”
- Chris Van Deusen, DSHS spokesperson: said the committee chose to skip 2022 and 2023 to avoid getting further behind, a decision made with no dissent.
- Women’s health advocates: criticized the delay as politically motivated, giving lawmakers less time to act.
- State Rep. Charlene Ward Johnson (D-Houston): filed a bill for a separate study on Black maternal health, echoing a previous effort that stalled in the Senate.
What to Watch
- The Texas legislative session begins in January; Democrats, now in the minority, may push for maternal health reforms.
- Whether the delayed release and missing years (2022-2023) become a point of contention between the committee and advocates.
- The impact of any new legislation, especially Johnson’s Black maternal health study bill, given its prior failure in the Senate.
Checked
12 claims in this story checked against 1 source: 11 supported.
Show each claim
- SupportedThe Texas maternal death rate has fallen to pre-pandemic levels.Texas Tribune: “The rate of women dying from pregnancy or childbirth has dropped to pre-pandemic levels”
- Partly supportedMental health is now the leading cause of pregnancy-related deaths.Texas Tribune: “For deaths that researchers determined were related to pregnancy, infection was the leading cause of death in 2021 and mental health in 2024.”
- SupportedBlack women’s pregnancy-related mortality rate is 2.4 times that of non-Hispanic white women.Texas Tribune: “Pregnancy-related mortality rates among Black women was the highest among all racial and ethnic groups and 2.4 times higher than non-Hispanic white women.”
- SupportedThe delayed report was released Friday, after officials had been supposed to release it by September 1 and after the midterm elections.Texas Tribune: “The biennial report, which state officials were supposed to release Sept. 1 but delayed until after the midterm elections”
- SupportedThe report reviews deaths from 2021 and 2024, skipping individual case reviews for 2022 and 2023.Texas Tribune: “The most recent report studies deaths that occurred in 2021 and in 2024, skipping 2022 and 2023 reviews of individual cases.”
- SupportedThe maternal mortality ratio was 20.5 per 100,000 births in 2024, down from 23.5 in 2021 and slightly above the 2019 rate.Texas Tribune: “In 2024, the maternal mortality ratio — the number of maternal deaths per 100,000 births in Texas — was 20.5, a decrease from 23.5 in 2021 (which excludes COVID-related deaths), and slightly above what rates were in 2019”
- SupportedMore than three-quarters of deaths were found preventable in both 2021 and 2024.Texas Tribune: “More than three-quarters of deaths were found to be preventable in both 2021 and 2024”
- SupportedInfection was the leading cause of pregnancy-related deaths in 2021, and mental health was the leading cause in 2024.Texas Tribune: “For deaths that researchers determined were related to pregnancy, infection was the leading cause of death in 2021 and mental health in 2024.”
- SupportedViolence, including suicide or homicide, was a factor in 5% of cases in 2021 and 19% in 2024.Texas Tribune: “a quadrupling in the number of cases where violence like suicide or homicide was a factor, from 5% to 19%.”
- SupportedDSHS spokesperson Chris Van Deusen said the committee moved from reviewing 2021 cases to 2024 cases so its data would not fall further behind.Texas Tribune: ““The committee was completing 2021 reviews and decided to move next to 2024 (the most recent full year available at the time) so the data wouldn’t continue to get farther and farther behind,” said Chris Van Deusen, a DSHS spokesperson, on Friday.”
- SupportedDonna Howard said by text message that it was unacceptable the department delayed release by more than two months.Texas Tribune: ““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 2 months,” Howard stated via text message.”
- SupportedWomen’s health advocates said the delay was politically motivated and left lawmakers less time to prepare bills before the January legislative session.Texas Tribune: “Women’s health advocates complained the delay was politically motivated and gave lawmakers less runway to craft bills based on the report ahead of the upcoming Texas legislative session which begins in January.”
