Harris County, Texas—home to Houston and one of the largest medical complexes in the world—has been identified as the most dangerous place in the United States for Black mothers to give birth, according to new public-health research.
Per Black Enterprise, the findings highlight how sharply maternal and infant outcomes for Black families in Texas diverge from both state and national trends.
Between 2016 and 2020, Black women in Harris County experienced a maternal mortality rate of 83.4 deaths per 100,000 live births. That figure surpassed statewide and national averages during the same period and was significantly higher than rates for white women.
Nationally, Black mothers continue to die at far higher rates than their peers, but Harris County stands out for the severity of the gap.
The data extend beyond maternal deaths. Infant mortality among Black babies in Harris County reached 11.66 deaths per 1,000 births during that same timeframe—more than double the national average reported in 2020.
Public-health officials say the numbers point to compounding risks during pregnancy, delivery, and the postpartum period.
Experts caution that the issue cannot be explained by a single factor. Esohe Faith Ohuoba, a Houston-based OB-GYN, says disparities are closely tied to social conditions that shape health long before pregnancy begins.
“Things like access to quality care, financial stability, housing, education, and even the stress that comes from navigating systemic inequities all play a role,” she said, noting that the size of Texas and uneven access to providers can worsen delays in care.
Communication inside medical settings has also emerged as a recurring concern. Ohuoba emphasized that breakdowns between patients and providers can prove deadly. “Were warning signs recognized, and was treatment timely?” she asked. “That’s where quality of care becomes critical.”
Broader statewide data reinforce the county-level findings. A Texas Advisory Committee report found that Black women in Texas face maternal mortality rates nearly three times higher than other women, regardless of income or education level.
The report also noted that mental-health conditions and interpersonal violence account for a significant share of pregnancy-related deaths, many of which occur months after delivery and are considered preventable.
In recent years, Texas has extended postpartum Medicaid coverage to 12 months, a move health advocates describe as necessary but insufficient on its own. Hospitals in Harris County say they are reviewing severe maternal cases and expanding quality-assurance efforts, particularly for high-risk patients.
Outside hospital walls, Black-led organizations are working to close care gaps. Groups like Pregnant and Black and The Shades of Blue Project focus on culturally competent support, advocacy, and mental-health awareness.