1. CATE CAMPBELL, MPH WHITNEY MICHAEL, MPH MATTHEW P. TURNER, PHD, MPH Growing Pains: Delivering Women's Health Services in Texas

2. Source: Texas Population Projections. Texas State Data Center, Austin, Texas. February 24, 2015. Projected Population Growth in Texas

3. Source: Texas Population Projections. Texas State Data Center, Austin, Texas. February 24, 2015. Race/Ethnicity of Texas Population

4. Source: Texas Hospital Inpatient Discharge Public Use Data File, Q1-Q4, 2013. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas. February 24, 2015. Female Obstetric Unit Admissions per 100,000 Female Population, 2013

5. Source: 2012 Birth Certificate finalized data files. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas. February 24, 2015. Birth Rates per 1,000 Population, Texas Residents, 2012

6. Source: 2012 Birth Certificate finalized data files. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas. February 24, 2015. Fertility Rates per 1,000 Female Population age 15-44, Texas Residents, 2012

7. Source: 2012 Birth Certificate finalized data files. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas. February 24, 2015. Percentage of Women Who Received Prenatal Care in the First Trimester of Pregnancy, Texas Residents, 2012

8. Source: 2014 Hospital survey file. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas. February 24, 2015. Highest Level Hospital Obstetrics Unit by County, 2014

9. Source: 2014 Physician licensure file. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas. February 24, 2015. Ratio of Population to Obstetrician/Gynecologist, 2014

10. Source: 2014 Nurse-midwife licensure file. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas. February 24, 2015. Ratio of Population to Certified Nurse- Midwives, 2014

11. Encouragement of earlier prenatal care for expectant mothers Better access to higher level facilities at which to provide prenatal care, women’s health and labor and delivery services More providers across state  Programs to attract doctors to HPSAs  Increased presence of medical/nursing schools in areas with high birth and fertility rates Conclusions

12. Questions?