Abstract
Access to maternal care has a significant impact on overall maternal health, with increasing challenges across the United States leading to increasing severe maternal morbidity (SMM) and mortality. While maternal mortality has been extensively examined, SMM research has not received the same attention despite the critical public health concerns. To develop targeted interventions to improve maternal outcomes, the factors associated with access to maternal care, rurality, and the occurrence of SMM among Texas women must be investigated. Chapter 2, Maternity Care Deserts: Bridging Gaps in Maternal Healthcare Access, provides an overview of maternal morbidity and mortality in the United States, including attributes of maternity care deserts (MCD), the impact of social determinants of health (SDOH), antecedents of MCDs, and innovative solutions and mitigation strategies. Chapter 3, Influence of Social Determinants on Maternal Outcomes in Maternity Care Deserts: A Systematic Review, presents a systematic literature review exploring relationships among limited access to maternal care, maternal morbidity and mortality, and SDOH.
Chapter 4, Predicting Severe Maternal Morbidity in Texas: Risk Factors and Racial Effect Modification, reports on an original research study evaluating the impact of access to care, rurality, and both modifiable and non-modifiable risk factors associated with SMM in Texas, utilizing secondary data analysis. Chapter 5 summarizes the manuscript, presents study strengths and limitations, and suggests next steps to build on this dissertation research. The practical implications for nursing practice and future research are also examined.
Date of publication
3-19-2026
Document Type
Dissertation
Language
english
Persistent identifier
http://hdl.handle.net/10950/5029
Committee members
Dixie Rose, Mandy Golman, Maeve Wallace
Degree
Doctor of Philosophy in Nursing
Recommended Citation
Waters, Antay L., "PREDICTING SEVERE MATERNAL MORBIDITY IN TEXAS: RISK FACTORS AND RACIAL EFFECT MODIFICATION" (2026). Nursing Theses and Dissertations. Paper 157.
http://hdl.handle.net/10950/5029
Grad School Dissertation Approval
Included in
Clinical Epidemiology Commons, Maternal and Child Health Commons, Maternal, Child Health and Neonatal Nursing Commons, Nursing Midwifery Commons, Public Health and Community Nursing Commons, Women's Health Commons