Texas faces some of the most urgent maternal and infant health challenges in the country. The state has the highest rates of uninsured in the nation, and one of the highest maternal mortality rates. Maternal health disparities persist, disproportionately impacting women of color, uninsured families and rural communities.
Recognizing these urgent needs, Blue Cross and Blue Shield of Texas expanded its Special Beginnings® Maternal and Infant Health Initiative in August 2023. The initiative is to improve maternal and infant outcomes by increasing access to care, reducing care gaps and engaging Texans at the community level. Guided by recommendations from the Texas Maternal Mortality and Morbidity Review Committee and the Department of State Health Services, Special Beginnings focuses on four priority regions — Dallas-Fort Worth, Houston, Central Texas and the Rio Grande Valley — while supporting mothers and babies statewide.
The initiative centers on:
- Implementing quality-based maternal health programs to reduce preterm births, low birth weight deliveries and obstetric/postpartum emergencies.
- Expanding access to comprehensive services, including behavioral health, from preconception through postpartum.
- Increasing community awareness and engagement to reduce maternal morbidity, mortality and health disparities, with an emphasis on diversifying and expanding the maternal health workforce through the training of doulas, midwives and lactation consultants.
Since its expansion, the Special Beginnings initiative has directed more than $10.2 million in investments to 16 community organizations and clinical providers. In two years, Special Beginnings collaborators have:
- Served more than 120,000 Texans, delivering nearly 650,000 maternal and infant health services.
- Screened more than 166,000 patients for sexually transmitted infections.
- Distributed nearly 3,800 bottles of prenatal vitamins to clients.
- Helped welcome more than 5,500 healthy babies. No maternal deaths were reported among program participants.
“This marks an important milestone as we recognize the second year of our commitment to improve the health outcomes for the moms and babies of Texas,” says Dr. Mark Chassay, BCBSTX vice president and chief medical officer. “We’ve served the state of Texas for more than 95 years through every stage of life. That starts with maternal care. BCBSTX is committed to improving health outcomes in Texas every step of the way.”
In November 2025, BCBSTX announced an additional $2 million investment to nine current maternal health community partners and three new partners, bringing the total investment to $12.2 million to 19 community partners.
Key partnerships include:
Abide Women’s Health Services: Angelina, Collin, Dallas, Denton, Harris, Ellis, Kaufman, Navarro, Robertson, Rockwall and Tarrant counties.
Abide Women’s Health Services’ mission is to improve birth outcomes in communities with the lowest quality of care by offering health care and complementary resources that are easily accessible, holistic, evidence-based and judgment-free.
With support from Special Beginnings, Abide is extending its reach in-office and through programs such as Abide on the Move, a mobile prenatal clinic launched in August 2025, and Abide at Home, a home birth program. These enhancements bring care to communities with the greatest need, ensuring women have access to prenatal and postpartum services close to home. Through partnerships with Delighted to Doula, the Center for Transforming Lives in Tarrant County and Hope Cottage in Dallas, Abide is building a maternal support network that addresses medical and social needs. These efforts are improving outcomes and creating healthier beginnings for moms and babies.
Access Esperanza Clinics: Hidalgo County
Access Esperanza Clinics’ mission is to provide education, advocacy and affordable high-quality health care so people in the community can access sexual and reproductive health services. For many families, AEC is the only available health care provider — more than 80% of its patients live below the poverty line.
The organization’s Preconception Care Project, supported by Special Beginnings, offers pregnancy testing, prenatal vitamins and comprehensive family planning counseling. AEC has expanded services with rapid STI screening and same-day treatment, improved tracking of social determinants of health, and strengthened referral networks through partnerships with organizations such as the Texas Workforce Commission and the Food Bank of the Rio Grande Valley and the Centers for Disease Control and Prevention. Community health workers, or Promotoras, include maternal health outreach as part of its engagement efforts.
Bracane Company Inc.: Statewide
Bracane Company Inc.’s mission is to transform organizations by aligning excellence with equity, delivering research, compliance and operational strength to solve complex challenges and build thriving, resilient communities worldwide.
With support from Special Beginnings, Bracane leads listening sessions and focus groups across Texas — bringing together pregnant women, new mothers, providers and community members to share experiences and shape maternal health strategies. These sessions, offered in-person and virtually, provide a safe space for candid conversations about care barriers, cultural needs and improvement opportunities. Insights gathered become actionable recommendations that guide BCBSTX’s maternal and infant health strategy, with focus on reducing preventable maternal deaths and eliminating disparities. Bracane’s work ensures programs are grounded in the lived experiences of those most affected by Texas’ maternal health crisis.
CenteringPregnancy: Statewide
Through its partnership with the Centering Healthcare Institute, the Special Beginnings program is increasing access to the CenteringPregnancy model across Texas to give expectant mothers the time, support and resources needed. CenteringPregnancy is a nationally recognized, evidence-based model that brings small groups of women with similar due dates together for prenatal care.
Each session, lasting up to two hours, combines individual health assessments with group learning and peer support, offering 10 times more interaction than a traditional prenatal visit. Research shows the model has a measurable impact, reducing preterm birth risks up to 47%, lowering rates of low birth weight.
Delfina Care: Harris and Travis counties
Technology is helping bridge maternal health gaps through Delfina Care, an AI-driven pregnancy care platform supported by Special Beginnings. Partnering with community providers such as Lone Star Circle of Care, Hope Clinic and Legacy Community Health, Delfina empowers clinicians to deliver more informed, proactive and connected care to pregnant and postpartum patients by helping identify risks early to prevent complications.
Patients using Delfina’s platform can schedule appointments with ancillary care providers at the Delfina Medical Group, access telehealth, track symptoms and health goals, and join virtual breastfeeding, yoga and exercise classes designed to make care more accessible, especially in underserved communities where pregnancy outcomes are often worse.
Founded by Dr. Senan Ebrahim, who was inspired by his own experience witnessing the challenges of pregnancy care — including a patient’s stillbirth — Delfina’s mission to support safer pregnancies is personal. With Special Beginnings support, the company is advancing medical technology and elevating care and funding additional staffing such as doulas and community health workers.
East Texas Community Clinic Inc: Henderson, Kaufman and Van Zandt counties
East Texas Community Clinic Inc. provides comprehensive primary and preventive care to people of all ages, regardless of ability to pay or health insurance. It offers family planning services, including prenatal/pregnancy care, birth control and OB/GYN services. Supported by Special Beginnings, the Healthier Mom’s and Families in Rural East Texas program aims to expand preventive and maternal care services to help increase education and awareness and improve health in Henderson, Kaufman and Van Zandt counties.
Maternity care statistics in the counties it serves show the need for increased support that can be provided by ETCC’s UT Athens residency program. The service areas have a higher teen birth rate, decreased level of prenatal care, increased rate of smoking during pregnancy, higher maternal obesity rate, and higher rate of neonatal abstinence syndrome. This reveals a need for increased education and awareness of the importance of obtaining prenatal care starting in the first trimester. ETCC plans to increase the number of OB patients and deliveries for the physicians and residents in their program.
HHM Health: Collin, Dallas, Denton, Ellis, Hunt, Kaufman, Rockwall and Tarrant counties
HHM Health's mission is to provide quality health care to neighbors with love, compassion and respect. With support from Special Beginnings, HHM Health expanded to bring quality, affordable women’s health care to Dallas-area communities lacking those services, opening locations in South Dallas, Hope Cottage and Mesquite. HHM Health offers care from preconception through postpartum, serving moms with medical expertise and social support.
With funding from Special Beginnings, HHM Health invested in advanced technology like a 3D Samsung SonoSync sonogram machine, allowing maternal-fetal medicine specialists to conduct real-time remote consultations for high-risk pregnancies. HHM also launched CenteringPregnancy cohorts, giving women the chance to experience group-based prenatal care and community-building. HHM also incorporates digital tools from Inovcares to help patients manage conditions like hypertension — providing kits for at-home monitoring and app-based connections to providers.
Holy Family Services Inc.: Hidalgo, Cameron and Willacy counties
In the Rio Grande Valley, where access to affordable, quality maternal care is limited, Holy Family Services is the region’s only freestanding birth center operated by certified nurse-midwives. For decades, HFS has provided comprehensive care for women and families from preconception through menopause, while also serving as a training site for health care professionals through its partnership with the University of Texas Rio Grande Valley’s medical school.
With support from Special Beginnings, HFS has expanded to deliver services to uninsured and underinsured families. HFS offers prenatal and postnatal care, STI testing, mammograms, ultrasounds, family planning and well-woman services. It's also grown its education programs, offering free breastfeeding, childbirth, infant care, nutrition and car seat safety classes, many available in Spanish to reach more families. In 2025, HFS launched its first three CenteringPregnancy groups, giving expectant mothers the opportunity to build community and learn together in a group-care model proven to improve outcomes.
HOPE Clinic: Harris County
For many Houston-area women, accessing affordable maternal care can be difficult — particularly for those who are uninsured, underinsured or face language and cultural barriers. HOPE Clinic was created to meet those needs, offering compassionate, culturally competent care at four Harris County locations. With services provided in more than 30 languages, HOPE ensures every patient, regardless of ability to pay, feels seen, heard and supported.
With support from Special Beginnings, HOPE Clinic strengthened its maternal health programs, blending clinical care with education and technology to help women before, during and after pregnancy. Expectant mothers can attend CenteringPregnancy groups, where they receive prenatal care in a supportive group setting while building community with other moms.
Patients also benefit from educational resources, maternal health booklets and walk-in pregnancy testing services, which lower barriers to early care. Through Delfina’s AI-driven platform, providers gain insights to identify early risks and prevent complications, helping standardize care across patient populations. HOPE also maintains a community resource list and provides staff training to better connect patients with support systems.
Huston-Tillotson University: Travis County
Huston-Tillotson University’s Boldly B.L.U.E. initiative — Birthing, Learning, Understanding and Empowering — is training a diverse generation of doulas, midwives and lactation consultants to expand Central Texas maternal health access. With support from Special Beginnings and in partnership with Black Mamas ATX and Healing Hands Community Doula Project, HTU provides training combining classroom learning, community health worker certification, and hands-on preceptorships supporting clients through births. Thirty-eight participants across three cohorts have advanced in employment and preceptorships, with 28 completing training and several employed by Special Beginnings grantees like Delfina.
HTU has piloted fast-track training for experienced doulas, launched a referral system to connect families with trained birth workers, and held focus groups to ensure community members guide program development. The university also launched midwifery training. Beyond workforce development, Boldly B.L.U.E. is building a maternal health research network to capture insights from doulas, midwives and their clients. These lived experiences will help inform best practices, guide future policy and reduce birth complications and unnecessary C-sections.
InovCares: Dallas and Hidalgo counties
For too many women, especially women of color, pregnancy can be deadly. Mohamed Kamara founded InovCares after the deaths of his sister to a pregnancy-related hemorrhage and aunt to preeclampsia. His mission is to harness technology and bridge gaps in maternal care.
Through the Special Beginnings initiative, InovCares is expanding its telehealth platform to connect women in Dallas and Brownsville with trusted, culturally competent providers — including OB/GYNs, nurses and doulas — 24 hours a day. Patients receive a home monitoring kit, including a blood pressure cuff and glucose monitor, which sync with the InovCares app. Real-time data alerts providers to risks, enabling early intervention to prevent complications.
In partnership with HHM Health in Dallas and New Horizons Health Center in Brownsville, InovCares has supported more than 615 women, alleviating social determinants of health like transportation barriers, food insecurity and lack of community support. Beyond medical care, the app offers wraparound services — from prescription and grocery delivery to peer support groups — ensuring mothers are receive guidance.
March of Dimes: Harris County
For thousands of Houston-area women, access to maternity care has often been defined by geography. According to the March of Dimes report Nowhere to Go: Maternity Care Deserts Across the U.S., more than 2.3 million women of reproductive age live in counties with little or no maternity care access. In Texas, 1 in 3 birthing people received prenatal care in their first trimester. This lack of access has fueled higher risks of preterm birth and maternal complications.
To bridge this gap, the Special Beginnings initiative awarded a $1.2 million grant to launch the state’s first Mom & Baby Mobile Health Center®, bringing care to neighborhoods most in need. The 40-foot mobile clinic, operated by Memorial Hermann Health System, has two exam rooms, a lab, vaccine-compliant refrigeration and telehealth technology — a maternal health center on wheels. Services include prenatal labs, newborn assessments, STI testing, wound care for C-sections and high-risk referrals. From January to September 2025, the mobile center served 135 patients and received 271 visits.
By partnering with schools and community organizations in Southwest Harris County, the program ensures care reaches women in places they live, work and raise families. Services are available to all women, regardless of insurance, income or immigration background.
Nexus Family Recovery Center: Dallas County/Statewide
For women struggling with substance use disorder, recovery has meant choosing between treatment and keeping their children. In Texas, a handful of facilities support pregnant and postpartum women while allowing them to bring their children into care. Nexus Family Recovery Center offers holistic, gender-specific, trauma-informed care to help women recover while nurturing their families. The center provides substance use treatment and parenting education, mental health support and developmental services for children, helping them build resilience with their mothers.
Over the past year, Special Beginnings grant funding expanded Nexus’s capacity to serve more families. In 2024, the center supported more than 3,300 women and their families, including 32 babies and 212 children in the child development program. Technology upgrades, expanded care programming and strengthened partnerships with organizations like Women’s Health Services, Children’s Medical Services, Delighted to Doula and Family Place Domestic Violence have enhanced maternal and child outcomes.
Parkland Health Foundation: Dallas and Hunt counties
Parkland Health Foundation's mission is to increase care access across the Dallas area, offering healing and hope to every person. Special Beginnings funding supports the extending Maternal Care After Pregnancy program, which offers support up to one year postpartum, addressing physical and mental health needs to women facing health care gaps and barriers in Dallas and Hunt counties.
With one of the highest maternal mortality rates in the nation, Texas reports up to 51 deaths per 100,000 births. The eMCAP program offers professional care through home visits, mobile clinics and integrated telehealth services. This program has empowered Dallas County’s most vulnerable women to improve their health by providing postpartum support access.
People’s Community Clinic: Bastrop, Caldwell, Hays, Travis and Williamson counties
People’s Community Clinic is helping bridge gaps to high-quality maternal and pediatric care in Central Texas, providing comprehensive prenatal, pediatric and preventive care for underserved and uninsured families. The clinic's Center for Women’s Health offers services, including prevention of unintended pregnancies, prenatal and postpartum care and annual well-woman exams. Pediatric primary care is integrated into family care, helping parents build nurturing relationships with their children. The clinic also provides early childhood development programs to set kids on a path toward lifelong health.
Through BCBSTX’s Special Beginnings funding, People’s has expanded its Center for Women’s Health with more exam rooms, increased lactation support and acquired equipment to enhance quality of care. The clinic also partners with Vitamin Angels to provide prenatal vitamins and offers translation support to ensure care is accessible to all families.
Project Unity: Brazos, Burleson, Grimes, Leon, Madison, Robertson and Washington counties
Project Unity Texas aims to empower children, families and individuals to reach their highest potential in their communities. Special Beginnings supports the Brazos Healthy Communities program, which serves pregnant moms and individuals with chronic illnesses and disabilities. The program employs community health workers who deliver in-home prenatal, postpartum and social services, reducing preterm births, low birth weight and maternal emergencies in Brazos, Burleson, Grimes, Leon, Madison, Robertson and Washington counties.
The program connects mothers to prenatal and postpartum care, behavioral health, housing, transportation, nutrition and stress supports. The Special Beginnings grant will expand Project Unity’s capacity to deliver coordinated, family-centered care that strengthens maternal and child health across the Brazos Valley.
Santa Maria Hostel: Austin, Bastrop, Brazoria, Fort Bend, Galveston, Harris, Hays, Jefferson, Liberty, Montgomery, Travis, Waller and Williamson counties
For mothers and families navigating substance use, trauma and mental health struggles, Santa Maria Hostel provides its Caring for Two program. One of the largest providers of substance use treatment for women in Texas, Santa Maria is among few programs in the state that allow mothers to bring their children into treatment, keeping families together while promoting recovery.
With support from Special Beginnings funding, the Caring for Two program offers maternal and infant care, integrating parenting education and coaching, behavioral health screenings, counseling, doula support, health care navigation, transportation, housing assistance and peer recovery services. These supports help mothers bond with their children, develop parenting skills and improve maternal and child health outcomes.
Special Beginnings supported the program's Austin expansion, building partnerships with Travis County and Williamson County courts to create paths for families to access care. In Houston, doula care is provided to Caring for Two participants who receive labor and postpartum support. Caring for Two provides services at Memorial Hermann Hospital Southwest and Northeast/Greater Heights locations. Across the state, Santa Maria served more than 12,000 women and children in 2024, with 90% of babies born at a healthy birth weight.
Texas Pediatric Society: Statewide
The Texas Pediatric Society works to strengthen the health and welfare of children across Texas, providing physical, emotional and social health services while also offering continuing education units for providers. Through its collaboration with Special Beginnings, TPS is equipping pediatricians and primary care providers with tools and training to improve maternal and infant outcomes statewide.
The initiative includes development of a clinical series program, advisory committee guidance and resources for pediatric health care spanning newborns through adolescents. In 2024, the program prioritized postpartum depression screenings and NICU care, providing provider resources such as microlearning videos, webinars, roundtables and virtual office hours. Additionally, the program recruited providers for Project ECHO®, a training model where participants present cases to specialists, fostering continuous learning, mentorship and peer support. TPS’s work builds on BCBSTX’s long-standing maternal and infant health programs and uses local expertise to increase care access, reduce care gaps and educate Texas families.
Vitamin Angels: Statewide
Vitamin Angels, a global public health nonprofit focused on improving maternal and child nutrition, works to ensure that pregnant, postpartum and family-planning women receive prenatal vitamins and minerals at no cost.
Through Special Beginnings funding, Vitamin Angels has distributed 20,870 six-month supplies of vitamins to community partners, reaching nearly 106,000 beneficiaries across Texas. These supplies are provided by clinics and community organizations, including Access Esperanza and HOPE Clinic. Research shows proper folic acid intake before and during early pregnancy can prevent serious neural tube defects, which often occur before a woman knows she is pregnant.
This collaboration enhances BCBSTX’s maternal and infant health efforts by reducing nutrition barriers, increasing care access and educating providers and families. Vitamin Angels uses its global expertise and local partnerships to ensure Texas mothers and babies have the nutrients they need for a healthy start.
Grantee collaborations:
- Access Esperanza: Vitamin Angels
- CenteringPregnancy: Hope Clinic, HHM Health, and Holy Family Services
- Delfina Care: Huston-Tillotson University and HOPE Clinic
- HHM Health: InovCares and CenteringPregnancy
- Holy Family Services: CenteringPregnancy
- HOPE Clinic: CenteringPregnancy, Vitamin Angels, and Delfina
- Huston-Tillotson University: Delfina
- InovCares: HHM Health
- People’s Community Clinic: Vitamin Angels
- Vitamin Angels: Access Esperanza, HOPE Clinic, and People’s Community Clinic