Texas is collecting more detailed data on pregnancy outcomes in county jails, as advocates push lawmakers to use the information to improve oversight after years of reported and litigated allegations of medical neglect and other harms to pregnant people in custody.
The effort stems from a budget rider that appropriated $15,000 for the Texas Commission on Jail Standards to study maternal health and mortality in county lockups. The commission is producing a report for the Texas Legislature and is expected to submit the full findings by December, according to the state-provided materials described in reporting shared with The Texas Tribune and distributed through The Associated Press.
The commission’s initial, high-level figures for county jails across Texas show the scale of the issue: jails held an average of around 430 pregnant inmates each month between September and November 2025. In that same period, the commission’s preliminary reporting that is now becoming public breaks out pregnancy outcomes, including a total of 42 deliveries, 28 miscarriages, and one ectopic pregnancy, as described by program specialist Kaitlin Hickner.
Advocates say the new data matters because the state has long tracked counts of pregnant people in county jails and whether restraints are used, but has not systematically gathered information about prenatal care, mental health indicators, and pregnancy outcomes. Texas Jail Project executive director Krish Gundu said the intent is to demonstrate that harm to the health of pregnant inmates—many of whom are arrested on non-violent or low-level charges—can be prevented, and that lawmakers should see “there is nothing to be gained by locking up this population and causing generational trauma.”
The legal and policy urgency for the study has been sharpened by prior case narratives and lawsuits. The reporting that frames the commission’s work points to the death of Ruby McPeters after she gave birth while jailed in Hood County in 2018. It also references multiple federal lawsuits filed over the past decade alleging mistreatment of pregnant jail inmates in Texas, according to a recent investigation by NBC and Bloomberg Law.
In addition to the numbers, the study’s early release has raised questions among clinicians about what the figures may not yet show. Carolyn Sufrin, a fellow of the American College of Obstetricians and Gynecologists and who also serves on the board of the National Commission on Correctional Health Care, said the data collection symbolizes a system problem—“women who don’t count, don’t get counted,” she said, adding that “women who don’t get counted, don’t count.”
Sufrin said more information is needed to assess outcomes properly, including how many deliveries were pre-term, which is a leading contributor to developmental problems and baby death after delivery. She also said the state needs details on timing for reported miscarriages, such as how many occurred in the second trimester, which she said is less common and more concerning than first-trimester losses.
She added that pregnancy outcomes in jails can also be shaped by conditions that extend beyond custody—such as limited access to medical care in the community, insecure housing, systemic racism, and higher prevalence of trauma and mental illness—citing a 2020 study of pregnant people in six large U.S. jails. Still, Sufrin said the “absolute numbers” are striking and that “a lot of moms are impacted by the criminal justice system.”
Reporting on the study’s first months also points to situations in which births occurred in custody settings. Hickner said all deliveries in the first three months happened in hospitals except for two cases, one involving an ambulance and the other occurring in Johnson County jail in September. A separate report by KERA News described a 27-year-old woman giving birth in her cell at a North Texas lockup while serving 30 days for failure to complete community service, and said jail staff refused to send her to the hospital; Johnson County’s sheriff’s office, Lt. Keven George told The Texas Tribune, could confirm a birth took place but could not share further details due to health privacy laws.
González, the Democratic state representative who authored the rider, said lawmakers want to wait for the full findings rather than politicizing partial figures. In her comments, she said legislators should rely on data “to make sure that the agencies and the institutions” in Texas’s jail ecosystem “are treating people with respect and compassion,” and she said she is looking forward to continuing work on the issue because it is “very critical that we take care of our families.”
The Texas Jail Project, Gundu said, has spent nearly a decade pushing for better tracking and standards for pregnant inmates. She said the effort began in 2006 after an activist, Diane Wilson, shared experiences from her incarceration in Victoria County that included mistreatment of a pregnant woman, followed by additional legislative changes such as House Bill 3563 in 2009 to largely ban restraints on pregnant inmates during labor and recovery, and House Bill 1651 in 2019 mandating obstetrical and gynecological care for pregnant people in jails.
While the new study collects a broader set of information than earlier reporting, advocates said it still does not cover a key period: people who delivered shortly before entering jail. The reporting says post-delivery tracking is not part of the rider, but that González’s office signaled openness to considering the issue in the future. Sufrin said postpartum care should be measured as extending up to 12 months after delivery, not only the first days or weeks, and Hickner acknowledged that expanding tracking to cover that period would not have been feasible within the study’s one-year timeframe.
The Texas Commission on Jail Standards will submit its full maternal health and mortality report to the Legislature later this year, with additional data from the rider still expected to become available as the commission compiles information from individual jails.