Katie Hawley will be 38 this year, but she almost didn’t get to celebrate. The previous year, a misdiagnosis nearly cost her her life.

Katie and her husband, Jarrett, live in Irving, Texas, in the Dallas-Fort Worth metro area. They have a healthy six-year-old, and they wanted to grow their family. In August 2022, Katie got pregnant, but soon after she miscarried. In December, she got pregnant again, and again, she miscarried. Several months later, Katie says, “Something didn’t feel right. I asked my provider for an ultrasound to confirm whether I was pregnant. But I kept getting put off. It was like they thought they knew more about my body than I did.”

A surreal experience

Worried, Katie decided to seek another provider and was recommended to the Fort Worth Birthing Center, which is staffed by nurse practitioners and certified nurse-midwives. There, she got the ultrasound she knew she needed. The results confirmed that she was having an ectopic pregnancy, in which the fertilized egg implants itself outside the womb, usually on one of the fallopian tubes. Katie’s first response was to thank them and return home, half in disbelief. “It was surreal,” she says.

Soon after, she got a call from the Birthing Center’s Lindsay Griffith, a nurse practitioner. “Your ectopic pregnancy is fairly far along, and you’re at the point of rupture,” Lindsay told her. “So stop what you’re doing, get in your car, and go to the hospital now.”

Katie had been scheduled to travel for work the following day. She called her supervisor and cancelled her flight, called Jarrett at work, and drove herself to the hospital. Later, Lindsay told her, “I’m glad you didn’t get on that plane. It could have been deadly to rupture at 30,000 feet.”

An ordeal that could have been avoided

When Katie arrived at the hospital, Lindsay was with another patient, so Carla Morrow, a certified nurse-midwife, sat on her bed and talked her through everything that was going to happen. “She was trying to do everything she could to calm me, and information calms me,” Katie says.

Carla told her, “I’m so sorry this is happening to you.” Carla told Katie that had she initially gotten the ultrasound she had repeatedly requested, this entire ordeal could have been avoided. And she assured Katie, “I’ll be right here with you until your husband gets here.”

The procedure to end Katie’s ectopic pregnancy cost her one of her fallopian tubes, which can make it twice as difficult to get pregnant again. However, she eventually did get pregnant. Under the guidance and skill of her nurse practitioners and certified nurse-midwives at the Fort Worth Birthing Center throughout her pregnancy, she delivered a healthy baby boy whom she and Jarrett named Jackson. Says Jarrett, “I can’t say enough about the people who helped my wife. During our baby’s birth, they were great, even taking care of me and making sure I was doing okay. I’ll never forget that they saved Katie’s life.”

The Hawleys are fortunate to live in an area with access to the immediate healthcare Katie needed. But even in urban areas, access to maternal health care can be a challenge. And without her certified nurse-midwife, Katie’s healthcare outcomes could have looked much different.

Nearly three million Texans live in rural communities, many miles — and often hours — away from the nearest healthcare facility. Despite the urgent need for accessible care, Texas’ outdated regulations continue to restrict certified nurse-midwives, like Carla Morrow, from providing the services they are fully trained to deliver. By modernizing these laws, we can empower nurse practitioners and certified nurse-midwives to step in where they’re needed most — closing the care gap and ensuring that all Texans, no matter where they live, have access to professional, high-quality healthcare.