Spotlight Series: Tegra Swogger and Circle Up UMW for Moms in Texas Fight for Maternal Health

Our new Spotlight Series features interviews with changemakers and advocates fighting for a better Texas.

In our second video for the series, we sat down with Tegra Swogger, the Communications Director for Circle Up United Methodist Women for Moms in Texas, to talk about the creation of the organization, her reaction to the last Legislative session, and the future of Texans. 

In the summer of 2018, Tegra and friends Kaycee Crisp, Emily George, Darcy Hamre, Terri Purdy and Whitney Thurman and were fed up with the state of maternal health. So they started the organization with women from their church with the belief that together, their voices of change would be powerful. It didn’t hurt that their church, First United Methodist Church, is located right next to the capital, with easy access to the Texas Legislature.

From that first frustration to the present, they went from silence and support to action. During the legislative session, the women testified on three separate bills, provided written testimony, and registered support for or against countless bills. In addition, Circle Up tracked over 70 pieces of legislation. The steering committee now sits at 18 people. 

Here’s a preview of our conversation, which has been edited for clarity and length:

RA: Did maternal mortality get the results you wanted?

Tegra: There were a handful of maternal health bills that got all the way and were signed by Governor Abbott. HB 25, a pilot program by Rep. Mary E. Gonzalez of El Paso, did pass. The transports that are covered by Medicaid to get women to their appointments did not cover anything besides transporting the mother, meaning children were not included. From my position of privilege, I’ve never had to think about how I get to my doctor’s appointments. 

People who created Medicaid were most likely men, and men didn’t think about the logistics that would need to be done in order to get women to these lifesaving check-ups…like maybe multiple seats in a van, so that they can bring their newborn with them. So women choose to leave their newborn or skip the appointment. This program allows Medicaid transport to work with Uber or Lyft. These ride-sharing options are great because it doesn’t charge you extra per person, whereas the way the Medicaid transports work now, it’s like a large shuttle and they fill up all the seats.

RA: So that will change lives?

Tegra: That will change lives. Originally this was for all of Texas, but it got kind of whittled down to a pilot program, but there is a cost associated with it. They lowered the fiscal note so it wasn’t huge. It started off very big because for some reason they factored in helicopters—probably not necessary in 99 percent of cases — but that one did pass, so I’m very excited to see where we can go from there. 

The encouraging thing was that I was able to be there for the committee hearing in the house, and there were three different [representatives] that said, “Well I want to put my city’s name out. I want to put El Paso on the map … I want to put Tyler on the map.” People were super pumped about this project coming to them, so if that doesn’t tell you that this project was needed, I don’t know what does. 

RA: When you go into representative’s offices how are you received? Are they surprised?

Tegra: Well I wouldn’t say they are surprised, but they’ve been open to the conversation…maybe [they’re] a little bit surprised that we’re here on behalf of a faith-based group having this conversation. People are surprised to hear that this is an issue, that this was a topic of discussion, and that it has caught the eye of United Methodist Women.

RA: What was on your slate for this session? What big umbrella changes did you want to see?

Tegra: Our big hairy audacious goal (BHAGS), [the] reach for the stars goal, was to get Medicaid expansion passed for new moms. Right now it only covers them 60 days after birth, and the majority of maternal deaths happen after that 60 day period. Almost 70 percent happen between two months after delivery and a year. So right now when Texas women roll off of Medicaid — and by the way, more than 50 percent of the births in Texas are covered by Medicaid, so we’re talking about a majority of the babies born and the moms delivering them — from there they go onto Healthy Texas Women. 

The issue there is that a lot of the providers that are covered under Medicaid are actually not covered under Healthy Texas Women. Now these women with brand new babies have to find new healthcare providers in new places, navigate that whole system … it’s just hard. The other thing about Healthy Texas Women is that it’s a great screening program. It can catch things that are happening. One of the most common complications that women end up dying from after birth is cardiomyopathy, a severe heart condition many women are diagnosed with during pregnancy. Afterwards their doctor will tell them, “You need to be monitored for this by a heart specialist for a full year.” But Healthy Texas Women doesn’t cover heart specialists. [So] these women aren’t going to get the care they need. Women under this program don’t have the funds to cover that out of pocket. 

RA: Do you hear the conversation changing when talking about healthcare, moving from reactive to preventative?

Tegra: When the conversation came up this session, which it absolutely did, it definitely felt more received than just talking to a brick wall. In the past, bringing up Medicaid expansion, you pretty much get doors slammed in your face. It’s a nonstarter. Now people are way more open to that. 

The big conversation this session was property taxes and how they fund public schools. What I think people don’t take into account is how much of their property taxes go to fund local hospitals, and then pay for people who go into the ER who don’t have insurance, or who go in for what would have been a minor issue had they been receiving treatment. People are having to treat ERs like their personal doctors because they can’t afford personal doctors. 

RA: Does your organization focus on the policy aspect, or are you working as a liaison for women who have come to you?

Tegra: We are definitely more on the policy side of things. Our whole steering committee is made up of moms, and a lot of us do have our own stories dealing with, not necessarily mortality, but some kind of morbidity (editor’s note: unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to a woman’s health). However, we do have women come forward with their stories, and what happens is we try and connect them to legislators who then work with them on committee hearing testimony and discussions on how a bill would have made a difference for them.

Groups like Black Mommas ATX, which I mean, the Black Mommas Community Collective, if you have not met them they are a POWERHOUSE of women, they have so many women with all these stories with things that have happened to them. They really do help those women harness their power and get their message across, and we have relied a lot on them, their stories, and their experience a lot in an effort to move change. 

RA: On the Circle Up United Methodist Women for Moms website, one of the goals is accurate data. Why is that a focal point?

Tegra: Accurate data is so important. Without it we can’t really create or maintain evidence-based care. Right now the way that maternal mortality is tracked in Texas is through death certificate data, and you don’t have to have a medical degree to declare someone dead. That normally doesn’t seem like a problem, but it actually is because a lot of times these death certificates are being reported with major errors in them, like not noting the person was pregnant, which is the big one that we are concerned about. 

The other part of this is reporting and the timeliness of reporting. Luckily that was one of the things that we got passed this session. I believe it was Rep. [Borris] Miles that passed it under SB 750, which was [Rep. Lori] Kolkhurst’s big overarching bill. People would just sit on the death certificates, which caused us to have a fuzzy picture of what is happening to Texas women. Texas also switched the system of reporting as well, and there may still be a backlog of reporting. Basically it’s a hot mess. Getting that under control is huge. 

Rep. [Shawn] Thierry had a bill that would start a reporting system that hospitals would have to fill out that had several data points for women while they’re pregnant, so that way we have information on the care that the woman received, if something were to happen, so we can better understand what caused the issues. Rep. Thierry had a maternal morbidity experience so she understands the trama, and I don’t want to tell her story, but she knows the fear. We don’t talk about that, and she wants to ensure that we have information to protect Texas women.

RA: What’s on the slate for next session? Have you already started planning?

Tegra: Yes! We’ve already started planning. Our main focus is going to be getting Medicaid expansion for women. Rep. [Toni] Rose’s bill, HB 744, made it all the way through the House, and I mean – we were shocked, in the best way possible. It came through really late in the session, and just didn’t get called in the Senate. 

Next session we’re starting with revisiting these relationships on both sides of the aisle. We are a bipartisan organization, but typically when it comes to things like expanding Medicaid, you typically have more of an ear with people who have already been fighting that fight. However, we are really excited to make new relationships in the Legislature and embolden people to really rally around our moms. 

RA: So for people who are reading this and want to help, how can people get involved with your movement?

Tegra: Our first thing is, go to our website, circleup It has a great amount of resources for people to get informed. The information here will really curb some unknowns for people, like touching on women of color and how they are three to four times more likely to die as a result of giving birth. 

Actually, American women, in general, are 50 percent more likely to die giving birth than our moms were. It is mind-blowing, and it is unacceptable. We have an obligation to change this. We want to empower change, to protect our daughters.