Rising Syphilis Rates in Pregnant Women: Prevention and Screening

When national headlines scream about rising syphilis rates among pregnant women, it’s easy to feel distant from the crisis—like it’s happening somewhere else, to someone else. But here in Austin, Texas, where the live music spills onto Sixth Street and the scent of breakfast tacos drifts from food trucks near the Capitol, this isn’t just a statistic. It’s a quiet emergency unfolding in clinic waiting rooms, community health centers, and even in the backseats of rideshares shuttling women to their prenatal visits along South Congress. The numbers from the National Center for Health Statistics aren’t abstract: a 222% jump in maternal syphilis between 2016 and 2022, followed by another 28% surge through 2024. In Travis County alone, public health data shows congenital syphilis cases in newborns have more than tripled since 2020, with clusters appearing in neighborhoods like Rundberg and Dove Springs where access to consistent prenatal care remains fragmented. This isn’t just about infection rates—it’s about who gets seen, who gets tested, and who falls through the cracks in a system stretched thin by geography, economics, and historic inequities.

The source material highlights a critical truth: syphilis is treatable, even in pregnancy, with a simple penicillin regimen—but only if detected early. Yet too many women in Central Texas aren’t getting that first-line defense. While state law mandates syphilis screening at the initial prenatal visit, follow-through varies wildly depending on where you live and what resources you have. In East Austin, where historic underinvestment has left pockets of the city without a full-service OB-GYN clinic within a five-mile radius, women often rely on rotating mobile units or travel to Dell Seton Medical Center for basic care. Meanwhile, in West Lake Hills, private providers offer same-day appointments and third-trimester rescreens as routine. That disparity isn’t just unfair—it’s fueling the rise in congenital cases, where babies face risks of severe anemia, liver damage, or neurological complications that could have been prevented with a $15 blood test and a dose of antibiotics.

What’s less discussed in national reports is how this crisis intersects with Austin’s rapid growth and housing instability. As rents climb near tech corridors like the Domain and South Lamar, long-time residents—particularly Black and Latina women—are being pushed further out to areas like Pflugerville and Manor, where public transit is sparse and clinic hours don’t align with shift work at warehouses or distribution centers. A 2023 study from the University of Texas at Austin’s Population Research Center found that 42% of reproductive-age women in eastern Travis County live in maternal healthcare “deserts,” defined as areas more than 30 minutes from the nearest provider offering prenatal syphilis screening. That gap helps explain why, despite Texas having some of the most robust screening laws on the books, outcomes remain dire: the state ranks fourth nationally in congenital syphilis rates, with Hispanic and Black infants disproportionately affected—mirroring the national disparities cited in the NCHS report, where Native American and Alaskan Native women faced rates over ten times higher than their white counterparts.

But Notice signs of movement. Organizations like Any Baby Can of Austin have expanded their outreach, deploying community health workers to knock on doors in St. John’s and Montopolis, offering not just syphilis education but assistance navigating Medicaid enrollment or arranging Lyft rides to appointments at People’s Community Clinic. The Austin Public Health Department, partnering with St. David’s Foundation, recently launched a pilot program offering rapid syphilis testing in emergency rooms at Brackenridge and University Medical Center—mimicking successful models from cities like San Francisco where opt-out screening caught infections that would have otherwise been missed during standard prenatal visits. And grassroots efforts, such as the Black Mamas Community Collective’s monthly wellness circles at the George Washington Carver Museum, are creating trusted spaces where women can discuss sexual health without stigma, a crucial step in a city where faith and family often shape conversations about wellness.

Given my background in public health journalism and community-driven storytelling, if this trend impacts you in Austin, here are the three types of local professionals you demand to know about—and exactly what to look for when seeking their help:

• Community Health Navigators Focused on Maternal Equity: These aren’t just case managers—they’re trusted connectors embedded in neighborhoods like Dove Springs and Rundberg. Look for individuals employed by organizations such as Any Baby Can or Planned Parenthood of Greater Texas who speak Spanish fluently, understand the nuances of Medicaid CHIP Perinatal coverage, and can accompany you to appointments or arrange transportation. The best navigators don’t just hand you a pamphlet—they build ongoing relationships, follow up after visits, and know which clinics offer same-day syphilis results.
• Culturally Competent OB-GYNs and Midwives Practicing Trauma-Informed Care: Seek providers who explicitly acknowledge how systemic racism and medical mistrust affect prenatal engagement—especially critical for Black and Indigenous women in Austin. Clinics like the People’s Community Clinic or the Mama Sana Vibrant Woman collective prioritize consent, offer extended appointment times, and integrate syphilis screening into holistic wellness visits without making it feel punitive. Ask whether they follow ACOG’s triple-test protocol (first trimester, third trimester, and at birth) and if they partner with local labs for rapid turnaround.
• Public Health Outreach Specialists Working in Non-Traditional Settings: The most effective interventions now happen outside clinic walls. Look for professionals affiliated with Austin Public Health or UT Health Austin who run syphilis screening pop-ups at locations like the ACC Highland Mall clinic, food distribution events at the Central Texas Food Bank, or even outside nightclubs on Rainey Street during peak hours. Effective specialists use discreet, rapid-test methods, offer immediate linkage to care if positive, and never require insurance or ID—lowering barriers for unhoused, undocumented, or uninsured women who might otherwise avoid traditional healthcare settings.

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