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Highway 170 along the Rio Grande connects Presidio to other border areas.

Highway 170 along the Rio Grande connects Presidio to other border areas.

Photographer: Lauren Withrow for Bloomberg Businessweek

A Very Dangerous Place to Be Pregnant Is Getting Even Scarier

Texas leads the US in maternity ward closures, and nowhere is this more of an issue than in the western part of the state.

Once a week, Adrian Billings drives his white Chevy pickup from his home in Alpine, Texas, to Presidio, a city along the Mexican border. This summer he’s been taking his son Blake, who’s home from college, with him. The drive, through mountains and desert on a two-lane highway across which actual tumbleweeds roll, takes an hour and a half.

Billings is a family doctor, one of only a handful in this part of West Texas. He offers a one-stop shop for his patients’ ailments: heart murmurs, kidney stones, etc. Most of the time he works in Alpine or the nearby city of Marfa. But he makes the weekly drive to Presidio because, without doctors like him, it wouldn’t have medical care. There’s no hospital and no full-time doctor. His clinic, which opened in 2007 with the help of government grants, is the only access residents have to even a local pharmacy.