The Woman's Hospital of Texas has expanded its Small Baby Unit so it can now care for eligible infants born as early as 21 weeks and five days of gestation, the hospital says, widening access to specialized neonatal care for some of the smallest and most fragile babies in the Houston area. The unit operates within the hospital's Level IV Advanced Neonatal Intensive Care Unit, one of the highest designations available for newborn critical care.
The unit launched in March 2025 and initially cared for infants born as early as 22 weeks gestation or those weighing less than 1,000 grams, according to The Woman's Hospital of Texas. The hospital has since broadened that threshold to an earlier gestational age, now serving babies born as early as 21 weeks and five days. Amy Urban said the Small Baby Unit achieved positive outcomes during its first year and that the program can now care for babies born as early as 21 weeks and 5 days, according to the seed reporting from Houston Business Journal.
The expansion means more critically premature infants can receive that intensive, specialized care close to their Houston-area families rather than being transferred elsewhere. The hospital, part of HCA Houston Healthcare, says it delivers more than 800 babies a month and operates a 146-bed Level IV NICU, one of only 24 Level IV Advanced NICUs in Texas, per the hospital's own account.
A Dedicated Team and Specialized Equipment
The Small Baby Unit's multidisciplinary team includes neonatologists, nurse practitioners, neonatal nurses, respiratory therapists, occupational therapists, social workers and case managers, the hospital's newsroom post states. Staff use specialized breathing equipment and advanced incubator-warmers, along with an environment built around lower lighting, reduced noise and controlled guest traffic — features intended to limit stimulation for the most vulnerable patients.
The Woman's Hospital of Texas reported a 69% survival rate in 2024 for infants born before 23 weeks, which it says surpassed a national average of 52.8%, according to the hospital's newsroom announcement. The hospital has focused on caring for women and newborns for 50 years and recently marked its 50th anniversary, per Houston Business Journal.
Preterm Births Remain a Persistent Regional Challenge
The expansion arrives as Texas continues to grapple with elevated preterm birth rates. Texas recorded 43,344 preterm births in 2024, representing 11.1% of live births statewide, according to March of Dimes. Harris County's preterm birth rate reached 12.0% of live births in 2024 — about one in eight babies — with 7,658 preterm births recorded that year, per the same March of Dimes data. Houston Business Journal reported the county's preterm birth rate at 12.0% and the city's at 12.1%, both attributed to the 2025 March of Dimes report card, which assigned both an F grade.
Preterm birth, along with low birth weight, makes up the second leading cause of infant deaths after birth defects, and preterm-related causes account for 30.0% of infant deaths in Texas when related causes are grouped together, March of Dimes notes. From 2021 through 2024, 107 Texas counties had preterm birth rates higher than the state rate of 11.2%, while just 41 counties met the Healthy People 2030 goal of 9.4%, the organization's data shows. Multiple births in Texas were seven times as likely to be preterm as singleton births in 2023, and among Texas women of childbearing age, preterm birth rates were highest for those 40 and older, at 17.0%.
Financial and Human Toll of Early Births
Jen Torres said preterm birth affects families in Houston and across Texas well beyond the walls of any single hospital, and that March of Dimes remains committed to advancing maternal and infant health, according to Houston Business Journal's report. A March of Dimes-commissioned analysis found the 2016 U.S. preterm birth cohort had estimated societal costs of at least $25.2 billion, averaging $64,815 per birth, with premature death and long-term health complications associated with roughly $4.8 billion in lost labor-market productivity. In Texas alone, preterm birth carried an estimated $2.56 billion in total costs, or about $61,910 per birth, in that same analysis — figures the group says exclude caregiver time and lost earnings for family members.
Infants born before 28 weeks represented just 7% of the preterm cohort studied but accounted for more than one-third of estimated costs, with an infant born before 28 weeks carrying estimated lifetime incremental costs of $344,355, compared with $28,367 for a baby born between 32 and 36 weeks. Nationally, research published in Nature notes that infants born at 22 to 24 weeks make up about one in 500 U.S. live births — roughly 7,500 infants annually — yet account for one in five U.S. infant deaths, and that three in four infants born at 22 weeks in hospitals with Level III-IV NICUs receive postnatal life support.
Not Alone in the Approach
The Woman's Hospital of Texas is not the only facility building a dedicated space for its smallest patients. Children's Hospital Los Angeles has created its own Small Baby Unit within a Level IV newborn and infant critical care unit, grouping babies born before 32 weeks into one dedicated area with rooms designed to reduce stimulation, according to Children's Hospital Los Angeles. That unit assigns dedicated nurses and therapists who have undergone specialized small-baby training, and CHLA says some of its patients were born as young as 22 weeks.
Texas as a whole received a D grade in the March of Dimes annual report card on maternal and infant health outcomes, according to Houston Public Media. Against that backdrop, the expanded eligibility threshold at The Woman's Hospital of Texas represents one Houston-area institution's attempt to push the boundaries of viability care closer to home for families facing the earliest and most uncertain deliveries.
