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The US has been critical of governments in Latin America for their response to gender-based violence. Yet, Texas is also confronting its own epidemic of preventable deaths through alarming maternal mortality rates. In this paper: 1) I contextualize my discussion of maternal mortality as gender-based violence. 2) I outline how health-based policies that limit Medicaid expansion and target reproductive rights in Texas are a form of structural violence against women-especially poor, racial minority and immigrant women. 3) I call for a reframing of maternal mortality as a form of American gender-based violence, one that is structural with deadly consequences.