A Texas midwife’s license has been suspended after two patients — an infant and a mother — died under her care, and state regulators say the evidence suggests she knew something was wrong and kept going anyway.
The Texas Department of Licensing and Regulation moved to suspend Salli M. Gonzalez, a midwife based in Georgetown, Texas, in an emergency action tied to the death of an infant in February 2023 and the death of a mother in April 2023. The suspension comes as Gonzalez also faces a separate criminal case involving allegations of unlawful abortions, making this one of the more serious and layered midwifery cases Texas regulators have had to address in recent memory.
What the Investigation Found
At the center of TDLR’s concerns is a social media conversation — yes, a social media conversation — in which Gonzalez reportedly discussed multiple complications that, under Texas Midwifery Law and Rules, would have required her to recommend transferring a patient to a higher level of care. The state reviewed those posts as part of its investigation and found her attitude toward those warning signs to be, at best, alarming.
Her response to those complications? “Those things are not concerning to me.” That quote, investigators say, captures a mindset that directly contradicts the legal obligations of a licensed midwife in Texas — and regulators weren’t inclined to let it slide.
The State’s Position
TDLR Executive Director Courtney Arbour didn’t mince words. “TDLR’s responsibility is to protect the health and safety of Texans,” Arbour said. “When a license holder’s conduct poses a risk to the public, TDLR will take action to protect Texans.” It’s the kind of statement that sounds like boilerplate until you consider the two families at the center of it — and then it doesn’t sound like boilerplate at all.
Under the terms of the emergency suspension, Gonzalez is prohibited from practicing midwifery in any capacity unless a court steps in to restore her license. That’s a high bar, and given the dual nature of the case — both a licensing action and an ongoing criminal matter — it’s not clear that relief is coming anytime soon.
A Bigger Picture
Still, this case doesn’t exist in a vacuum. Texas has seen growing tension around birth care, reproductive rights, and the role of midwives in a state where access to obstetric services — particularly in rural areas — remains a persistent problem. Midwifery fills a real gap for many families. That’s precisely why cases like this one sting: they hand critics a ready-made argument against expanded home birth options, even when the vast majority of licensed midwives practice responsibly.
That’s the catch, isn’t it? One practitioner’s apparent indifference to life-threatening complications becomes a headline that shadows an entire profession — and leaves families who trusted the system asking questions no suspension order can fully answer.
