Zak Tiemann picked up his daughters from school early this Halloween. Zayleeana, 3, and Zoey, 5, were beaming with excitement as they donned their "Frozen" costumes and went trick-or-treating in their small hometown of Seguin, Texas.
. Seguin, United States. Reuters/Callaghan O'Hare
Zak helps Zayleeana carry her candy bucket while trick-or-treating.
But for their 34-year old father family occasions have been bittersweet. The girls' mother, Amanda Garcia, died three years ago just days after giving birth to Zayleeana. She was 26 years old.
. Seguin, United States. Reuters/Callaghan O'Hare
Zak and Zoey peer out of a window as their dogs bark at a passerby.
"I just feel like they're missing something," he said during an interview at his home in Seguin, about 50 miles (80 km) south of Austin, the state capital. "Even though I'm doing the best I can... they still need a woman that's going to show them how to go about stuff in life."
. Seguin, United States. Reuters/Callaghan O'Hare
Zak rests on the couch while Zayleeana, Zoey and Zay'dyn play at their home.
Tiemann has since fathered a third child, Zay'dyn, 1, with another woman, although he said she is not consistently involved in the care of his two daughters.
. Seguin, United States. Reuters/Callaghan O'Hare
Zoey and Zayleeana eat popsicles in their room.
Garcia - whose family say she died after she suffered a blood clot - was one of an estimated 700 women who die of pregnancy-related complications each year in the United States, according to data from the Centers for Disease Control and Prevention. That is the highest rate in the developed world, and U.S. maternal deaths have been rising over the last two decades, according to investigations by ProPublica and NPR.
. Seguin, United States. Reuters/Callaghan O'Hare
Zak helps Zoey put on her Elsa wig while the family get ready for Halloween.
After Garcia's death, Tiemann had to step into an unfamiliar role, one he said he was not prepared for.
"I buy products for their hair, I buy little rubber bands," he said. "I've tried to paint their nails sometimes."
The feeling of inadequacy weighs on him daily.
. Seguin, United States. Reuters/Callaghan O'Hare
Zak applies lotion to Zayleeana after her bath.
Advocates, healthcare professionals and lawmakers have long been sounding the alarm on the high rates of maternal mortality and the effect on women of color, who are approximately three to four times more likely to die from pregnancy-related issues.
"It's abysmal. I mean, we're worse than some Third World countries," said Shawn Thierry, a Democratic member of the Texas House of Representatives and the sponsor of numerous bills on the issue.
. Seguin, United States. Reuters/Callaghan O'Hare
Zayleeana rests her head on Zak’s chest.
For every 100,000 live births in Texas, there are 14.6 maternal deaths, according to the most recent data by the state's Maternal Mortality and Morbidity Review Committee. As in the rest of the country, women of color are disproportionately affected.
Elizabeth Warren, the U.S. Senator for Massachusetts who is running for president, has made improving maternal health a big part of her 2020 campaign.
Warren's plan would modify insurance payment systems and reward hospitals that are successful in improving care.
. Seguin, United States. Reuters/Callaghan O'Hare
Zak holds an urn during a small memorial honouring Amanda Garcia's life.
Story
For Tiemann, losing his partner due to pregnancy-related complications still stirs deep frustration.
"I just look back and I wonder if it could have been prevented. But I don't know," he said.
Photo editing Gabrielle Fonseca Johnson; Text editing Diane Craft; Layout Julia Dalrymple
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Slideshow
. Seguin, United States. Reuters/Callaghan O'Hare
Zayleeana and Zoey play on a boat parked in their family's driveway.
. Luling, United States. Reuters/Callaghan O'Hare
Zayleeana and Zak hold hands during a Father's Day trip to the river in Luling.
. Seguin, United States. Reuters/Callaghan O'Hare
Zayleeana plays in a pool before a small memorial honouring the life of her late mother Amanda Garcia.
. Seguin, United States. Reuters/Callaghan O'Hare
Zoey and Zak both stare into the mirror as they flex their muscles before Zoey's school's "superhero day".
. Seguin, United States. Reuters/Callaghan O'Hare
Zoey shuffles through papers on the kitchen table before going to school.
. Seguin, United States. Reuters/Callaghan O'Hare
Dressed as Elsa from Frozen, Zoey reaches into the fridge while her family gets ready for Halloween.
. Seguin, United States. Reuters/Callaghan O'Hare
Zoey eats a bowl of ice cream in her Elsa costume on Halloween.
. Seguin, United States. Reuters/Callaghan O'Hare
Zayleeana gives Zak a kiss on Father's Day.
. Seguin, United States. Reuters/Callaghan O'Hare
Zoey leans on a chair while playing in the living room.
. Seguin, United States. Reuters/Callaghan O'Hare
Zoey recites words during a meeting with her speech therapist at her home.
. Seguin, United States. Reuters/Callaghan O'Hare
Zak closes his eyes while his daughter Zoey presses her hands to his face.
. Seguin, United States. Reuters/Callaghan O'Hare
Zayleeana leans her head back while wrestling with her father and sister.
. Seguin, United States. Reuters/Callaghan O'Hare
Zoey aims a toy water gun at her dog as she takes a bath with her Zayleeana.
. Seguin, United States. Reuters/Callaghan O'Hare
Zayleeana and Zoey sleep before their first day of school.
. Seguin, United States. Reuters/Callaghan O'Hare
Zayleena cries in the shower while brushing her teeth before school.
. Seguin, United States. Reuters/Callaghan O'Hare
Zayleeana tries on her backpack before her first day of school.