Karla Holcombe, 58, died along with her husband John "Bryan" Holcombe, 60 on Sunday.
Bryan was serving as a guest pastor Sunday morning at Sutherland Springs First Baptist Church when a shooter opened fire inside the church.
Eight members of the Holcombe family died in the shooting.
Karla's son Danny was killed, along with his 18-month-old daughter Noah.
Her daughter-in-law Crystal, who was pregnant at the time of her death, also perished, as did three of her children from a previous marriage.
Crystal, a widower, had four children with her first husband.
The children, 13-year-old Greg Hill, 11-year-old Emily Hill, and 8-year-old Megan Hill, were killed inside the church, 6-year-old Evelyn was taken to University Hospital but is in stable condition.