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Pregnancy care is sparse in New Mexico and getting worse

A pregnant person is examined
Felipe Dana
A pregnant person is examined at a hospital.

Healthcare options for pregnant New Mexicans are few and far between and the issue is getting worse, according to reporting by Heerea Rikhraj with New Mexico In Depth. Rikhraj spoke with KUNM about why birthing centers and prenatal care options are dwindling and what it can look like to be pregnant in rural New Mexico. Her story cited a 2022 study by March of Dimes that found more than 33% of New Mexico counties are considered “maternity care deserts.”

HEEREA RIKHRAJ: So, that means there's essentially no care or access to care to OB services or maternal care services. It's higher than the national average, especially for rural areas. In addition to that, prenatal care is actually really low in New Mexico. It's actually quite devastating and it deserves a lot more attention.

KUNM: And the problem is growing. What are some of the recent developments?

RIKHRAJ: So, one of the big ones is Las Vegas. Their Alta Vista hospital recently shut down their birthing unit in the past couple of years. Hospitals in Gallup and Artesia have also shut down their birthing units. That just creates a lot of inequity and lack of access to care. There are other hospitals that are considering closing down their units, and a lot of it has to do with financial sustainability.

KUNM: And you spoke with a resident of Mora county named Christina. What was it like for her to get the care she needed — and really still needs, now postpartum?

RIKHRAJ: She had to travel for about 100 miles, just a one way trip from her home in northern New Mexico, in order to get prenatal care services as well as delivery care services. Whereas, if there was a hospital open in Las Vegas at the time, she would have been able to get there within 30 miles, which is still not the best.

KUNM: I imagine that all that travel is not ideal for somebody who's pregnant, especially in the third trimester.

RIKHRAJ: Exactly. For Christina specifically, she was saying her doctors recommended that she would be moving around, you know, not sitting down for long periods of time. But, you know, that's what she ended up having to do to access some of the care that she needed.

KUNM: Yeah, she's not able to follow her doctor's instructions in order to get to her doctor.

RIKHRAJ: Exactly.

KUNM: Well, I want to talk a little bit about why this is the case. And it's not just one thing. Your story lays out a whole set of circumstances that are contributing to the situation. What all is at play?

RIKHRAJ: The system is not really set up to support rural care hospitals. Back in COVID, in 2020, the Center for Medicaid Services changed their model in terms of the way that they funnel money to hospitals. They prioritize high-volume hospitals. Just because rural hospitals weren't serving as many patients, they lost out a lot when it comes to financial sustainability that they relied on. And then, the second part of the issue is that once these hospitals shut down, prenatal services also start shutting down. Because the way that Medicaid works is that the nine months leading up to birth and birthing is essentially reimbursed in one go by the state of New Mexico. So essentially, if a birthing unit shuts down, and there is an OB provider or midwife who has their own practice close by and cannot use that birthing unit, then those patients have to go somewhere else to give birth. When that happens, that hospital, that's like 100 miles away, gets the majority of that Medicaid reimbursement. And so, that's not enough for those who provide the prenatal care to sustain their services.

KUNM: Is there anything that can be done to stem these closures?

RIKHRAJ: Ensuring that there's, you know, adequate flow of cash and prioritizing rural hospitals as more of a need because of the fact that they're the only ones really serving up to like 100-, maybe 200-mile radius. And ensuring that there is equitable Medicaid reimbursement so that those who are providing prenatal care services are reimbursed the same amount as those who are providing the birthing care. So, those are two things that people are looking into. Another one is ensuring that telehealth services remain open as well.

KUNM: And that might be one of the solutions for patients in rural New Mexico who already no longer have options nearby?

RIKHRAJ: Yes, exactly.

Read Rikhraj's full report, "Growing New Mexico maternity care deserts bring long drives, increased worry," at nmindepth.com

Nash Jones (they/them) is a general assignment reporter in the KUNM newsroom and the local host of NPR's All Things Considered (weekdays on KUNM, 5-7 p.m. MT). You can reach them at nashjones@kunm.org or on Twitter @nashjonesradio.
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