For women living in rural parts of New Mexico, access to obstetric and gynecological (OB-GYN) care is often limited. Obstetric care, which involves the treatment of pregnant women including child delivery, is a particularly limited service in the state. So much so, that parts of New Mexico are referred to as “OB deserts.” It’s an issue that The University of New Mexico’s College of Population Health (COPH) is trying to help solve.
As of 2022, one in three counties statewide are considered OB deserts. While sparsely populated areas often face the most severe shortages, even some urban and suburban communities in New Mexico may struggle with insufficient access to these essential health care services due to socioeconomic challenges.
The scarcity of OB care stems from various factors, including the geographic size of New Mexico, the challenging work schedules of health care providers, and the need for infrastructure development. In rural areas, professional isolation and limited health care development further exacerbate the problem. Some hospitals across the state have closed their labor and delivery units due to financial pressures and staffing shortages leaving those who are pregnant with fewer options for care, often forcing them to travel long distances for routine check-ups or emergency services. A notable series of delivery care unit closures in the state occurred at Alta Vista Hospital in Las Vegas, in June 2022, accompanied by closures in the cities of Gallup and Artesia.
For those who are from low-income or marginalized communities, these barriers to care are especially present, regardless of their geographic location. Transportation costs, time off work, and child care arrangements can make it difficult or impossible to access regular prenatal care. This lack of consistent care increases the risk of complications during pregnancy and childbirth for both women and babies.
In a recent interview with a single mother of a newborn in Las Vegas, New Mexico, she described some of her experience accessing maternal health care.
"It’s rough having kids out here in Vegas. My doctor had to help schedule out all my visits for my pregnancy so I could schedule time off," she said.
In her case, it meant traveling over one hour to either Albuquerque or Santa Fe. She also needed to find child care for her other children during her pregnancy, sometimes twice a week, in order to drive to maternity care appointments.
Indigenous people and other minority populations in New Mexico are particularly affected by OB deserts. Historical discrimination, cultural barriers, and systemic inequities regarding health care access compound the difficulties people face in receiving adequate maternal care. The shortage of culturally competent health care providers further widens the gap in health opportunities for these underserved populations, both in rural and urban settings across the state.
Telemedicine has emerged as a potential solution to bridge some of the gaps in obstetric care, especially in areas with provider shortages. However, limited broadband access in many New Mexico communities, particularly in isolated and low-income areas, delays the adoption of this technology. Additionally, while telemedicine can provide valuable support, it cannot fully replace in-person care for many aspects of obstetrics and gynecology, highlighting the need for comprehensive solutions. Broadband access is not the only obstacle considering this type of treatment however, as New Mexico Medicaid has yet to authorize telemedicine for OB-GYN care.
UNM’s COPH is aiming to help by offering a 12-credit online mixed discipline minor and certificate in Maternal and Child Health (MCH) leadership program. This MCH program allows participants to develop knowledge and skills around the health and well-being of families. Topics covered within this program include women’s health, children’s health, social determinants of health, equity and racism, life course theory, MCH policy, MCH research, MCH programs, cultural and linguistic centered interventions, nutrition, oral health, MCH leadership, interdisciplinary approaches, and prevention and health promotion practices. The COPH strives to educate about and promote values that make up excellent MCH services, such as cultural sensitivity and thoughtfulness in respect to each unique individual’s needs.
“We aspire to grow a MCH workforce responsive to the needs of our New Mexico communities who are prepared to address the inequities faced by women, pregnant people, children, and families, as well as those residing in our rural and frontier communities.”
Addressing OB deserts in New Mexico requires a strategic approach that considers the diverse and intersecting needs communities have. This may include incentives for OBs to practice in underserved areas, support for hospitals to maintain services, investment in telemedicine infrastructure, and programs to train and retain local health care providers. Funding rural hospitals is another pivotal element of reducing the gaps in care for underserved populations.
One organization aiming to help to alleviate these difficulties is the ROAMS (Rural OB Access and Maternal Service) Project. For those seeking care, ROAMS provides free support and resources to mothers and pregnant individuals living in Colfax, Harding, Mora, Taos and Union counties.
Policymakers and health care leaders must prioritize these efforts to ensure equitable access to quality maternal and reproductive health care for all people in New Mexico, regardless of their geographic location, socioeconomic status, or cultural background. UNM COPH is committed to research, outreach, and collaboration with state agencies and communities in hopes of improving health equity for individuals in the state facing challenges accessing OB care.