Across the United States, a tragic and preventable health crisis is growing. Women are dying in childbirth and from pregnancy-related causes at rates far greater than any other economically advanced nation. According to a recent report from the World Health Organization, the United States is one of only two countries worldwide where the rate of pregnancy-related death is definitively rising. Unfortunately, New Mexico communities are not immune from this crisis. Here the rate of such deaths – 26 per 100,000 live births over 2014-2017 – is higher than the national average. We cannot accept this as inevitable.
Any pregnancy-related death is an unthinkable tragedy for a family, and it can be devastating to a community. To make matters worse, according to the U.S. Centers for Disease Control and Prevention, three out of every five maternal deaths is due to a preventable cause. Not only are maternal deaths increasing, but women are experiencing a rise in health complications during pregnancy and postpartum.
It is critical to acknowledge that communities of color are disproportionately affected. According to the March of Dimes, black women in our state are 26% more likely to have a preterm birth. The rate of infant mortality in New Mexico is 5.9%, with the greatest impact being on communities of color. These disparities are not typically caused by biological or genetic factors; they point to a health care system that has failed to address the needs of our most vulnerable communities. We must address racism and bias within healthcare delivery in order to effectively prevent, recognize and manage complications.
In New Mexico, we have incredible strengths to draw on as we commit to reversing these trends. Within our state, we have strong midwifery traditions, national leaders in clinical medicine and reproductive justice, and a public health infrastructure that has a history of collaborating with community-based providers to improve outcomes. New Mexico boasts model training programs for families and across the spectrum of professionals, from medicine, nursing and midwifery, to doulas, peer counselors and home visitors. As a Medicaid expansion state, New Mexico provides health insurance to cover a larger percent of maternity care than any other state in the nation.
In a climate of urgency to leverage these strengths, there are hopeful developments. During the 2019 legislative session, a law passed that gives more structure and authority to the New Mexico Maternal Mortality Review Committee (MMRC), a committee of health care providers, researchers and community stakeholders led by the Department of Health. A federal law passed in December 2018, the Preventing Maternal Deaths Act, authorizing funding to support a robust process for MMRCs to understand the causes of pregnancy-related death and eliminate preventable ones. Our MMRC is one of the first to be funded for this purpose.
An important resource for linking the findings of the MMRC to action and improving the quality of care for women is the New Mexico Perinatal Collaborative (NMPC). The NMPC, formed in 2014, is part of a national network of perinatal quality collaboratives, and it is the lead organization for our state within the national Alliance for Innovation on Maternal Health (AIM). The NMPC collaborates with Project ECHO to engage birthing hospitals through a telementoring platform to implement evidence-based patient safety practices.
In October, the NMPC and the N.M. March of Dimes cohosted an interdisciplinary convening to address key issues affecting safe birth outcomes. We know that life-saving improvements will not happen within silos. The best results come from collaboration to center the experience and expertise of our unique communities. This meeting, drawing over one hundred participants from around the state, is just the beginning. It will take considerable cross-sector coordination, responsibility and accountability to leverage our strengths and resources. We hope that you will join us in making New Mexico a safe and supportive place to give birth and be born.