Bringing a child into the world has long meant heightened risks in New Mexico’s vast and rugged landscapes, where rural counties often stretch for hundreds of miles between clinics and hospitals. The state’s maternal mortality rate is well above the national average, with mental health conditions playing an outsized and deadly role. Amid these challenges, a quiet but decisive push is underway, led in part by specialists at the University of New Mexico Health Sciences Center and supported by insurers, state agencies, and community partners. It combines rigorous data collection with expanded mental health services to make maternal care, such as pregnancy and postpartum, safer and more equitable.
New Mexico’s challenges are not unique in rural America; however, they are acute. Approximately one in three counties qualifies as a maternity care desert, lacking adequate maternal services. Mothers who received inadequate prenatal care gave birth to nearly 1 in 4 infants in 2024, according to New Mexico Maternal and Child Health. Disparities hit the hardest among Native American and Hispanic populations, with deaths associated with pregnancy disproportionately high in the northwestern and northeastern regions.
Mental health looms large. According to the New Mexico Maternal Mortality Review Committee (MMRC), mental health conditions accounted for nearly half of pregnancy-related deaths in reviewed cases from 2015–2020. Substance use often overlaps with these issues. Throughout the United States, maternal mental health provider shortages are prevalent. But New Mexico and parts of neighboring Arizona stand out for severe risk.
Data as a Tool for Change
Dr. Trevor Quiner, a maternal-fetal medicine specialist and assistant professor in UNM’s Department of Obstetrics & Gynecology, is trying to address these gaps through information. The renewed fund support from Blue Cross and Blue Shield of New Mexico’s Special Beginnings® Maternal and Infant Health initiative enabled his team to establish the New Mexico Maternal Data Center — a statewide platform that allows hospitals to efficiently collect, share, and analyze maternal and neonatal results.
“It’s a more efficient way to gather this quality improvement outcome data,” Quiner explained, “and allows us to take those next steps instead of being constantly stuck just looking at our data and not having the time to make changes.”
The program supports a perinatal quality and safety specialist, focusing on issues like postpartum hemorrhage, hypertensive disorders, and screening for substance abuse. Clinicians move beyond crude survival metrics, examine near-misses and suboptimal experiences, and use those insights to identify patterns and implement evidence-based protocols across facilities. This data-driven approach is also in line with broader efforts by the New Mexico Perinatal Collaborative, which collaborates with hospitals on quality initiatives informed by MMRC recommendations.
Quiner underscored a collaborative culture: “It’s not just OB-GYN; it’s not just midwives. It’s all of us together.”
Such systems are important in a state where Medicaid covers prenatal care for more than 6 in 10 births. Evaluations by UNM’s Center for Health Policy have investigated care coordination for Medicaid populations when clinicians incorporate behavioral health alongside traditional complications such as preeclampsia.
Training Specialists for the Perinatal Mental Health Crisis
In parallel to the system, Dr. Marquette Rose, director of the Reproductive Psychiatry Fellowship in UNM’s Department of Psychiatry & Behavioral Sciences, is attending to the mental health side. Backed by BCBSNM Special Beginnings funding, her project supports recruitment and training of fellows in reproductive psychiatry — specialists trained to handle conditions that emerge or worsen during pregnancy and the postpartum year.
“The leading cause of pregnancy-associated deaths is psychiatric illness,” Rose said, “so it is imperative that we’re training providers to take care of patients who are pregnant or postpartum.”
The fellows earn hands-on experience through programs like UNM Hospital’s Journeys Program for behavioral health in reproductive care and the Milagro Program for pregnant patients with a dual diagnosis of mental illness and addiction. The goal goes beyond UNM, training additional specialists who can consult while equipping general providers with stronger tools and greater confidence.
Rose envisions both clinical and far-reaching. “The goal is showing up and being there for these patients in these vulnerable times in their lives. It’s truly far-reaching,” she said.
New Mexico has also taken policy steps. The state requires screening for postpartum depression during well-child visits for Medicaid patients. It has backed initiatives, including telemedicine, to expand mental health coverage and collaborate with groups like Postpartum Support International. Workforce shortages persist, however, especially in rural areas.
Persistent Challenges
Progress is measurable. But it is uneven. Breastfeeding rates have increased, and some child well-being indicators have improved; severe maternal death remains a concern, and access to care remains a challenge. Six hospitals across the state have closed maternity wards, and at least three clinics have closed or been forced to downsize their operations in the last decade, compounding “OB deserts.” Native American women face particularly tremendous burdens, including heightened traumatic stress and financial pressures during pregnancy.
Insurer-led programs, such as HCSC/BCBSNM’s expanded maternal and infant health efforts, invest in quality improvement, substance use support, and telemedicine. Community-based case management under Medicaid’s Turquoise Care program seeks to improve collaborative services.
“This marks an important milestone as we celebrate the first year of our commitment to improving health outcomes for moms and babies in New Mexico,” said Dr. Latha Raja Shankar, BCBSNM vice president of health care delivery and chief medical officer. “We look forward to supporting families at every stage of life, and that starts with maternal care.”
Maternal Care: A Shared Commitment
Quiner and Rose’s projects advanced, underscoring that maternal health extends beyond clinical care. That it is a public health imperative requiring coordinated action. The National Maternal Health Hotline (1-833-852-6262) and resources from Postpartum Support International offer immediate lifelines, while 988 is dedicated to crisis needs.
New Mexico’s initiatives illustrate both the hard realities of rural and underserved America and the promise of targeted, evidence-based maternal care interventions. Officials and clinicians hope to upend preventable deaths and give every family a safer start — even in rural counties.