Limited access to basic maternal health services and prenatal care remains a problem across the country and is especially dire in some areas, contributing to poor outcomes for babies and their mothers.
In New Mexico and Texas, Health Care Service Corporation is addressing these issues at the community level by providing grant funding to clinics in regions where patients struggle to receive care before, during and after pregnancy.
Grants to Gallup Community Health Center and East Texas Community Clinic have helped increase the availability of prenatal and preventive care, identified and addressed behavioral health needs in soon-to-be mothers and built up the local maternal health workforce.
The investments are part of HCSC’s expanded maternal and infant health initiative. Launched in 2023, the program collaborates with organizations focused on improving maternal and infant health access and outcomes in Illinois, New Mexico and Texas communities.
Data from New Mexico shows that more pregnant patients are visiting the clinic during their first trimester and all patients are being screened for behavioral health needs. In Texas, a family medicine obstetrician is developing prenatal clinics capable of seeing up to 45 additional appointments weekly.
“The state of maternal health in New Mexico and Texas is especially challenging in our rural communities where access to health care services is limited,” says Dr. Angela Moemeka, HCSC’s chief medical officer of government programs. “These capacity-expanding and scope-enhancing grants are driving improved outcomes for moms and babies through access to integrated preventive health, behavioral health, and obstetric services.”
About 23% of pregnant New Mexicans receive inadequate prenatal care. Gallup and surrounding McKinley County rank among the worst areas in the state for prenatal care access.
Gallup Community Health Center received a grant from HCSC to bolster its primary care and maternal and infant care services. The nonprofit opened in 2022, offering ultrasounds, fetal monitoring, screenings, lactation support and newborn wellness visits, among other services.
Since opening, the clinic has seen a large uptick in first trimester visits, says Gallup OB-GYN Dr. Marcie Richmond.
In the past 12 months alone, 78% of pregnant patients have visited the clinic during their first trimester, up from the 44% previously estimated by the New Mexico Department of Health.
“Patients were desperate for care,” says Dr. Richmond. “Gallup Community Health has not only filled a prenatal care gap but a huge primary care gap in the community.”
In Texas, East Texas Community Clinic used a Special Beginnings grant to hire a family medicine obstetric physician in January at its Canton clinic.
Trained in providing maternal and infant health services along with primary care, the hire has been an immediate boost to a region without an OB-GYN doctor, says Dr. Douglas Curran, an East Texas Community Clinic family medicine physician who provides OB-GYN services.
“There are so many rural, maternal care deserts in our state,” says Curran, who co-founded East Texas Community Clinic in 2020. “It’s unacceptable for a state that has the resources of ours to not be working on this problem.”
New prenatal clinics in Athens, Canton and Gun Barrel City will each see up to 15 patients each day, providing needed care and education.
The added capacity expands access and the number of babies that can be delivered while training physicians and residents in providing obstetrics care.
“At the end of the day if we’re successful with this, we’ll see healthier babies, healthier mothers and reduced costs,” says Curran. “This is an opportunity to improve care in Texas — that’s exciting.”
Gallup Community Health Center also put grant funding toward the local workforce, training its new and existing staff in preconception counseling, pregnancy-related medical conditions, intrafamily violence, medications for opiate use disorder and Native American perspectives on health, among other topics.
Community health workers screen for needs related to social determinants of health like food access, housing or substance misuse and connect patients to local resources.
Every pregnant patient who comes through the door is also screened for behavioral health needs. They can be connected to in-house therapists or psychiatrists, support groups or referred to community organizations.
“It's important to get patients in while they're pregnant, especially if there's any possibility that they could face postpartum depression,” says Behavioral Health Director Kris Pikaart. “That way we have a safety net for them before they give birth.”
