Owing to a warped sense of priorities, you can go online and find the nearest medical cannabis store anywhere in the state, but no such search tool exists to find maternity care.
In New Mexico, both services are under the purview of the Department of Health, though the marijuana locator is maintained by the private company Weedmaps. SFR couldn't find a prominent public database of pregnancy care clinic locations nor the kinds of care such clinics offer.
The reality of this information desert is that women and their families have to rely mostly on word-of-mouth referrals for access to services they need. There are scattered clinics in Santa Fe and Northern New Mexico that offer varying degrees of care, and it can be hard to keep track of who does what. That's only been compounded by the closure and re-opening of maternity services across the region.
This fluidity in services offered, and the abruptness with which it can change, can be especially disruptive for women carrying babies.
Libby King was living in Chupadero a little over two years ago, traveling to prenatal appointments at Southwest Care Center on West Alameda to prepare for the birth of her second child. She felt confident in the birthing plan she had created with midwives there, and planned to have her baby at the onsite birthing center, fulfilling her desire to avoid the clinical environment of a hospital.
But then she got a call from Southwest Care, right as she was beginning her final trimester: The birthing unit was closing, and all prenatal services would end. She was referred to an independent midwife, for whom she paid out-of-pocket.
"I was pissed," says King, who had her first child at her home. "I ended up hiring a home birth midwife that didn't work out, I had to pay [for nine months of services], and that was frustrating because she didn't attend to my whole pregnancy; only a third of it."
The other nearest nonhospital birthing centers were in Taos and Rio Rancho, too far of a trek for a woman in labor. King wound up having her baby at Presbyterian Española Hospital, where she needed to have a C-section because the baby was breech—something she believe her midwife should have noticed.
According to Dr. Sarah Fatland, the chief medical officer at Southwest Care, the birthing center was closed in early 2016 because it "didn't have enough volume to make it [financially] sustainable." These days, Fatland says, women in need of prenatal care "get referred to other providers, then we'll take moms and babies after delivery back to us" for individualized postpartum family care.
One place where Southwest Care refers women is Perinatal Associates, which provides "high-risk pregnancy care" including fetal assessments, ultrasounds and genetics counseling, and whose roster of physicians is all men (all of its midwives are women.) With 10 locations in New Mexico, Perinatal Associates exists as a referral business, and women generally come into contact with it once they're already receiving some kind of care elsewhere.
Another clinic in town, La Familia Medical Center, sees patients referred by Southwest Care and other obstetricians, though it enjoys a name recognition that comes with decades of service.
"We do between 300 and 400 deliveries a year," says Dr. Wendy Johnson, the medical director at La Familia. "We have good collaborative relationships with other [obstetricians and gynecologists] in town, [including at] Christus St. Vincent and Presbyterian Medical Group."
While La Familia has obstetrical specialists and nurses to care for women before birth, complicated matters could be referred out to other OB-GYNs, and deliveries happen at the hospital or the Presbyterian clinic.
A spokesman for Christus St. Vincent says the hospital delivers 1,500 babies a year and provides "prenatal examinations" for thousands more. It also has a four-week childbirth preparation class, and has 11 "suites" where women can give birth and recover for a limited time. A spokeswoman for Presbyterian Healthcare Services, which plans to open a hospital in Santa Fe later this year, says the new medical center will have a six-bed family birthing unit and four suites similar to those at Christus St. Vincent.
Last year, Presbyterian also opened a small clinic to provide prenatal care in Las Vegas, New Mexico, after the Alta Vista Regional Hospital there shuttered its maternity services in March 2016. That closure prompted Attorney General Hector Balderas to send a letter to Alta Vista CEO Chris Wolf expressing concern that the closure created "an unacceptable gap in services for women across the northeastern part of the state."
After receiving the letter, and after a Las Vegas woman died in a car accident while traveling to Santa Fe for prenatal care, Alta Vista announced that it had hired two OB-GYN physicians in order to "reestablish OB services," although a spokeswoman for the hospital did not answer when it made the hires.
Dr. Tracy Wilkerson-Burton, one of those physicians, began working at Alta Vista on April 1. The clinic is "picking up and getting busier every day," she tells SFR, but the hospital continues to struggle to get the word out that it's open to women once again.
"The number of patients realizing we're open" is still low, Wilkerson-Burton tells SFR. "I know some of them are still going to other locations."
If only there were a Weedmaps, but for having babies.
