by Marjorie Childress for New Mexico In Depth
American Indian women in northwestern New Mexico bore the brunt of a temporary surge in pregnancy-related deaths during the COVID-19 pandemic, state health officials told lawmakers Monday.
The latest Maternal Mortality Review Committee report to lawmakers, covering 2018 through 2023, shows the state recorded 74 pregnancy-related deaths over that six-year span. But the year-by-year data show deaths were concentrated in 2021. Kevin Peine, executive director of the department’s Centers for Public Health, told lawmakers during a meeting of the Legislature’s Health and Human Services Committee in Taos that 2021 alone accounted for roughly 43% of all pregnancy-related deaths across the six-year period, and that about two-thirds of that year’s deaths were tied to either a COVID-19 infection or a mental health condition.
Death rates among racial and ethnic groups “clumped together” — meaning women across demographic categories died at similar rates — across the six-year period, Peine said, but 2021 broke from that trend, with the burden hitting the American Indian and Alaska Native community hardest.
The rate of pregnancy-related deaths in the state’s Northwest region — which includes McKinley and San Juan counties and overlaps with the Navajo Nation — was more than double than in other regions of the state. Peine said this was “heavily driven” by the 2021 spike, and that it “also ties back to that sort of racial demographic breakdown because a big driver of that time period was the deaths among the American Indian/Alaskan Native community in that region.”
The committee also tracks a broader category, pregnancy-associated deaths, covering any death during pregnancy or within a year afterward regardless of cause — such as car crashes or homicides unrelated to the pregnancy itself. New Mexico recorded a total of 153 deaths over the same period. The number of pregnancy-associated deaths also peaked in 2021, though the pandemic years accounted for a smaller share of total fatalities, about 31%, compared with 43% of deaths from pregnancy-related causes .
Mental health was the leading underlying cause of pregnancy-related death overall, with 41.9%, followed by infection at 16.2%.
“Mental health conditions, especially substance use disorders remain the most significant contributing factor to maternal mortality and the most common underlying cause of death,” said Dr. Miranda Durham, chief medical officer for the New Mexico Department of Health.
Nearly all pregnancy-related deaths, 97.3%, were deemed preventable by the committee. More than 45% of those deaths occurred more than six weeks after delivery, which the report considers the “late postpartum” period.
Being able to stretch postpartum care out to a year can prevent quite a few cases of pregnancy-related mortality, Peine said.
Lack of access to prenatal care also contributed to the rate of fatalities.. Women who received no prenatal care, or whose care was unknown, died at a rate of 326 per 100,000 births, compared with 36 per 100,000 for those who began care in their first trimester, according to the report.
“This drives home the point to me that access to prenatal care in the state is critical,” said Peine. Early prenatal care can be a driving factor in prevention, he said.
New Mexico continues to face major gaps in maternity care access, Durham told lawmakers, noting that about a third of the state’s counties are considered maternity care deserts, lacking any birthing hospital, obstetric provider, or midwife.