Since the fall of Roe v. Wade, an influx of out-of-state patients to New Mexico has sent wait times skyrocketing for abortion and reproductive care services in a state already struggling with a health care worker shortage.
Now, physicians at one of just three main reproductive health clinics offering procedural abortion care in Albuquerque are seeing people with appointments set up six weeks in advance. At Planned Parenthood, another facility in the city, patients seeking medication abortion have wait times of seven to 10 days for something that was previously a walk-in visit. And any procedural abortion could have a wait of up to two weeks.
There is an extremely limited number of abortion care providers in New Mexico, said Dr. Eve Espey, chairwoman of the Department of Obstetrics and Gynecology at the University of New Mexico.
Most general reproductive health care clinics in New Mexico are focused in Albuquerque. In the city, there are three major clinics that offer procedural abortion services: UNM’s Center for Reproductive Health, Planned Parenthood and Southwestern Women’s Options.
UNM’s center is over capacity and scheduling out patients six weeks in advance of their first appointment, Espey said.
She estimated that around 75% of UNM’s patients are coming from other states.
Whitney Phillips, vice president of operations for Planned Parenthood of the Rocky Mountains, noted a rise in cases for the regional network. She said more than half of patients going to Planned Parenthood clinics in New Mexico, Colorado and Nevada are from out of state.
All of this is causing increased wait times, an issue when abortion care often requires timely measures. The burden from the bans causing higher inpatient treatment is having a negative impact on people who need abortion care, Espey said.
Planned Parenthood tried to stay ready for this reality, Phillips said. But the decision caused unforeseeable problems.
“Although we have been preparing for this decision and expanding our services for years, health centers in our region will struggle to manage the demand in the long term,” Phillips wrote via email.
The delay in services can result in difficulties for patients in a variety of ways including scheduling, child care and travel, Espey said. “And then of course, it increases the gestational age at which we see patients, which means their procedure may be more complex,” she said.
UNM is trying to figure out ways to expand its capacity, Espey said, looking for any flexibility in appointment scheduling or expanding existing spaces.
She said the center is potentially looking at grants to help out.
Still, even more patients could be traveling across state lines in light of President Joe Biden’s executive order Aug. 3 that heightened protections for people traveling for abortion care.
Charlene Bencomo, executive director of Bold Futures, a nonprofit organization focused on reproductive justice, said the order puts safeguards in place for patients and providers.
“If people are being forced out of their homes to access basic reproductive health care, they should not be punished,” she said.
While the order may not influence New Mexico directly because so many clinics are already at their max, Espey said, it could get rid of negative psychological effects for patients who need to travel for abortions.
Clinics that were offering abortion care in states where it’s now illegal are being forced to relocate, and some of those are moving to New Mexico. But unintentional consequences may come with this.
“Unintended consequences for shortsighted care is that it won’t stand the test of time,” Bencomo said.
Temporary clinics could actually hurt New Mexico, Bencomo said. Providers who don’t understand the needs throughout the state, from cultural differences to economic barriers, won’t truly help, she said.
Espey has been providing care in New Mexico for 30 years and said she echoes UNM’s reproductive health care clinic’s sentiments that homegrown clinics are their strong preference. They have connections across the state, too, she said.
“We are uniquely situated to provide care in the state,” Espey said.
Still, she acknowledged the gaps in the state’s abortion care system that could be alleviated with other clinics and health care workers moving into New Mexico.
Bencomo said New Mexico needs people committed to working within the fabric of the needs in the state.
Abortion care is tied directly to reproductive health care as a whole, Bencomo said, and that’s strained too in New Mexico. She said there’s a great need “for basic reproductive health care that includes abortion, but it’s certainly not limited to that procedure alone.”
Other reproductive health care is where the state’s health care worker shortage can cause issues, Espey said. There’s less access to care for reproductive services that are often confused with abortion care, such as miscarriage management or getting contraception like an IUD.
Abortion care and reproductive services are especially lacking in rural areas of the state, both Bencomo and Espey said. Services like prenatal and postnatal health care and mental health care aren’t accessible, Bencomo said.
“There’s a huge access problem for health care in general that’s even more acute for reproductive health care,” Espey said. “And specifically abortion care is basically not available in other parts of the state.”
Telehealth is something that can be used to increase rural access, Bencomo and Espey said.
“We just need to start thinking out of the box of what health care has been historically in the state,” Bencomo said.
Espey anticipates states with abortion bans will make reproductive health care even more limited, resulting in more out-of-state patients coming to New Mexico for those services.
One way to help with the health care shortage and potentially secure additional funding for reproductive care could be by implementing collaborative systems with practitioners beyond gynecologists, such as doulas, midwives or community health workers, Bencomo said.
“When we start to look at what the provider network really looks like beyond doctors and nurses, we start to understand that we can figure out ways to fund this,” she said.
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