Tele-ultrasound provide answer to NM's maternal health deserts

Maternal mortality and maternal health in the U.S. lag behind many industrialized nations, and New Mexico lags behind other U.S. states.

In the most recent March of Dimes report card, New Mexico received a pre-term birth grade of C minus. In addition, according to the March of Dimes, which advocates for mothers and babies, 23.3% of women in the state experienced inadequate prenatal care in 2023.

There are many maternal health deserts throughout New Mexico, and maternal fetal medicine specialists, perinatologists, who deal with high-risk pregnancies, are scarce, according to doctors.

One emerging method for addressing this scarcity is through telemedicine, and more specifically, tele-ultrasound. Tele-ultrasound allows specialists to work out of any location and provide services to remote patients.

It’s more convenient or necessary for patients to go to a facility near where they live rather than having to drive more than six hours roundtrip to receive care in a larger city like Albuquerque.

That is the reality today for Dr. Michael Ruma and Perinatal Associates of New Mexico, the largest maternal-fetal medicine specialty practice in the state of New Mexico.

“Unfortunately, as a very wealthy, very complex and sophisticated health care system in America, we face a rising and unacceptable maternal mortality rate,” Ruma said. “In New Mexico, we have the 2nd highest maternal mortality in the country. By reaching these pregnant patients around the state, the earlier we’re able to access and provide them care through tele-ultrasound and telemedicine, the greater probability we have to actually help that patient survive her pregnancy.”

Perinatal Associates offers numerous services for low- and high-risk patients including first trimester screening, including detailed anatomic ultrasounds, 3D/4D ultrasound, obstetric follow-up ultrasound, genetic counseling, and fetal assessment and co-management of complicated pregnancy for referring clinicians.

The medical clinic has 12 sites throughout the state, including Ruidoso and Roswell, and touch 40% of all pregnancies in the state. Reaching into underserved communities with state-of-the-art health technology is helping to treat women with high-risk pregnancies in a timely manner, and telehealth may just be the best path forward, Ruma said.

“We have five (medical) specialists, 17 advanced practice nurses, and three genetic counselors, so we have 25 clinicians utilizing tele-ultrasound telemedicine every day throughout the state, and it’s been a great benefit to pregnant people throughout the state,” he said.

The technology that makes remote medical visits more efficient came into practice around late 2019, Ruma said, and it allows great flexibility in the interaction with patients.

“Literally, I’m able to call in right to the system, looking at their baby on the ultrasound system and with an image of my face in real time, right there next to what they’re looking at in the baby, and the interaction is just as it would be if I was there in person and the patient,” Ruma said. “Their interaction is just like an in-person visit and it’s given us a lot of flexibility in how we provide care to patients.”

Overall, it’s a path to improving New Mexico’s maternal mortality. And Perinatal Associates of New Mexico is at the forefront of those efforts. Last year there were about 19,500 births in New Mexico, Ruma said, and Perinatal Associated took care of about 8,500.

“We have a vast diverse population, from very wealthy to very poor and that type of socioeconomic disparity really creates complexity for patients,” Ruma said. “So by being as close to the patient in places like Roswell, Ruidoso, Socorro, Espanola, Los Alamos, being in those local communities allows the patient a little closer access point ... to do a lot of complicated ultrasound care for patients.

“We’re hoping by doing this outreach that we actually see that incremental benefit,” he said.