Solely three of the 14 counties in north-central Florida present full entry to obstetric care. Six have low entry to care – which means there are fewer than two hospitals providing obstetric care or delivery facilities per 10,000 births and fewer than 60 obstetric suppliers. The remaining five counties are maternity care deserts. Roughly 3,400 women of childbearing age reside in these deserts.
In 2024, a report discovered that hospitals across Florida were discontinuing obstetric care on account of lack of funding. Eighteen of the state’s 21 rural hospitals now not present obstetric care.
To deal with this hole in care, in February 2025 the College of Florida established the OB/GYN Mobile Outreach Clinic. The cellular clinic supplies comprehensive maternal health services, together with prenatal and postpartum care, breastfeeding help, household planning, annual gynecological exams and preventive well being screenings. The one companies not supplied on-site are deliveries.
We’re the director and assistant director of the clinic and a medical student on the College of Florida. Outdoors of our work with the cellular clinic, we additionally analysis interventions to enhance maternal well being in low-resource settings.
We launched the clinic in February 2025. By the tip of 2025, we had offered care to 194 ladies in 616 visits.
Based mostly on our expertise, we imagine that cellular clinics targeted on maternal well being might be an efficient approach to attain extra rural and low-income communities.
Maternity deserts throughout the US
Two and a half million American ladies of childbearing age – nearly 4% – live in a maternity care desert: a county with no single hospital, birthing middle or obstetric well being care skilled.
Over the previous decade, the closure of hundreds of obstetric units has exacerbated this downside, significantly in rural areas. Ladies in maternity care deserts travel an average of 35 miles to succeed in a birthing hospital, in comparison with a median of 9 miles for ladies in full-access counties.
The maternal mortality charge within the U.S., which peaked during COVID, remains higher than that of most different high-income nations. Entry to well timed prenatal and postpartum care is essential to stopping pregnancy-related deaths. Research have proven that traveling longer distances for obstetric care is related to worse toddler and maternal health outcomes.
Our cellular mannequin
Cell well being clinics are autos, corresponding to buses or vans, outfitted with medical instruments and provides to ship well being care companies.
The College of Florida OB/GYN Cell Outreach Clinic is a retrofitted bus with two examination rooms, an ultrasound machine and provides for serum and urine testing for prenatal labs. A small dispensary permits suppliers to present prenatal nutritional vitamins and drugs for common conditions, such as vaginitis or urinary tract infections. This reduces the necessity for sufferers to make further pharmacy or lab visits or pay for treatment.
Care offered on the cellular clinic is free to the affected person. If sufferers are eligible for Medicaid or different medical health insurance, our staff assists them in making use of for advantages. In 2023, about 1 in 7 women of childbearing age in Florida have been uninsured.
Working on a special mannequin
The Cell Outreach Clinic operates twice weekly in constant, rotating places, together with northeast Gainesville in Alachua County, Lake Metropolis in Columbia County, Bronson in Levy County and Trenton in Gilchrist County. Of those places, solely Levy County is a maternity care desert, however all of those places have been chosen to take care of sufferers of low socioeconomic standing and restricted entry to care.
We arrange the clinic at websites which are already trusted or often visited by our goal inhabitants. This consists of household useful resource facilities, church buildings and public libraries. Sufferers and households know they’ll count on us on a constant day of the week. A core precept of our program is that we present up, it doesn’t matter what. This ethos has helped us set up and keep belief with our sufferers.
Appointments are walk-in or scheduled, with wait occasions considerably shorter than conventional clinics. Sufferers are scheduled inside per week, usually by referrals from trusted associate businesses or from different sufferers.
In contrast to conventional clinics, which schedule for 15- to 20-minute appointments, the cellular clinic allots 30-60 minutes for affected person visits. This permits time to deal with social wants, transportation limitations, meals insecurity or housing wants. The medical care staff is led by nurse midwives and features a physician assistant, certified nurse-midwives, nurses, a nurse practitioner and lactation consultant, medical assistants and promotoras, group well being employees who act as peer educators and affected person liaisons in Hispanic communities. Maternal-fetal medication physicians evaluate ultrasound photographs remotely.
Working outdoors a conventional medical setting typically requires our workers to be versatile and artistic to fulfill the wants of our sufferers. As an illustration, the week earlier than Thanksgiving, our clinic was at capability whereas parked in a church lot in Trenton. One among our sufferers wanted a nonstress test, and with house restricted, the nurse and well being educator interpreter labored collectively to finish the take a look at in a quiet space inside the church. The affected person acquired well timed care regardless of the total schedule and house constraints.
Taking well being care to the streets
At present, there are roughly 3,600 mobile health clinics in the US, with 1,319 tracked by the Mobile Health Map.
These clinics can present a wide range of services, from catastrophe reduction and psychological well being care to mammography and dental care, to major and preventive care. They significantly goal low-income and uninsured populations. A research of 811 cellular clinics discovered that amongst patients treated between 2007 and 2017, 36% have been from rural areas, 38% have been homeless, 55% have been low earnings and 56% have been uninsured.
Cell well being clinics have been proven to improve health by delivering common care on to populations that will not have entry in any other case.
In a survey of cellular clinic customers, sufferers reported receiving holistic care, feeling safer than they’d felt in other health care settings and interacting with workers who have been conscious of health care costs.
No matter insurance coverage standing, sufferers mentioned they were able to maintain continuity of care, which means the cellular clinic managed their care persistently and was in a position to share their information with new suppliers to make sure they acquired applicable care.
Increasing cellular well being to pregnant sufferers
Sadly, solely 128 of the 1,319 cellular clinics tracked within the cellular well being map present maternal and infant health services, and the companies they provide pregnant, postpartum and new child sufferers are usually fairly restricted. As maternity care deserts broaden, mobile health clinics might supply a sensible resolution for assembly prenatal and postpartum care wants.
We imagine our mannequin might be replicated elsewhere, and different related clinics are already up and operating, such because the University of Arizona Mobile Health Program.
The first problem for cellular clinics is funding, as they’re usually free to patients and supported through grants. With projected latest changes to Medicaid and ACA marketplace coverage, much more sufferers could face restricted entry to prenatal and postpartum well being care.
Research on cellular well being clinics have recognized a number of further challenges related to this mannequin of care. Cell clinics usually are not outfitted to handle emergent issues, complicated medical procedures or labor and supply.
Additionally they face staffing limitations, significantly find well being care professionals who perceive and benefit from the distinctive alternatives and challenges inherent in offering care on a cellular clinic, along with their scheduled clinic or hospital shifts.
However our hope is that as our clinic and others prefer it exhibit an enchancment in well being care in maternal care deserts, elevated consciousness and help could assist broaden this mannequin to extra communities.
Learn extra tales from The Dialog about Florida.