Learning Objective #1: Examine the effect four rural clinics have on access to early prenatal care.

Learning Objective #2: Relate the impact early prenatal care has on materal and infant health outcomes.

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The project's purpose is to increase to 95%, the pregnant women residing in four rural West Texas Counties who receive prenatal care within the first trimester of pregnancy. In 1984, state supported programs were initiated to provide prenatal services to medically under-served rural areas in Texas. Since 1996, Texas Tech University Health Sciences Center at Odessa Obstetrical/Gynecological Department has overseen the nurse practitioner managed prenatal clinics in these four rural communities. In June 2004, a team consisting of the prenatal nurse practitioner (mentee), public health administrator and nurse practitioner (mentor), two obstetrical/gynecology physicians, three registered nurses, social psychology researcher PhD, and one administrative support person was established. The team compared 1983 vital statistics data (total births, low birth weight infants born, onset of prenatal care, mothers less than 17 years of age, infant deaths, neonatal deaths) in the four communities to 2002 data. The literature review revealed multiple factors that influence access to health care. The rural clinics have been structured to limit the barriers to accessing prenatal care. The team will assess the impact of early prenatal care on post-delivery maternal infant outcomes. The data from the women who receive services in the four rural clinics will be collected and analyzed. Results will be presented.