Rural Maternal Health – Models and Innovations

Evidence-Based Examples

Domestic Violence Enhanced Home Visitation Program (DOVE)

Updated/reviewed March 2026

• Need: To reduce violence against pregnant women and women with infants in rural Missouri.
• Intervention: A tool for existing home visiting programs, DOVE was a brochure-based and safety planning intervention for women experiencing interpersonal violence.
• Results: Women receiving the DOVE intervention saw a larger average decrease in number of violent incidents than women in the control group.

UAMS IDHI High-Risk Pregnancy Program

Updated/reviewed February 2026

• Need: Arkansas had high rates of low birthweight babies, and pregnant patients in rural areas had difficulty accessing specialty obstetric care.
• Intervention: The University of Arkansas for Medical Sciences (UAMS) created the Institute for Digital Health & Innovation (IDHI) High-Risk Pregnancy Program to increase access to care for pregnant patients in an effort to improve outcomes for high-risk pregnancies.
• Results: The program has increased access to care and improved neonatal outcomes for rural Arkansas individuals through a variety of programs and has been recognized by various organizations as a model program.

Promising Examples

Contingency Management Smoking Cessation in Appalachia

Updated/reviewed March 2026

• Need: To reduce smoking rates of pregnant adult and adolescent women in Appalachian regions of eastern Kentucky and Ohio.
• Intervention: In 2009, a web-based smoking cessation program offered monetary incentives to reduce smoking.
• Results: Participants significantly reduced smoking rates or quit altogether.

Healthy Connections, Inc. Healthy Families Arkansas

Updated/reviewed December 2022

• Need: High poverty rates and lack of access to healthcare make caring for unborn and newborn children difficult for young mothers in Arkansas's Polk and Garland Counties.
• Intervention: An Arkansas-based program provides a national healthcare service to expectant and young mothers. Prenatal check-ups, education, transportation, well-baby checks and child immunizations are all provided by the Healthy Connections, Inc.
• Results: The program's results demonstrate an increase in first trimester prenatal care rates and child immunization rates, as well as a dramatic decrease in confirmed cases of child abuse.

Other Project Examples

One Health Recovery Doulas

Updated/reviewed November 2025

• Need: To support pregnant and parenting women with a history of substance use, mental health, or co-occurring disorders in rural areas of Montana.
• Intervention: One Health, a consortium of Federally Qualified Health Centers (FQHCs), developed a team of "recovery doulas" – individuals who are dual-certified as doulas and peer-support specialists. The One Health recovery doula program offers group and individual services to women and their partners from pregnancy through the first years of parenthood.
• Results: A team of four recovery doulas (or doulas-in-training) employed by One Health offer services in 8 rural eastern Montana counties. One Health has also successfully trained and certified 35 Peer Recovery Doulas statewide through their Peer Recovery Doula certification curriculum.

Kid One Transport

Updated/reviewed June 2025

• Need: Transportation to medical appointments for children and expectant mothers living in rural Alabama.
• Intervention: Kid One Transport provides rides to medical appointments for clients who otherwise have no other means of transportation.
• Results: The program has transported 477,880 children and expectant mothers to and from medical appointments. Children have recovered from life-threatening illnesses and are experiencing a higher quality of life.

Structured Training for Rural Enhancement of Community Health in Obstetrics (STRETCH-OB)

Updated/reviewed June 2025

• Need: To improve maternal and birth outcomes in rural and underserved areas by increasing the number of family medicine physicians in these areas who have high-quality, evidence-based obstetrical care skills.
• Intervention: The STRETCH-OB program trains a select number of family medicine residents at the University of Illinois College of Medicine Rockford each year to provide high-quality maternity care, including surgical obstetrical care.
• Results: Four STRETCH-OB residents have graduated as of June 2025 and all have cesarean section privileges in their practice.

Mother's Milk Bank of South Carolina

Updated/reviewed April 2025

• Need: Neonatal Intensive Care Units (NICUs) across the state of South Carolina were purchasing breast milk from out-of-state milk banks for preterm infants.
• Intervention: The Mother's Milk Bank of South Carolina (MMBSC) opened 25 sites in South Carolina for breast milk to be donated, safely pasteurized, and delivered to NICUs across the state.
• Results: Over 24,320,167 ounces of milk have been donated to MMBSC depot sites and over 14,932,920 ounces of milk have been delivered to South Carolina NICUs.

ROAMS (Rural OB Access & Maternal Service)

Updated/reviewed April 2025

• Need: To improve maternal health in northeastern New Mexico.
• Intervention: The Rural OB Access & Maternal Service program provides obstetric and maternal fetal medicine telehealth, home telehealth kits, and free access to lactation consultants and family navigators.
• Results: ROAMS has worked with 2,000 unique individuals since July 2021.

Healthy Mujeres in the Texas Rio Grande Valley

Added December 2024

• Need: To provide basic pregnancy-related and preventive health services to women in the Texas Rio Grande Valley.
• Intervention: A mobile clinic travels to different communities and provides basic preventive care, contraception, and pregnancy testing and ultrasounds.
• Results: Since the program began, clinical staff have provided services to nearly 6,000 women.

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