Provision of comprehensive perinatal services through rural outreach: a model program.

A university-based program of perinatal care was extended to serve a spectrum of underserved populations through both urban and rural outreach. The program centered on the use of a multidisciplinary health care team comprised of a physician, nurse-midwife, health educator, social worker, nutritionist, pediatric nurse-practitioner, and patient case manager for health service delivery. It emphasized a decentralized service model with central referral and management of high-risk problems. The program has become a model for perinatal access and is reflected in current state legislation. The implementation of this program in four geographically rural communities is presented. Selected indices of perinatal outcome are presented, with San Diego County, CA, and national statistics as comparisons.