Assessing the population access to obstetric care can be challenging based on existing databases of obstetric providers. Applying a patient-centered perspective, access to care includes distance to nearest provider or hospital, and in the antepartum setting includes barriers to first obstetric visits. We sought to directly evaluate details regarding scheduling a first obstetric appointment at obstetric provider offices across the state of Maryland.METHODS:
A hospital database of obstetric providers in the state that have the ability to refer patients was used to identify all clinics in the state. The study design was designated as IRB exempt by our institutional IRB. Each clinic site was contacted by phone to survey details regarding time until this next available appointment, interpreter services or accommodation, and financial requirements for patients without insurance.RESULTS:
A wide variety of clinic practices were identified in our study. Wait times to first visit ranged from one day to one month, with some counties without available appointments for weeks. Most clinics accepted patients without insurance, although some required upfront payment of up to $2,500 prior to being seen. Although many clinics would see patients who did not speak English, a number required the patient to provide interpreter services.CONCLUSION:
Barriers exist to establishing obstetric care across the state of Maryland. Addressing barriers that delay patients first establishing prenatal care may help patients access timely prenatal care. Data collection assessing scheduling the first prenatal appointment can provide important information for efforts to improve patient accession of obstetric care.