Boston, MA —A new national study provides the first comprehensive look at prenatal care services offered by federally qualified health centers (FQHCs), revealing that while these safety-net providers play a critical role in caring for low-income and racially diverse pregnant populations, significant gaps in access remain.
Researchers from the Harvard Pilgrim Health Care Institute and the Boston University School of Public Health found that about two-thirds of centers offer prenatal care, while one in three does not—pointing to missed opportunities to address inequities in maternal health access.
Addressing a Critical Knowledge Gap
Low-income pregnant and postpartum patients face growing barriers to accessing care, driven in part by maternity ward closures and a growing shortage of providers over the past decade. Serving more than 32 million low-income patients nationwide, FQHCs—also known as community health centers—are uniquely positioned to help address these challenges because they offer comprehensive primary care regardless of ability to pay and are required to be located in underserved communities. FQHCs may either provide prenatal care on-site or refer patients to external providers, and until now, national data on these patterns have been limited.
“Despite the potential for FQHCs to address maternal health access barriers, we actually know little about the extent to which they directly provide maternal health services,” said Megan Cole Brahim, lead author and Harvard Medical School Associate Professor of Population Medicine at the Harvard Pilgrim Health Care Institute. “Understanding where and for whom these services are available is essential to improving maternal health equity.”
Study Design and Scope
The study analyzed data from 1,326 federally qualified health centers across the United States, representing 100% of FQHCs in operation as of 2024 (excluding U.S. territories and centers serving fewer than 100 adult female patients). Together, these centers serve approximately 8 million females of reproductive age.
Researchers assessed (1) availability of on-site prenatal care at FQHCs, (2) characteristics of centers offering on-site care, and (3) geographic variation in on-site availability of prenatal care, including differences in whether or not the FQHC was located in a “maternity desert” region.
Key Findings
The study revealed several key takeaways:
FQHCs Play a Critical Role, But with Room for Improvement to Reach Full Potential
The findings, note Dr. Cole Brahim, underscore both the critical role of FQHCs and the need for expanded access to prenatal care within the safety-net they provide.
“With one in three FQHCs lacking prenatal services, expanding on-site prenatal care at FQHCs—and addressing the workforce and financial barriers that currently hinder this expansion—must be a priority. At the same time, ensuring that patients can access timely, coordinated external referrals when on-site prenatal care is unavailable is critical,” adds Dr. Cole Brahim. “Strategically growing health centers in maternity care deserts—potentially through HRSA ‘New Access Point’ FQHC capacity-building grants—could be a critical step toward closing these gaps.”
As maternal health disparities persist nationwide, the study highlights an urgent opportunity to strengthen access through proven safety-net providers. Targeted investments in community health centers could play a pivotal role in ensuring equitable, timely prenatal care for all patients.
Citation:
Cole MB, Auty S, Zi Jin G, Safon C, Gordon SH. Provision of Onsite Prenatal Care Services at U.S. Federally
Qualified Health Centers. Annals of IM . Published July 14, 2026. doi:10.7326/ANNALS-26-00381
Research reported in this press release was supported by the National Institute on Minority Health and Health Disparities under Award Number 5R01MD019661 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
About the Harvard Pilgrim Health Care Institute’s Department of Population Medicine
The Harvard Pilgrim Health Care Institute's Department of Population Medicine is a unique collaboration between Harvard Pilgrim Health Care and Harvard Medical School. Created in 1992, it is the first appointing medical school department in the United States based in a health plan. The Institute focuses on improving health care delivery and population health through innovative research and education, in partnership with health plans, delivery systems, and public health agencies. Follow us on Bluesky and LinkedIn .
Annals of Internal Medicine
Provision of Onsite Prenatal Care Services at U.S. Federally Qualified Health Centers
14-Jul-2026