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Poster Session 3

Category: Health Equity/Community Health

Poster Session 3

(707) Provider Perspectives of Socioeconomic Barriers and Facilitators of Tailored Prenatal Care in Academic Medical Systems

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author(s)

Tanvi Sharma, BS

Medical Student
University of Michigan Medical School
Ann Arbor, Michigan, United States

Coauthor(s)

EK

Elizabeth Krans, MD, MSc

Associate Professor, Department of Obstetrics, Gynecology & Reproductive Sciences
UPMC Magee-Womens Pregnancy and Women's Recovery Center
Pittsburgh, Pennsylvania, United States
DH

David M. Haas, MD

Robert A. Munsick Professor of Obstetrics & Gynecology
Indiana University
Indiannapolis, Indiana, United States
Michelle Moniz, MD, MSc (she/her/hers)

Associate Professor
University of Michigan
University of Michigan, Michigan, United States
Molly J. Stout, MD, MS (she/her/hers)

Associate Professor
University of Michigan
Ann Arbor, Michigan, United States
Rachel A. Clark, MD (she/her/hers)

OBGYN Resident
Trinity Health - Ann Arbor Hospital
Ann Arbor, Michigan, United States
Sophia D. Fraga, BA (she/her/hers)

Medical Student
University of Michigan Medical School
University of Michigan, Michigan, United States
KH

Kelsey Hoskin, BA

Medical Student
University of Michigan Medical School
Ann Arbor, Michigan, United States
JE

Julia Erickson, BS

Clinical Research Coordinator
University of Michigan
University of Michigan, Michigan, United States

Presenting Author(s)

Alex Peahl, MD, MSc (she/her/hers)

Assistant Professor of Obstetrics and Gynecology
University of Michigan Department of Obstetrics & Gynecology
Ann Arbor, Michigan, United States

Objective:
At the onset of the COVID-19 pandemic, providers adapted prenatal care to incorporate telemedicine and targeted visit schedules. With these changes in clinical practice, the American College of Obstetricians and Gynecologists Clinical Consensus: Tailored Prenatal Care was published in May 2025. We describe providers’ perspectives of barriers and facilitators of adopting one component of tailored prenatal care models: addressing unmet social needs.

Study Design:
We conducted semi-structured interviews with 30 clinically active maternity care professionals at three academic sites. Interviews were transcribed, imported into MaxQDA, and iteratively coded using the Consolidated Framework for Implementation Research (CFIR), a structured framework for identifying barriers and facilitators of implementing evidence-based interventions. Findings were organized by component of tailored care and then by CFIR domain to summarize drivers of tailored prenatal care adoption.

Results:
Drivers of addressing unmet social needs were concentrated in the inner, outer, and individual settings. Inner setting facilitators were colocation of medical and social services and coordination of workflows, as well as a clinical culture of meeting social needs. Outer setting facilitators included support from community organizations and their integration with clinics. Outer setting barriers were maternity care deserts and varying insurance coverage for social needs (e.g., transportation, blood pressure monitors). Individual level facilitators included how tailored care could better accommodate work schedules, childcare, and transportation challenges. Barriers included lack of accommodations for specific populations (e.g., patients who do not primarily speak English).

Conclusion:
Multilevel facilitators support clinics’ ability to address unmet social needs through routine prenatal care. Future work is needed to scale these interventions to the variety of locations where prenatal care is delivered, particularly safety net clinics where patients have higher rates of unmet social needs.