Skip to main content

Impact of a Mobile Van on Prenatal Care Utilization and Birth Outcomes in Miami-Dade County


The study aimed to determine if there was a difference in prenatal care utilization and birth outcomes among demographically similar women who used or did not use a mobile van for prenatal care. Mothers who utilized the mobile van at least one time for their prenatal care and delivered between August 2007 through September 2008 were considered the Mobile group (n = 182) and a Comparison group of the same size who delivered within the same time period was randomly matched by sociodemographic characteristics. Birth data was obtained from Florida Department of Health Office of Vital Statistics and from the mobile clinic’s Health Management System (HMS) database. Nearly 95% of mothers in both groups were foreign born, with the majority from Mexico. The evaluation of prenatal care showed that there was a significant difference (P = 0.0006) in the trimester in which mothers began care. Both the Kessner (P = 0.0003) and Kotelchuck (<0.0001) Indices demonstrated a statistically significant difference in that more mothers in the Mobile group had adequate care. Birth weight distribution did not reveal a statistically significant difference (P = 0.0911) however the Mobile group did have a lower percentage of low birth weight infants (4.4% vs. 8.8%). There was a statistically significant difference in the amount of pre-term births (P = 0.0492) between the groups. The results suggest that a mobile van can be used to improve both early access to adequate prenatal care as well as birth outcomes such as prematurity.

This is a preview of subscription content, access via your institution.


  1. 1.

    U.S. Census Bureau: State and County QuickFacts. (2008). Population estimates, census of population and housing, small area income and poverty estimates, state and county housing unit estimates, county business patterns, nonemployer statistics, economic census, survey of business owners, building permits, consolidated federal funds report, Revised 2008.

  2. 2.

    Florida Charts Birth Query System. Florida Department of Health, Office of Vital Statistics, Florida Birth Certificate.

  3. 3.

    County Health Status Summary, Dade County, Florida. Florida Department of Health, Office of Vital Statistics.

  4. 4.

    McCormick, M. C., et al. (1992). The health and developmental status of very low-birth-weight children at school age. JAMA, 267(16), 2204–2208.

    Article  CAS  PubMed  Google Scholar 

  5. 5.

    United Nations Children’s Fund (UNICEF) Strategic Information Unit, Division of Policy and Planning, and World Health Organization (WHO) Department of Reproductive Health and Research. Low birth weight: Country, regional and global estimates 2004. birthweightestimates.pdf.

  6. 6.

    Stephenson, T., & Symonds, M. E. (2002). Maternal nutrition as a determinant of birth weight. Archives of Disease in Childhood- Fetal and Neonatal Edition, 86, F4–F6.

    Article  CAS  PubMed  Google Scholar 

  7. 7.

    Negi, K., et al. (2006). Epidemiological factors affecting low birth weight. Journal of Medical Education, 8, 31–34.

    Google Scholar 

  8. 8.

    Alexander, G., & Korenbrot, C. (1995). The role of prenatal care in preventing low birth weight. Future of Children, 5(1), 103–120.

    Article  CAS  PubMed  Google Scholar 

  9. 9.

    Lee, E., & O’Neal, S. (1994). A mobile clinic experience: Nurse practitioners providing care to a rural population. Journal of Pediatric Health Care, 8(1), 12–17.

    Article  CAS  PubMed  Google Scholar 

  10. 10.

    Reguero, W., & Crane, M. (1994). Project MotherCare: One hospital’s response to the high perinatal death rate in New Haven, CT. Public Health Reports, 109, 647–652.

    CAS  PubMed  Google Scholar 

  11. 11.

    Edgerley, L., et al. (2007). Use of a community mobile health van to increase early access to prenatal care. Maternal and Child Health Journal, 11, 235–239.

    Article  Google Scholar 

  12. 12.

    Institute of Medicine, Subcommittee on Nutritional Status and Weight Gain during Pregnancy. (1990). Nutrition during pregnancy. Washington, DC: National Academy of Sciences.

  13. 13.

    Institute of Medicine, National Academy of Sciences. (1973). Infant deaths, an analysis by maternal risk and health care. Contrasts in health status. Washington, DC: Institute of Medicine.

  14. 14.

    Alexander, G., & Kotelchuck, M. (1996). Quantifying the adequacy of prenatal care: A comparison of indices. Public Health Reports, 111, 408–418.

    CAS  PubMed  Google Scholar 

  15. 15.

    U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Healthy people 2010. Maternal, infant and child health (Vol. 2).

  16. 16.

    Mobile Health Units. (2006, May). Methodological approach. Geneva, Switzerland: ICRC.

  17. 17.

    Loue, S. (1992). Access to health care and the undocumented alien. Journal of Legal Medicine, 13, 271–332.

    Article  CAS  Google Scholar 

  18. 18.

    Passel, J., & Cohn, D. (2009). A portrait of unauthorized immigrants in the United States. Washington, DC: Pew Hispanic Center. April.

    Google Scholar 

  19. 19.

    Kuiper, H., et al. (1999). The communicable disease impact of eliminating publicly funded prenatal care for undocumented immigrants. Maternal and Child Health Journal, 3, 39–52.

    Article  CAS  Google Scholar 

  20. 20.

    Lu, M. C., et al. (2000). Elimination of public funding of prenatal care for undocumented immigrants in California: A cost/benefit analysis. American Journal of Obstetrics and Gynecology, 182(1), 233–239.

    Article  CAS  PubMed  Google Scholar 

  21. 21.

    Huntington, J., & Connell, F. A. (1994). For every dollar spent- the cost savings argument for prenatal care. NEJM, 331, 1303–1307.

    Article  CAS  PubMed  Google Scholar 

  22. 22.

    Page, R. L. (2004). Positive pregnancy outcomes in Mexican immigrants: What can we learn? Journal of Obstetric, Gynecologic, and Neonatal Nursing, 33(6), 783–790.

    Article  PubMed  Google Scholar 

  23. 23.

    Cobas, J., et al. (2006). Acculturation and low birthweight infants among Latino women: A reanalysis of HHANES data with structural equation models. American Journal of Public Health, 86, 394–396.

    Article  Google Scholar 

  24. 24.

    Zukevas, A., et al. (2000). Mexican American infant mortality rate: Implications for public policy. Journal of Health Care for the Poor and Underserved, 11, 243–257.

    Google Scholar 

  25. 25.

    Joseph, K., et al. (2007). Reconciling the high rates of preterm and postterm birth in the United States. American Journal of Obstetrics and Gynecology, 109, 813–822.

    CAS  Google Scholar 

  26. 26.

    Viswanathan, M., et al. (2008) Outcomes of maternal weight gain, evidence report/technology assessment No.168. Prepared by RTI International–University of North Carolina Evidence-based Practice Center under Contract No. 290-02-0016. Agency for Healthcare Research and Quality Publication No. 08-E009, May 2008. Rockville, MD.

Download references


The authors would like to thank staff of the March of Dimes South Florida Chapter, the Children’s Trust, the Healthy Start Coalition of Miami‐Dade, the Blue Foundation and the Miami-Dade County Health Department Office of Women’s Health and Preventive Services for their dedication to the MOMmobile project.

Author information



Corresponding author

Correspondence to Erin O’Connell.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

O’Connell, E., Zhang, G., Leguen, F. et al. Impact of a Mobile Van on Prenatal Care Utilization and Birth Outcomes in Miami-Dade County. Matern Child Health J 14, 528–534 (2010).

Download citation


  • Mobile van
  • Birth outcome
  • Prenatal care
  • Foreign born