Telerobotic ultrasound enters rural OB care. Will it fix Alabama’s OB/GYN shortage?
Industry Buzz
The real debate should not be whether robots belong in obstetrics. It should be why some communities have pregnancies but no obstetric care, and why technology is being asked to compensate for a workforce that no longer exists.
–Amos Grünebaum, MD
There may be a case where a mom... needs to go to a hospital, but if you're in a part of the county that doesn't have a hospital that has obstetrical services, now you have to drive an hour to an hour and a half to receive those services from a physician that did not do the ultrasound.
–LoRissia Autery, MD
With rural OB access dwindling, Alabama officials are betting on telerobotic ultrasounds as a solution to close maternity care gaps and improve care for mothers.
The “Maternal and Fetal Health Initiative,” announced as part of the Alabama Rural Health Transformation Program (ARHTP), aims to connect rural facilities with specialists, provide access to telerobotic ultrasound, address OB/GYN shortages, and reduce high-risk maternal and infant morbidity in underserved communities.[]
During a January White House roundtable, Centers for Medicare & Medicaid Services Administrator Mehmet Oz called the move “pretty cool,” adding that most Alabama counties do not have OB/GYNs available.[]
Alabama has faced a significant OB/GYN shortage in recent years. Less than one-third of Alabama’s rural health centers offer labor and delivery (L&D) services, and OB/GYN residency applications dropped 21.2% in 2023–2024 following the state’s abortion ban.[][][] Alabama also has the highest maternal mortality rate in the country, with 59.7 deaths per 100,000 live births.[]
“No, Dr. Oz, it’s not ‘cool’ that we don’t have OBGYNs in many rural counties in America,” Sen. Bernie Sanders wrote in a post on X. “It is an international embarrassment. In the richest country on earth, we need more doctors, nurses, dentists and mental health counselors, not more robots.”
What’s in the plan?
The plan targets Alabama’s maternal health crisis, which has been exacerbated by the cost-centric closure of rural L&D units. The loss of these services has led to a decrease in maternity care across rural counties as OB/GYNs seek L&D units closer to hospitals.[]
By connecting rural providers to regional hubs that can provide access to robotic services, Alabama officials believe they can bridge gaps in access to care and improve outcomes, particularly for women with “high-risk” pregnancies.
The plan also includes:
An expansion of an existing pilot program that provides emergency L&D carts to rural hospitals
Central coordinating providers to help patients access specialty services not offered at the regional level
Equipment upgrades and minor building renovations to provide maternal and fetal healthcare services
How are physicians responding?
Despite Trump administration officials touting Alabama’s efforts to implement telerobotic ultrasounds, the plan has sparked a larger debate about maternity health access beyond Alabama.
“There may be a case where a mom may have low fluid, and that patient needs to go to a hospital, but if you’re in a part of the county that doesn’t have a hospital that has obstetrical services, now you have to drive an hour to an hour and a half to receive those services from a physician that did not do the ultrasound,” LoRissia Autery, MD, an OB/GYN at Walker Women’s Specialists, told Fox54 News Huntsville.
Julie Fontaine, who operates an ultrasound robot at a clinic in the remote Canadian village of La Loche, told KFF Health News that patients like the robot because it saves them time and money on traveling to regional health facilities that are 6 to 7 hours away.
“The real debate should not be whether robots belong in obstetrics,” Amos Grünebaum, MD, a professor of obstetrics and gynecology at the Zucker School of Medicine, told Feminist. “It should be why some communities have pregnancies but no obstetric care, and why technology is being asked to compensate for a workforce that no longer exists.”