While some government leaders in Alabama are working on implementing robotics to augment missing obstetrics care in rural counties, others are questioning the technology’s effectiveness in a rural setting.
The robotic ultrasound program is part of the state’s Maternal and Fetal Health Initiative, designed to connect rural healthcare facilities with specialists and address shortages of obstetric healthcare professionals, with a goal to reduce infant and maternal mortality.
But how effective robotic ultrasounds will be remains to be seen.
Katy Backes Kozhimannil, University of Minnesota School of Public Health professor and co-director of the University of Minnesota Rural Health Research Center, said it’s unclear how the technology would work in rural communities.
“While new technology is exciting and often has the potential to improve access to care, it does require basic community and health care infrastructure for patients to benefit from that technology,” she wrote in an email interview.
“This includes reliable broadband internet access, as well as basic health care infrastructure [a clinic or other safe, secure location and a trained staff member to operate the robotic ultrasound machine and to support interpretation].”
It is also unclear how it would affect patient care, she said, especially when the tests are over.
“It’s important to consider how patients would receive information about results from their ultrasounds, especially when those results reveal a potential problem with their pregnancy or their baby’s development,” Kozimannil wrote. “Greater access to maternal health technologies can be positive but requires attention to all aspects of the patient experience.”
The program is part of the Alabama’s Rural Health Transformation Program (ARHTP) initiative, which was formally approved in December of 2025. Focusing on 11 different tenets, the ARHTP was designed by Governor Kay Ivey’s office, along with the Alabama Department of Economic and Community Affairs, the Alabama Department of Finance, the Alabama Medicaid Agency, the Alabama State Health Planning, Development Agency, and other state leaders and stakeholders. The money is part of the federal funding that was approved by Congress to offset cuts to Medicare spending.
“After President Trump signed the One Big Beautiful Bill Act into law in July, Alabama got to work preparing for this program so we could hit the ground running once our state’s new comprehensive rural health strategy was approved,” Ivey said in a statement.
“Now that it has been approved, we will take the next steps to ensure our citizens and communities benefit for generations. Making America Healthy Again begins in rural America, and I look forward to being able to improve health care across Alabama.”
The ARHTP seeks to improve healthcare access, healthcare quality, and health outcomes for the more than 1.6 million Alabama residents who live in one of its 58 rural counties. Of those, 36 counties lacked any obstetrics care at all, according to a Harvard University study in 2024. The Alabama Department of Public Health said 41 of the state’s 54 rural counties are currently without labor and delivery services. According to the Center for Healthcare Quality and Reform, the average time for mothers to travel for labor and delivery services in the state is 45 minutes. Additionally, Alabama has the highest maternal mortality rate in the country, with 59.7 deaths per 100,000 live births.
In January, Centers for Medicare and Medicaid Services (CMS) Administrator Mehmet Oz called the program “pretty cool.”
“Alabama has no OB/GYNs in many of their counties, so they’re doing something pretty cool. They’re actually having robots do ultrasounds on these pregnant moms, so we can actually get those images back to the big center, so we know if the child has a problem, and we know that mother’s at risk,” he said during the January 16 press conference.
“We have one of the highest maternal mortality rates in the country, with the best medicine in the world. People ask, ‘Does health care stink in America?’ Well, they don’t like it. ‘Would you leave America to get health care elsewhere?’ Nobody leaves. We have the best health care if you can get to it. We don’t want rural America left behind anymore.”
But U.S. Senator Bernie Sanders, I-Vermont, countered that the program wasn’t “cool.”
“No, Dr. Oz, it’s not ‘cool’ that we don’t have OBGYNs in many rural counties in America,” Sanders posted 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.”
The ARHTP Maternal and Fetal Health Initiative will also expand a pilot program that provides emergency labor and delivery carts to rural hospitals; create a program that connects patients with specialty providers; and provide for equipment upgrades and minor building renovations.
Despite praise from many state and federal officials, the plan has received mixed reviews.
Queries to the Alabama Perinatal Quality Collaborative were forwarded to the University of Alabama at Birmingham (where the program resides), Office of Marketing and Communications. Assistant public relations manager Anna Jones said the program itself is still in its infancy.
“This resource would serve as an additional tool to help local providers deliver timely, appropriate care when specialty support may not be readily available. To our knowledge, no grant recipients have been selected for related projects as program details have not yet been finalized,” Jones wrote in an email interview.
But LoRissa Autery, MD, an OB/GYN at Walker Women’s Specialists in Jasper, Alabama, told regional reporters the problem is not technical support, but access.
“There may be a case where a mom may have low fluid, and that patient needs to go to a hospital,” Autery told Fox54 News in Huntsville. “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.”
The Alabama Public Health Department and the Alabama Rural Health Association did not respond to the Daily Yonder’s requests for comment.
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