Problem: In rural areas, the distance to medical services presents a problem. Pregnant women often must travel a good distance both for prenatal care and for the delivery itself. Proposed Solution: In Monroe County, TN, the Monroe Maternity Center was created to help alleviate these problems. While not a hospital, the center offers prenatal care and provides a place for low-risk deliveries that do not require the full services of a hospital. Prenatal screening identifies those mothers who will be likely to need the resources of the hospital instead. In addition to deliveries, the center offers prenatal care as well as support for new mothers. Certified nurse midwives provide the center's services, which are available regardless of income. Malpractice insurance is provided at a reasonable rate through the state's medical association. Evaluation: The center is the only publicly funded non-hospital option for delivery in the nation. Local women have benefited from having a less expensive, more convenient, and simpler option for having a baby. The center is a potential model for other localities with the same problems; although problems with availability of nurse midwives might slow the expansion of such centers, the system is an effective way to provide needed services. Contact: Barbara Levin, M.D., Medical Director, Monroe Maternity Center, Inc., Lost Sea Pike Highway 68, PO Box 115, Madisonville, TN 37354. Citation: "Innovations in State and Local Government 1991." New York: The Ford Foundation, 1991. pp 22-23. Keywords: health care prenatal care