Sarah Jane Tribble, KFF Health News
It seems like one thing from a science fiction novel, however Alabama officers’ plan to make use of robots to enhance look after rural pregnant girls and their infants is actual.
During a January White House roundtable touting the primary grants to states below a brand new $50 billion rural well being fund, Centers for Medicare & Medicaid Services Administrator Mehmet Oz known as the concept “pretty cool.” Later that day, Sen. Bernie Sanders, the impartial from Vermont, stated it’s decidedly not cool. And obstetricians and others chimed in on social media to specific alarm, with one political activist calling it a “dystopian horror story.”
The disparate responses spotlight how pleasure over the tech-heavy concepts states pitched of their purposes for the federal Rural Health Transformation Program conflicts with the truth that there merely aren’t sufficient well being employees to serve sufferers in lots of rural communities. Now, as states put together to spend their first-year awards, pressure is mounting, and nowhere is that pressure extra seen than in Alabama.
Oz has lauded the state’s proposal to put money into the comparatively new expertise of robotic ultrasounds.
“Alabama has no OB-GYNs in many of their counties,” Oz stated, sitting with President Donald Trump and Cabinet members. The dearth of care, he said, prompted the proposal to make use of robots for ultrasounds on pregnant girls.
Britta Cedergren directs the Alabama Perinatal Quality Collaborative and has a agency grip on actuality: “No one is using autonomous robots.”
While robotic ultrasounds are a “really neat technology,” she stated, they aren’t but getting used within the state. Instead, clinicians offering obstetric care lean on cellphone consultations and — when tools and web can be found — telehealth.
The purpose, she stated, is to “support places where there is no care.”
Cedergren is a part of a number of state maternal and fetal well being teams and works day by day with docs, hospitals, and first responders. While enhanced expertise is significant for affected person care, it’s not a substitute for a well-trained workforce and a coordinated care and information system, she stated.
In 2024, the latest 12 months for which information is on the market, Alabama’s toddler mortality fee was 7.1 deaths per 1,000 dwell births. The nationwide fee was 5.5 per 1,000 dwell births, in accordance with provisional data launched by the Centers for Disease Control and Prevention.
Hospital-based obstetric unit closures, which frequently result in a lack of well being care suppliers who can look after expectant moms and their infants, are a long-standing, ongoing pattern in rural America. But Alabama’s lack of providers has been notably profound.
In 1980, 45 of the state’s 55 rural counties had hospital-based obstetric providers. By 2025, only 15 offered such care, in accordance with state information. And the losses aren’t slowing. Five hospital obstetric items closed in 2023 and 2024, together with in three rural counties: Monroe, Marengo, and Clarke.
Katy Backes Kozhimannil, a professor on the University of Minnesota School of Public Health, discovered that closures in distant areas lead to an increase in preterm births, a number one reason for toddler mortality.
“People will be pregnant and give birth in communities all over the place,” she stated. “You have to be able to get to a place where you can be cared for.”
Nearly all 50 states’ purposes for the Rural Health Transformation Program declared workforce shortages and maternal well being wants as priorities, however solely Alabama proposed utilizing robots to fill the hole. The rural fund, which Congress created as a last-minute sweetener in Trump’s One Big Beautiful Bill Act final summer time, inspired states to be inventive, be modern, and pitch tech options.
Alabama was awarded $203 million for the primary of this system’s 5 years. Among almost a dozen rural health initiatives, the state’s utility included bolstering its rural workforce in addition to enhancing maternal and fetal well being.
Mike Presley, a spokesperson for the Alabama Department of Economic and Community Affairs, which is overseeing the plan, stated nobody was accessible for an interview about telerobotic ultrasounds.
LoRissia Autery, an obstetrics and gynecology specialist in rural Alabama northwest of Birmingham, stated the robots gained’t lower maternal and toddler mortality. There are nuances, she stated, to doing ultrasounds.
Many of her sufferers have high-risk pregnancies with diabetes, hypertension, and hepatitis C, she stated. She stated she worries concerning the sort of care that can be given to her sufferers, a lot of whom drive an hour or extra to get to her, if robots are used as a substitute of a educated specialist.
“It takes away just the care that we need to have for women,” stated Autery, who co-founded Walker Women’s Specialists. The clinic contains three docs, attracts sufferers from 5 counties, and will use an extra doctor to fulfill the demand, Autery stated.
“Probably for the past six or seven years, we’ve been putting out feelers trying to find a fourth partner,” Autery stated. “It’s difficult for a variety of reasons.”
In his social media remarks to Oz, Vermont’s Sanders known as the shortage of rural well being care suppliers within the U.S. an “international embarrassment.”
“In the richest country on earth, we need more doctors, nurses, dentists and mental health counselors, not more robots,” Sanders wrote on the social platform X.
At least one nation is utilizing robots paired with educated employees to lower deaths.
In the distant Canadian village of La Loche, Julie Fontaine operates an ultrasound robotic at a clinic with two on-site nurse practitioners and rotating docs. She stated sufferers just like the robotic as a result of it saves them the time and expense of touring to a much bigger regional well being care facility six to seven hours away.
“When people come in, they’re like, ‘Wow, like, technology these days,’” stated Fontaine, a member of the Métis people in northern Saskatchewan. “It’s something they’ve never seen before or even used.”
When working with sufferers, Fontaine connects the robotic ultrasound machine to a tele-sonographer at a management station in Saskatoon. The sonographer then remotely operates a robotic arm on the machine. A radiologist, who might be anyplace, reads the scan’s report and sends it again to the household physician in La Loche, stated Ivar Mendez, a neurosurgeon and the director of Canada’s Virtual Health Hub. Most infants in Canada, he stated, are delivered by household docs or midwives, not specialists.
“The most important thing is the identification of a high-risk pregnancy early enough so you can intervene,” stated Mendez, who added that the robotic ultrasound is “as good as the in-person ultrasound” however can’t be used when a affected person wants a extra invasive vaginal ultrasound. The mortality fee for moms and newborns within the north, web site of the La Loche clinic, is 20 to 25 occasions better than in the remainder of the nation, he stated.
“One of the reasons is that there’s no availability of prenatal ultrasonography in those communities, so pregnant women have to travel to cities and they’re put up at hotels,” he stated.
In a 2022 paper, Mendez and his staff on the University of Saskatchewan examined 87 telerobotic ultrasounds and located that 70% of the time, the robotic ultrasound made journey for care pointless. Nearly all of the sufferers stated they’d use the robotic once more.
The similar robotic ultrasound expertise was approved in 2017 for use within the U.S.
Nicolas Lefebvre, chairman and chief govt of the robotic’s creator and producer, AdEchoTech, stated the corporate has “U.S. maternity-specific projects that are currently under preparation.” The common value of a robotic can be $250,000 to $350,000, in accordance with AdEchoTech’s U.S.-based enterprise growth guide.
Using robotic ultrasounds is one a part of Alabama’s proposed maternal and fetal well being initiative, in accordance with the state’s application. Acknowledging lack of hospital obstetric items, officers stated they deliberate to attach smaller rural suppliers and well being care amenities that lack “high-quality maternal and fetal health services” to regional care hubs that may present the providers digitally, together with by way of telerobotic ultrasound.
For their workforce initiative, state officers proposed coaching applications for docs, emergency providers, and nurse-midwives.
The estimated required funding for the maternal and fetal well being initiative is $24 million over five years. Alabama officers proposed $309.75 million for his or her workforce initiative over 5 years.
KFF Health News is a nationwide newsroom that produces in-depth journalism about well being points and is among the core working applications at KFF—an impartial supply of well being coverage analysis, polling, and journalism. Learn extra about KFF.
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