Prenatal care services are often lacking in poor rural areas. Consequently, rates of infant mortality and negative birth outcomes are relatively high. To address these problems, since 1987 St. Elizabeth Hospital Medical Center (SEHMC), Youngstown, OH, has successfully operated an innovative rural-based prenatal care clinic for indigent women. The Leetonia Clinic serves residents of Leetonia, OH, and about 20 surrounding communities. It offers on-site medical care using SEHMC obstetrics and gynecology residents and volunteer nurses. The local Catholic Charities organization funds a professional social worker. A prolife advocacy group and a women's self-help group offer volunteer counseling and referral services. They also manage paperwork at the clinic. The local Catholic church provides space in one of its school buildings to house the clinic. SEHMC also provides patient education and outreach. Over the past 4 years the clinic has served about 165 patients annually. About half are on welfare, and the rest are primarily self-paying. Studies are under way to assess the program's effect on infant mortality and morbidity.