A Texas family physician is rebuilding maternity care around time, trust and access
When Esther Khatibi, M.D., opened New Life Direct Primary Care in Corpus Christi in 2020, she intended to practice medicine across the lifespan. As a family physician with obstetric training, she also planned to stay involved in pregnancy and delivery care. The plan collided with a familiar barrier in American medicine: patients who needed obstetric care could not afford the monthly maternity membership, and many had no insurance or no realistic path to financial assistance.
She was not willing to turn them away. The result was My Direct Obstetrics Care, a nonprofit she established in 2022 to provide maternity care for underserved patients. The organization opened in September 2023 and now offers free obstetric, delivery and postpartum care to patients who are uninsured, underinsured or facing circumstances that increase pregnancy risk.
The model is simple to describe and hard to build. It is also a direct rebuke to the idea that maternal access problems can be solved by coverage alone.
Building a nonprofit required a second medical education
Starting a nonprofit demanded skills far beyond prenatal care. Legal formation came first, followed by the practical work of recruiting a board, drafting bylaws, arranging referrals, raising money and pursuing grants. Khatibi quickly learned that the work of charitable medicine depends as much on administration and relationships as it does on clinical training.
She had to ask for help, and she had to do it early. Donor outreach, financial documentation, grant applications and bookkeeping required people with expertise she did not have time to develop while also running a practice. One fundraising event brought in only about $3,500, enough to signal interest but nowhere near enough to sustain a maternity program. Later, local grants helped purchase an ultrasound machine, a small but meaningful acquisition for a clinic serving pregnant patients who may otherwise have little continuity of care.
A critical part of her strategy is not just keeping the clinic open, but making the process reproducible. Khatibi wants other physicians to have the legal and administrative groundwork needed to offer charitable care without building everything from scratch. In a system where independent physicians often face margins that leave no room for experimentation, that kind of blueprint matters.
Obstetrics inside family medicine depends on backup, not heroics
Khatibi’s experience also exposes the strain of trying to preserve obstetrics within family medicine when the surrounding system is thin. A solo physician can manage direct primary care more easily than delivery medicine. Obstetrics carries call burdens, hospital coordination and sudden clinical escalation that no one can safely absorb alone.
One case made the point sharply. A patient’s membranes ruptured at about 24 weeks of pregnancy, forcing daily rounding until delivery. For a solo doctor with a clinic to run and a family at home, that level of responsibility is not sustainable without support. Obstetric care, especially for higher-risk pregnancies, relies on nearby physicians, hospital relationships and community trust. Without those, a noble mission can become a practical trap.
Opposition to the model was not always about clinical quality. Some colleagues assumed that direct primary care meant concierge medicine, a premium service for affluent patients who wanted extra access. Khatibi had to explain that her patient panel was composed largely of women facing financial hardship, not luxury consumers purchasing convenience. The distinction changed how some covering physicians viewed her work and helped her recruit volunteers.
Free care can still be high-quality care
Khatibi’s message is not that access alone solves maternal health. Her point is harsher and more useful: access without time can leave critical pathology hidden. Brief prenatal visits often reduce the encounter to fetal heart tones, a few screening questions and a handoff to staff. Those tasks matter, but they do not reliably surface the social and medical problems that alter pregnancy outcomes.
In her experience, it often takes at least 10 minutes before a patient begins to open up. Once that happens, the conversation can shift from routine prenatal checklists to domestic abuse, sexual assault or other destabilizing circumstances that influence maternal and fetal health. Longer visits make room for disclosures that short visits routinely miss.
A small detail from clinic life carries a larger clinical truth: the quality of the room, the equipment and the time all shape what a physician can detect. A working light, the right speculum and enough minutes to use them are not minor operational details. They determine whether important findings are seen or missed.
Free care has another advantage: it changes trust. Some patients and community members respond differently when they understand the service is charitable rather than commercial. Khatibi saw people become more willing to help once they understood the care was free. She also learned that the phrase “my patients” can obscure the team-based nature of the work. She prefers to say, “These are our patients.”
The clinic’s future depends on paid roles, volunteer support and a larger model
Khatibi has stepped back from personally performing deliveries so she can focus on fundraising, recruiting and running My DOC. Volunteer physicians now provide delivery care, and she wants the organization to evolve into a structure that includes paid positions for family physicians who want to keep delivering babies.
Her longer-term vision is even broader. She imagines branches of My DOC that other doctors could join while maintaining their own direct primary care practices, using shared nonprofit infrastructure instead of inventing one alone. For physicians who want to serve pregnant patients without surrendering their autonomy to a corporate or hospital system, that could offer a new path.
The funding challenge remains severe. Funders are often wary of new nonprofits, and large grants usually require professional grant writing and accounting support. Even one grant opportunity fell through because the nonprofit shares space with her for-profit practice, a reminder that the financial architecture surrounding medical charity can be surprisingly unforgiving.
Still, the clinic now exists, and it is doing what many policy discussions about maternal health never manage to do: delivering actual care to actual patients. In South Texas, where insurance gaps and delayed prenatal access remain common, that is not a theoretical achievement. It is a clinic schedule, an ultrasound machine, a volunteer roster and a physician who refuses to let pregnancy care disappear because the business model is difficult.
The remaining question is not whether the need exists. It is whether enough physicians, hospitals and donors will help make this kind of care durable enough to outlast the stamina of the doctor who started it.