Brittany and her husband, Seth, had gone from joy to despair.

Joy upon learning that Brittany was pregnant with twins. Despair when she experienced complications early in pregnancy, and initial physician visits presented a bleak outlook. Brittany and Seth prepared for the worst.

Then, her obstetrician referred her to the new All Children’s Specialty Physicians Maternal-Fetal Medicine Clinic in Fort Myers, Florida. Consultations with Jose Prieto, M.D., chief of maternal-fetal medicine at Johns Hopkins All Children’s Hospital, and Lauren Silva, M.D., a maternal-fetal specialist based in Fort Myers, gave Brittany and her husband something they had been lacking … hope.

 

“Dr. Prieto and Dr. Silva gave us options — medication, monitoring, and a plan to give our babies every possible chance,” says Brittany, who has an older daughter from a previous relationship. “I truly believe that if we hadn't gone to Johns Hopkins All Children’s, I would have delivered weeks ago.”

Maternal-fetal medicine specialists — also called perinatologists — are OB-GYNs with special training in high-risk pregnancies. The Fort Myers clinic is part of an expansion of women’s health services by Johns Hopkins All Children’s Maternal, Fetal & Neonatal Institute, which now has seven maternal-fetal medicine locations along Florida’s west coast. In October, it opened All Children’s Specialty Physicians OBGYN 54 Crossing, which will grow into a full-service obstetrics and gynecology clinic in Land O’Lakes, just north of Tampa. It is Johns Hopkins All Children’s second OB-GYN clinic, joining one in St. Petersburg.

“Our Maternal, Fetal & Neonatal Institute is expanding women’s services in our communities to meet the growing need for comprehensive women’s health and OB care,” says Jen Bowlby, M.S.N., R.N., director of nursing for the institute. “By enhancing access to care close to home, we’re helping support families through every stage — providing streamlined coordination from routine visits to high-risk pregnancies, delivery and advanced care when needed.”

A Commitment to Care

Many health systems are cutting back on women’s health care, particularly related to maternity services. Medicaid covers nearly half of all births in the United States, and reimbursement rates are low. Maternity units need specialized staffing available 24 hours a day, seven days a week, even when patient volume is low.

There is a national shortage of OB-GYNs, so recruitment can be challenging.

But Johns Hopkins All Children’s, rated the #1 children’s hospital in Florida by U.S. News & World Report for three years in a row, has made women’s health a key part of the “Be a Trusted Leader” pillar of its strategic plan. The hospital showcases a 97-bed neonatal intensive care unit (NICU), which carries a Level IV rating, meaning it offers the highest level of care. Challenging patients often are transferred from other hospitals in the region to Johns Hopkins All Children’s.

Neonatologists from All Children’s Specialty Physicians also direct the care of infants in Level I through III NICUs at several other community and regional hospitals along Florida’s west coast, stretching from Sarasota Memorial Hospital — Venice in the south to HCA Florida Trinity Hospital in the north.

“From conception to delivery to subsequent neonatal and infant care, our goal in the Fetal Care Center at Johns Hopkins All Children's Hospital is to provide a multidisciplinary comprehensive approach to the high-risk pregnant patient and her family in their time of greatest need,” Prieto says. “We are expanding regionally along the Gulf Coast of Florida to reach as many families in need as possible.”

Despite the national shortage of OB-GYNs and maternal-fetal medicine specialists, Johns Hopkins All Children’s believes its commitment to expanding women’s health services makes it an attractive destination for clinicians.

“Johns Hopkins All Children’s attracts top OB-GYNs and maternal-fetal medicine specialists by offering a combination of high-level, collaborative care and a mission-driven environment focused on personalized, compassionate service to women and families,” Bowlby says. “Specialists are drawn to the opportunity to have a meaningful impact as part of a dedicated, multidisciplinary team that delivers advanced, integrated care across all stages of pregnancy — including high-risk cases.”

Recent expansion includes opening the maternal-fetal medicine clinic in Fort Myers in August 2025 and the 54 Crossing Clinic in Land O’Lakes, which initially offers only gynecology but will add obstetrics when a second OB-GYN is recruited to join Randdie-Joyce Rameau, D.O., M.P.H. The Land O’Lakes clinic will work closely with the All Children’s Specialty Physicians maternal-fetal medicine clinic in nearby Trinity.

“Despite national trends, the need for accessible, high-quality women’s health and OB care remains vital — especially in our region, where many families face limited options,” Bowlby says. “By expanding services, All Children’s is addressing critical gaps in care, ensuring that women have access to comprehensive support — from prenatal through postpartum and beyond. This strengthens the health of mothers and babies and reinforces our commitment to supporting families and building healthier communities through easier access and coordinated care.”

In the Community

Johns Hopkins All Children’s commitment to maternal health extends beyond clinical services.

The hospital educates and advocates on issues such as breastfeeding and maternal nutrition, including the importance of folic acid during pregnancy for healthy development of the brain and spinal cord. New mothers can be screened for post-partum depression.

The hospital’s Community Division recently redesigned its Maternal and Child Health program, which offers resources and support throughout pregnancy. For instance, “Infant Academy” provides education and supplies to prepare expectant parents for the journey ahead. The program also offers Community Education Workshops that cover topics such as prenatal health and managing chronic health conditions.

“Improving birth outcomes and maternal, fetal and infant health are critical needs in our community,” says Kimberly Brown-Williams, Maternal and Child Health program manager at Johns Hopkins All Children’s. “We believe every family deserves quality health care and support through pregnancy and into childhood.”

Feeling at Ease

For Brittany and Seth, the expert care closer to home gives them peace of mind.

She remembers Prieto spending nearly an hour with them “going over every detail” and explaining risks, benefits and options at her initial consultation at the Fort Myers clinic. At her next appointment, she met Silva.

“She immediately made me feel at ease,” Brittany says. “She listened carefully and answered all of our questions and concerns about my situation. After that appointment, for the first time in weeks, I felt like there was real hope for our babies. I remember her calm demeanor the most, which made me feel more calm. I knew we had found a great medical team.”

Brittany’s pregnancy has been anything but easy, but with guidance from All Children’s Specialty Physicians and a team in the clinic she calls “phenomenal,” she has gained confidence with each week that passes. She even has begun to plan for the twins’ arrival.

“The biggest resource Dr. Silva and the MFM team gave us was hope,” Brittany says. “Before coming to them, we felt defeated and were afraid to get excited about our babies in case something went wrong. Dr. Silva gave back the hope we had lost. 

“I truly don’t have the words to express how thankful and grateful I am for her and the entire MFM team. It's incredibly important to have Johns Hopkins All Children’s here in our community. Because of them, we were given hope when we needed it most — and now, we get to meet our baby girls.”