This study was designed to describe adequacy and satisfaction with prenatal care in a group of rural low-income women (n = 60) and to determine whether either was correlated with birth outcomes. Despite less than adequate prenatal care in 50% of the women, they were satisfied with their care, and outcomes for infants were good. When compared with women who received adequate prenatal care, there were no differences between the two groups. Tailoring prenatal care to individual needs, including care provided by certified nurse midwives with fewer prenatal visits, could be cost-effective without sacrificing quality. It is time to reexamine the recommended prenatal visit structure and care delivery in this country.