Our study demonstrates the importance of access to prenatal care at medical centers for hypertensive and high-risk pregnant women. It highlights the significance of collaboration and co-operation in terms of the so-called Integrated Health Care Delivery System between medical centers and local medical facilities, and it should encourage decision makers to investigate disease severity, bi-directional referral patterns, the linkage between independent physician-based prenatal care and coordinated hospital-based obstetric care, health policies, as well as health planning and resource-allocation issues. In contrast, other researchers have argued that the quality of care is somewhat higher among independent physicians [23] . There are still many issues to be resolved. Our results do not allow us to conclude which type of practice provides a better quality of prenatal care; however, it is possible to identify the features of discontinuity versus continuity of standard prenatal care and heterogeneous or homogeneous types of obstetric care.