INTRODUCTION: Food insecurity, a social determinant of health defined as limited availability of and access to adequate food, may heighten risks for poor pregnancy outcomes particularly if compounded by existing co-morbidities in high-risk pregnancies. The Upstream Obstetrical Clinic is a quality improvement project that seeks to address food insecurity in high-risk obstetrics patients. This study aims to identify the prevalence and impact of food insecurity among pregnant patients in the clinic population. METHODS: This project was deemed IRB-exempt by the HSRD. Validated survey questions regarding food insecurity were administered to high-risk obstetrics patients. Screen positive individuals were offered counseling by a team member to identify nutrition resources in the patient's residential area. Data collected were used to assess prevalence of social needs, correlation of social needs with co-morbidities, and effects on pregnancy outcomes. RESULTS: One hundred eighty-five women completed the survey, with 24% (44/185) screening positive. Diabetes was the most prevalent co-morbidity for screen positive patients (25/44, 57%). Twenty-two percent of screen positive, delivered patients were affected by diabetes (9/40). The prevalence of abnormal HgbA1C was 66% (6/9) among these patients. There was no difference in perinatal outcomes between patient subgroups. CONCLUSION: Twenty-four percent of all patients and 22% of diabetic patients identified as food insecure. Statistical differences could not be assessed due to limited sample size. Nevertheless, these results suggest that food insecurity may be associated with adverse health outcomes. As the Upstream Clinic population increases, the impact of food insecurity on obstetric and neonatal outcomes will continue to be assessed.