For the expectant mother, pregnancy should be a time of excitement and peaceful preparation. In the United States most obstetric practices require a minimum of a dozen (and frequently more) in-person office visits. This taxing demand on soon-to-be new parents can be mitigated through the utilization of telehealth. Can the application of telehealth help women have healthier pregnancies, while maintaining a high quality of care without compromising positive outcomes and feelings of support?
Telehealth for the Low Risk Pregnant Woman
Women with low-risk pregnancies are a great example of a population that can benefit from telehealth. A low-risk pregnancy is defined as a pregnancy where there is neither a need for nor a benefit from medical intervention. In other words, both the mother and her baby are healthy and there is no reason to believe that there will be serious complications during labor and delivery.
High risk pregnancies are characterized by an increased likelihood of complication. There are various factors that can increase the risk associated with pregnancy, including high blood pressure (causing preeclampsia), multiple births (such as twins), gestational diabetes, or an age over 40.
In the United States, over 85% of pregnant woman are considered low risk. For these women, telehealth can be used to augment traditional care. Telehealth interventions can also replace some in-person appointments that primarily exist to confirm that both the mother and her baby are healthy (a conclusion that can often be reached at home). With telehealth, pregnant women can decrease the amount of in-person doctor’s visits during the prenatal period, while still maintaining good quality of care and patient satisfaction.
With telehealth, a pregnant woman is able to monitor her weight and track both her blood pressure and fetal heart rate in the comfort of her own home. If a patient experiences abnormal or confusing results, she simply reaches out to her clinician. This allows for a constant stream of communication between patient and provider throughout the prenatal period and limits unnecessary utilization of costly medical resources, such as obstetric providers, clinic time, and nursing support.
Innovative Applications
There is research to support that telemedicine is a good option for pregnant women. A study out of the Mayo Clinic evaluated the efficacy of self-monitoring (weight, fundal height, blood pressure, fetal heart rate), text-based communication between care team and patient, and an online community (a forum moderated by a nurse where cohorts of pregnant women could consult with one another and their providers). The study found many benefits of the telemedicine model, including:
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Increased sense of control and reassurance
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Lower cost of care
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Supportive partnerships between care team and pregnant woman
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Increased patient satisfaction
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Increased patient engagement and continuity of care
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Less time away from work
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Facilities savings
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Increased provider engagement and satisfaction
The study concluded that telehealth aided in anticipating the needs of patients and provided access to care in a way that better accommodates the lives of patients.
Telehealth in Rural Locations
The benefits of telemedicine for expectant mothers have also been explored in rural settings, where access to care is often limited or nonexistent. Many rural hospitals have closed their maternity wards because of cost or other factors. The reduction in maternity facilities has resulted in significant gaps in care for pregnant women across the country.
With telehealth, women in rural locations can be treated by providers outside of their immediate vicinity. This allows for a wider network of provider options and facilitates a connection to specialists if necessary. Women can access care immediately instead of having to travel long distances to the clinic or wait for an appointment that may not occur for days, or even weeks.
A Family-Centric, Emotional Model Through Telehealth
Pregnancy is an exciting and unforgettable period in a woman’s life, a time that should be empowering and positive. Innovative telehealth applications allow low-risk pregnant woman to experience the joy of pregnancy, while improving healthcare efficiency and increasing access to specialized care.
Telehealth for the expectant mother embraces the emotional component of pregnancy, focusing on a family-centric model, while also ensuring that the goals of prenatal care (detection, management, and amelioration of complication when they arise) remain a priority.
References:
Marko, Kathryn I, et al. “Testing the Feasibility of Remote Patient Monitoring in Prenatal Care Using a Mobile App and Connected Devices: A Prospective Observational Trial.” JMIR Research Protocols, vol. 5, no. 4, 2016, doi:10.2196/resprot.6167.
Mooij, Marnie J. Meylor De, et al. “OB Nest: Reimagining Low-Risk Prenatal Care.” Mayo Clinic Proceedings, vol. 93, no. 4, 2018, pp. 458–466., doi:10.1016/j.mayocp.2018.01.022.