Telehealth and high-risk pregnancy
High-risk pregnancies can be treated and managed through telehealth as long as the patient and provider have an emergency plan in place.
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What are considerations for using telehealth for high-risk pregnancies?
Telehealth can provide life-saving health care for pregnant patients. Some rural patients live far from high-risk specialists. Others can’t afford to take time off work or find childcare to go to their provider’s office. There are several ways to ensure access to high quality care for high-risk patients through telehealth.
Use remote patient monitoring
There are several devices that can monitor a patient’s health without the patient having to come into the office for multiple check ups. Remote patient monitoring can also be used to gauge whether a patient has breached the high-risk threshold, meaning it’s time to seek immediate medical care.
Pregnancy-related remote monitoring devices may include:
Blood pressure monitors
Blood glucose testing
At home fetal monitors
Patients should be sent to in-person care when:
- There is decreased fetal movement
- There are known fetal abnormalities that require multiple check ups
- The patient is experiencing pre-eclampsia symptoms
- The patient is experiencing signs of early labor
Know when to seek in-person care
Part of your telehealth workflow should include a protocol for when to send a high-risk patient to the office or hospital. Some high-risk conditions, including pregnancies with multiple babies and certain chronic conditions, need more in-person oversight than telehealth can provide.
Partner with local resources for rural and underserved patients
Telehealth can be a life-saving resource and also the first line of defense for potential pregnancy complications. This is especially true for rural and underserved patients who may delay, or entirely forgo, prenatal care.
High-risk care tends to be more hands on than complication-free maternal health care. But there are many ways telehealth providers can make sure rural and underserved patients get the care they need, when they need it. Some examples include:
- Identify and partner with the patient’s local clinic or hospital. Local facilities can often provide routine testing that will help you determine the best course of care, and keep an eye on potentially serious complications. This could include baseline 24 urine collection and labs for pre-eclampsia, STI panels, blood sugar monitoring, and ultrasound.
- Work with local OB-GYNs for in-person appointments. Underserved patients may often feel more comfortable with providers that are not local to their area.
- Research local resources and online help post-childbirth. Rural and underserved parents don’t stop needing maternal telehealth care once the baby is born. Telehealth providers can help in those first few days and weeks with telehealth lactation consulting and mental health counseling. Other potential resources following high-risk pregnancies could include maternal or pediatric specialists, local and online behavioral health support, substance use counseling, smoking cessation, and parenting classes.
More information
Telehealth for chronic conditions — Health Resources and Services Administration
Statewide Telehealth Program Enhances Access to Care, Improves Outcomes for High-Risk Pregnancies in Rural Area — Agency for Health Care Research and Quality
Spotlight
Maternal Hypertension Remote Patient Monitoring Project
Using remote patient monitoring (RPM) technology, the University of Mississippi Medical Center, a HRSA-funded Telehealth Center of Excellence, is monitoring women who are at high risk for hypertension during their pregnancy. A nurse coordinator will assist the mothers in coordinating care including connecting them to community and health resources to support a healthy pregnancy. The program also provides maternal child and chronic disease management support and virtual consultations with an obstetrician in the home.
Learn more about the University of Mississippi Medical Center's Maternal Hypertension RPM project.