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.
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 the doctor’s office.
There are several ways to ensure quality telehealth care for high-risk patients.
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
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 multiples and certain chronic conditions, need more in-person oversight than telehealth can provide.
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 severe pre-eclampsia symptoms
- The patient is experiencing signs of early labor
To share with your patients
These online resources from the University of Arkansas for Medical Sciences will help your patients learn about their bodies, their pregnancy, and their maternal health.
For more topics and information:
Pregnancy and childbirth patient resources — University of Arkansas for Medical Sciences
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.
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
- COVID-19 testing and treatment
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. This is especially true for Black patients who have reported feeling unheard or mistreated by non-Black physicians.
Telehealth providers can also help non-English speaking patients understand their local, in-person care and birth plan if they share a native language. In these cases, telehealth providers can partner with local OB-GYNs for in-person testing and exams while still continuing monitoring and management via telehealth.
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
- Substance abuse counseling
- Smoking cessation
- Parenting classes
Statewide Telehealth Program Enhances Access to Care, Improves Outcomes for High-Risk Pregnancies in Rural Area — Agency for Health Care Research and Quality