As maternal and infant mortality rates deteriorate, practices should adopt more tools to better serve patients.
In recent years, it has been nearly impossible to ignore the maternal and infant health crisis that is affecting the United States.
Maternal mortality has been steadily rising, doubling between 1999 and 2019. In fact, the United States has the highest maternal death rate among the world’s wealthiest nations. Perhaps even worse, according to the Centers for Disease Control and Prevention, it is estimated that as many as 80% of these pregnancy-related deaths are preventable.
As we look back on 2023, and look forward to the year ahead, two seemingly paradoxical realities are becoming clear — our country’s maternal and infant health is in a state of crisis, and yet the future holds tremendous hope for continued and meaningful improvement. While countless parents attempt to navigate a lack of access to adequate pre- and post-natal care, digital solutions are fortunately helping to begin to bridge the gap.
The average recommended number of in-office visits for pregnant individuals is between 12 and 14. Leaving work during the day to attend another appointment is not feasible for many expecting parents, and for an increasing percentage, it means traveling long distances.
In fact, a staggering 4.7 million pregnant women live in counties with limited maternity care. Women who live in rural areas—which account for two-thirds of all maternal care deserts—have a 9% higher chance of maternal mortality or morbidity.
But one of the lasting effects of the COVID-19 pandemic—telehealth—is on course to upend this long-standing paradigm. While some prenatal appointments must be conducted in person, a great deal of the routine monitoring required during pregnancy (urine screening, the mother’s weight or blood sugar levels) can be done at home and self-reported to providers.
Telehealth and mobile applications also create the opportunity for countless new parents to consult with lactation experts, report postpartum mental health symptoms sooner than they may have otherwise, and visit with specialists (such as genetic counselors) to whom they might not have had access.
In addition, new mobile app’s are providing a continuous source of connection for pregnant people, offering support and assistance between appointments, connecting with case managers, identifying whether risk levels have changed, or if further action needs to be taken.
Historically, adoption of telehealth prenatal care has been low, in part because of the high up-front cost to provide patients with necessary monitoring equipment, and because reimbursement rates for telemedicine visits are inconsistent. Surprisingly, there is currently no federal mandate that health plans reimburse for telehealth care.
Barriers to virtual care also exist on the patient’s end. One is internet connectivity, which disproportionately affects rural patients. To battle that concern, experts are advocating for healthcare organizations to invest in stronger internet infrastructure to reach more patients and to partner with digital device manufacturers to make affordable options for those without smartphones.
However, the recent implementation of virtual visits by provider organizations such as the Mayo Clinic and George Washington University suggests that the saturation rate of telemedicine for prenatal care will only increase. That spells good news for the many women whose lack of access to high-quality, convenient prenatal care has for too long put them at risk.
While telehealth-based maternal care may still be slow to be adopted, it promises to greatly expand access to quality maternal healthcare particularly for women in rural areas and lower-income women faced with transportation barriers.
Linda Genen, MD, MPH is the chief medical officer for ProgenyHealth – a leading national, tech-enabled women’s healthcare company dedicated to Maternity and NICU Care Management.