Study Finds Tension in Virtual Postpartum Care Models
A new study on virtual postpartum care highlights the effectiveness of "tiered escalation" models that combine digital access with in-person options. Researchers found that while virtual visits improve patient satisfaction, clear triage protocols are crucial to avoid missing high-risk conditions. The study notes a tension between efficiency, patient preference, and clinical safety in designing these hybrid care systems.
- A "tiered" or "escalation" model of virtual care allows for seamless transition from virtual to in-person consultations when clinically necessary, which mothers in one study identified as a key factor in feeling safe and heard. - In 2022, the pregnancy-associated death rate in Virginia was 70.1 per 100,000 live births, an increase from 66.9 in 2021. For Black women in Virginia, the rate was 138.1 per 100,000 live births, compared to 50.6 for white women. - The American College of Nurse-Midwives (ACNM) supports the use of telehealth as a way to increase access to care, and a systematic review of midwives' experiences with telehealth found that it can improve connectivity with patients. However, some midwives expressed concerns about the challenges of building relationships and the potential to distance some patients. - More than 80% of pregnancy-related deaths in the U.S. are considered preventable. The leading causes of death include hemorrhage, infection, blood clots, and heart conditions. - Virginia law requires private insurers and Medicaid to cover telemedicine services, including remote patient monitoring. The state's 2026-2030 Telehealth Plan aims to further expand telehealth access, particularly in hospitals and for chronic illness management. - The World Health Organization (WHO) has identified increasing the midwifery workforce as an evidence-based approach to decreasing maternal mortality and has promoted a model of intrapartum care that is respectful, personalized, and woman-centered. - A significant portion of maternal deaths occur in the postpartum period, with approximately 33% of pregnancy-associated deaths in Virginia in 2022 happening between 43 and 365 days after the end of the pregnancy. - Midwives are increasingly using telehealth for a range of services beyond pregnancy, including sexual and reproductive health care. Studies have shown that telehealth can be effective for providing services such as childbirth education and remote monitoring of conditions like hypertension.
