Telehealth Critical for Rural Virginia
“Virginia's rural communities continue to face significant barriers in access to midwifery care. Expanding telehealth and integrating community birth centers are critical for reversing negative outcomes,” stated Dr. Alicia Franklin, a perinatal epidemiologist. She noted that pilot programs using hybrid in-person and telemidwifery models have reportedly reduced non-medically indicated cesareans by 11% in participating counties.
- Around 36% of Virginia's counties are classified as "maternity care deserts," lacking access to hospitals with obstetric care, birth centers, or certified nurse midwives. Pregnant women in these rural areas often face long travel times to reach facilities with obstetric services. - In a significant move to address these shortages, Virginia House Bill 1904, which took effect in July 2025, allows certified nurse midwives and licensed certified midwives to provide nursery care in hospitals when a pediatrician is unavailable. This change is intended to help keep labor and delivery units in rural areas open. - Another legislative victory, House Bill 1923, ensures insurance reimbursement parity for Licensed Certified Midwives (LCMs) and Licensed Midwives (LMs), mandating that private insurers and Medicaid reimburse them at the same rates as Certified Nurse Midwives (CNMs) for the same services. This is expected to improve the financial sustainability of midwifery practices, especially in underserved areas where a high percentage of clients are Medicaid recipients. - The Virginia Department of Health has launched new public dashboards to track maternal and child health data, including maternal mortality and pregnancy-associated deaths. These tools allow users to view data by locality and health district, helping to identify trends and inform decision-making. - The state is also investing in community-based solutions, with a recent $2.5 million allocation to expand perinatal health hubs into underserved areas, including a rural community. These hubs, operated by organizations like Urban Baby Beginnings, provide comprehensive support services to families, including doula care and home visits. - To address the digital divide in rural areas, Virginia is expanding coverage for audio-only telehealth services through Medicaid, a move that acknowledges the lack of reliable broadband in many parts of the state. Additionally, a maternal health monitoring pilot program for patients with hypertension and diabetes will utilize remote patient monitoring technology. - Looking ahead, the Virginia General Assembly is considering the creation of a task force to address remaining barriers to midwifery care. This task force would examine issues such as varying insurance credentialing requirements that can prevent midwives from joining insurer networks. - Virginia is projected to face a significant shortage of nurses, with an estimated deficit of over 20,000 within the next decade. In response, the newly formed Virginia Nursing Workforce Center is tasked with developing a statewide plan to address educational capacity and workforce shortages through data-driven strategies.
