Telehealth for Equitable Obstetric Care: Addressing Gaps for Patients, Providers, and Payers

Abstract

In June 2022, President Biden and Vice President Harris released their blueprint for addressing the maternal health crisis, stating their “vision for the future is that the United States will be considered the best country in the world to have a baby.” Currently, it is one of the worst among industrialized countries despite the US spending nearly double the average amount on healthcare per capita. The US is amidst a maternal mortality crisis, particularly for Black and American Indian/Alaska Native pregnant people, with more than 80% of the deaths preventable. Telehealth in obstetrics has the potential to reach pregnant people who are not currently being served by the medical system and to improve rates of severe maternal morbidity and mortality; however, more research is needed to understand and monitor its equity, costs, and optimal usage. Extant research shows that telehealth can produce a small positive effect for certain obstetric health outcomes, but these research findings are rarely stratified by pregnant patients’ demographics. To prevent the perpetuation of existing health inequities, gaps in obstetric telehealth research will need to be addressed. Key knowledge gaps for researchers and policy makers include outcomes, access, satisfaction by patients and providers, potential time savings for patients, and health system cost savings. Im​plementation of equitable obstetric coverage of telehealth services requires clarity from private and public payers for inter-state provisions of care, liability and risk, and service and payment parity.Note: While we use pregnant and postpartum people where possible here to recognize that not all pregnant people identify as women, we occasionally use maternal to reflect terminology used in federal, state, and local data.