Telehealth in maternity care: benefits, barriers, and the future of digital maternity care: a narrative review
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20254319Keywords:
Telehealth, Telemedicine, Nursing, Maternity careAbstract
Telehealth is emerging as a vital tool in maternity care, supporting pregnant women and their families through remote healthcare services, it creates new opportunities to provide continuous, patient-centered, and accessible care. This review examines the applications, benefits, and challenges of telehealth in maternity care with a focus on its implications. A structured search strategy was conducted across PubMed Medline, Google Scholar, Research Gate, Scopus, and Science Direct. Keywords included telehealth, telemedicine, nursing, and maternity care. Relevant studies were screened and references cross-checked to capture additional evidence. Telehealth interventions in maternity care demonstrate significant benefits such as reduced travel costs, decreased waiting time, and improved access in rural or underserved areas. For health care workers, telehealth supports timely antenatal education, early detection of complications through remote monitoring (e.g., blood pressure and weight), and enhanced patient engagement via mobile applications. The COVID-19 pandemic has accelerated the use of virtual antenatal consultations, creating opportunities for nursing professionals to extend their role in health promotion, psychosocial support, and counseling. However, challenges persist technological barriers, inequitable access, patient trust issues, and limitations in replacing physical examinations with virtual care raise concerns about patient safety. Telehealth in maternity care holds promise for advancing practices through innovations like tele-ultrasound, remote blood pressure surveillance, self-monitoring of fundal height, and digital maternal health education platforms. Yet, barriers related to equity, nurse preparedness, provider adoption, and regulatory frameworks must be addressed. Collaborative, research and policy support are essential to harness the full potential of telehealth, ensuring safe, equitable, and holistic care for pregnant women and their families.
References
Barbosa W, Zhou K, Waddell E, Myers T, Dorsey ER. Improving Access to Care: Telemedicine Across Medical Domains. Annu Rev Public Health. 2021;42:463-81.
Ganjali R, Jajroudi M, Kheirdoust A, Darroudi A, Alnattah A. Telemedicine solutions for clinical care delivery during COVID-19 pandemic: A scoping review. Front Public Health. 2022;10:937207.
Calton B, Abedini N, Fratkin M. Telemedicine in the time of Coronavirus. J Pain Symptom Manag. 2020;60:e12-4.
Zork NM, Aubrey J, Yates H. Conversion and optimization of telehealth in obstetric care during the COVID-19 pandemic. Semin Perinatol. 2020;44:151300.
Couch D, Doherty Z, Panozzo L, Naren T, Burzacott J, Ward B, et al. The impact of telehealth on patient attendance and revenue within an Aboriginal Community Controlled Health Organisation during COVID-19. Aust J Gen Pract. 2021;50:851-5.
Suran M. Increased use of medicare telehealth during the pandemic. JAMA. 2022;327(4):313.
Gajarawala SN, Pelkowski JN. Telehealth benefits and barriers. J Nurse Pract. 2021;17(2):218-21.
Manjavidze T, Rylander C, Skjeldestad FE, Kazakhashvili N, Anda EE. The impact of antenatal care utilization on admissions to neonatal intensive care units and perinatal mortality in Georgia. PLoS One. 2020;15(12):e0242991.
Shamsabadi A, Dashti M, Ghasemzadeh A, Mehraeen E, Saber Mashhad Taraqi A, Jalali A, et al. Virtual clinic in pregnancy and postpartum healthcare: A systematic review. Health Sci Rep. 2022;6(1):e970.
Saad M, Chan S, Nguyen L, Srivastava S, Appireddy R. Patient perceptions of the benefits and barriers of virtual postnatal care: a qualitative study. BMC Pregnancy Childbirth. 2021;21(1):543.
Aziz A, Zork N, Aubey JJ, Baptiste CD, D’Alton ME, Emeruwa UN, et al. Telehealth for high-risk pregnancies in the setting of the COVID-19 pandemic. Am J Perinatol. 2020;37(8):800-8.
Fryer K, Delgado A, Foti T, Reid CN, Marshall J. Implementation of obstetric telehealth during COVID-19 and beyond. Matern Child Health J. 2020;24(9):1104-10.
Palmer KR, Tanner M, Davies-Tuck M, Rindt A, Papacostas K, Giles ML, et al. Widespread implementation of a low-cost telehealth service in the delivery of antenatal care during the COVID-19 pandemic: an interrupted time-series analysis. Lancet. 2021;398(10294):41-52.
Nakagawa K, Umazume T, Mayama M, Chiba K, Saito Y, Kawaguchi S, et al. Feasibility and safety of urgently initi ated maternal telemedicine in response to the spread of COVID-19: a 1-month report. J Obstet Gynaecol Res. 2020;46(10):1967-71.
Whittington JR, Hughes DS, Rabie NZ, Ounpraseuth ST, Nembhard WN, Chauhan SP, et al. Detection of fetal anomalies by remotely directed and interpreted ultrasound (teleultrasound): a randomized noninferiority trial. Am J Perinatol. 2022;39(2):113-9.
Hadar E, Wolff L, Tenenbaum-Gavish K, Eisner M, Shmueli A, Barbash Hazan S, et al. Mobile self-operated home ultrasound system for remote fetal assessment during pregnancy. Telemed e-Health. 2021;28(1):93-101.
Baschat AA, Galan HL, Lee W, DeVore GR, Mari G, Hobbins J, et al. The role of the fetal biophysical profile in the management of fetal growth restriction. Am J Obstet Gynecol. 2022;226(4):475-86.
Tucker KL, Bankhead C, Hodgkinson J, Roberts N, Stevens R, Heneghan C, et al. How do home and clinic blood pressure readings compare in pregnancy? Hypertension. 2018;72(3):686-94.
Bowen L, Pealing L, Tucker K, McManus RJ, Chappell LC. Adherence with blood pressure self-monitoring in women with pregnancy hypertension, and comparisons to clinic readings: a secondary analysis of OPTIMUM-BP. Pregnancy Hypertens. 2021;25:68-74.
Pealing LM, Tucker KL, Mackillop LH, Crawford C, Wilson H, Nickless A, et al. A randomized controlled trial of blood pressure self-monitoring in the management of hypertensive pregnancy. OPTIMUM-BP: a feasibility trial. Pregnancy Hypertens. 2019;18:141-9.
Chappell LC, Tucker KL, Galal U, Yu LM, Campbell H, Rivero-Arias O, et al. Effect of self-monitoring of blood pressure on blood pressure control in pregnant individuals with chronic or gestational hypertension: the BUMP 2 randomized clinical trial. JAMA. 2022;327(17):1666-78.
Bergman E, Kieler H, Petzold M, Sonesson C, Axelsson O. Self-administered measurement of symphysis-fundus heights. Acta Obstet Gynecol Scand. 2007;86(6):671-7.
Palmer KR, Tanner M, Davies-Tuck M, Rindt A, Papacostas K, Giles ML, et al. Widespread implementation of a low-cost telehealth service in the delivery of antenatal care during the COVID-19 pandemic: an interrupted time-series analysis. Lancet. 2021;398(10294):41-52.
Choudhury A, Choudhury M. Mobile for Mothers mHealth Intervention to Augment Maternal Health Awareness and Behavior of Pregnant Women in Tribal Societies: Randomized Quasi-Controlled Study. JMIR Mhealth Uhealth. 2022;10(9):e38368.
Liu Y, Wang X. Application of Smart Mobile Medical Services in Maternal Health Care Management. Teekaraman Y, editor. Contrast Media Molecular Imaging. 2021;2021:6249736.
van den Heuvel JFM, Teunis CJ, Franx A, Crombag NMTH, Bekker MN. Home-based telemonitoring versus hospital admission in high risk pregnancies: a qualitative study on women's experiences. BMC Pregnancy Childbirth. 2020;20(1):77.
Alves DS, Times VC, da Silva ÉMA, Melo PSA, Novaes MA. Advances in obstetric telemonitoring: a systematic review. Int J Med Inform. 2020;134:104004.
Paul JJ, Dardar S, River LM, St John-Larkin C. Telehealth adaptation of perinatal mental health mother-infant group programming for the COVID-19 pandemic. Infant Ment Health J. 2022;43(1):85-99.
Parameswaran UD, Pentecost R, Williams M, Smid M, Latendresse G. Experiences with use of technology and telehealth among women with perinatal depression. BMC Pregnancy Childbirth. 2022;22(1):571.
Buultjens M, Gill J, Fielding J, Lambert KA, Vondeling K, Mastwyk SE, et al. Maternity care during a pandemic: Can a hybrid telehealth model comprising group interdisciplinary education support maternal psychological health? Women Birth. 2023;36(3):305-13.
Escobar MF, Echavarria MP, Vasquez H, Nasner D, Ramos I, Hincapié MA, et al. Experience of a telehealth and education program with maternal and perinatal outcomes in a low-resource region in Colombia. BMC Pregnancy Childbirth. 2022;22(1):604.
van den Heuvel JFM, van Lieshout C, Franx A, Frederix G, Bekker MN. SAFE@HOME: cost analysis of a new care pathway including a digital health platform for women at increased risk of preeclampsia. Pregnancy Hypertens. 2021;24:118-23.
Sung Y-S, Zhang D, Eswaran H, Lowery CL. Evaluation of a telemedicine program managing high-risk pregnant women with pre-existing diabetes in Arkansas’s Medicaid program. Semin Perinatol. 2021;45(5):151421.
Konnyu KJ, Danilack VA, Adam GP, Friedman Peahl A, Cao W, Balk EM. Changes to prenatal care visit frequency and telehealth: a systematic review of qualitative evidence. Obstet Gynecol. 2023;141(2):299-323.
Hofmann G, Hampanda K, Harrison MS, Fasano M, Nacht A, Yeoman M. Virtual prenatal and postpartum care acceptability among maternity care providers. Matern Child Health J. 2022;26(7):1401-8.
Hargis-Villanueva A, Lai K, van Leeuwen K, Weidler EM, Felts J, Schmidt A, et al. telehealth multidisciplinary prenatal consultation during the COVID-19 pandemic: enhancing patient care coordination while maintaining high provider satisfaction. J Matern-Fetal Med. 2022;35(25):9765-9.
Holman C, Glover A, McKay K, Gerard C. Telehealth adoption during COVID-19: lessons learned from obstetric providers in the Rocky Mountain West. Telemed Rep. 2023;4(1):1-9.
Wali R, Alhakami A, Alsafari N. Evaluating the level of patient satisfaction with telehealth antenatal care during the COVID-19 pandemic at King Abdul-Aziz Medical City, Primary Health Care Center, Specialized Polyclinic. Womens Health (Lond). 2022;18:17455057221104659.
Ghimire S, Martinez S, Hartvigsen G, Gerdes M. Virtual prenatal care: a systematic review of pregnant women’s and healthcare professionals’ experiences, needs, and preferences for quality care. Int J Med Informatics. 2023;170:104964.