COVID-19, Pregnancy Care, and Telemedicine

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Being pregnant during the time of a pandemic like COVID-19 is stressful. The risks to pregnant women and babies are largely unknown. During a shelter-in-place period, or even afterwards, pre and postnatal visits could increase your risk of exposure to the virus. It is harder for pregnant women to maintain social distancing, because some prenatal care requires hands-on-care for exams and testing. However, a significant amount of pre and postnatal care can be done virtually. This option has become more common during the age of pandemics, and is called telemedicine.

Telemedicine is the use of both audio and visual technology to communicate with your health care provider. If you can do FaceTime or Skype on your phone or computer, you can do telemedicine. Telemedicine has been around for a long time. It started as a way to help patients get medical care in rural and remote areas of the country. Some early users of telemedicine included astronauts in space. The use of telemedicine has skyrocketed during the COVID-19 pandemic and that includes pregnancy care.

According to the American Medical Association, in the four years before the coronavirus pandemic, the use of telemedicine had already doubled, with up to 30 percent of doctors participating. After the experience of sheltering at home and social distancing required for flattening the curve of coronavirus, telemedicine may be the new normal for many types of doctor visits, and this may include pregnancy care.

For usual medical care, telemedicine has proven effective for treating common ailments that can be treated by telemedicine including back pain, colds, mental health, eye problems, and allergies. Health education, such as teaching you how to use your inhaler or walking you through smoking cessation program are also valuable uses for telemedicine.

According to Kaiser Family Foundation, many pregnancy related services can also be delivered through telemedicine. Examples include:

  • Virtual prenatal care visits
  • Home monitoring
  • Consultation with specialists
  • Mental health care
  • Virtual postpartum visits
  • Lactation support

The American College of Obstetrician and Gynecologists (ACOG) is encouraging prenatal practices and clinics to start using telemedicine to limit exposure of patients and health care workers. ACOG says that new federal health laws are making it easier for doctors to offer this service and for insurance providers to cover it.

An example of how telemedicine is being used during COVID-19 is the OB clinic at the University of Michigan. To limit clinic visits, they have decreased in-person prenatal visits to three visits at 28, 36, and 39 weeks. All labs and ultrasound exams will be done at these visits. All other visits will be done by telemedicine. They also make use of home blood pressure cuffs, home ultrasound devices, and home weigh-ins that can be discussed during virtual prenatal visits. As long as your pregnancy is low-risk, you may also be able to take advantage of this type of care.

In addition to lowering your risk for viral infection, there are lots of advantages to telemedicine. A virtual prenatal visit can save you a long trip if you live in a rural area. Even for an average doctor visit, studies suggest that less than 20 percent of the time you spend will actually be the visit. The rest will be travelling and waiting. Reducing the time you spend in a waiting room is both safer and more convenient.

The two biggest obstacles that telemedicine has had to overcome are insurance coverage and regulations. During the COVID-19 pandemic many of these regulations and obstacles have been lifted. Even before coronavirus, it was estimated that telemedicine would grow at about 50 percent per year, and about 50 percent of hospitals already offered it. Today there is a good chance your health care system is offering telemedicine.

If you have not tried telemedicine yet, start by calling your pregnancy health care provider to find out if it is available. You can also use telemedicine for routine heath care that you might have used a walk-in clinic or urgent care clinic for in the past. This type of care can be replaced by telemedicine in many cases. If not your own provider, your local hospital may have telemedicine you can use. Another option is a national telemedicine chains with catchy names like TelaDoc, HealthTap, CareClix, or SnapMD. These are easy to find online.

Christopher Iliades
Dr. Chris Iliades is a medical doctor with 20 years of experience in clinical medicine and clinical research. Chris has been a full time medical writer and journalist since 2004. His byline appears in over 1,000 articles online including EverydayHealth, The Clinical Advisor, and Healthgrades. He has also written for print media including Cruising World Magazine, MD News, and The Johns Hopkins Children's Center Magazine. Chris lives with his wife and close to his three children and four grandchildren in the Boston area.

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