Models of Incorporating Telehealth into Obstetric Care During the COVID-19 Pandemic, Its Benefits And Barriers: A Scoping Review

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) is a highly contagious viral infection. Hospitals worldwide have decreased face-to-face visits to reduce the exposure to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Prenatal and postpartum care are essential for the health of women and their fetuses. Therefore, many hospitals have incorporated telehealth into their protocols. Objectives: The aim of this review was to determine how health care organizations are responding to the COVID-19 pandemic by incorporating telehealth visits into their protocols for obstetrics care, what services were converted to telehealth, and its benefits and barriers. Method: A computerized literature search was performed using PubMed and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases using terms, including ''telehealth,'' ''virtual visits,'' ''obstetric,'' ''pregnancy,'' ''postpartum,'' and ''COVID-19'' for articles published before October 2020. Peer reviewed articles and guidelines were included in this review. Results: A total of 25 articles were identified. Fifteen articles reported protocols. During this pandemic, protocols developed replaced some in-person visits with telehealth visits, when no testing or vaccinations are required. The main reported benefits were minimizing exposure to SARS-CoV-2 and the continuity to provide high-quality and safe care. Lack of access to high-speed internet and hardware and inaccessibility to patients were the most reported barriers. Conclusion: Telehealth provided the opportunity for reducing in-person visits during the COVID-19 pandemic. Some prenatal services could be completely provided through telehealth and others require medical equipment to be delivered. Health care organizations recognized that using telehealth could be continued beyond this pandemic, as they provided many benefits for patients, medical staff, and the organizations themselves.

Centering the Right to Health of Childbearing People in the US During the COVID-19 Pandemic

“…Recent studies have demonstrated overall patient and provider satisfaction with telehealth prenatal care ( 12 , 13 ). However, overall satisfaction can conceal inequities including technological barriers, unreliable data connection, and difficulties utilizing interpreter services ( 14 ). These concerns further perpetuate existing health disparities, particularly for women with limited English proficiency, those living in rural areas where internet access is limited or for those unable to afford these services ( 13 ).…”

Postpartum Length of Stay and Hospital Readmission Before and During the Coronavirus Disease 2019 (COVID-19) Pandemic

“…The increase in telehealth usage is consistent with the transition many institutions made to provide telehealthbased care in the prenatal and postpartum periods. 35,36 Telehealth co-interventions used in our study cohort are unknown and likely varied across departments and health systems; however, it is plausible that the increase in telehealth encounters helped to mitigate potential hospital readmissions, especially if health care professionals were targeting specific, high-risk populations.…”

Fear is the Path to the Dark Side: Unsafe Delivery, One of the Consequences of Fear of the SARS-CoV-2 Pandemic, A Case Report

“…11 Although there are multiple strategies reported to maintain the quality of obstetric care during the pandemic, most of them focus on prenatal care. 12 , 13 With regard to delivery care, few publications recommend strengthening midwife-assisted home births, all in countries with robust health systems. 14 , 15 The Colombian health system, as in many other low- and middle-income countries, continues to recommend hospital care for all deliveries, probably due to the impossibility of providing support and surveillance for home births.…”