The current structure of pregnancy care began with the issuance of the IOM study in 1985, which called for increased prenatal visits as a mechanism to reduce low birthweight. Yet 35 years later, though the number of visits has increased, the rate of low birthweight babies has not decreased. Furthermore, the rising rates of maternal mortality and morbidity in the US — some of the highest in the developed world — manifest the inadequacy of current structures of care to protect mothers, especially the minority and low-income women who comprise the majority of these statistics.
An additional review of alternative schedules can be found in a control study found here, as well as a study conducted by Kaiser. What's the key take away? In most developed countries, the reduced frequency of visits did not show a statistically significant difference in maternal and fetal outcomes.
However, a reduction in visits could potentially impact patient satisfaction and Provider-patient intimacy. Several programs have been created to augment a reduced visit schedule to maintain or increase patient satisfaction for low risk pregnancies. These programs include group prenatal care (or Centering), which uses physician helpers in group prenatal care for low risk patients, and OB Nest program implemented at the Mayo Clinic
The COVID-19 pandemic showcased the value of virtual solutions for improving pregnancy care for mothers, especially the medically underserved. As a result, the current landscape is more open to using digital solutions to manage health than ever before. However, the challenges of reimbursement — temporarily resolved through emergency measures — are resurfacing, and can provide barriers to enhancing in-person care through virtual tools, especially for Medicaid populations. Though the pandemic may cease to become a threat, the economic repercussions will be long-standing, further widening the health disparities for minority and low-income populations already exacerbated by systemic racism and structural disadvantages. Babyscripts is supporting mothers by creating products that directly address these disparities like our Care Navigator, making rigorous investments in the Medicaid space, and advocating for maternal healthcare mandates at the state and federal levels. We’ve worked and continue to advocate to open up pathways to reimbursement and access, so that delivering the best in maternal healthcare never has to be a choice or come at a cost to the mother.
