At a time when creativity and flexibility are needed more than ever to meet public health needs, the right kind of telehealth sessions can help provide key care and support to pregnant women.

A study highlighted during the Tuesday APHA 2021 session “Improving Pregnancy Outcomes: Impact of Social Connectedness on Pregnancy Outcomes” found equipping pregnant women to monitor their own blood pressure and fetal heart tones during virtual health visits was both empowering and effective. And such sessions can boost both mental and physical health.

“Women were all over it. What a way to become health literate and really take control,” presenter Lauren Lessard of the University of Alaska said about the self-monitoring. “It was great.”

Of course, as we all know in this increasingly virtual environment, certain types of support become even more important when health interventions are relying on online tools.

“You cannot anticipate enough needing tech support and the creative ways that Zoom can fail you,” Lessard said.

In a small study of pregnant women who had already been enrolled in a larger study or were part of the Fresno County Black Infant Health program, researchers found rates of depression were “through the roof” and participants’ chief concerns were social isolation, mental health, and finances and job security.

Researchers found keys to success in addressing each of those through a group telehealth prenatal care program.

For example, to help strengthen meaningful social connections:

• Organize virtual or COVID-safe, in-person meet and greets with the program facilitator prior to the official start of group meetings.
• Use creative ways to make the virtual space more welcoming. Lessard said that can include using positive images and allowing participants time to talk about themselves.
• Maintain a “robust, private social media page for on-going social support between sessions.

And to support mental wellness:

• Start and end each group televisit with mindfulness exercises.
• Ask participants to complete a wellness questionnaire at each session. Provide perinatal wellness program referrals as needed.
• Talk openly and often about the stigma and cultural considerations linked to seeking mental health support.
• Prior to sessions, ask about concerns related to COVID-19 and pregnancy and birth.

Other session presentations touched on issues such as addressing the link between perceived discrimination and depression among pregnant women by boosting resiliency and social support. Annette Regan, of the School of Nursing and Health Professions at the University of San Francisco, shared findings that echoed other studies showing pregnant women are more susceptible to severe COVID-19 symptoms, and certain populations are at even higher risk, such as those with asthma, coronary heart disease or other pre-existing conditions.

In an analysis of insurance claim and electronic health record data for more than 78,000 pregnancies, Regan and her colleagues found 3.4% had a COVID-19 infection. While just 5% of those were classified as “severe” COVID-19 cases, the risk was up to threefold for those with pre-existing medical conditions and was also higher for certain races and ethnicities.

“Prevention should really be a high priority for pregnant persons of color and with pre-exisitng medical conditions,” Regan said.

Photo by Prostock-studio, courtesy iStockphoto