By Jennifer Threat PhD, MSN, RN and Nirvanni Chatoori, PhD, RNC-MNN
According to the World Health Organization, 95 percent of maternal deaths are related to access to healthcare, inadequate quality of care, health system fragility, and social determinants. Maternal death occurs in lower-income and socioeconomic households and most of the deaths were preventable if cared for by health professionals during the perinatal and postpartum periods.
During the perinatal period, women should have one prenatal visit per month in weeks four to 28 and increase to every two weeks in weeks 28 through 36, and then one every week in weeks 36 through 40. However, Obstetrical health visits are sporadic and inconsistent among patients related to negative attitudes to health care, inconvenience of long wait times, financial problems, childcare issues, emotional concerns, lack of transportation, and poor access to care.
Healthcare professionals play a vital role in promoting the well-being of pregnant women and ensuring optimal maternal-infant health outcomes. Regular obstetrical health visits during the perinatal period provide an opportunity for healthcare providers to detect and address potential complications early in pregnancy. However, insufficient or delayed obstetrical visits have become a concern leading to poor maternal-infant outcomes. Healthcare related to inadequate obstetric visits could lead to missed early detection and prevention of complications, missed opportunities for pregnancy-related education, increased maternal psychological stressors, and increased health disparities for women of lower socioeconomic status.
Addressing the issue of timely and adequate obstetrical care during the perinatal period requires a collaborative effort from healthcare providers, policymakers, and society at large. By prioritizing and ensuring timely and comprehensive prenatal care, nurses can play a crucial role in promoting the well-being of pregnant women, reducing healthcare disparities, and ultimately improving maternal and infant health outcomes.
Telehealth provisions during perinatal and postpartum care can be a solution to improve patient outcomes and compliance. The implementation of telehealth in other healthcare fields has decreased racial disparities, increased accessibility, built stronger relationships with healthcare providers, and reduced delays in care. Currently, women's health providers have successfully implemented mobile mammogram programs to help close the gap to access screening by providing resources to underserved communities.
Bringing telehealth and mobile health clinics to obstetrics can help decrease the mortality rates in perinatal and postpartum patients and extend targeted healthcare approaches to marginalized populations.
It is understandable that all healthcare practices cannot provide mobile, or telehealth services, but the following practices can be implemented to build engagement with patients:
- Depression screening
- Contraception Selection
- Breastfeeding Support
- Glucose Tolerance Testing
- Blood Pressure Checks
- Urine Dip Analysis
- Doppler Fetal Heart Tone Checks
- Fundal Height Measurements
Early interventions and accessibility to healthcare are key steps to decreasing maternal mortality. Improving healthcare systems is the goal to enhance equity of care and increase visits, thereby improving newborn and maternal outcomes. The partnership of mobile clinics and telehealth is a supportive healthcare alternative to address disparities in access to healthcare, strengthen early interventions, and improve maternal health barriers. Providing outreach to patients can help break the socioeconomical barriers that can be a lifeline to obstetric care.
Jennifer M. Threatt PhD, MSN, RN Lead Nursing Professor| Subject Matter Expert in Mom/Baby and Women's Health| Author| Philanthropist
Nirvanni Chatoori, PhD, RNC-MNN. Nursing Faculty, Perinatal Educator and Board Certified Maternal-Newborn Nurse