By: Betsy McKay
Britney Stewart was nervous at first when her obstetrician told her she’d like her to see a specialist in high-risk pregnancies. “Once I know a doctor I like to stick with that doctor,” says the 27-year-old, whose high blood pressure and weight issues put her and her unborn baby at risk.
Now she says those appointments—conducted by video link with the specialist, Anne Patterson in Atlanta, a two-hour drive away—saved her baby’s life.
Ms. Stewart’s obstetrician, Joy Baker, is one of many physicians seeking to improve care for pregnant women as childbirth in rural America has grown more dangerous. Pregnancy-related complications are rising across the U.S., meaning more women need specialized care, and rural areas have higher rates of obesity and other risk factors for complications.
Telemedicine programs like the one Ms. Stewart used are helping to fill those gaps. Some of those programs are expanding, and experts hope that the development of professional guidelines and the shrinking costs of technology will encourage wider use of telemedicine for obstetrics.
Ms. Stewart, who lives in rural Milner, Ga., saw Dr. Patterson, a maternal-fetal medicine specialist who is chief executive officer of Women’s Telehealth, a company in Atlanta. Dr. Baker began offering her patients appointments with Women’s Telehealth from her office earlier this year. Starting halfway through her pregnancy, Ms. Stewart had special ultrasounds administered regularly by a local technician trained by Women’s Telehealth to perform them, followed by a consultation by video with Dr. Patterson.
In early August, one of those special ultrasounds showed that blood wasn’t flowing properly through the umbilical cord—a sign that the baby wasn’t getting enough nutrients or oxygen, even though his vital signs appeared fine. Worried, Dr. Patterson told Ms. Stewart to come back in a week for another test. The new test showed the baby wasn’t taking in any blood through the umbilical cord. He had gone limp. “You know you’re in trouble there,” says Dr. Patterson.
After seeing the ultrasound, Dr. Baker delivered baby Titus by an emergency caesarean section right away. “Had I not had an ultrasound that day, it would have been a different situation and he would not be here,” Ms. Stewart says.
About 70% of Dr. Baker’s pregnant patients are high-risk, because they are obese, diabetic or have other risk factors for complications, the doctor says. Based in Thomaston, Ga., she is one of two full-time obstetrician-gynecologists serving eight counties.
Previously, Dr. Baker had to send high-risk patients to specialists an hour or more away—appointments many couldn’t make because they couldn’t find a ride, afford the gas, or get time off from work. Now they have those appointments from her office.
“We really needed it, because of our population that we are serving and our remote location,” says Dr. Baker. “I want my patients to have the same thing they would have living in Atlanta.”
She paid more than $15,000 for videoconferencing equipment, an upgrade to the office’s internet service, and training in the advanced ultrasound techniques with a grant secured by her hospital, Upson Regional Medical Center, she says. Appointments are scheduled one day a week, but she plans to expand to two soon. Women’s Telehealth gets paid for the consultation, while the hospital, which owns the practice where Dr. Baker works, gets paid for the use of its facilities and the ultrasound technician’s work.
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