Prenatal care redesign: creating flexible maternity care models through virtual care

Peahl, Alex; Smith, Roger; Moniz, Michelle H.

doi:10.1016/j.ajog.2020.05.029

Cited by 155 publications

(158 citation statements)

References 8 publications

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“…For vulnerable populations, such as pregnant women with opioid use disorder (OUD), this shift in practice represented an abrupt transition and compounded the significant barriers to care that already exist for this population. 3 , 4 Here, we report our experience with implementation of telehealth services for a cohort of pregnant women with OUD.…”

Section: Objectivementioning

confidence: 99%

Unintended consequences of the transition to telehealth for pregnancies complicated by opioid use disorder during the coronavirus disease 2019 pandemic

McKiever

Cleary

Schmauder

et al. 2020

American Journal of Obstetrics and Gynecology

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Section: Objectivementioning

confidence: 99%

Unintended consequences of the transition to telehealth for pregnancies complicated by opioid use disorder during the coronavirus disease 2019 pandemic

McKiever

Cleary

Schmauder

et al. 2020

American Journal of Obstetrics and Gynecology

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“…Considering these findings, the provision of targeted resources to incarceration exposed women, such as vouchers for childcare services or providing onsite childcare services at prenatal care clinics may be beneficial approaches to minimize barriers to prenatal care [ 52 ]. Likewise, given the logistical barriers noted above, incarceration exposed women may benefit from expanded telemedicine, which can provide more flexible appointments [ 53 ] and enhance accessibility for women who face time constraints, childcare responsibilities, and difficulty with reliable transportation [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

Incarceration Exposure and Barriers to Prenatal Care in the United States: Findings from the Pregnancy Risk Assessment Monitoring System

Testa

Jackson

2020

IJERPH

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Previous research demonstrates that exposure to incarceration during pregnancy – either personally or vicariously through a partner – worsens parental care. However, little is known about the specific barriers to parental care that are associated with incarceration exposure. Using data from the Pregnancy Risk Assessment Monitoring System (years 2009–2016), the current study examines the relationship between exposure to incarceration during pregnancy and barriers to prenatal care in the United States. Negative binomial and logistic regression models were used to assess the association between the recent incarceration of a woman or her partner (i.e., incarceration that occurred in the 12 months prior to the focal birth) and several barriers to prenatal care. Findings indicate that exposure to incarceration, either personally or vicariously through a partner, increases the overall number of barriers to prenatal care and this association operates through several specific barriers including a lack of transportation to doctor’s appointments, having difficulty finding someone to take care of her children, being too busy, keeping pregnancy a secret, and a woman not knowing she was pregnant. Policies designed to help incarceration exposed women overcome these barriers can potentially yield benefits for enhancing access to parental care.

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“…Prenatal care designed with flexible maternal care models and using virtual visits has been devised with the aim of reducing in‐person visits while continuing care via teleconsultations. This model may prove to be of excellent help while the pandemic continues 9 …”

Section: Discussionmentioning

confidence: 99%

“…This model may prove to be of excellent help while the pandemic continues. 9 Creating separate teams and separate shifts has been described as a key initiative to reduce the risk of infection among healthcare providers at work places, thus creating a "social bubble". 10 This could be achieved with rearranging the roster and segregating the teams.…”

Section: F I G U R E 1 Revised Distribution Of Teams At Different Plamentioning

confidence: 99%

The impact of a segregated team roster on obstetric and gynecology services in response to the COVID‐19 pandemic in a tertiary care center in India

Mahey

Sharma

Kumari

et al. 2020

Intl J Gynecology & Obste

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Objective: To determine the impact of roster reorganization on ensuring uninterrupted services while providing necessary relief to healthcare workers (HCW) in the obstetrics department of a tertiary care center amid the COVID-19 outbreak. Methods: The COVID-19 rostering response began in April 2020 and evolved in two phases: (1) development of new areas for screening and managing suspected/positive cases of COVID-19; and (2) team segregation according to area of work. The impact of these changes on HCWs and patients was assessed 3 months later. Results: Developing separate areas helped to minimize the risk of exposure of patients and HCWs to those with COVID-19. Residents and consultants worked intensively in clinical areas for 1 week followed by 1-2 weeks of non-clinical or standby assignments, providing adequate opportunity for isolation. Frequent re-evaluation of the roster was nevertheless required as the pandemic progressed. Segregating teams vertically significantly reduced the number of contacts identified on contact tracing and quarantine leaves, while maintaining patient satisfaction with no increase in adverse events. Residents found the roster to be "smart" and "pandemic-appropriate." Conclusion: The "COVID emergency roster" helped ensure quality care with minimum risk of exposure and sufficient breaks for physical and psychological recovery of HCWs.

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Prenatal care redesign: creating flexible maternity care models through virtual care

Cited by 155 publications

References 8 publications

Unintended consequences of the transition to telehealth for pregnancies complicated by opioid use disorder during the coronavirus disease 2019 pandemic

Unintended consequences of the transition to telehealth for pregnancies complicated by opioid use disorder during the coronavirus disease 2019 pandemic

Incarceration Exposure and Barriers to Prenatal Care in the United States: Findings from the Pregnancy Risk Assessment Monitoring System

The impact of a segregated team roster on obstetric and gynecology services in response to the COVID‐19 pandemic in a tertiary care center in India

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