Obstetrical telecare: a promising opportunity for midwifery in The Netherlands

In the Netherlands primary obstetrical care in low-risk pregnancies (84%) is provided by midwives, while high-risk pregnancies (16%) are followed by obstetricians. When complications in low-risk pregnancies arise, women will be referred to an obstetrician (at the hospital) for further evaluation. Afterwards, a large number of those visits will not corroborate any underlying pathological condition. Women may experience stress or anxiety because of these visits, which may result in unwanted pregnancy outcomes. Telecare is a tool to provide the same hospital care at the community level, thereby reducing the number of hospital visits, possibly leading to a reduction in stress and anxiety. Aims and objectives: To examine if low-risk pregnant women, who have an indication for obstetrical evaluation at the hospital when a mild pregnancy complication is suspected, experience less stress and anxiety if they are screened via telecare compared with regular consultation at the hospital. To examine whether telecare can safely reduce the number of hospital visits to an obstetrician in low-risk pregnant women. Methods: UOC provides low-risk obstetrical midwife led care at several locations in Utrecht. At one of these sites pregnant women who have an indication for hospital consultation by an obstetrician will be offered a teleconsult. The necessary examinations (e.g. ultrasound, cardiotocography) will be performed on site. Subsequently an obstetrician will assess and discuss the obtained information via video conferencing. Pregnant women at the other sites will receive regular care with hospital consultation if necessary. Data between the groups will be compared. Results and conclusions: Because this project is still in progress, it is not possible to provide results and conclusions at present.