Most pregnancy-related deaths in the United States are preventable, and many happen after patients go home. CDC data show that more than 80% are preventable and 53% occur between one week and one year after delivery. Risk also builds during pregnancy, when hypertension and diabetes can progress in the weeks between prenatal visits. The time between appointments is the part of maternal care health systems see least.
Where maternal care breaks down
Hypertensive disorders affect up to 10% of U.S. pregnancies and can persist, worsen, or first appear after birth. Postpartum blood pressure often peaks three to six days after delivery, once patients are home, and as many as 40% of women miss the postpartum visit entirely. During pregnancy, a patient with rising blood pressure, early preeclampsia symptoms, or poorly controlled gestational diabetes may be asymptomatic and unaware their condition is worsening at home.
Geography widens every gap. More than 57% of rural hospitals no longer offer labor and delivery, and more than 35% of U.S. counties are maternity care deserts. For rural patients, every prenatal visit and postpartum check can mean a long drive, leading to longer periods between appointments or lack of follow up completely.
Monitoring works when a care team acts on it
Remote patient monitoring (RPM) gives obstetric teams visibility between visits, covering blood pressure for hypertensive disorders and glucose, including continuous glucose monitor (CGM) data, for gestational and pre-existing diabetes. The programs with the strongest results pair it with structured care management. Patients enroll at a guaranteed touchpoint: the prenatal visit where a diagnosis is made, or the bedside before discharge. Nurses review every reading against thresholds set by obstetric leadership, escalate severe readings the same day, and reach out when readings stop coming in. .
For postpartum care, an AHRQ-commissioned systematic review found home monitoring roughly doubled the likelihood of a blood pressure reading in the first 10 days postpartum and cut racial disparities in ascertainment by about half. At UChicago Medicine, attendance at the first postpartum blood pressure check rose from 33.5% to 84.0% as telehealth and RPM were layered in to a protocol bundle. Novant Health’s program for rural and underserved patients reported 0% readmissions for RPM patients versus 5% for matched controls.
During pregnancy, a meta-analysis of 32 randomized trials found telemedicine for gestational diabetes lowered HbA1c and reduced cesarean delivery, neonatal hypoglycemia, and macrosomia. The CONCEPTT trial found CGM improved neonatal outcomes for patients with type 1 diabetes. Home self-monitoring of blood pressure in pregnancy showed mixed results in the BUMP trials , which strengthens the case for a clinical team behind every reading.
Extending care into rural America
Rural programs depend on access design. Cellular cuffs and glucose meters work without broadband or a smartphone, and centralized clinical monitoring covers nights and weekends without new OB nursing hires. A regional obstetric team can monitor patients across counties, including areas whose hospitals no longer deliver babies.
Funding is following. RPM is one of the most common uses of the $50 billion Rural Health Transformation Program, and a growing number of state plans name maternal monitoring directly. Pennsylvania plans RPM for high-risk pregnancies and postpartum complications in 48 of its 69 counties, Oklahoma is deploying blood pressure cuffs for pregnant patients with hypertension, and Missouri has sought input on a dedicated maternal RPM track. Eligibility varies, and Nebraska’s RPM initiative excludes hypertensive disorders of pregnancy. In most states, the strongest position is to present maternal monitoring as an extension of the hypertension and diabetes infrastructure the state already funds.
Grants end, so programs also need a sustainability plan. Pregnant and postpartum patients are covered by Medicaid and commercial plans, and Medicaid finances about four in ten U.S. births. RPM coverage varies by state and by plan, but many state Medicaid plans specifically cover maternal health applications of RPM.
A practical place to start
The strongest entry point for a maternal health RPM program is often postpartum hypertension , with patients enrolled before discharge. Antepartum hypertension, high-risk pregnancy, and diabetes pathways can then run on the same platform. Health systems that extend their obstetric teams into the home can find problems earlier and keep more patients connected to care, wherever they live.
Health Recovery Solutions has led remote patient monitoring for more than a decade, serving more than 2 million patients through more than 250 organizations across all 50 states and Canada. That includes more than 20 maternal health programs and diabetes programs that integrate CGM data from Abbott, Dexcom, and Eversense. If you are building a maternal monitoring program, including one funded through your state’s Rural Health Transformation plan, reach out to the Health Recovery Solutions team.
Learn more about Sudeep Pisipaty and Health Recovery Solutions.
The post Closing the Maternal Care Gap: How Remote Monitoring and Care Management Extend Prenatal and Postpartum Care Into Rural America appeared first on Becker's Hospital Review | Healthcare News & Analysis.