BACKGROUND:
The COVID-19 pandemic accelerated the adoption of telehealth in prenatal care, prompting innovation in care delivery. As telehealth becomes more routine, it is essential to evaluate implementation strategies that promote health equity in perinatal care.

OBJECTIVES:
This study explored the motivations, experiences, and telehealth use among patients in a hybrid (video visits mixed with in-person visits) prenatal care program. The goal was to understand how telehealth affects those at risk of receiving inadequate prenatal care.

METHODS:
In this mixed-methods observational study at a U.S. academic midwifery center (2023–ongoing), the affects of telehealth were studied in 21 pregnant patients. Eligible participants had low-risk pregnancies and faced barriers such as rurality, poverty, or demographics associated with disparities. Data sources included: (1) electronic health records (demographics, care utilization, outcomes), (2) patient surveys (enrollment reasons, satisfaction), and (3) interviews (20–60 minutes via video conference) on care experiences.

RESULTS:
Of 21 enrolled participants, 3 transferred care and 1 miscarried. Most were White (90%) and English-speaking (95%); 50% had public insurance and 62% lived rurally. Most participants enrolled in the study to reduce travel time and allow for access to midwifery care. Participants averaged 3.6 prenatal visits via video call (SD 2.6). Almost all participants (95%) received adequate prenatal care by typical US standards (indexed by ultrasound at 20 weeks, gestational diabetes testing at 28 weeks, and GBS testing within 4 weeks of delivery). No adverse maternal or neonatal events were reported.

CONCLUSIONS:
This pilot hybrid prenatal program is effective and safe while providing flexible options to patients to extend access to midwifery care. However, reaching urban Black and Hispanic populations as well as those who do not speak English continues to be a challenge that requires continued, intentional research.

KEY MESSAGE:
Innovating prenatal care through telehealth is an important opportunity to increase access to midwifery care to systematically underserved communities. Poster session 2 (Group A)