The landscape of maternal healthcare is evolving rapidly, and midwives are at the forefront of this transformation. Telehealth — the delivery of healthcare services through digital communication technologies — has become an essential tool for midwifery practices worldwide. From remote prenatal consultations to home-based fetal monitoring, virtual care is expanding access to the compassionate, personalized support that defines the midwifery model.
For midwives serving rural communities, underserved populations, or families facing transportation barriers, telehealth offers a bridge to continuous care. This guide explores how midwives can effectively integrate virtual services into their practice while maintaining the relationship-centred approach that makes midwifery care so impactful.
Why Telehealth Matters for Midwifery Practice
The maternal healthcare crisis has reached critical levels globally. Over 35% of counties in the United States are now classified as maternity care deserts — areas with no hospitals offering obstetric services, birth centres, or obstetric providers. Counties with limited telehealth access are 30% more likely to become maternity care deserts, making virtual care a crucial solution for expanding midwifery reach.
The American College of Nurse-Midwives recognizes telehealth as a legitimate and valuable method of care delivery, with midwives providing services across diverse settings including remote care delivery. Virtual consultations allow midwives to maintain continuity of care even when in-person visits are not possible — whether due to geographic distance, health concerns, or scheduling constraints.
Research demonstrates that telehealth prenatal care produces outcomes comparable to traditional in-person visits. Studies show high patient satisfaction with virtual appointments, with providers reporting that telehealth increases access and provides adequate care for low-risk pregnancies. The key is knowing when virtual care is appropriate and when in-person assessment is essential.
The Hybrid Care Model: Balancing Virtual and In-Person Visits
Most successful telehealth implementations in midwifery use a hybrid approach — combining virtual appointments with strategic in-person visits. The “4-1-4 prenatal plan” developed during the pandemic demonstrates one effective model: four in-person visits (at 8, 28, 36, and 39 weeks), one antenatal ultrasound at 20 weeks, and four virtual check-ins throughout pregnancy.
Visits That Work Well Virtually
Certain prenatal appointments translate effectively to telehealth format. Early pregnancy counselling and education sessions allow midwives to discuss nutrition, exercise, warning signs, and birth planning without requiring physical examination. Follow-up consultations after test results provide opportunities for detailed discussion and emotional support. Postpartum check-ins addressing breastfeeding challenges, mental health screening, and recovery questions are particularly well-suited to virtual delivery, as new parents often appreciate not having to leave home with a newborn.
Visits That Require In-Person Care
Physical examinations including fundal height measurement, fetal position assessment, and cervical checks necessitate in-person appointments. Laboratory work and vaccinations require clinic visits for sample collection and administration. Ultrasound examinations and other diagnostic imaging must occur in appropriate clinical settings. When complications arise — elevated blood pressure, concerning symptoms, or abnormal findings — transitioning to in-person care ensures proper assessment and intervention.
Remote Patient Monitoring: Extending Care Beyond the Clinic
Remote patient monitoring (RPM) represents one of the most promising applications of telehealth in midwifery. Using connected devices, pregnant individuals can track vital measurements at home while their midwife monitors data remotely.
Blood Pressure Monitoring
Hypertensive disorders remain a leading cause of maternal morbidity and mortality. Home blood pressure monitoring with validated cuffs allows midwives to track trends, identify concerning patterns early, and intervene before complications escalate. Research shows that RPM programmes can double patient compliance with blood pressure screening compared to standard care.
Blood Glucose Tracking
For individuals with gestational diabetes, connected glucometers transmit readings directly to their midwife, enabling real-time feedback on dietary choices and medication adjustments. Studies demonstrate improved glycemic control when patients use automated tracking with measurement reminders.
Fetal Heart Rate Monitoring
FDA-cleared devices now allow pregnant individuals to record fetal heart rate at home, with data transmitted to their healthcare provider. While not a replacement for comprehensive fetal assessment, these tools provide reassurance between appointments and can flag potential concerns requiring evaluation.
Implementing Telehealth in Your Midwifery Practice
Successfully integrating virtual care requires thoughtful planning and preparation. The U.S. Department of Health and Human Services provides comprehensive guidance for providers through their Telehealth for Maternal Health Services best practice guide.
Technology Requirements
At minimum, you will need a HIPAA-compliant video conferencing platform, reliable internet connection, and secure messaging system for non-urgent communication. Many electronic health record systems now include integrated telehealth capabilities. For remote monitoring programmes, establish relationships with device vendors and create protocols for data integration into patient records.
Workflow Considerations
Develop clear criteria for determining which appointments can occur virtually versus in-person. Create standardized documentation templates for telehealth visits. Establish protocols for technical difficulties — what happens if the connection fails mid-appointment? Train all staff on the technology and workflows to ensure smooth operations.
Patient Preparation
Not all patients are equally comfortable with technology. Provide clear instructions for accessing virtual visits, including test connections before appointments. Consider offering phone-based options for those without reliable internet access. Address privacy concerns by explaining how patient information is protected during virtual visits.
Addressing Telehealth Barriers and Limitations
While telehealth expands access, it also presents challenges that midwives must navigate thoughtfully.
Technology Access Disparities
The digital divide disproportionately affects the same populations already facing healthcare access barriers. Rural communities may lack reliable broadband internet. Low-income families may not have smartphones or computers capable of video calls. Audio-only telephone visits, while less comprehensive, can serve as an alternative when video is not possible.
Building Rapport Virtually
The midwifery model emphasizes relationship-building and trust. Some providers worry that virtual visits diminish this connection. However, research indicates that with intentional effort — maintaining eye contact through the camera, allowing adequate time for questions, and demonstrating active listening — meaningful therapeutic relationships can develop through telehealth.
Regulatory and Reimbursement Considerations
Telehealth regulations vary significantly by location. Licensing requirements may restrict practice across state or national boundaries. Reimbursement policies differ between insurers and are continually evolving. Stay current with your professional organization and regulatory bodies regarding telehealth policies in your jurisdiction.
The Future of Virtual Midwifery Care
The CMS Transforming Maternal Health (TMaH) programme, launched in January 2025 across 15 states, specifically promotes telehealth for managing conditions like gestational diabetes and hypertension. This federal investment signals growing recognition that virtual care is essential for improving maternal health outcomes.
Emerging technologies will continue expanding possibilities. Wearable sensors capturing continuous vital signs, artificial intelligence supporting clinical decision-making, and enhanced remote monitoring devices will give midwives increasingly sophisticated tools for supporting pregnant individuals wherever they are.
For midwives committed to shaping the future of maternal care, telehealth represents not a departure from traditional midwifery values but an extension of them. By meeting families where they are — sometimes literally through a screen — midwives can ensure that compassionate, evidence-based care reaches everyone who needs it.
Practical Steps to Get Started
If you are new to telehealth, begin with a pilot programme. Select a small group of established patients comfortable with technology. Start with straightforward appointment types like postpartum check-ins or education sessions. Gather feedback, refine your approach, and gradually expand your virtual offerings.
Connect with colleagues who have implemented telehealth successfully. The peer support networks within the midwifery community offer invaluable guidance for navigating this transition. Professional organizations provide resources, training, and advocacy support for midwives adopting telehealth.
Most importantly, approach telehealth as a tool to enhance — not replace — the human connection at the heart of midwifery. When implemented thoughtfully, virtual care extends your ability to be present with families throughout their pregnancy journey, regardless of the miles or circumstances that might otherwise separate you.
The midwifery model has always been about meeting people where they are in their lives. Today, that sometimes means meeting them on a screen — and the families we serve are better for it.
