JMIR Publications

ABSTRACT

Background:

Development of telehealth in an obstetric care model is important to prepare for possible infection outbreaks when social distancing is required and face-to-face consultation is limited. It is important to explore and acknowledge pregnant women’s concerns prior to the implementation of obstetric telehealth in Hong Kong.

Objective:

The aim of this study was to investigate the attitudes, expectations, acceptance, and the conception of potential limitations on the implementation of obstetric virtual clinic services among pregnant women.

Methods:

A prospective cross-sectional questionnaire study was conducted at Queen Mary Hospital, Hong Kong. The questionnaire explored pregnant women’s preferences and expectations of virtual clinic services, their perceptions on the feasibility and limitations of implementing virtual clinics, and the concerns of privacy using a 5-point rating scale. Statistical analyses with Chi-square tests and multinomial logistic regression were performed to compare questionnaire responses and investigate the association between advancing gestation and attitudes towards virtual clinic.

Results:

664 women (269 before 18 gestational weeks, 198 between 24-31 weeks and 197 after delivery) participated in the study from November 2021 to August 2022. The overall preference of virtual clinic was < 20% for routine antenatal checkup and clinical complaints during pregnancy such as vaginal bleeding, reduced fetal movement, suspected leaking of liquor or uterine contraction. The acceptance of virtual clinic progressively increased with advancing gestation and in the postnatal period. Furthermore, women preferred virtual clinic to face-to-face visits for antenatal education talks, postnatal exercise classes and breastfeeding problems. Women were less confident with virtual clinic in self-taking swabs in rectum and vagina, performing physical examination, measuring symphysis-fundal height under supervision, arranging further investigations, listening to fetal heartbeat using hand-held doppler machine and making diagnosis. Nevertheless, compared to women at < 18 gestational weeks, postpartum women were more confident with measuring symphysis-fundal height and using a hand-held doppler machine to listen to fetal heartbeat under supervision, and making the diagnosis via virtual clinic.

Conclusions:

Our study demonstrated increasing acceptance of telehealth with advancing gestation and after delivery. Although virtual clinic cannot totally replace conventional antenatal care, incorporation of virtual services for antenatal education talks, postnatal exercise classes and breastfeeding issues can be easily implemented to improve flexibility and efficiency of healthcare services for pregnant and postpartum women. Development of a comprehensive telehealth system to supplement current obstetric services is vital to prepare for sudden interruptions to face-to-face consultations and enable maintenance of care provision should isolation and social distancing become unavoidable.