The maternal healthcare industry has been divided over the use of telehealth since the early days of its use for obstetrics.
Concerns about losing the personal connection of the physician-provider relationship, compromising the quality of care, and adding more work to a strained labor force initially complicated the adoption of telehealth. However, a growing body of research and on-the-ground experience slowly dispelled those concerns, and the COVID pandemic accelerated an emerging clinical consensus in favor of telehealth.
Despite this consensus, barriers to adoption remain, specifically related to reimbursement. Though industry experts have expressed approval and support for telehealth, many insurance plans still consider it a solution that is outside the scope of the standard of care.
Take remote patient monitoring (RPM) as an example: though ACOG (The American College of Obstetrics and Gynecology) and others (notably the American Board of Obstetrics and Gynecology and the Alliance for Innovation in Maternal Health) reinforce the value of RPM and recommend its use for issues such as hypertensive disorders of pregnancy (HDP), many health plans are unwilling to fulfill claims for reimbursement. Their reasoning? Patients at risk for HDP are monitored during their prenatal visits. It is not the standard of care to request remote monitoring.
ACOG’s Ethical Framework for Innovation
A recent committee statement released by ACOG introduces a new angle to the discussion. The statement, Ethical Considerations With Telehealth in Obstetrics and Gynecology, goes beyond illustrating the clinical benefits of telehealth (a position that the medical society has long held and supported through guidance and recommendations). It offers an ethical framework to guide clinicians in their evaluation of telehealth solutions and determine their responsibility for using telehealth in provision of care.
In the statement, ACOG defines telehealth as:
Technology-enhanced health care frameworks that allow traditional clinical diagnosis and monitoring to be delivered or facilitated by technology. The terms ‘telemedicine,’ ‘connected health,’ and ‘digital health’ are also used to describe similar technological applications in health care. These frameworks may include such services as virtual visits, remote patient monitoring, and mobile health care.
Included under the definition are “discrete devices or software programs used to facilitate obstetric and gynecologic care, including remote monitoring devices for pregnant patients.” These solutions, as the statement notes, have demonstrated value in monitoring hypertension and preventing progression to preeclampsia, among other clinical benefits. The implication is that, if remote patient monitoring is not the standard of care presently, it should be — under the ethical framework laid out by the statement.
Deploying Telehealth As An Ethical Imperative
Based on the principles outlined, ACOG emphasizes that telehealth is a legitimate and important tool for expanding access to obstetric and gynecologic care. It can safely serve as an alternative to in-person visits when appropriate protocols are in place. They emphasize that decisions about telehealth should occur within a framework of shared decision-making, always preserving in-person care as an option. Physicians are called to provide targeted support to patients, employ platforms designed specifically for telehealth with strong data protections, and remain mindful of equity barriers such as language, literacy, or technology gaps.
ACOG also acknowledges that systemic challenges, particularly reimbursement disparities, remain a serious barrier to adoption. Physicians and health systems have a responsibility to minimize these barriers and advocate for parity. As evidence supporting the benefits of telehealth continues to grow, ACOG concludes that it becomes increasingly incumbent upon OB/GYNs to self-educate and integrate these tools into practice, regardless of reimbursement opportunities.
This last point is what makes the statement unique. By positioning telehealth within the physician’s duty of care, ACOG challenges providers to recognize telehealth as part of their ethical responsibility to meet patient needs. While this perspective alone may not immediately change insurer policies, it sets a professional standard that reinforces the importance of adoption.
A Positive Shift on the Reimbursement Front
Encouragingly, practical reimbursement changes that support ACOG’s Committee Statement may soon take effect. The Centers for Medicare & Medicaid Services (CMS) has proposed new billing codes for RPM in its 2026 Physician Fee Schedule. These codes aim to reduce the minimum requirements for monitoring periods and clinical interactions, which previously limited clinicians’ ability to use RPM effectively.
If finalized, this development could help align policy with both clinical evidence and ethical guidance. It may expand access to RPM—particularly for underserved populations and patients in rural areas—and support the integration of telehealth as a sustainable, standard component of obstetric care.
About Anish Sebastian
Anish Sebastian co-founded Babyscripts in 2014 with the vision that internet-enabled medical devices and big data would transform the delivery of pregnancy care. Since the company’s inception, they have raised more than $40 million. As the CEO of Babyscripts, Anish has focused his efforts on product and software development, as well as research validation of their product.
