Telehealth has served as a flashpoint in maternal health since its origins. When it first started gaining traction in obstetrics, many providers worried that it would weaken the physician-patient relationship, lower the quality of care, or pile more work onto a strained labor force. Over time, research and lived experience showed that those concerns were largely unfounded—and the COVID-19 pandemic fast-tracked acceptance of telehealth in maternity care.
Despite growing clinical consensus on the benefits of telehealth, major barriers remain. Chief among them is reimbursement. Many insurers continue to view telehealth as outside the scope of the standard of care, and refuse to cover it. Remote patient monitoring (RPM) is a perfect example. Groups like ACOG, ABOG, and AIM all recommend RPM for conditions like hypertensive disorders of pregnancy, but health plans often won’t pay for it—arguing that the standard of care is to monitor blood pressure during routine prenatal visits.
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 this definition are “discrete devices or software programs used to facilitate obstetric and gynecologic care, including remote monitoring devices for pregnant patients,” a specific reference to the kind of services provided by Babyscripts RPM program. As the statement acknowledges, these solutions have been shown to effectively monitor patients with hypertension who are at risk of progression to preeclampsia, among other benefits.
Here's why the Committee Statement matters. Instead of just making the case for the clinical benefits of telehealth, this statement takes things further: it frames telehealth as part of a physician’s ethical responsibility to patients.
Here’s what that looks like in practice: Telehealth can and should be used to expand access to care when it’s safe and appropriate, but patients must always have a choice. It should be delivered within a shared decision-making framework—patients and providers weighing together what’s best, whether that’s in-person, virtual, or a mix of both. Doctors are responsible for making sure that patients feel supported and confident in using telehealth, and for choosing tools that are private, secure, and designed for virtual care. Equity matters too—physicians must consider barriers like language, literacy, or lack of tech access, and avoid setting up exclusionary criteria.
The statement also addresses reimbursement. ACOG acknowledges that unequal reimbursement makes it harder for patients to access telehealth. The responsibility to push back doesn’t just fall on insurers, though; physicians and health systems also share a duty to advocate for fair coverage.
The most striking part of the statement comes at the end: if the evidence continues to support telehealth, doctors have an ethical obligation to educate themselves and use it when it meets their patients’ needs. In other words, this isn’t just about clinical effectiveness anymore. ACOG is saying that using telehealth—whether that’s RPM for high blood pressure, virtual visits, or other tools—is part of the duty of care.
That’s a big step forward. It may not be enough to change every policymaker’s or insurer’s mind—but it should be.
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