Evaluating the Impact of Telehealth Prenatal Care at a Federally Qualified Health Center.

Clients chose their care model, and those who chose telehealth group care may already have been more engaged, so the comparison is not randomised. Both groups enrolled after 16 weeks on average, and the adequacy measure counts early entry, which can make care look inadequate for people who face structural barriers to starting prenatal care. Blood pressure readings were inconsistently documented in records, and home monitors did not upload automatically, so the blood pressure result may reflect documentation rather than care quality. Satisfaction surveys were optional, completed by 33% of group clients, not linked to individual clients, and not collected for individual care clients, so satisfaction cannot be compared between groups. The evaluation was retrospective, single-site, pandemic-era, and limited to Spanish-speaking, low-risk clients eligible for midwifery care, so it may not apply to other languages, risk levels, or settings.

The work was supported by NIH National Center for Advancing Translational Sciences award KL2TR001432, and the authors declared no conflicts of interest. The first author is a nurse-midwife who practices at Mary's Center, the study site.

Do not read the higher adequate prenatal care rate as proof that telehealth group prenatal care causes better outcomes. Clients self-selected into the group model, both models included telehealth, and blood pressure documentation was inconsistent, so motivation, resources, and record-keeping could explain the differences.