It is something of a technological miracle. Over the past two years, doctors in a remote corner of India have eradicated maternal deaths during pregnancy and childbirth from more than 180 rural villages. Eight years earlier, 400 women died annually per 100,000 live births.
The life-saving change that has brought safety to more than 4,900 pregnant women in Araku over those two years is basic video conferencing, or telemedicine. The connection between telemedicine and maternal health is clear: women from rural areas are able to receive diagnoses and treatments by medical experts that they would otherwise go without. By establishing webcam links between local clinics, big city doctors, and regional hospitals, pregnant women can be properly supported by a network of professionals.
It is a low technology, high-concept initiative that saves lives–and other nations should be paying attention. Sadly, maternal health technologies such as telemedicine connections with experts could also be used in the U.S., which has the highest rate of maternal deaths in the developed world and stands alone as the only one with a rising mortality rate.
Telemedicine and Maternal Health in India
The life-saving and not-for-profit initiative outlined above is run partly by volunteers based in the central India city of Hyderabad. From a remote telemedicine center, maternal health experts can speak face-to-face with local doctors and their pregnant patients on the ground in areas such as Araku over a basic video link. The doctors on site double as assistants, translators, and nurses for women from surrounding areas that are too far removed from Hyderabad to seek regular specialist attention.
If the remote expert diagnoses a serious problem with a patient, they can instantly scale up the video call to include doctors from the nearest regional hospital. Using a now three-way, four-person connection, the patient can be advised on how best to proceed while the receiving hospital prepares from their arrival.
Telemedicine technology amplifies the reach and capacity of medical expertise.
The process has already saved the lives of women showing early signs of pregnancy complications or the presence of disease, such as malaria. The technology involved is no more complicated than the webcam or smartphone camera you’d use to make a simple Skype call, and it requires only basic broadband or wifi infrastructure. With India currently undergoing a major national internet upgrade, it is reasonable to expect such initiatives could be rolled out across the country.
In this case, telemedicine, which uses communications technology to conduct remote medical interventions–amplifies the reach and capacity of medical expertise. In a country struggling with a booming population, the ability to have a single remote doctor visit dozens of regional locations without leaving their own office is a much-needed digital solution–one that could have applications in the U.S. as well.
Rising U.S. Maternal Dangers
While the rate of maternal death in the U.S. is nowhere near that of India, as many as 900 U.S. women die from pregnancy-related complications every year and it is the only developed country with a rising maternal mortality rate.
While the U.S. maternal mortality rate escalates, other developed nations get safer every year.
The rate of 26.4 deaths per 100,000 live births is triple that of Canada, four times higher than in Australia, and more than six times the rate of some European countries. While the U.S. maternal mortality rate escalates, other developed nations get safer every year–statistically, a British man is now more likely to die when his partner is pregnant than she is.
The reasons for this alarming trend in the U.S. are complicated, but five key trends have been identified:
- First-time mothers are older than earlier generations with more complex medical histories
- About 50% of pregnancies are unplanned and pre-existing health concerns often go unaddressed
- A higher rate of C-sections means an increased risk of complications
- A fragmented healthcare system leads to increased risk of caregiver error
- A greater emphasis on infant health means less focus on women
Under these circumstances, telemedicine and maternal health technologies could be used not just to bring expectant mothers to specialist attention, but to keep them in constant contact with existing healthcare networks.
Creating a Digital Safety Net in the U.S.
The U.S. is good at telemedicine–and continually getting better. The technology is already being used to provide online mental health support, to provide outreach services to rural and regional communities, and to enlist remote surgical assistance during complicated operations.
Given that almost 110 million U.S. households have a broadband internet connection, telemedicine is primed to become a very domestic health solution. Pregnant women should be able to reach a medical opinion and assistance in an instant for the small cost of an HD webcam with easy plug-and-play setup.
Every smartphone is just an app away from becoming a telemedicine portal.
So, let’s surround pregnant women with medical advice and support. It is possible to establish a 24-hour network of medical platforms that can provide guidance on nutrition and exercise, perform routine check-ups, offer emotional support, and even conduct remote ultrasound screenings. All this can be accessed from home or work whenever it is needed, because every smartphone is just an app away from becoming a telemedicine portal.
Just as in the India example, local family doctors can act as an instant conduit whenever symptoms require expert medical opinion, and there are already initiatives in place that smooth the transition between healthcare organizations.
The U.S. has state-of-the-art medical facilities and world-leading digital communications technologies. Together, those factors should provide pregnant women with a digital safety net that protects them from the dangers of childbirth the rest of the developed world is already leaving behind.