Mark Herzog

Mentor: David C. Gordon

Current Status: Undergraduate at Duke University


High Risk Preganany Care in Southwest Virginia


To ensure optimal health outcomes for the mother and child, high risk mothers need routine access to specialty care throughout their pregnancy. Mothers from rural regions have lower access to this specialized care which contributes to a disparity among high-risk pregnancy health outcomes. Health care providers in Southwest Virginia were engaged in preliminary research to understand the current management of high-risk pregnancies and the potential role for a telemedicine program to improve access to specialty care in two health districts. Twenty-one interviews were completed with local stake holders including obstetric-gynecologists (OB/GYN), nurses at OB/GYN practices, obstetric nurse directors at local and referral hospitals, and the maternal-fetal specialist seeing women from Southwest Virginia. The remoteness of these health districts has impacted how local health care providers manage high-risk mothers. Faced with low compliance for referrals in the Lenowisco Health District, providers have relied on managing high-risk factors such as diabetes and hypertension locally. Providers at the only OB/GYN in the Cumberland Plateau Health District continue to care for high-risk mothers, but rely on routine referrals to the closest maternal-fetal specialist located two hours away in Johnson City, Tennessee. This research demonstrates the potential benefit of a telemedicine program, such as the University of Virginia’s High Risk Obstetrics Program, to coordinate the use of telemedicine for the region. Use of telemedicine has the potential to improve management of high-risk women by lowering the travel barriers to specialty care and increasing the coordination between local OB/GYN providers and maternal-fetal specialists.