The American College of Obstetrics and Gynecology has issued a landmark declaration that fundamentally reframes the role of technology in maternal healthcare, elevating telehealth from a convenient alternative to an essential ethical obligation for practitioners. This pivotal shift is designed to dismantle long-standing systemic barriers, most notably those concerning insurance reimbursement, by establishing a new professional standard of care. By asserting that the use of virtual tools is a core responsibility, ACOG aims to accelerate the integration of telehealth into the daily practice of obstetrics and gynecology, ensuring that expanded access and improved patient outcomes are no longer just potential benefits but are central to the physician’s duty. This move signals a definitive turn away from viewing telehealth as a temporary or supplementary service, heralding an era where remote monitoring and virtual visits are recognized as indispensable components of comprehensive maternal health management and a crucial step toward achieving greater health equity across the country.
From Skepticism to Clinical Consensus
The journey of telehealth within maternal healthcare was initially met with considerable resistance and doubt from many within the industry. A significant portion of clinicians expressed valid concerns that virtual care could potentially erode the crucial, personal connection inherent in the physician-patient relationship, a bond that is particularly vital in the intimate context of obstetrics. Fears also circulated that shifting to remote models might inadvertently compromise the quality of care, introduce new risks, or place an additional burden on a healthcare workforce already facing immense strain. These apprehensions were not unfounded, as they stemmed from a deep-seated commitment to patient safety and the established traditions of in-person medical practice. The primary debate revolved around whether technology could safely and effectively supplement or replace hands-on examinations and face-to-face consultations without losing the nuances of patient assessment and compassionate care that define the field of obstetrics.
However, the global health crisis triggered by the COVID-19 pandemic served as an unexpected and powerful catalyst, compelling a rapid and widespread adoption of telehealth out of sheer necessity. This forced implementation on a massive scale provided an unprecedented, real-world laboratory for testing the efficacy and safety of virtual care in obstetrics. The experiences and data gathered during this period were instrumental in dispelling many of the initial fears. A growing body of research, combined with positive clinical outcomes, began to form a robust consensus affirming the value of telehealth. It became clear that when guided by appropriate protocols, virtual visits and remote monitoring were not only safe but could also enhance patient access, improve monitoring for high-risk conditions, and empower patients to take a more active role in their own care. This accelerated validation effectively shifted the industry’s perspective, moving telehealth from a controversial innovation to a widely accepted and indispensable tool in the modern OB/GYN’s toolkit.
The Reimbursement Roadblock
Despite achieving broad clinical approval from leading medical societies and industry experts, the full-scale integration of telehealth into standard obstetric care continues to face a formidable and persistent obstacle: inadequate and inconsistent insurance reimbursement. Many health plans have been slow to adapt their policies, often continuing to categorize telehealth solutions as supplementary or outside the established standard of care, rather than as an essential and integrated component of the patient’s journey. This financial barrier creates a significant disincentive for health systems and individual practices to invest in and expand their virtual care offerings, even when the clinical benefits are well-documented. The lack of reliable payment models means that providers who adopt these technologies often do so at a financial loss, creating an unsustainable environment that stifles innovation and limits patient access to proven tools that could otherwise dramatically improve maternal health outcomes across diverse populations.
This disconnect is starkly illustrated by the case of Remote Patient Monitoring (RPM) for Hypertensive Disorders of Pregnancy (HDP), a leading cause of maternal morbidity and mortality. Prominent organizations, including ACOG itself, have long and strongly recommended the use of RPM for at-risk patients to allow for continuous monitoring and early intervention. Yet, insurers frequently deny claims for these vital services. Their reasoning often hinges on the argument that the existing schedule of in-person prenatal visits is sufficient for monitoring blood pressure, thereby rendering remote services non-essential and not part of the standard care protocol. This stance creates a frustrating paradox where a clinically endorsed, life-saving technology is deemed unworthy of payment, leaving providers in a difficult position and preventing countless patients from benefiting from a higher standard of proactive and preventative care that telehealth is uniquely positioned to deliver.
A New Standard of Professional Responsibility
In a strategic and game-changing move, ACOG’s recent committee statement, “Ethical Considerations With Telehealth in Obstetrics and Gynecology,” directly confronts these systemic challenges by moving beyond clinical recommendations to establish a formal ethical framework. This document intentionally re-contextualizes the conversation, positioning the adoption of telehealth not as a matter of preference or convenience but as a fundamental professional duty. The framework is built on the premise that if a technology is proven to expand access to care and prevent severe negative outcomes, such as preeclampsia, then clinicians have an ethical responsibility to integrate it. ACOG’s definition of telehealth is deliberately broad, encompassing virtual visits, mobile health applications, and, very specifically, “remote monitoring devices for pregnant patients.” By doing so, the statement makes a powerful and undeniable case that if these tools are not yet considered the current standard of care by all stakeholders, they ethically should be, thereby pressuring the entire healthcare ecosystem to evolve.
This new framework meticulously outlines the core principles for the ethical deployment of telehealth, emphasizing a patient-centered approach. It calls for physicians to engage in shared decision-making, ensuring patients are active partners in their care plans, and to always maintain in-person care as an available and accessible option. Furthermore, it highlights the importance of providing support to help patients overcome technology gaps, using secure platforms to protect patient privacy, and remaining acutely conscious of equity barriers that could otherwise be exacerbated by a poorly planned digital transition. Most significantly, the statement directly tackles the reimbursement issue by asserting that physicians and health systems have an ethical duty to advocate for payment parity. The document’s most impactful assertion is that as the evidence supporting telehealth’s benefits continues to grow, it becomes increasingly incumbent upon OB/GYNs to self-educate and implement these tools into their practice, regardless of the immediate reimbursement landscape, as part of their foundational duty of care to meet their patients’ needs.
Aligning Policy with Professional Ethics
ACOG’s formal declaration of telehealth as an ethical imperative was a deliberate and strategic effort designed to accelerate its integration into routine obstetric care. By elevating the use of virtual tools to a professional duty, the organization established a powerful new standard that provided a much stronger foundation for advocacy. While this ethical stance alone could not force an immediate reversal in insurer policies, it fundamentally shifted the professional landscape. It equipped physicians and health systems with a compelling argument to pressure payers and regulators, reinforcing the clinical evidence with a clear ethical mandate. This move was intended to create sustained momentum that would make it increasingly difficult for outdated reimbursement models to persist in the face of a unified professional consensus.
Encouragingly, this push from the leading professional body in the field occurred as promising developments began to emerge on the policy front. A significant signal of this alignment came from the Centers for Medicare & Medicaid Services (CMS), which had proposed new, more flexible billing codes for Remote Patient Monitoring in its 2026 Physician Fee Schedule. These proposed codes were specifically designed to reduce previous administrative barriers, such as stringent minimum monitoring periods, that had long limited the effective and widespread use of RPM. The finalization of this development from a major federal payer signaled a monumental practical shift, helping to align national reimbursement policy with ACOG’s ethical guidance and the extensive clinical evidence. Such a change ultimately expanded access to crucial telehealth services, particularly for underserved and rural populations, and helped solidify the role of telehealth as a sustainable, standard, and ethically essential component of modern obstetric care.
