A Collection of 2021 ACOG Posters: How the Internet Is Changing Patient Care

The COVID-19 pandemic has played a key role in spurring the widespread adoption of telehealth while also causing many patients to rely on the internet and social media for medical guidance. But what were some of the benefits and drawbacks of these transitions, specifically for our pregnant patients?

That’s the question the following posters presented at the virtual 2021 American College of Obstetricians and Gynecologists (ACOG) Annual Clinical and Scientific Meeting sought to explore.

Implementation of Tele-Obstetrics During the COVID-19 Pandemic: Assessing Patient & Provider Satisfaction, by Karampreet Kaur

To find out what the telehealth experience was like for obstetrical patients and providers during the COVID-19 pandemic, a cross-sectional study was conducted from June to October 2020. An anonymous and self-administered survey was sent to patients while a separate perspective survey was sent to all providers in the Department of Obstetrics and Gynecology, including advanced practice providers, genetic counselors, social workers, and dieticians.

Based on data collected from the 103 patients who completed the survey, below are the results:

• 75 percent felt safer using telehealth
• 18 percent would have delayed care if telehealth wasn’t an option
• 74 percent thought telehealth reduced travel time
• 46 percent saved at least $35 by having a telehealth visit
• 96 percent were satisfied with the telehealth system
• 93 percent would use telehealth again for specialty care

And based on data collected from the 73 providers who completed the survey, below are the results:

• 94 percent thought telehealth was safer for themselves, colleagues, and patients
• 96 percent believed telehealth significantly improved access to care
• 97 percent would be willing to use telehealth post-pandemic

These results suggest that telehealth options should continue to play a role in delivering prenatal care beyond the COVID-19 pandemic.

Stay Home, Stay Connected: A Virtual Model for Enhanced Psychosocial Support in Pregnancy, by Chloe Ramirez Biermann

While necessary, social distancing amid the COVID-19 pandemic not only predisposed patients to stressors and isolation, but it also decreased access to support services. This highlighted the importance of having flexible and remote psychosocial support available for pregnant patients.

To help meet that need, a virtual prenatal support program called Stay Home, Stay Connected was created. There were three main goals of this program:

• Facilitate additional antenatal education
• Foster a community of pregnant patients and providers
• Connect patients with mental health experts

To value this program’s effectiveness, 180 pregnant volunteers were recruited and asked to complete an entry survey to gain demographic data as well as baseline depression and anxiety rates. Volunteers were then divided into small groups of about 10-12 people, and each group met with maternity care providers on a monthly basis. In addition, providers gave bi-monthly online coping skills lectures.

Based on the entry survey, 61 out of the 162 volunteers who completed the survey screened positive for anxiety while 8 screened positive for depression.

One month after the launch of the program, a satisfaction survey was distributed, and out of the 61 volunteers who completed this survey, over 90 percent said that Stay Home, Stay Connected helped them feel connected. Responders also indicated that they benefitted from increased anticipatory guidance, sharing experiences with other pregnant patients, and receiving COVID-19 education.

These results reveal just how prevalent anxiety and depression might be among our pregnant patients amid the COVID-19 pandemic and how online pregnant support groups can help. Additional research to learn more about patient satisfaction and this program’s impact on mental health outcomes during and beyond the pandemic is currently underway.

Internet Users’ Ability to Access, Interpret, & Apply Information About Safe Self-Managed Abortion, by Dr. Julia Tasset

At a time when barriers to abortion care are growing, more and more patients are looking for alternatives and information online about managing abortions at home. But are patients able to interpret this information and determine which methods of self-managed abortion are safe and effective and which are dangerous and ineffective?

To find out, an online survey was distributed in which respondents were asked to use the Internet to find and give recommendations on how to end a pregnancy safely and effectively without medical supervision. Respondents were then randomized to face three of four scenarios, like health and legal risks, to gauge their ability to respond to emergencies.

Below is a recap of the results from the 485 respondents:

• 74 percent were able to identify safe and effective methods
• 23 percent provided ineffective but likely safe methods
• 13 percent provided potentially dangerous methods
• 93 percent said that self-managed abortions are not recommended in the second trimester
• 82 percent said that self-managed abortions are not recommended in the case of an ectopic pregnancy
• 86 percent identified bleeding as a reason for emergency care
• 78 percent identified infection as a reason for emergency care
• 51 percent identified retained products as a reason for emergency care
• 85 percent identified that patients pursuing self-managed abortion may face legal risks

Based on these findings, the study concluded that most patients can not only find safe self-managed abortion methods online but that they can also identify contraindications that require emergency care and give advice about complications.

Uncovering Reasons Pregnant Women Refused Tdap: Insights from Social Media, by Shanyi Feng

According to the CDC, Tdap vaccinations should be given during the third trimester of pregnancy. However, newborn pertussis is a common problem due to Tdap refusal among pregnant patients.

To uncover social media’s potential role in affecting public opinions about prenatal Tdap vaccination, posts were identified on Facebook, Instagram, and Reddit. Posts that had more than 10 likes/shares and 10 comments were gathered between 2012 and February 2020 and then categorized into subthemes.

Health professional websites were also assessed for accuracy and completeness of information based on CDC guidelines.

Below is a summary of the Facebook posts analyzed:

• Nearly 20 percent of 31 health professional posts suggested that Tdap may contain neurotoxin, questioned the safety of the vaccine, or alluded to the risk of miscarriage
• 40 percent of private posts conveyed concerns for miscarriage
• 25 percent of private posts mentioned the safety of Tdap

The analysis of 95 posts on Instagram found that:

• 10 percent declared pertussis was a result of Tdap
• Out of 597 comments, 12 percent claimed that Tdap breeds asymptomatic carriers
• Out of 597 comments, 8 percent claimed that Tdap is ineffective

Below is a summary of the 100 Reddit posts analyzed:

• 19 percent discussed the safety and side effects of Tdap
• 8 percent questioned its timing and duration
• 7 percent asked if pregnant women need Tdap
• Out of 2,872 comments on the 100 posts, 115 were inaccurate
• 96 percent of inaccurate comments were about the timing and frequency of Tdap

Lastly, the analysis of 100 health professional websites found that:

• 33 websites had accurate and complete information
• 4 percent had inaccurate information about Tdap

These results show that despite CDC guidelines, the public—and even some clinicians—still have many misconceptions and questions about the Tdap vaccine, which can contribute to vaccine hesitancy among pregnant patients. The study concludes that clinicians should be aware of these misconceptions and be prepared to counsel patients by sharing accurate and complete information.