Ep. 1: OB video visits offer care and convenience

Women's health series kicks off with Sarah Roe, certified nurse-midwife

Sarah Roe, certified nurse midwife talks into a podcast microphone.

Episode Transcript

Courtney Collen (Host): Hello, and welcome to Her Kind of Healthy, a brand-new health podcast series brought to you by Sanford Women’s. I’m your host, Courtney Collen with Sanford Health News. We want to start brand new conversations about age old topics from fertility and postpartum depression to managing stress, healthy living, and so much more. Her Kind of Healthy is designed to bring you honest conversations about self care, happiness and your overall well-being with our Sanford Health experts. We’re so excited to have you here today. We’re talking with Sara Roe on OB video visits. She is a Certified Nurse Midwife here at Sanford Women’s and Sarah, we are so thrilled to be talking to you about OB video visits today. Welcome.

Sarah Roe: Yes, thank you so much. I’m happy to be here.

Host: So, tell us about your role here at Sanford Women’s and what you do.

Roe: I am one of the certified nurse midwives at Sanford Women’s. Our group is eight midwives strong, and we represent all the different clinics in the area. And so we see women adolescents through menopause for well woman exams, pregnancy care, and other GYN concerns that they have.

Host: What do you enjoy most about your role as a caregiver with Sanford Women’s?

Roe: I really love that in the women’s realm, you can create relationships with their patients. You get to see them on a yearly basis, hopefully go through a pregnancy or two with them, and you really just become friends on the other side of caregiver and patient, because you get to know their family. You get to walk through a very personally event with them. And even though you don’t see each other for sometimes a year at a time, it’s just like when they come into the clinic, you get to catch up. It’s like seeing an old friend again, and you really do form a bond with each other. And I really enjoy that part of it.

Host: I love that. So let’s dive right in to OB video visits. What is an OB video visit?

Roe: This is something that we rolled out this year and a lot of the backing behind it was trying to make it more accessible for women who drive a ways to see us, to have more accessibility to their care. And so we get to do a telehealth visit. So basically it’s like a FaceTime or a Skype call between the provider and the patient. And we try and mimic the experience that you would have in the clinic through video. So we ask all of the history questions, update anything that needs to be updated, talk about concerns and questions. And the OB part of it is we are also taking care of a baby. And so not only are we asking you about your own personal health, we’re asking you about baby’s movements and fetal kick counts. And we have a unique program where we can rent out fetal dopplers to women so that they can listen to their baby. We can hear the Doppler during the visit, even in listen to the heartbeat, make sure it sounds normal. There’s no abnormalities, it’s a good rhythm. And that’s just one other checkmark that we have in place to be sure that baby’s health is good as well.

Host: Yeah. To have that fetal Doppler and blood pressure cuff, that must really enhance the experience for an expecting mother. Doesn’t it?

Roe: It really does. And they feel more bonded and connected to their baby because they’re taking charge of listening to the heartbeat, monitoring their own pressure and their own symptoms and reporting back to us. And for sure, if we have any concerns, we’re going to be asking them to come into the clinic for further evaluation, but it really just empowers them and helps them know that they know their baby better than anybody. And they can do some of those tests at home too. We really empower the women to be a part of their own care. And they also incorporate that with maybe other members of the family, their husband, their younger children, they get to come in, listen to baby’s heartbeat, maybe help with the blood pressure a little bit. And it really becomes a family bonding thing rather than just the woman coming in on her own to the clinic. So that has been a fun aspect of it, but we are not only caring for the woman herself during these video visits, we’re caring for the baby also. So, it’s just really important for us to be able to assess the fetal wellbeing through the Doppler.

Host: Yeah. What an awesome way to get your care when you’re expecting, be able to do it from the comfort of your couch, your, if you need to be at work and take an appointment, I mean, that’s a great convenience, isn’t it?

Roe: That was another big factor that we found is that women were having a hard time finding enough vacation days or sick days to leave from work and have their visits. And they weren’t getting the appointment times that they needed. So they were having to use their vacation time early. And this has just really alleviated some of that, where they can visit with us on their lunch break or even before work. And we’ve been able to really accommodate that for them.

Host: So, talk about the scheduling for an OB video visit. How would a woman see her provider over video versus in person? Are these scheduled out? How often? And is there a certain point where, okay, it’s time to start coming in, in person.

Roe: Yes. We kind of establish at their new OB visit, whether they would be a candidate for video visits or not. And if they are then our front desk staff can schedule that for them. We actually schedule it as if they were going to be here in person so that they have their time blocked. We’re not seeing any other patients in clinic during their appointment time. And then they just log into their, My Sanford chart. There’s a little green button that they can push that says join the call. And they’re connected to us via like a Skype type visit. And it’s really simple and easy to use.

Host: So, you mentioned, you determine early on if a woman might be the right fit for these video visits. Tell me not everybody is a candidate for this type of care, is that right?

Roe: We are really looking for the low risk woman that won’t need any extra testing outside of her regular prenatal testing. So if they have any blood pressure issues or diabetes or something that just needs a little extra monitoring during the pregnancy, this might not be the best fit for them because we’re going to want to be putting eyes on them at every appointment, just to make sure things are going along as they should be.

Host: If I look at the Sanford Women’s website, it’s usually about 16 weeks or could start around there for OB video visits. What would that first appointment look like compared to maybe one of the later video visits, which could be around 37 weeks or postpartum, two weeks, a couple weeks postpartum?

Roe: Yeah. So the first two appointments of your pregnancy, we really want you in the clinic because we are going to be doing an ultrasound at one of them. And then another one, we are going to be doing a physical exam. If you’re due for a pap smear, you get that done. You need some blood work done. So those are things that you actually do need to come to the clinic for the 16 week visit. If you are coming to the clinic is a pretty short visit. We really just review your lab results, listen to your baby’s heartbeat and answer any questions that you have. So this can easily be done via telehealth. We can review your lab results right through the chart while we’re talking with you. And then you listen with your Doppler. So we can hear your baby’s heartbeat and answer questions that you have. Now later in the pregnancy, you know, you mentioned the 37 week visit. This one is more geared towards fetal movement, making sure the blood pressure is normal and screening for any other diagnosis that can pop up at the end of pregnancy.

Host: And then after the baby is born, you can have the option to continue seeing via video every once in a while, right?

Roe: Yeah. Ideally the two week video visit postpartum is great because you’re really not ready to leave your house with your baby yet. And you might not have slept the night before you might have other kids to take care of. And so if we can just quick see you in your home, see your baby, make sure everything’s going well, then at six weeks, we can have you come to the clinic for a postpartum exam and make sure everything’s healing correctly and answer questions or provide contraception.

Host: So now that we’re shifting and we’re about five months into the COVID-19 pandemic, are you seeing a lot more patients via video now?

Roe: We really are. In fact, we really push for video visits for those normal, healthy, low risk pregnancies during COVID because it kept you quarantined in your house. It kept you out of the clinic. It kept our staff here safe, and we saw great results with that. So we are definitely excited to keep that style of care going post COVID even, because it’s just been such a satisfaction for caregivers, as well as the patients. And we’ve realized that it just works really well.

Host: What have you heard from women that you work with, your patients, about this pandemic, especially if they’re pregnant are they concerned?

Roe: You know, every pregnant woman has that mama bear instinct to want to protect them and their child. And so to be able to offer something like this, where they could stay in their own home, not have the fear of coming into the clinic or going out in public and knowing that they’re still receiving really great care, it was huge for them. And their response has been very positive and those women are wanting to see this continue post COVID as well. If they’re interested in it at their new OB visit, which would be 12 weeks, we would get them scheduled out for video visits while they’re in the clinic here. And our front staff is capable of doing that and does a really great job with it if they’re kind of on the fence, but they decide after they leave the clinic, that that’s something that they would enjoy. They can call the clinic and they can get those appointments switched over to video visits, or they can do it through their My chart.

Host: Getting that same great care, that doesn’t change does it when you’re at home?

Roe: It really doesn’t. And so we’re still monitoring the well-being of the mother and the baby, but we aren’t cutting out clinic visits completely. So we are still seeing the woman in the clinic, making sure that everything is going smooth… And we use this assessment to make sure that the baby is growing appropriately. So even though every other visit, they aren’t able to do that. We can do it in the clinic when they come for their next visit and we will be able to catch any abnormalities or any outliers that would need further assessment.

Host: Convenience is really key in this, isn’t it?

Roe: It really is. Yes. And you know, for the working mamas or for the ones that have to drive quite a distance to see us, this is just a super convenient way for them to continue care with our facility, but not always have to make the drive.

Host: Sarah Roe, thank you so much for your wonderful insight on these OB video visits. A great addition to Sanford Women’s and Sanford health and all your expertise was wonderful. And we thank you for joining us at home. I’m Courtney Collen with Sanford Health News. So be on the lookout for our next episode of Her Kind of Healthy coming your way very soon.

Posted In Nursing and Nursing Support, Pregnancy, Specialty Care, Virtual Care, Women's