More than 80% of pregnancy-related deaths in the United States are preventable, and 53% occur between seven days and one year after delivery, according to CDC maternal mortality review data. Risk also builds during pregnancy, when hypertension and diabetes can progress in the weeks between prenatal visits. For the growing number of mothers who live far from an obstetric team, both periods are harder to manage.
A new Health Recovery Solutions whitepaper, Closing the Maternal Care Gap, examines how remote patient monitoring (RPM) and care management extend obstetric care into the home. It covers the clinical evidence, results from health system partners, and how states are funding maternal monitoring through the Rural Health Transformation Program.
Hypertensive disorders of pregnancy affect up to 10% of U.S. pregnancies. Postpartum blood pressure typically falls after delivery and then rises again around days three to six, after most patients have gone home. ACOG recommends a blood pressure evaluation within 7 to 10 days of delivery for patients with hypertensive disorders, and within 72 hours for those with severe hypertension. Yet as many as 40% of women do not attend a postpartum visit at all.
Geography widens the gap. More than half of rural hospitals no longer offer obstetric care, and more than 35% of U.S. counties are maternity care deserts, home to about 2.3 million women of reproductive age. For a rural patient, a postpartum blood pressure check may mean a long drive with a newborn, and the nearest emergency department may have no obstetric staff.
A 2023 systematic review in Obstetrics & Gynecology found that postpartum home blood pressure monitoring improves blood pressure ascertainment and visit completion and narrows racial gaps in follow-up. Remote glucose monitoring has the strongest prenatal evidence base. A meta-analysis of 32 randomized trials found telemedicine for gestational diabetes lowered HbA1c and reduced cesarean delivery, neonatal hypoglycemia, and macrosomia.
Results for home blood pressure self-monitoring during pregnancy are more mixed. The UK BUMP trials found that self-monitoring with app-based telemonitoring did not lead to earlier diagnosis or better clinic blood pressure control, which puts more weight on the care model around the device.
UChicago Medicine’s STAMPP-HTN program runs RPM on the HRS platform for a predominantly Black, Medicaid-insured population. As the program layered a postpartum hypertension protocol bundle, telehealth, and RPM, attendance at the first postpartum blood pressure check rose from 33.5% to 84.0%, with no statistically significant difference between Black and non-Black patients.
Across more than 20 maternal health programs, HRS partners have monitored more than 50,000 high-risk maternal patients. Novant Health reported a 0% readmission rate for RPM patients in its postpartum hypertension program for rural and underserved patients, versus 5% for a matched control group. Boston Medical Center reported that 44% of its hard-to-control patients met their blood pressure goal.
A blood pressure cuff sent home with a patient produces data. Outcomes depend on who reviews that data, how quickly, and what happens next. The programs with the strongest results share four traits:
With those decisions made, programs typically move from kickoff to full operation in three to four months.
The $50 billion Rural Health Transformation Program funds states over federal fiscal years 2026 through 2030. Allowable uses include technology-driven health solutions and training and technical assistance for technologies including remote monitoring, and RPM has become one of the most common uses of the funds. Pennsylvania, Oklahoma, and Missouri are among the states naming maternal monitoring in their plans or funding solicitations. Eligibility varies: Nebraska’s RPM initiative excludes hypertensive disorders of pregnancy.
In most states, the strongest position is to present maternal monitoring as an extension of the hypertension and diabetes infrastructure the state already funds, with a plan to transition to Medicaid, commercial, or value-based funding when grant awards end.
Pregnancy and the weeks after delivery are when maternal risk builds fastest and contact with the care system is thinnest. Health systems that extend their obstetric teams into the home across both periods can find problems earlier and keep more patients connected to care, wherever they live.
HRS supports maternal health programs with cellular devices, CGM integration, 24/7 clinical monitoring through CareConnect, EHR integration with Epic and other systems, and fully managed PatientFirst programs. Health systems can start with postpartum hypertension at a single delivering facility and expand across pregnancy and into rural communities on the same platform.
Want to bring maternal monitoring to your patients? Contact us today to speak with one of our Digital Health Advocates.