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Pregnant in the Pandemic: How Penn Medicine Is Supporting New and Expectant Parents


The pandemic has left everyone with questions about what the future holds and whether or not they’re truly safe. For those expecting a child, the number of questions is exponentially bigger. “Will my partner be allowed into the hospital when I deliver?” “Is it even safe for my baby and me to deliver in the hospital if there are COVID-19 patients there?” “What about bringing my baby back to the hospital or the doctor’s office?”

“It feels like a scary time to have a baby,” said Sindhu Srinivas, MD, MSCE, director of Obstetrical Services at the Hospital of the University of Pennsylvania and an associate professor of Obstetrics and Gynecology at the Perelman School of Medicine at the University of Pennsylvania. “And it can already be an intimidating time.”

But thanks to years of work and ingenuity by Penn Medicine faculty in the department of Obstetrics and Gynecology, pregnant Penn patients are in safe hands. Penn Medicine’s hospitals delivered over 3,000 babies during March and April alone, spanning the peak of the pandemic. Clinicians here have implemented telemedicine tools and techniques which are designed for both safety and convenience.

“The novel coronavirus really turned 2020 into the golden age of telemedicine,” said Samuel Parry, MD, interim chair of the department of Obstetrics and Gynecology at the Perelman School of Medicine. “Instead of using telemedicine for convenience or in order to bring medical assessments to people in remote locations, telemedicine now has become a necessity. Every patient is now basically ‘remote’ and needs to stay that way as much as possible.”

When COVID-19 began spreading in the United States, Penn Medicine OB/GYN practitioners were well positioned to shift and scale up pilot programs that had already proven effective. Previous research, spearheaded by researchers and clinicians like Anna Graseck, MD, an assistant professor of Clinical Obstetrics and Gynecology, had shown that, for the vast majority of patients, it’s possible to have fewer in-person appointments during pregnancy and maintain safety for both moms and their babies. Only around 8 or 9 of the 15 appointments before delivery, like the first pregnancy appointment— during which the pregnancy is confirmed and a due date is estimated — and appointments for vaccinations and ultrasounds really need to be done in person.

“We are not going into this move to telehealth totally blindly, wondering whether the care we offer remotely will work or even thinking it will probably work,” Srinivas said. “We know that it has worked well and will work well now.”

Even over the 12 months prior to COVID-19, 550 pregnant patients at Penn OB/GYN Associates were armed with electronic blood pressure cuffs. Patients receiving these were and are instructed to check their blood pressure periodically, and the patients themselves text or use an app to send in their results. Blood pressure monitoring is a key part of the care for pregnant patients to check for signs of gestational hypertension which can give way to preeclampsia, both conditions that can seriously harm mother and baby and even have fatal complications. The team’s research shows that remote monitoring of blood pressure has worked just as effectively as monitoring during office visits. And it’s a part of Penn’s care that seems to draw patients. A survey of pregnant women found 67 percent of those asked said they would be more likely to seek care at Penn because of remote-monitoring options.

In addition to blood pressure monitoring, patients have access to “Penny,” an AI texting platform, created, tried, and tested at Penn, which can answer routine patient questions or elevate more complex concerns to obstetric experts on the other end of the line. Research evaluating all Penn’s innovations in this space is still ongoing.

“When we were studying the (texting) platform with some of our patients, we kept hearing how much they liked it,” said Kirstin Leitner, MD, an assistant professor of Clinical Obstetrics and Gynecology. “You come up with so many questions when you’re pregnant and want to know if just about everything is ‘normal.’ You’re not forced to make a special call to your clinical team or wait until your next appointment. And this platform is even more helpful these days when we, as health care staff, have less opportunity to answer questions face to face.”

Numerous safeguards have been put in place for women in labor during the COVID-19 pandemic, including a universal masking policy for both patients and staff, testing for the disease in every patient in labor, and limiting visitors to just one person for each expectant mother. Penn Medicine clinicians emphasize that the hospital is the safest place to deliver babies, though they recognize that being at the hospital may prompt anxieties. To further support patients and enhance safety during this anxious time, they have put more telemedicine to work during the affectionately named “fourth trimester” — the weeks following the birth — in order to safely lessen the amount of time that mom and baby have to stay at the hospital.

The Hospital of the University of Pennsylvania had already launched an initiative to decrease the length of hospital stays for new moms without complications, long before COVID-19 came to everyone’s shores, last year. It was simple: new moms just wanted to go home sooner with their babies. The solution employed remote monitoring of both physical and mental health.

On average, most HUP obstetrics patients can now return home with the Penny chatbot, blood pressure cuffs, and access to nurses and lactation consultants to help sustain their care safely and comfortably from home, after just 48 hours in the hospital. Before, patients were in the hospital for closer to 72 hour. And patients at home with questions that require a quick response have their messages returned within about an hour or less, day or night — faster than a typical call to the doctor’s office.

The ease with which Penn’s obstetrics team adapted to the spread of COVID-19 underscores the real value of advancing medicine all the time, not just during critical moments.

“The fact that our department was inventing and innovating during calm seas has led us to sail so well now while the water is choppy,” Srinivas said. “We hope the systems we have in place give our patients confidence that the care they receive is still as just complete and safe and even more convenient.”

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