OBGYNs Pre- and Peri-Pandemic Views on Telehealth

The COVID-19 global pandemic has drastically changed the way people access reproductive health care. With stay-at-home orders, health center closures, and concerns about exposure to the novel coronavirus, for many traveling to a clinic for birth control is no longer an option. 

As a result, telehealth has become a convenient way to access contraception while staying safely at home. So, it makes sense that the availability and usage of telehealth has expanded in the US since the beginning of the pandemic. Our own recent national polling found that 77% of respondents agree that telehealth is a useful way to get birth control when in-person visits aren’t possible.

How do health care providers feel about the changes brought about by the pandemic? And what do they think about telehealth? Recently, both the Kaiser Family Foundation (KFF) and Power to Decide  independently surveyed health care providers to gain perspective on these questions. The KFF sample included OBGYNs while Power to Decide’s sample was more diverse and included nurse practitioners, certified nurse midwives, physicians (primary care, OBGYNs, and other specialties), nurses, health educators, and social workers. 

Prior to the pandemic, KFF found that only 14% of OBGYNs surveyed provided telehealth visits. But by June 2020, 84% reported having incorporated telehealth into regular practice. This tracks with our own survey results, which highlight comparable differences between the provision of reproductive health care via telehealth among health care providers that were surveyed in January 2020 and a separate group who were surveyed in December 2020.

Significantly more providers (77%) surveyed in December 2020, during the pandemic, reported ever providing reproductive health care via telehealth compared to those surveyed in January 2020 (before the pandemic, 12%). 

The pivot from in-person care to delivering care via telehealth has not been without some challenges. Approximately 90% of providers from the KFF survey reported patient difficulties when using telemedicine and noted limitations when conducting a physical while delivering care. Positively, Power to Decide’s research shows that by December 2020, less than 4% of health care providers interviewed reported discomfort with using telehealth technology. 

Regardless of whether or not a provider used telehealth before the pandemic, KFF stated that most OBGYNs surveyed worried that patients who chose to or had to delay sexual and reproductive health care over the course of the last year will have negative health consequences as a result. In particular, KFF found that 60% of respondents mentioned being “very or somewhat worried” about delays in care related to birth control, STIs, pregnancy, and abortion. 

Nearly all OBGYNs also mentioned to KFF that they are still providing many contraceptive services; more than 50% prescribe hormonal birth control pills via telehealth. Power to Decide similarly found that among health care providers surveyed during the pandemic that ever provided services via telehealth in the last 12 months, 96% of them provided contraception. 

However, when looking at other sexual and reproductive health care services, telehealth use was reported less often. For example, very few in the KFF sample reported using telehealth for STI testing. Of the health care providers surveyed by Power to Decide, 48% had used telehealth to provide emergency contraception, 47% had provided STI treatment, and 38% had provided prenatal care via telehealth. 

Power to Decide found that over the course of last year that providers surveyed pre-pandemic (in January 2020) reported less favorable attitudes towards telehealth in comparison to those surveyed during the pandemic (December 2020). In December, nearly 83% of providers felt that telehealth was an acceptable way for patients to get birth control compared to only 57% previously. Also in December 2020, more than 70% of health care providers surveyed indicated they were very likely to recommend telehealth to their patients for birth control as well as promote the use of telehealth among their colleagues.

Here are several examples of patient benefits of telehealth use that health care providers shared with Power to Decide:

• “Many of my patients live in rural areas and cannot reliably get to the clinic so telehealth is much easier for them.”
• “Since COVID, telehealth has made access to care much more manageable.”
• “I can see a greater volume of patients so more of those with needs are served.”
• “Patients are able to have the soonest available appointment no matter the site and transportation issues.”
• “Improved same day access.”
• “I work with university students, many of whom are off-campus this semester, and I was able to provide birth control to them via telehealth. Otherwise they may not have obtained it and certainly could have become pregnant.”
• “Without telehealth there have been times over the last 8 months where they wouldn’t have received services if not.”

The way in which health care is delivered and received has greatly changed over the last 12 months, and it will likely continue to change over the next year. The survey conducted by KFF and those conducted by Power to Decide provide novel insights into how health care provider’s attitudes towards telehealth and utilization of telehealth in practice are changing. 

Editor's Note: For those interested, you can learn more about the specifics of state-level policies around telehealth using our newly created telehealth maps and tables.