Hans van den Heuvel

Telemonitoring group 1) Experience with obstetric care The home-based telemonitoring started with an elaborate explanation of the care-pathway and the use of the monitoring equipment. The devices were easy to use and participants had no to very little technical issues. The daily results and plans for future antenatal management were discussed by phone by the Obstetric Telemonitoring Team members. [TM03] “…[the midwife] explained the use of the equipment and took us through all the steps of the entire process. For me it was really nice to speak to somebody on the phone every single day. In my experience they would call quickly after sending the CTG and they would take the time to answer all of my questions.” The weekly appointments in the outpatient clinic during TM were often appreciated (7/11), although, some women experienced getting back and forth from the hospital as a hassle. All highly valued the daily contact with the Obstetric Telemonitoring team, primarily midwives. By telephoning each day, they had the chance to ask their questions and be reassured if needed. The clinical midwives of the Obstetric Telemonitoring Team were often described as ‘empathetic’ and ‘very competent’. [TM01] “I really appreciated the daily phone calls, and when things got to my head, the midwife functioned as a sympathizing listener (…) They were really helpful.” In general, mobility did not seem to be a pressing issue for the women at home, even though some of the women were told to rest as much as possible. Being home-based, all the women agreed that sleeping in their own bed was much more comfortable than a hospital bed, waking up well- rested. Those women, who were admitted first and subsequently received telemonitoring, added that the noises on ward during night had profound impact on their sleep, which was not the case at home. 2) Feelings regarding pregnancy In general, all of the telemonitoring women agreed that the indication for daily monitoring was clear. Again, the complications caused feelings of uncertainty, anxiety and restlessness. [TM05] “We understood the reasons for all the extra assessments during pregnancy. It gave us a safe and reassuring feeling, knowing that somebody kept an eye on the baby on a daily basis, and that our concerns were taken seriously. “ [TM03] “I am very happy that I didn’t need to stay in the hospital for weeks, but that I was offered telemonitoring instead.” CHAPTER 8 134