Pregnancy
Equity in maternal healthcare: femtech holds the key for rural hospitals
By Blanca Lesmes, CEO of BB Imaging and TeleScan

In the last 20 years, 184 rural hospitals in the United States have closed. Today, nearly 700 more of them stand at risk of closing. Of those that remain, less than half (45 per cent) provide labor and delivery services.
As a result, more than two million women of childbearing age live in a county completely devoid of obstetric care, and an additional three and a half million women live in a county with limited access.
The four sentences above stir a sense of sadness or anger in many of us. I appreciate my partners in progress, who acknowledge the depth of the maternal care problem and who are eager to build solutions that create a healthier future for our underserved family members, friends, and neighbours.
What won’t work
Let’s start with some “solutions” that I wholeheartedly reject.
I founded an onsite sonography services company nearly 20 years ago. At that time, rural hospitals and clinics were feeling the early pains of a sonographer shortage — a shortage that, today, has grown into a very real crisis.
The numbers of rural physicians, maternal-foetal medicine specialists, and nurses with obstetric experience have continued to dwindle dramatically over this time.
We’re left with thousands of healthcare vacancies that greatly exceed the number of professionals available to fill them (a difficulty my recruiting team works to overcome daily). So, sadly, the answer to our problem isn’t simply to “hire more people.”
Rural hospitals aren’t closing just because they can’t hire the right people, though. They’re closing because they can’t continue to operate at a loss.
Unfortunately, insurers usually pay for maternal services on a per-birth basis. This model works well for hospitals with high volumes of births per year but largely fails rural facilities.
Payments from a low volume of births throughout the year typically aren’t enough to cover operating costs for a rural obstetric department. If other service lines, like emergency and primary care, are also operating at a loss, the hospital has no choice but to close its doors permanently. These facilities are often patients’ last resort, so the answer can’t be to “allow unprofitable healthcare centres to close.”
Financially bolstering tech solutions
Although the system is inherently full of challenges, I do hold on to hope. Developments in femtech make me believe that real solutions are in the pipeline. We’ve seen these problems and responded with efficiency-supporting solutions like telemedicine, remote monitoring devices and AI.
Access to this depth and breadth of maternal-foetal support gives rural providers and their patients so many benefits.
Remote diagnostic tools, like TeleScan, provide an immediate connection to expert sonographers who can identify high-risk pregnancies and anomalies that require additional care. Remote monitoring devices provide round-the-clock data collection and can initiate care and expedite time to treatment.
With telemedicine, local providers can collaborate on treatment plans that keep their patients close to home, limit travel and financial stress, and create peace of mind. Through their exchanges, providers and remote experts also engage in knowledge sharing, building local expertise that enhances care levels for years to come.
AI-enabled tools increase efficiency and clear mundane, tedious, or repetitive tasks from staffer to-do lists. And they aid in patient communication, providing timely responses and assisting with scheduling tasks and documentation.
All these benefits—and there are so many more—are impossible without modern technology. Thankfully, the technology is there, and it’s getting better every day. It’s our responsibility to harness it and make it work for rural hospitals that are on the brink of closure.
The challenge we have to face
There is one last piece of the puzzle to discuss, and that’s the financial component. Our challenge is to make our technology affordable for the most vulnerable systems.
In a world where femtech is repeatedly undervalued, and funding is frustratingly difficult to procure, this is our challenge.
Finding the intersection of prosperity and purpose may impact the investment and attention maternity care requires. It’s up to us to find funders and founders who feel the same way we do.

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Pregnancy
More than half of women with gestational diabetes face harmful stigma, research reveals

More than half of women with gestational diabetes report stigma from healthcare staff, family, friends and wider society, new research shows.
A survey of 1,800 UK women found widespread emotional distress at diagnosis of the condition, a form of high blood sugar that develops during pregnancy, with effects lasting beyond birth.
Gestational diabetes affects around one in 20 pregnancies in the UK, and the findings highlight the wider toll on women diagnosed with the condition.
The study was funded by Diabetes UK and led by researchers at King’s College London and University College Cork.
Dr Elizabeth Robertson, director of research and clinical at Diabetes UK, said: “Stigma can have a dangerous and devastating impact on pregnant women diagnosed with gestational diabetes, particularly at a time when emotions and anxieties may already be heightened.
“We know that stigma can lead to shame, isolation and poorer mental health, and may discourage people from attending healthcare appointments, potentially increasing the risk of serious complications.
“This research highlights the urgent need for better support systems, based on understanding and empathy to ensure no one feels blamed or judged during their pregnancy.”
More than two-thirds of women, 68 per cent, reported anxiety at diagnosis, while 58 per cent felt upset and 48 per cent experienced fear.
The psychological impact continued beyond birth, with 61 per cent saying the condition negatively affected their feelings about future pregnancies.
Nearly half of women, 49 per cent, felt judged for having gestational diabetes, while 47 per cent felt judged because of their body size.
More than 80 per cent felt other people did not understand gestational diabetes, and more than a third, 36 per cent, concealed their diagnosis from others.
Gestational diabetes stigma was also common in healthcare settings, with 48 per cent reporting that professionals made assumptions about their diet and exercise, and more than half, 52 per cent, feeling judged based on their blood glucose results.
Many women described a loss of control and a sense of disruption during pregnancy.
Nearly two-thirds, 64 per cent, felt they were denied a normal pregnancy, while 76 per cent reported a lack of control over their pregnancy.
More than a third, 36 per cent, felt abandoned by healthcare services after giving birth, and one in four, 25 per cent, continued to experience depression or anxiety postpartum.
Focus group participants described harmful stereotypes, including assumptions that they were ‘lazy’, had ‘poor eating habits’ or ‘lacked willpower’.
Comments from family and friends included remarks such as “should you be eating that?” and “you must have eaten too much, that’s why you have gestational diabetes.”
The researchers are calling for targeted interventions alongside structured emotional support for women during and after pregnancies affected by gestational diabetes, to improve both mental and physical health outcomes.
Professor Angus Forbes, lead researcher from King’s College London, said: “Stigma and emotional distress are far more common in women diagnosed with gestational diabetes than many realise.
“Everyday interactions, even with those who mean well, can deepen this harm, shaping women’s emotional wellbeing and the choices they feel able to make.
“It’s clear that meaningful action is needed to protect women’s mental and physical health.”
Risk factors for gestational diabetes include living with overweight or obesity, having a family history of type 2 diabetes, and being from a South Asian, Black or African Caribbean or Middle Eastern background.
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