Virtual Birth Planning Appointments as a Mechanism to Improve Birth Outcomes for High-Risk Pregnancies [ID 1308]

INTRODUCTION: Birth planning is associated with improved shared decision-making about labor and delivery and improved birth outcomes, yet it is not routinely incorporated into prenatal care. Virtual birth planning has the potential to increase access to this service. We aim to test whether a virtual birth planning appointment during a high-risk pregnancy is associated with improved birth outcomes. METHODS: This analysis included 979 individuals enrolled in Maven, a digital health platform for women’s and family health, who enrolled between August 2024 and June 2025 and were diagnosed with at least one gestational condition during pregnancy. Adjusted logistic regression models estimated the associations between attending a birth planning appointment and three outcomes: 1) participation in shared decision-making about labor and delivery; 2) preterm birth; and 3) admission to the neonatal intensive care unit (NICU). RESULTS: Among people with high-risk pregnancies, attending a virtual birth planning appointment was associated with increased odds of shared decision-making during labor and delivery (adjusted odds ratio [aOR] 3.88 [95% CI, 2.76, 5.50], P <.001) and decreased odds of a NICU admission (aOR 0.41 [95% CI, 0.20, 0.75], P =.01). Attending the appointment was directionally but not significantly associated with decreased odds of preterm birth (aOR 0.49 [95% CI, 0.20, 1.03], P =.08). CONCLUSIONS/IMPLICATIONS: Virtual birth planning appointments may be an effective and accessible intervention to improve self-advocacy and birth outcomes in high-risk pregnancies.