Virtual Maternity Care During Pregnancy: A Metasynthesis of the Qualitative Literature on Women's Experiences

The adoption of Virtual Maternity Care (VMC) in antenatal settings is increasing, propelled by technological advancements that facilitate remote communication and telemonitoring. A spectrum of care models exists globally, ranging from fully virtual to hybrid approaches. This review seeks to synthesise the qualitative evidence on women's experiences of antenatal VMC in high-income countries, developing a conceptually rich understanding of factors that facilitate or hinder engagement and perceived safety. In June 2025, four databases were searched for peer-reviewed literature published in English between January 2010 and June 2025. After screening for quality and eligibility, 21 articles were included. Four core themes were identified: Virtual Care Worked Well, Seeking Good Connections, Empowerment and Safety Through Virtual Care Monitoring, and Feeling Disconnected and Unsafe. Women described feeling empowered through active participation and shared responsibility in their care (Empowerment and Safety Through Virtual Care Monitoring), particularly when relational care and continuity were present (Seeking Good Connections). Flexibility, convenience, and access to daily telehealth and reliable technologies were highly valued (Virtual Care Worked Well). Hybrid models were generally preferred; in contrast, exclusively remote models sometimes inhibited quality care and heightened feelings of insecurity (Feeling Disconnected and Unsafe), particularly for women with previous pregnancy loss, experiences of intimate partner violence, mental health concerns, or those facing language barriers, digital poverty, financial hardship, or low health literacy. In conclusion, women's perspectives underscore priorities for designing and scaling high-quality, accessible virtual midwifery care: relational continuity, technological reliability, flexible delivery, and hybrid models integrating virtual and in-person care.