Abstract
The rapid expansion of telehealth in prenatal and postpartum care has been widely promoted as a means of improving access to maternal health services, yet its equity implications remain insufficiently understood. This paper presents a narrative review synthesizing current evidence on equity gaps in maternal telehealth across six domains: racial and ethnic disparities, rural and infrastructural barriers, global perspectives from low- and middle-income countries (LMICs), the mental health-specific digital divide, language- and immigration-related barriers, and equity implications of emerging AI-driven maternal health tools. A literature search was conducted across PubMed, Google Scholar, and Web of Science for peer-reviewed articles and institutional reports published between 2015 and 2026, yielding 39 sources. Findings reveal a consistent "digital-first" paradox: telehealth adoption frequently follows pre-existing lines of digital advantage, in some cases widening rather than narrowing disparities in the timeliness and continuity of care for Black, Hispanic, rural, immigrant, and lower-income patients, and LMIC populations. Barriers identified include inadequate broadband, device costs, low digital literacy, language-inaccessible platforms, algorithmic bias in AI tools, and compounding stigma for mental health services. However, equity-oriented interventions—hybrid care models, subsidized connectivity, community health worker integration, language-inclusive design, and low-bandwidth mHealth or AI-supported solutions—can measurably reduce these gaps. A fragmented policy and reimbursement landscape emerges as a structural barrier, independent of intervention design. The review concludes that closing the maternal telehealth digital divide requires treating broadband access, device affordability, language accessibility, and digital literacy as core social determinants of maternal health, and calls for more research to guide policy design.