Pregnancy apps can help in the maternal mortality crisis. But surveys show they’re failing women

If you’re an expecting parent wondering whether your fetus is more likely to be the size of a butternut squash or a Buzz Lightyear action figure during week 26, there’s an app for that. But if you are wondering whether your headaches post-delivery warrant concern or want information about pelvic floor exercises, it might be a bit harder to find that answer in your pregnancy app of choice. That’s because many of those apps focus on sharing information about fetal development and prenatal symptoms, but provide little information about self-care and support post-pregnancy. Yet, that’s exactly what many new parents could use as an additional prevention tool in the current mortality crisis. A majority of pregnancy-related deaths and other complications happen in the first week to one year after birth.

The continued bodily changes coupled with the likelihood of facing problematic health conditions such as postpartum anxiety and mastitis make the fourth trimester a risky period. Those symptoms are often missed due to fewer healthcare appointments and less time for self-care.

There’s no healthcare without self-care

A 2022 study found that self-care can play a huge role in the prevention of pregnancy-related mortality and complications. A pregnant person’s daily routines, community building and health awareness outside of pregnancy all play a role in a smooth transition into the postpartum period.  Since many apps don’t ask for or offer that information, 60% of people who already use pregnancy apps plan to stop using them almost immediately after delivery, according to a study conducted by Emagine Solutions Technology.

Another survey focusing primarily on Chinese women found that the number of respondents using pregnancy apps fell from 70% of users in the first trimester to 41.3% of users by the third trimester. Some of the most common reasons for the decline? Poor functionality and questionable information. Bottom line: What should be considered a lifeline is failing pregnant women.

According to the survey, apps generally address up to the first six weeks after delivery. If concerning issues arise, most pregnancy apps on the market miss the opportunity to address them in an easily accessible way—helping to quash the guilt many moms might feel when focusing on their own needs in the newborn days.

Courtney Williams, health tech founder and CEO of Emagine, experienced mom guilt and anxiety when leaving her newborn baby to take care of her health needs shortly after delivery. In the weeks following her delivery, she experienced headaches, trouble breathing, swelling and chest pain.

“I knew it wasn’t looking good but my doctor didn’t have any immediate appointments available. My option was to go to the hospital, but that was terrifying during the pandemic,” she says. Williams eventually did go to the hospital and learned her symptoms were signs of preeclampsia, which can be severe. Though it was clear she was in need of dire medical attention, Williams found there was nothing to address the anxiety and connect her to more professional help in the interim. That experience is what led her to create The Journey, an app that enables patients to track vital signs in pregnancy and postpartum and transmits this information to providers in real-time, providing notifications when health trends are out of range.

Williams wasn’t alone in feeling unsupported during the postpartum period. Calming the nerves of new and expectant mothers and mental health support were noticeably lacking across pregnancy apps.

Because of failed IVF attempts in the past, L’Oreal Thompson Payton didn’t download pregnancy apps until she was in the second trimester. “In the beginning, I wasn’t about that app life because I was afraid something bad would happen and I wanted to protect myself,” the author and mother says.

Now the mother of a thriving 2-year-old daughter, Thompson Payton has since learned that she lives with anxiety and lingering postpartum depression but found the apps she was using offered little support in those realms, preferring to track symptoms on her Apple Watch. Anxiety from IVF attempts along with postpartum depression are conditions she noticed few pregnancy apps address thoroughly.

Other common complaints about pregnancy apps? Lack of cultural sensitivity or acknowledgment of various identities such as race, religion, sexuality or even health history—highlighting a clear need for improvement.

Missing the mark with extended maternal care

Postpartum abandonment is real. There’s a major loss of one’s sense of self during the postpartum period and no one, not even the apps, ask how the mom is doing, says Williams. Providers, loved ones and technology tend to focus most care inquiries on the baby. Even when parents do want to prioritize their self-care and notice something questionable, their concerns are often dismissed because of medical gaslighting or because they’re assumed to be “new parents” unfamiliar with what’s within the range of normal.

Most postpartum patients have one appointment with their birth provider 6 to 12 weeks after delivery, and that’s the extent of their follow-up care. Meanwhile, newborns tend to have anywhere from 5 to 7 touch points with medical providers in the first 3 months after birth.

Of course, it’s not always possible for new and expectant parents to visit with their healthcare providers. Some of those reasons can be financial or transportation-related, lack of childcare or time off work. But it can also even be because of little knowledge about what symptoms, ailments or recurring experiences warrant concern due to the gaps in postpartum care.

How apps can help in the maternal mortality crisis

When caring for a new baby, there’s too much going on to hang onto an app that’s not meeting you at your current life stage, says Thompson Payton. Aside from the advice on returning to work and some postpartum meditations, she didn’t see the need to keep using the apps that she used in pregnancy.

Given the fact that mobile apps are largely accessible in varying income classes, research suggests that health apps, such as pregnancy apps, can be important in preventing and treating several health conditions.  An effective pregnancy app is one that follows moms from conception through the postpartum phase, offers functionality, and provides methods to easily take care of themselves. Furthermore, it offers data that can’t be ignored and helps parents regain control. In these cases, pregnancy apps can serve as a resource for long-term care and be instrumental in self-advocacy.

A well-known example of functionality in the pregnancy phase is the baby kick monitoring app Count the Kicks. The platform gives users easy-to-follow tips and provides doctors with concrete data. Williams says it’s a strong example of an instance where providers look toward the mother’s experiences and the information gathered in apps to identify issues in health and fetal development, without question.

That same functionality beyond fetal development could be instrumental in the postpartum phase. Features to track data on recurring headaches, blood pressure, feelings of anxiety, and even when users last spoke with a friend could all lead to improving maternal care outcomes.

Sharing your data with a provider is one of the first steps you can take to address some of the biases inherent within maternal mortality. “If they have the tools and data to track their blood pressure; it is what it is. It can’t be ignored [regardless of] what the patient looks like, or what their background is,” says Williams.

Providers open to using pregnancy apps would appreciate many of the same features, says Kelly Elmore, MD, a board-certified OB/GYN and chief of staff at Viva Life Health Hub.

“To have all of your patients’ information, HIPPA compliant, at your fingertips, and seamlessly integrated into the electronic health record would be heaven,” she adds.

What to look for in pregnancy apps

Most patients get no more than 15 minutes during an appointment with their medical provider, so the ability to connect directly with an expert such as a virtual doulas could help close the care gap. It’s a feature Williams hoped for when dealing with her complications—and one she’s included as a premium feature in her app.

According to Consumer Reports, one red flag to look out for is whether or not the app is offering a diagnosis. Good pregnancy apps shouldn’t offer a diagnosis, but instead should assist in providing resources on making medical decisions you can bring up with your healthcare provider.

The most reliable pregnancy apps are ones that source information from the American College of Obstetricians and Gynecologists, the Society of Maternal-Fetal Medicine, the Academy of Family Physicians, and the American Academy of Pediatrics, says Dr. Elmore.

Also look for apps that can provide group-based support, as it can be helpful to connect with others in the same stage as you. Postpartum Support International (PSI) recently launched an app called Connect by PSI that aims to fill a very real need for mental health support, including easy-to-share information about perinatal mental health, more than 50 online support groups and accessible resources from PSI, including a one-click connection to their helpline, hotline and crisis line.

Before you download: What to look for in your pregnancy app

Beyond fetal development, here’s what other criteria to scan for before adding a new app, Dr. Elmore suggests:

• Mental health support, nutrition guidance and exercise guidance

• Reminders and alerts for appointments, medication, follow-up appointments and health milestones

• An overview of postpartum care needs, including newborn feeding advice

• Risk assessment tools for conditions such as gestational diabetes, preterm labor and preeclampsia

• An ability to save prenatal care records

• Community support such as forums or meetup opportunities

• Culturally sensitive support with awareness of beliefs, practices and communication strategies

Finally, the app should have a clean user interface. “I think of banking and certain airline apps. All the correct information is not only there but it’s easy to navigate. It makes such a difference in the early morning hours when your provider is not easily available,” says Dr. Elmore.

Pregnancy apps alone can’t fix the maternal crisis, but they can play an essential role in health management and awareness. With these features, apps can serve as an additional resource for long-term care—and can be instrumental in self-advocacy.