Since the 1930s, prenatal care for pregnant people has looked essentially the same: a series of 12 to 14 in-person obstetrician visits delivered by a doctor or other health care provider in an office. With patients and health systems becoming increasingly complex, and with more people having access to smartphones and other technologies, the time is ripe to rethink the perinatal care model, panelists said at the annual meeting of the American College of Obstetricians and Gynecologists (ACOG) in May.
One panel focused on larger issues of technology while another discussed digital startup companies created for pregnant Black people and pregnant people of color. Here is a summary of their remarks, which could tip off journalists to interesting stories to pursue.
A quarter of patients do not access prenatal care in the first trimester of pregnancy, when doctors could intervene for any troubling signs, said Alex Peahl, M.D., an ob/gyn with the University of Michigan. There is an increasing burden of maternity care “deserts” and an increasing rate of diabetes and mental health conditions, she said. Additionally, social services may not meet people’s educational needs or the social support they’re seeking. Worse, she noted, Black and Indigenous people, as well as those living on low incomes, are two to five times more likely to die in childbirth.
“Suffice it to say, we have a prenatal care quality issue in the United States,” Peahl said.
Tech-enabled prenatal care can help obstetricians and others better identify risk, she said. Automated intervention recommendations incorporated into electronic health records can help ensure that clinicians offer particular services to each patient, not just when they remember. Some already are built into hospital records systems like Epic, or clinicians could create their own checklists based on their unique patient populations to ensure that when they’re managing a new symptom like high blood pressure, they don’t forget other routine testing that needs to be completed.
Virtual visits can help connect patients with services they need, allowing patients to connect with a provider anywhere at any time, Peahl added. Providers also can make use of technologies like online depression screenings and remote blood pressure monitoring systems for antenatal testing to evaluate the well-being of the fetus late in pregnancy. Digital wraparound services could be added to provide education or case management. Online peer support groups could also help.
ACOG is in the midst of building a new, tech-enabled model of prenatal care they hope to release later this year, Peahl said. To stay abreast of this, see ACOG’s Redesigning Prenatal Care Initiative website.
Bring a critical eye to digital tech
There’s a misconception that only a certain portion of pregnant patients can access technology, said Adam Lewkowitz, M.D., and ob/gyn at Brown University. Reproductive-age pregnant people are the most technologically-savvy demographic in the U.S., he noted, with smartphone ownership and home broadband internet access nearly universal. “It’s not a question about whether patients can access digital health intervention, it’s a question of which ones they are accessing,” he said.
A lesson he gave to colleagues also holds weight for journalists: It’s important to assess the credentials of a digital technology for pregnant people such as an app, as very few of them are evidence-based. For a clue, look at who makes it. If there’s a board-certified ob/gyn or provider of prenatal care behind it, it’s most likely going to be accurate, he said. However, patients are gravitating to short videos on Instagram or TikTok created by people who look like them or have similar experiences.
Tech startup companies for pregnant people of color
With non-Hispanic Black people experiencing some of the highest rates of maternal morbidity and mortality in the United States, a number of femtech companies have emerged to provide support for them through perinatal care and pregnancy, another panel of experts said at ACOG.
Many health information apps related to pregnancy that doctors recommended in the past provided just information, while newer technologies connect what the patient knows, does and experiences back to work being done in the clinics, said Audra Meadows, M.D., M.P.H., an ob/gyn with the University of California, San Diego.
Panelists highlighted several companies, many started by Black founders, listed here in alphabetical order. Journalists could find good stories speaking with some of the founders or users of these technologies, and physicians could use it to find out how or if users’ experiences may be influencing pregnancy and birth outcomes.
- Babyscripts – A digital platform and app to provide reminders and checklists through prenatal and postpartum phases, and a content library of information in English and Spanish. A blood pressure tracking tool in the platform for postpartum patients that sends patient info to doctors at UC San Diego is helping ob/gyns better understand when intervention is needed, Meadows said.
- Cayaba Care – A digital platform offering home-based personalized pregnancy support between OB visits, including maternity navigators to visit patients at home or virtually.
- Cityblock – A membership model program covered by insurance companies through which pregnant people can get access to medical, mental and social care anytime where they are.
- Emagine Solutions Technology – A digital platform with integrated medical devices such as a handheld ultrasound device that connects to a cell phone or tablet, and apps that track health trends and alert for abnormal values.
- Health in Her HUE – A digital platform that connects Black people and people of color to culturally competent, sensitive health care providers.
- Irth – An app providing reviews and ratings of ob/gyns, hospitals and pediatricians written by people of color. Information is available in English and Spanish.
- Mae – A digital platform and app offering pregnancy and postpartum support, weekly health tracking, personalized lifestyle and care tips, and access to culturally competent experts.
- Mahmee – A membership platform offering support and services for pregnancy and postpartum care from registered nurses, doulas, lactation consultants, mental health coaches, nutritionists and care coordinators.
- Maven – A digital platform and virtual care model that works with employers, health plans and individuals offering services such as on-demand appointments, personalized education content and a care advocate.
- MOMentum Park – A digital platform offering services such as a prenatal program centered on the holistic prenatal needs of expectant parents and their newborns and a program that brings baby supplies to families with an infant in a neonatal intensive care unit.
- Wolomi – A digital platform and app with free and paid membership models that includes virtual group coaching and community discussions, referrals to culturally competent health experts, weekly tips and assessments, and more.
Experts for stories on prenatal tech
- Alex Peahl, M.D., M.S., assistant professor of obstetrics and gynecology at the University of Michigan
- Adam Lewkowitz, M.D., assistant professor of maternal-fetal medicine at Brown University in Providence, R.I.: firstname.lastname@example.org
- Sharon Thompson, M.D., M.P.H., managing director of Central Phoenix Obstetrics and Gynecology: email@example.com
- Audra Meadows, M.D., M.P.H., associate professor and vice chair for culture and justice in the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of California, San Diego
- Neel Shah, M.D., chief medical officer for Maven Clinic in Cambridge, Mass.
- Renaisa Anthony, M.D., M.P.H., physician founder of MOMentum Park
- Courtney Williams, M.B.A., co-founder and CEO of Emagine Solutions Technology