Today the daily telegraph reported this rather extraordinary story. I’d like to unpack this because apart from the tragic truth that two babies are dead I am sure that almost everything else about this report is confused or just plain wrong. Lets unpack it:
DOCTORS are warning pregnant women not to rely on smart phone apps to avoid stillbirth after two women recently lost babies.
I agree pregnant women certainly should not reply on smart phone apps to avoid stillbirth. The key word in this sentence is “rely”. While I have not had access to this specific app I can see from the app store screen shots (above) there is a “disclaimer” and would be astounded if it didn’t say something like “don’t rely on this app if you are concerned seek the advice of your maternity care provider.”
Dr Lucy Bowyer, Acting Head of Maternal Fetal Medicine at Sydney’s Royal Hospital for Women, said the hospital had cared for two women who had relied on a smart phone app to assure them that their unborn baby’s heart beat had been normal, but had gone on to experienced stillbirth.
Well for a kick off (excuse the pun) the MBM app cant be used to take the baby’s heart rate and I can’t quite believe that any doctor involved with the trial would not know this. So if the women reassured themselves their baby’s heart rate was normal then they weren’t using the MBM app to do that
A range of baby heart beat apps are available on the market for download onto smart phones, but Dr Bowyer said there was no clinical evidence these apps could monitor heart beat successfully or reliably.
Again this makes me think that the women were using MBM AND also an app that takes the fetal heart rate. The MBM app only encourages women to get to know their baby’s movement, see screen shots above. While I agree that there is no clinical evidence for the success or reliability of these apps that is in fact the whole point of the “my baby’s movements” clinical trial!
“Women with reduced foetal movements must ring for medical advice, not rely upon phone apps which cannot listen to the foetal heart with any clinical success,” Dr Bowyer said. “Even if you could hear the heartbeat, if you are not clinically trained you don’t know what you listening out for.
This is absolutely true. However, once again it is very important to note that as the MBM app doesn’t provide women with a fetal heart rate that saying this indicates the reporter is slightly confused. My hunch is the women were ALSO using a fetal heart rate app as well as the MBM app.
“It’s such a tragedy to deliver a stillborn baby when urgent medical assessment and intervention may have prevented that loss,” Dr Bowyer said.
This is also absolutely true. Preventable stillbirth is indeed a dreadful tragedy and we need to do better in reducing preventable stillbirth especially when the unborn baby has signalled they are in trouble by reducing movement.
Dr Bowyer said the increasing popularity of smart phone apps which claim to help you hear baby’s heart beat are often advertised to help you bond with baby but they can give a false sense of security.
Once again very true. Using a device to help women listen to the fetal heart absolutely does provide a false sense of security and should never be relied on by pregnant women because simply hearing the fetal heart tells you little. As I have said before on this blog, merely listening to a heart rate tells you virtually nothing about the baby’s health, just as merely taking the pulse of an adult or child does not tell you if they are well, you need to make a full assessment.
“One lady was using the app to listen to the foetal heart beat because the baby had not been moving and she had been partially reassured the baby was okay. In both cases the women were given a false sense of security.”
This is completely distressing and I am sure the Stillbirth Foundation as well as the leaders of the MBM clinical trial are equally distressed to hear that these women were falsely reassured by using an app. BUT the MBM app is designed to raise awareness of changes in baby’s movement and urges women to take action (the very action that Dr Bowyer is talking about) if their baby is not moving as normal. Dr Bowyer goes on to say how incredibly important it is that women immediately report decreased fetal movement and do not think they are being a burden or a bother, all true and this is a course of action that the MBM app is specifically designed to encourage.
Many women fear they are being a burden if they are concerned about reduced baby movement and hold off calling a health professional, but decreased movement is a serious risk factor for stillbirth.
“Many women don’t want to waste our time, but if you are concerned about your baby’s movements, we would rather hear from you than take the risk of stillbirth.
“We would rather you make a fuss so just ring the doctor, the midwife of the delivery suite, there is always someone to talk to,” Dr Bowyer said.
So the bottom line is that I hope this confused report does not put women off from participating in this important trial. That said I also hope that women using the MBM app do not rely on it but use it as the tool it was designed to be. Further if pregnant women use the MBM app, or indeed any other app, and they have any concerns at all about their unborn baby’s behaviour that they seek an immediate assessment of their unborn baby’s wellbeing from their maternity care provider.
DOCTORS are warning pregnant women not to rely on smart phone apps to avoid stillbirth after two women recently lost babies.
I agree pregnant women certainly should not reply on smart phone apps to avoid stillbirth. The key word in this sentence is “rely”. While I have not had access to this specific app I can see from the app store screen shots (above) there is a “disclaimer” and would be astounded if it didn’t say something like “don’t rely on this app if you are concerned seek the advice of your maternity care provider.”
Dr Lucy Bowyer, Acting Head of Maternal Fetal Medicine at Sydney’s Royal Hospital for Women, said the hospital had cared for two women who had relied on a smart phone app to assure them that their unborn baby’s heart beat had been normal, but had gone on to experienced stillbirth.
Well for a kick off (excuse the pun) the MBM app cant be used to take the baby’s heart rate and I can’t quite believe that any doctor involved with the trial would not know this. So if the women reassured themselves their baby’s heart rate was normal then they weren’t using the MBM app to do that
A range of baby heart beat apps are available on the market for download onto smart phones, but Dr Bowyer said there was no clinical evidence these apps could monitor heart beat successfully or reliably.
Again this makes me think that the women were using MBM AND also an app that takes the fetal heart rate. The MBM app only encourages women to get to know their baby’s movement, see screen shots above. While I agree that there is no clinical evidence for the success or reliability of these apps that is in fact the whole point of the “my baby’s movements” clinical trial!
“Women with reduced foetal movements must ring for medical advice, not rely upon phone apps which cannot listen to the foetal heart with any clinical success,” Dr Bowyer said. “Even if you could hear the heartbeat, if you are not clinically trained you don’t know what you listening out for.
This is absolutely true. However, once again it is very important to note that as the MBM app doesn’t provide women with a fetal heart rate that saying this indicates the reporter is slightly confused. My hunch is the women were ALSO using a fetal heart rate app as well as the MBM app.
“It’s such a tragedy to deliver a stillborn baby when urgent medical assessment and intervention may have prevented that loss,” Dr Bowyer said.
This is also absolutely true. Preventable stillbirth is indeed a dreadful tragedy and we need to do better in reducing preventable stillbirth especially when the unborn baby has signalled they are in trouble by reducing movement.
Dr Bowyer said the increasing popularity of smart phone apps which claim to help you hear baby’s heart beat are often advertised to help you bond with baby but they can give a false sense of security.
Once again very true. Using a device to help women listen to the fetal heart absolutely does provide a false sense of security and should never be relied on by pregnant women because simply hearing the fetal heart tells you little. As I have said before on this blog, merely listening to a heart rate tells you virtually nothing about the baby’s health, just as merely taking the pulse of an adult or child does not tell you if they are well, you need to make a full assessment.
“One lady was using the app to listen to the foetal heart beat because the baby had not been moving and she had been partially reassured the baby was okay. In both cases the women were given a false sense of security.”
This is completely distressing and I am sure the Stillbirth Foundation as well as the leaders of the MBM clinical trial are equally distressed to hear that these women were falsely reassured by using an app. BUT the MBM app is designed to raise awareness of changes in baby’s movement and urges women to take action (the very action that Dr Bowyer is talking about) if their baby is not moving as normal. Dr Bowyer goes on to say how incredibly important it is that women immediately report decreased fetal movement and do not think they are being a burden or a bother, all true and this is a course of action that the MBM app is specifically designed to encourage.
Many women fear they are being a burden if they are concerned about reduced baby movement and hold off calling a health professional, but decreased movement is a serious risk factor for stillbirth.
“Many women don’t want to waste our time, but if you are concerned about your baby’s movements, we would rather hear from you than take the risk of stillbirth.
“We would rather you make a fuss so just ring the doctor, the midwife of the delivery suite, there is always someone to talk to,” Dr Bowyer said.
So the bottom line is that I hope this confused report does not put women off from participating in this important trial. That said I also hope that women using the MBM app do not rely on it but use it as the tool it was designed to be. Further if pregnant women use the MBM app, or indeed any other app, and they have any concerns at all about their unborn baby’s behaviour that they seek an immediate assessment of their unborn baby’s wellbeing from their maternity care provider.
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