A review of Mobile ‘Apps’ for women with anxiety in pregnancy: Maternity care professionals guide to locating and assessing Anxiety Apps (Preprint)

2021 ◽  
Author(s):  
Kerry Evans ◽  
Jasper Donelan ◽  
Stefan Rennick-Egglestone ◽  
Serena Cox ◽  
Yvonne Kuipers
Keyword(s):  
Pregnant Women ◽  
Maternity Care ◽  
Mobile Apps ◽  
Healthcare Providers ◽  
Evidence Base ◽  
Current Evidence ◽  
Digital Information ◽  
Care Providers ◽  
Pregnancy Anxiety ◽  
In Pregnancy

BACKGROUND Mental health and pregnancy Apps are widely available and have the potential to improve health outcomes and enhance women’s experience of pregnancy. Women frequently access digital information throughout their pregnancy. Healthcare providers and women have little information to guide them to potentially helpful or effective Apps. OBJECTIVE To develop a methodology to systematically search and evaluate commercially available Apps in order to assist maternity care professionals to identify resources to recommend to pregnant women with symptoms of anxiety. METHODS A stepwise systematic approach to identify, select, describe and assess the most popular and user rated Apps available in the UK from January – March 2021. This included developing a script-based search strategy and search process, developing evaluation criteria and conducting a narrative evaluation and description of the selected Apps. RESULTS Useful search terms were identified which included non-clinical, aspirational and problem-based phrases. There were 39 Apps selected for inclusion in the review. No Apps were located which specifically targeted women with anxiety in pregnancy. Of the 39 Apps included in the review, 33 focused solely on mind-body techniques to promote relaxation, stress reduction and psychological wellbeing. Only eight of the 39 Apps included in the review reported that healthcare professionals had contributed to the App development and only one provided empirical evidence on the effectiveness and acceptability of the App. The top 12 Apps were evaluated by two independent reviewers using the developed criteria and scores. The was a small negative correlation between the reviewers scores and App user rating scores, with higher user rating scores associated with lower reviewer scores. CONCLUSIONS App developers, publishers and maternity care professionals should seek advice from women with lived experience of pregnancy anxiety symptoms to assist in locating, promoting and optimising the visibility of Apps for pregnant women. There is a lack of resources which provide coping strategies based on current evidence for the treatment of anxiety in pregnancy. Maternity Care Providers are hindered in their ability to locate and recommend acceptable and trustworthy Apps due to the lack of information on the evidence-base, development and testing of Apps. Maternity care professionals and women need access to libraries of trusted Apps which have been evaluated against relevant and established criteria.

scholarly journals Exploring the potential for introducing home monitoring of blood pressure during pregnancy into maternity care: current views and experiences of staff—a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e037874
Author(s):  
Lisa Hinton ◽  
James Hodgkinson ◽  
Katherine L Tucker ◽  
Linda Rozmovits ◽  
Lucy Chappell ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Maternity Care ◽  
Healthcare Providers ◽  
Home Monitoring ◽  
Structured Interviews ◽  
Group Discussions ◽  
Self Monitoring ◽  
Team Members ◽  
Registration Number ◽  
In Pregnancy

ObjectiveOne in 20 women are affected by pre-eclampsia, a major cause of maternal and perinatal morbidity, death and premature birth worldwide. Diagnosis is made from monitoring blood pressure (BP) and urine and symptoms at antenatal visits after 20 weeks of pregnancy. There are no randomised data from contemporary trials to guide the efficacy of self-monitoring of BP (SMBP) in pregnancy. We explored the perspectives of maternity staff to understand the context and health system challenges to introducing and implementing SMBP in maternity care, ahead of undertaking a trial.DesignExploratory study using a qualitative approach.SettingEight hospitals, English National Health Service.ParticipantsObstetricians, community and hospital midwives, pharmacists, trainee doctors (n=147).MethodsSemi-structured interviews with site research team members and clinicians, interviews and focus group discussions. Rapid content and thematic analysis undertaken.ResultsThe main themes to emerge around SMBP include (1) different BP changes in pregnancy, (2) reliability and accuracy of BP monitoring, (3) anticipated impact of SMBP on women, (4) anticipated impact of SMBP on the antenatal care system, (5) caution, uncertainty and evidence, (6) concerns over action/inaction and patient safety.ConclusionsThe potential impact of SMBP on maternity services is profound although nuanced. While introducing SMBP does not reduce the responsibility clinicians have for women’s health, it may enhance the responsibilities and agency of pregnant women, and introduces a new set of relationships into maternity care. This is a new space for reconfiguration of roles, mutual expectations and the relationships between and responsibilities of healthcare providers and women.Trial registration numberNCT03334149.

scholarly journals Prevalence, incidence and bothersomeness of urinary incontinence in pregnancy: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Heidi F. A. Moossdorff-Steinhauser ◽  
Bary C. M. Berghmans ◽  
Marc E. A. Spaanderman ◽  
Esther M. J. Bols
Keyword(s):  
Systematic Review ◽  
Urinary Incontinence ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Care Providers ◽  
Case Definitions ◽  
Monthly Basis ◽  
Policy Makers ◽  
In Pregnancy

Abstract Introduction and hypothesis Urinary incontinence (UI) is a common and embarrassing complaint for pregnant women. Reported prevalence and incidence figures show a large range, due to varying case definitions, recruited population and study methodology. Precise prevalence and incidence figures on (bothersome) UI are of relevance for health care providers, policy makers and researchers. Therefore, we conducted a systematic review and meta-analysis to investigate the prevalence and incidence of UI in pregnancy in the general population for relevant subgroups and assessed experienced bother. Methods All observational studies published between January 1998 and October 2018 reporting on prevalence and/or incidence of UI during pregnancy were included. All women, regardless of weeks of gestation and type of UI presented in all settings, were of interest. A random-effects model was used. Subgroup analyses were conducted by parity, trimester and subtype of UI. Results The mean (weighted) prevalence based on 44 included studies, containing a total of 88.305 women, was 41.0% (range of 9–75%). Stress urinary incontinence (63%) is the most prevalent type of UI; 26% of the women reported daily loss, whereas 40% reported loss on a monthly basis. Bother was experienced as mild to moderate. Conclusions UI is very prevalent and rising with the weeks of gestation in pregnancy. SUI is the most common type and in most cases it was a small amount. Bother for UI is heterogeneously assessed and experienced as mild to moderate by pregnant women.

Measurement of Barriers, Attitudes, and Expectations for Sitting Less in Pregnancy

2021 ◽  
Vol 45 (6) ◽  
pp. 956-970
Author(s):  
Bethany Barone Gibbs ◽  
Melissa A. Jones ◽  
Kara M. Whitaker ◽  
Sharon Taverno Ross ◽  
Kelliann K. Davis
Keyword(s):  
Pregnant Women ◽  
Sedentary Time ◽  
Healthcare Providers ◽  
Outcome Expectations ◽  
Physical Symptoms ◽  
Third Trimester ◽  
Household Chores ◽  
Prenatal Interventions ◽  
Specific Barriers ◽  
In Pregnancy

Objective: Our objective was to develop, validate, and describe findings from an instrument to measure barriers, attitudes, and outcome expectations of sitting less in pregnant women. Methods: This validation (sub-study 1) and descriptive study (sub-study 2) evaluated a new questionnaire measuring sedentary time in pregnant women (N=131) in each trimester. Results: In sub-study 1, construct validity was supported by associations between device-measured sedentary time and questionnaire scores. An optimized questionnaire removed infrequently reported and non-correlated items. The original and optimized questionnaires with scoring instructions are provided. In sub-study 2, physical symptoms and work were most commonly reported as major reasons for sitting in pregnancy, followed by leisure, family, and social activities. Some women reported limiting sitting due to boredom/restlessness, to improve energy or health, and to control weight. In the third trimester, some women reported sitting more/less due to pain and encouragement from family, friends, and co-workers. Few women reported household chores or pregnancy risks as reasons to sit, felt sitting was healthy or necessary during pregnancy, or were encouraged to sit by healthcare providers. Conclusions: The developed questionnaire demonstrated validity and identified barriers to and expectations of sitting less during pregnancy. Prenatal interventions to reduce sitting should address general and pregnancy-specific barriers.

scholarly journals Developing a complex intervention to support pregnant women with mild to moderate anxiety: application of the Medical Research Council framework

2020 ◽  
Author(s):  
Kerry Evans ◽  
Helen Spiby ◽  
Jane C Morrell
Keyword(s):  
Pregnant Women ◽  
Maternity Care ◽  
Public Involvement ◽  
Complex Interventions ◽  
Psychological Theory ◽  
Intervention Component ◽  
Group Discussions ◽  
Mrc Framework ◽  
Care Systems ◽  
In Pregnancy

Abstract Aim: To design and develop an intervention to support women with symptoms of mild to moderate anxiety in pregnancy.Methods: The development followed the MRC framework for complex interventions, utilising psychological theory, review level evidence and professional and public involvement. Two systematic reviews were completed which helped identify potentially beneficial intervention components. The theory underpinning the components was explored to consider the potential benefit for women with mild to moderate anxiety symptoms in pregnancy. Methods of delivering the intervention within maternity services were explored. The intervention comprised: group discussions, one to one support and assisted self-help resources. Midwives were identified as ideally placed to facilitate the intervention supported by midwifery support workers. A bespoke training package was provided by subject experts to prepare the facilitators. Discussion: The absence of established interventions and a paucity of evidence based approaches for pregnant women with symptoms of mild to moderate anxiety indicated the need for a rigorous and systematic approach to the intervention design. This approach led to the development of an intervention feasible for implementation in maternity care systems tailored to the needs of pregnant women. The involvement of a multi-professional advisory team and active engagement of service users helped to consider the acceptability of the intervention for women and the feasibility of delivering the intervention in the context of maternity care. Conclusion: The MRC Framework provided useful overarching guidance to develop a midwife facilitated intervention for women with symptoms of anxiety in pregnancy. The framework assisted the development of a robust rationale for each intervention component and considered the processes of evaluation and implementation into maternity care systems.

scholarly journals Is quality maternal healthcare all about successful childbirth? Views of mothers in the Wa Municipality, Ghana

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257401
Author(s):  
Linus Baatiema ◽  
Augustine Tanle ◽  
Eugene Kofuor Maafo Darteh ◽  
Edward Kwabena Ameyaw
Keyword(s):  
Service Delivery ◽  
Maternity Care ◽  
Healthcare Providers ◽  
Care Providers ◽  
Maternal Healthcare ◽  
Cross Sectional ◽  
West Region ◽  
Adverse Pregnancy ◽  
Wa Municipality

Introduction In spite of the countless initiatives of the Ghana government to improve the quality of maternal healthcare, Upper West Region still records poor childbirth outcomes. This study, therefore, explored women’s perception of the quality of maternal healthcare they receive in the Wa Municipality of the Upper West Region of Ghana. Materials and methods This is a qualitative cross-sectional study of 62 women who accessed maternal healthcare in the Wa Municipality of Ghana. We analysed the transcripts using the analytic inductive technique. An inter-coding technique (testing for inter-coding agreement) was employed. The iterative coding process resulted in a coding scheme with four main themes. We used peer-debriefing technique in ensuring credibility and trustworthiness. Results Logistics and equipment; referral service; empathic service delivery; inadequacy of care providers; affordability of service; satisfaction with services received; as well as experience and service delivery were the parameters used by the women in assessing quality maternity care. A number of gaps were reported in the healthcare system including limited healthcare providers, limited beds and inefficient referral system. Conversely, some of them reported that some healthcare providers offered empathetic healthcare. Contrary views were expressed with respect to satisfaction with maternity care. Conclusion Government and all stakeholders seeking to enhance quality of maternal health and accelerate the attainment of the third Sustainable Development Goal need to reconsider the financing of service delivery at health institutions. Indeed, our findings have illustrated that routine workshops on empathetic healthcare are required in efforts to increase the rate of facility-based childbirth, and thereby subside maternal mortality and all adverse pregnancy outcomes.

scholarly journals A review of guidance on fish consumption in pregnancy: is it fit for purpose?

2018 ◽  
Vol 21 (11) ◽  
pp. 2149-2159 ◽  
Author(s):  
Caroline M Taylor ◽  
Pauline M Emmett ◽  
Alan M Emond ◽  
Jean Golding
Keyword(s):  
Pregnant Women ◽  
Fish Consumption ◽  
Evidence Base ◽  
Positive Contribution ◽  
National Guidelines ◽  
International Guidelines ◽  
Beneficial Effects ◽  
Use Of Technology ◽  
The Impact ◽  
In Pregnancy

AbstractObjectivePublic health messages to reduce Hg exposure for pregnant women have focused exclusively on advice on fish consumption to limit Hg exposure, with little account being taken of the positive contribution of fish to nutritional quality. The aim of the present review was to compare and contrast the content and presentation of national guidelines on fish consumption in pregnancy, and comment on their evidence base and impact on consumption.DesignWe searched for national and international guidelines on fish consumption in pregnancy using Internet search strategies. The detailed content and style of presentation of the guidelines were compared. The evidence base for the guidelines, and evidence for the impact of the guidelines on fish consumption levels, were assessed.ResultsWe identified nineteen national guidelines and three international guidelines. There was great variation in the content, complexity and presentation style. The guidelines were based largely on the Hg content of fish with far less consideration being given to the positive beneficial effects of nutrients provided by fish. The complexity of the guidelines may lead to pregnant women reducing their fish intake, or not eating fish at all.ConclusionsGuidelines on fish consumption in pregnancy should take the beneficial effects of fish into account. Guidelines need to be clear and memorable, and appropriately disseminated, to achieve impact. Guidelines could include visual rather than narrative content. Use of technology, for example apps, could enable women to record their fish consumption in real time and log compliance with guidance over a week or other time period.

Psychiatric Diseases in Pregnancy

2019 ◽  
Author(s):  
Jennifer Ludgin ◽  
Deanna Sverdlov ◽  
Errol R. Norwitz
Keyword(s):  
Substance Abuse ◽  
Pregnant Women ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Care Providers ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Psychiatric Conditions ◽  
In Pregnancy

The exacerbation of pre-existing psychiatric conditions and the development of a new-onset psychiatric disorder during pregnancy directly affects the care of pregnant women. Depression and anxiety are highly prevalent in reproductive age women and may be exacerbated in the perinatal and postpartum periods. Post-traumatic stress disorder is another common condition seen in this population and may worsen under the stress of pregnancy, delivery, and childrearing. Substance abuse is also pervasive in this population, requiring obstetricians to have a thorough understanding of how to manage and treat pregnant women with dependence disorders. Psychiatric conditions and substance abuse often co-exist. These and other disorders present significant risk to the mother and fetus. It is essential therefore for obstetric care providers to understand how to screen for, diagnose, and treat psychiatric disorders during pregnancy and in the postpartum period. This review contains 4 tables, and 58 references. Keywords: perinatal depression, postpartum depression, postpartum psychosis, anxiety in pregnancy, substance abuse in pregnancy, post-traumatic stress disorder in pregnancy, eating disorders in pregnancy, pregnancy screening

scholarly journals Disclosure of herbal medicine use to health care providers among pregnant women in Nepal: a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mansoor Ahmed ◽  
Hyea Bin Im ◽  
Jung Hye Hwang ◽  
Dongwoon Han
Keyword(s):  
Health Care ◽  
Herbal Medicine ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Health Concern ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background Pregnant women’s disclosure of herbal medicine (HM) use to their health care providers during pregnancy is crucial, as misuse of HM can have a detrimental effect on both pregnant woman and the fetus. However, the lack of disclosure of HM use to physicians remains a public health concern in developing countries such as Nepal. Methods A cross-sectional study was conducted among 400 postpartum women admitted at Maternity and Women’s Hospital located in Kathmandu, Nepal. The survey instrument included 30 questions on the use of HM during pregnancy, sociodemographic and health characteristics, and pregnancy outcomes. Chi-square test and logistic regression were conducted for data analysis using SPSS ver. 21.0., and a p-value of less than 0.05 was considered statistically significant for all analyses. Results 60.3% of respondents used at least one herbal remedy during their previous pregnancy, and the overall disclosure rate of HM use to healthcare providers was 54.6%. Women with secondary education level and four or more antenatal care visits were more likely to disclose their HM use to healthcare providers. Conclusions This study highlights that despite the popular use of HM among pregnant women in Nepal, most women obtained HM-related information from informal sources and did not disclose their HM use to physicians. To ensure the safe use of HM, physicians should integrate questions regarding patients’ HM use into their routine patient assessments to facilitate active communication and improve the quality of care.

scholarly journals Many Women and Providers Are Unprepared for an Evidence-Based, Educated Conversation About Birth

2011 ◽  
Vol 20 (4) ◽  
pp. 185-187 ◽  
Author(s):  
Michael C. Klein
Keyword(s):  
Decision Making ◽  
Pregnant Women ◽  
Maternity Care ◽  
Informed Decision ◽  
Current Evidence ◽  
Evidence Based ◽  
Informed Decision Making ◽  
Knowledge And Beliefs ◽  
Canadian Studies ◽  
First Time

Findings from recent Canadian studies on the knowledge and beliefs about birth practices among first-time pregnant women and among obstetricians and other birth providers indicate that many women are inadequately informed and many providers deliver non-evidence-based maternity care. Consequently, informed decision making is problematic for pregnant women and their providers. New strategies are needed to inform pregnant women about key procedures and approaches that might be used in birth so they can have an educated, shared discussion with their provider and successfully advocate for their preferred birth experience. In addition, providers can be encouraged to supplement their knowledge with current, evidence-based maternity care practices. To avoid a lack of informed decision making and to ensure that natural, safe, and healthy birth practices are based on current evidence, pregnant women and providers must work together to inform themselves and to add childbirth to the women’s health agenda.

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