Comprehensively addressing postpartum maternal health: A content and image review of commercially available mobile health apps

Abstract

Background: The United States is currently facing a maternal morbidity and mortality crisis, with the highest rates of any resource-rich nation. In efforts to address this, new guidelines for postpartum care suggest that mobile health apps can help provide complementary clinical support for new mothers during the postpartum period. However, to date no study has evaluated existing mobile health tools targeted to this time period for sufficiency of maternal health information, inclusivity of people of color, or accessibility to users.Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to review the peripartum apps from the Apple and Google Play stores in either the Health/Fitness, Medical, or Education categories. Apps were then evaluated for extent and quality of maternal health information, inclusivity of people of color, and accessibility to app users.Results: Of the 301 apps from the Apple and Google Play stores, 25 met criteria for final evaluation. Of the 30 maternal health topics coded for, the median number addressed by apps was 19.5 (65%). Peripartum behaviors were more frequently addressed than peripartum outpatient care topics and peripartum acute health risks. The amount of maternal health information correlated positively with the Mobile Application Rating Scale (MARS) quality score of the app, and inclusivity of people of color in app imagery also correlated positively with the MARS quality score. Only 8 apps (32%) portrayed greater than 24% images of people of color- the percent of non-white Americans according to 2019 census estimates. There was no correlation between number of users as estimated by number of store ratings and MARS quality. In addition, apps with clinical authority had greater MARS engagement, information, aesthetics, and quality scores, but did not have greater numbers of store ratings.Conclusions: Current commercially available peripartum apps overall do not provide adequate maternal health information, are not inclusive of women of color, and are not optimally accessible to the target users. Apps authored with clinical authority and higher-quality apps, by MARS score, are more likely to meet these standards, but are not more likely to be downloaded and used.