The Rise of Pregnancy Apps and the Implications for Culturally and Linguistically Diverse Women: Narrative Review

Abstract

BackgroundPregnancy apps are a booming global industry, with most pregnant women in high-income countries now using them. From the perspective of health care and health information provision, this is both encouraging and unsettling; the demand indicates a clear direction for the development of future resources, but it also underscores the importance of processes ensuring access, reliability, and quality control.ObjectiveThis review provides an overview of current literature on pregnancy apps and aims at describing (1) the ways in which apps are used by women, in general, and by those of a culturally and linguistically diverse (CALD) background; (2) the utility and quality of information provided; and (3) areas where more research, development, and oversight are needed.MethodsWe chose a narrative review methodology for the study and performed a structured literature search including studies published between 2012 and 2017. Searches were performed using MEDLINE, EMBASE, and CINAHL databases. Studies were identified for inclusion using two separate search criteria and strategies: (1) studies on pregnancy apps and pregnant women’s use of these apps and (2) studies on CALD pregnant women and their use of technology for accessing information on and services for pregnancy. Overall, we selected 38 studies.ResultsWe found that pregnancy apps were principally used to access pregnancy health and fetal development information. Data storage capability, Web-based features or personalized tools, and social media features were also popular app features sought by women. Lower rates of the pregnancy app uptake were indicated among lower-income and non-English-speaking women. Preliminary evidence indicates that a combination of technological, health literacy, and language issues may result in lower uptake of pregnancy apps by these groups; however, further investigation is required. A marked limitation of the health app industry is lack of regulation in a commercially dominated field, making it difficult for users to assess the reliability of the information being presented. Health professionals and users alike indicate that given the choice, they would prefer using pregnancy apps that are relevant to their local health care context and come from a trusted source. Evidence indicates a need for greater health professional and institutional engagement in the app development, as well as awareness of and guidance for women’s use of these resources.ConclusionsThis is the first review of pregnancy app use, types of information provided, and features preferred by pregnant women in general and by those of a CALD background in particular. It indicates the demand for access to accurate information that is relevant to users, their community, and their associated health services. Given the popularity of pregnancy apps, such apps have enormous potential to be used for the provision of accurate, evidence-based health information.

The association between reproductive health smartphone applications and fertility knowledge of Australian women

“…There is an increasingly large volume of users accessing the range of health apps for female reproductive health. Yet these types of apps have previously only been studied in small samples with a focus on reviewing the information within apps [30,32,41,42], or the design and testing of novel apps [43][44][45][46][47]. Presently, the association between knowledge about female reproductive health and the use of reproductive health-themed apps has yet Fig.…”

“…In the survey, 24 app using respondents self-identified that they were trying to conceive, yet 55 app using respondents were reportedly using a 'plan a pregnancy' app. There are a range of pregnancy-related apps available to accommodate for many stages throughout pregnancy (planning to conceive, trying to conceive, predicting gestation monitoring pregnancy, etc) [42], and respondents may have selected this to cover this broad range of applications. Apart from the free-text option, 'plan a pregnancy' was the only selectable option that mentioned pregnancy.…”

Maternal and Newborn Health Concerns in a Growing Urban Population

“…However, despite data that indicate that over 90% of women in their peak reproductive years (19-34 years of age) own a smartphone (Silver et al 2019), there are lower levels of pregnancy app use for women in low socioeconomic groups. Technology literacy, health literacy, and language barriers are suspected to be causes for the reduced use of digital health resources, including pregnancy apps (Hughson et al 2018). Likewise, as cities expand, the urban population tends to become more culturally and ethnically diverse and socioeconomic disparities can become even more pronounced.…”

Comprehensively Addressing Postpartum Maternal Health: a Content and Image Review of Commercially Available Mobile Health Apps

“…Commercial apps communicating about pregnancy-related health, speci cally, are becoming increasingly common [19,20], with healthcare providers endorsing that they play a growing role in maternity care [18,19]. Using mobile health apps as a widespread form of supplementary clinical support shows promise in both increasing patient education and in narrowing the knowledge gap in health disparate communities [21,22].…”

“…Due to the striking maternal health disparities which currently exist, the risk of further distancing health disparate communities has worrying consequences. Several studies have critically reviewed the content of pregnancy apps [20,28,29], with Thomas & Lupton (2016) nding that pregnancy and other reproductive health apps fail to be inclusive of diverse pregnant people. These kinds of ndings raise concerns of bias in the language and imagery used in pregnancy-health apps.…”