Using e-technology to support maternal-child health

The Hope Project app
With most everyone having a smartphone these days, people are using apps to support their health. There are a few apps directed to pregnant women about their substance use and mental health. Some recent efforts developed together by researchers and health providers show how these apps can be used to offer focused information and support to pregnant women.

A perinatal mental health research project in Alberta, The Hope Project, is exploring how e-technology can be used to support pregnant women with mental health concerns. Dr. Dawn Kingston and her team at the University of Calgary developed an app for screening and treating pregnant women experiencing anxiety and depression. It provides information, support, and help to women in the research study whenever they need it. The project will also look at how this intervention affects post-partum depression and the health of their children.

SmartMom Canada, was developed as part of a study from the University of British Columbia. Through text messaging, Optimal Birth BC provides women in Northern BC with prenatal education endorsed by the Society of Obstetricians and Gynaecologists of Canada (SOGC). Many of these women live in rural areas and may have limited access to prenatal care. Women who enroll in the study complete a confidential survey and then receive personalized text messages that include pregnancy tips, info on health topics, and available resources in their own community.

SmartMom Canada app
Women outside of these studies may find it challenging to find similar apps. Popular pregnancy apps do not offer much info or ideas for resources for women with mental health or substance use issues. One that has been positively evaluated is Text4baby in the U.S. The sponsors partner with national, state, and private organizations and offer local resource information in some states. Also available to Spanish speakers, an evaluation of the app can be found here.

As well, apps are being targeted to health care providers on improving the care they provide. A preconception care app available to physicians provides them with information from the National Preconception Health and Health Care Initiative and makes suggestions for responding to patient questions. Research is being done on using an app to provide motivational interviewing interventions to pregnant women who use substances.

Most apps available on smartphones are directed toward the general population and seek a large user base. Mental health apps and substance use apps that might support prevention, are not designed specifically for women, pregnant or not. And most pregnancy apps focus on fetal growth and “kick counters”, the woman’s weight and blood pressure, and checklists to get ready for a child.

So, while there is an app for everything, they may not an app for everyone. However, healthcare technology is growing at a fast pace, so hopefully we will see more apps in future that can expand FASD prevention efforts.

Related topics:



FASD prevention needs to begin before pregnancy: findings from the US National Survey of Family Growth


Most interventions and programs to prevent alcohol use during pregnancy focus on encouraging pregnant women to abstain from alcohol use. However, one of the most consistent predictors of alcohol use during pregnancy is women’s drinking patterns before pregnancy. As well, a large majority of women have been drinking alcohol for many years prior to getting pregnant.

A recent journal article published in the Maternal and Child Health Journal (April 2015) looks at data from the National Survey of Family Growth in the United States to estimate the number of women during a one month period who are at risk of having an alcohol-exposed pregnancy. (An “alcohol-exposed pregnancy” means that a woman is drinking alcohol, sexually active and not using contraception).

The study found that during a one-month period, nearly 2 million women in the United States were at risk of an alcohol-exposed pregnancy, including 600,000 who were binge drinking. This translates to 3.4%, or 1 in 30, non-pregnant women being at risk of an alcohol-exposed pregnancy.

Interestingly, being at risk for an alcohol-exposed pregnancy was not clearly associated with most demographic and behavioral characteristics (e.g., income level, tobacco use, ethnicity, education level, etc).

That said, women in this study who were planning to get pregnant were the ones who were at highest risk of an alcohol-exposed pregnancy – because they often continue to drink until they find our they are pregnant (and thus exposing the fetus to alcohol for several weeks or even months).

As a recent report on alcohol use in OECD countries describes how rates of alcohol use (including binge drinking) continue to rise in young women in many parts of the world. This suggests the importance of strategies to improve women’s overall health in relation to alcohol (e.g., emphasizing a culture of moderation with low risk drinking guidelines) and FASD prevention activities that target alcohol and contraception use prior to pregnancy and in the preconception period.


Cannon, M.J., Guo, J., Denny, C.H., Green, P.P., Miracle, H., Sniezek, J.E., Floyd, R.L. (2015). Prevalence and Characteristics of Women at Risk for an Alcohol-Exposed Pregnancy (AEP) in the United States: Estimates from the National Survey of Family Growth. Maternal and Child Health Journal, 19:776–782. DOI 10.1007/s10995-014-1563-3.

The Sacred Journey – new resource for service providers who work with First Nations families

New resource explores the journey from preconception to parenting

The Best Start Resource Centre  in Toronto, Ontario has released a resource for service providers who work with First Nations families called The Sacred Journey from Preconception to Parenting for First Nations Families in Ontario.

Alcohol use and FASD is covered in the sections on preconception and pregnancy, but alcohol use is also discussed from a historical and cultural perspective:

“The impact of intergenerational trauma from disease, forced relocation, religious indoctrination, the residential school system and racism have left a “soul wound” in the heart of First Nations communities (Duran, Duran, 1995)…. When addressing substance use, keep in mind that information and advice may not be enough. Understanding and addressing underlying factors such as poverty, stress, abuse, mental health concerns etc., may be particularly important in setting the stage to address substance use.”

The resource brings together up-to-date statistics on use, practice tips and resources for service providers.

I especially like that the resource challenges service providers to view alcohol use as an issue that is integrated throughout the lifespan and isn’t just something to get concerned about when a woman gets pregnant. Historically, FASD prevention efforts have been very “fetus-centric” and have missed seeing a woman within a greater context (e.g., partner, family, community) as the route for action and awareness.

Jessica Yee (Mohawk), Founder and Executive Director of the Native Youth Sexual Health Network, comments in the resource:

“I am quite concerned about the isolation of the rest of sexual and reproductive health to pregnancy and birthing. It’s almost as if pregnancy and birthing gets treated like it’s a separate issue—disconnected from other issues like sexual self-esteem and pleasure, and it is typically approached with a very heteronormative, monogamous lens (as in it’s an identified “woman” who is pregnant with an identified “man” and they have a monogamous relationship). This does not allow any resources, support, or dialogue for Two Spirit, transgender, or gender non-conforming persons, alternative families, surrogacy, or single mothers to be.”

This resource can be downloaded for free from the Best Start Resource Centre.

For more on similar resources in Aboriginal/indigenous communities, see previous posts: