The Challenges in Antenatal Care and The Potential For Technology

While the number of maternal deaths has reduced globally, many women continue to die due to pregnancy and childbirth-related issues. This is especially so in low and middle-income countries such as India. 

According to UNICEF, more than 44,000 women die each year due to pregnancy-related issues. Poor mothers are 2.5 times more like to die than the average. Less than 40% of women receive antenatal care in India. 

These are concerning statistics, especially since most maternal deaths are often entirely preventable. While the government is taking focused steps to improve the quality of care by establishing the right set of policies and improving healthcare access, technology, when used right, can help us navigate a few of these challenges and improve the quality of antenatal care.

Quality of healthcare providers

All women should get access to the right antenatal care at the right time. But how do we define quality care? Quality, especially in the healthcare scenario in India, still seems to be amorphous. It is also a challenge to get unbiased information on the quality of care of healthcare providers.

We can alleviate this burden by looking at a technology platform that evaluates healthcare providers on metrics that matter to this demographic. WHO has defined global indicators for the quality of maternal and newborn care. These indicators, coupled with reviews from mothers on their care experiences, can be used to qualify quality healthcare providers. 

Mothers can use the technology platform to evaluate these care providers. They can then make informed decisions when selecting a healthcare provider to handhold her through the most challenging and yet, the most exhilarating experience of her life.

Access to timely and quality information

Information is worth its weight in gold when it comes to antenatal care. However, it is also something that is most wanted. The average time that doctors spend with their patients in India is 2 minutes. An expectant mother would surely need more than two minutes to get her check-up done and go through her exhaustive list of questions.

Pregnancy is a roller coaster ride, to say the least. You're up one day and down the other. Minor health issues can actually signal something more significant or preventable. The mother obviously wants to be as informed as possible. But with the internet becoming a doctor, we need to make sure that trusted, verified and reliable information reaches the mother at the right time so that she's not running to the hospital for every small concern.

A healthcare technology platform can be used to disseminate trusted information (verified with obstetricians) and provide customised content based on the stage of pregnancy. 

Given that smartphone penetration and internet access have reached the rural areas, such a platform can be invaluable as it will help underserved expecting mothers become more invested in their and their unborn child's care process. Healthcare technology also assists those with limited mobility with reliable information and advice so that hospital visits can be kept to a minimum without compromising knowledge.  

Personalised healthcare plans

'Personalisation' is emerging as a healthcare imperative now. With patients on the path to becoming consumers of healthcare, healthcare providers want to create more tailored and personalised care plans for their maternity patients.

This can only happen when clinicians and doctors have access to complete health data of the patient and a method to communicate with the patient proactively. Clinicians can leverage technology and provide tailored maternal care and disseminate advice based on antenatal age to ensure healthier pregnancies. They can also use such a platform to ensure better adherence to healthcare best practices and receive smart alerts to take better care of high-needs patients.

Personalised care becomes especially important because no two pregnancies are the same. A normal and healthy pregnancy experience and care plan will be vastly different from that of a mother who has gestational diabetes, for example. The number of interventions, dietary restrictions, assessments, and points of care will also be vastly different and, hence, need personalisation.

Technology can skilfully help us cross this chasm of the 'one-size-fits-all' approach that plagues maternal care and can help to make the entire process more stress-free and beautiful.

Community help

There is an African proverb that says, "it takes a village to raise a child". 

But today nuclear families are a ground reality. Expecting mothers more often than not have to be completely self-reliant to navigate this minefield called motherhood.

Most countries abroad have thriving communities that help new and expecting mothers prepare for their life shift. These communities are a saving grace and contribute deeply towards a mother's mental health as she has someone to take her concerns, worries, and doubts. In countries such as India, these facilities are not easily available and often inaccessible. It is perhaps a handful of very high-end hospitals providing these services. But should community help be limited in access? What about those who do not have the financial means or come from the underserved parts of the community?

Technology can solve this problem, as well. It can be leveraged to create a place where expectant mothers can connect and communicate with their doctors. It can also become a peer to peer community that can be accessed by everyone irrespective of their location or financial status and hence can be a great boon to mother care.

Out-of-hospital specialist care

The antenatal experience does not end at childbirth. Mothers need more care and attention upon hospital discharge and in the weeks following childbirth. Women remain at risk of mortality due to problems such as sepsis, anaemia, and haemorrhage. During pregnancy, conditions such as eclampsia and pre-eclampsia, conditions that are associated with high blood pressure, can be dangerous for the mother and the child.

What is common in all these cases is that all of these conditions can be treated and deaths because of these can be prevented. Sepsis, for example, is common in India. But death from sepsis generally only takes place when there is a delay in diagnosis, treatment, and the escalation of that treatment.

To boost antenatal care, we have to focus on out-of-hospital specialist care. Mothers should not have to go back to the hospital for the smallest of concerns. But how can they determine what is a small concern? How can they be sure that the niggling headache or the acidity that was bothering them is not preeclampsia setting in? How can they know that the fever they are experiencing is not sepsis?

Healthcare providers need access to a high-end technology solution that helps them connect and communicate with their patients proactively, manage the patient remotely by capably tracking patient journeys, and ensure timely intervention when required. By enabling out-of-hospital specialist care, the healthcare experience of the mother across the care continuum can be dramatically improved, ensuring better mother and baby health.

We have a long haul ahead to elevate the quality of antenatal care to global standards in India. But taking small, calculated, measured, and continuous steps to identify problems and then exploring technology solutions to solve these problems can bring about the much-needed change. 

We owe it to mothers, to their newborn children and to the broader community.