East Tallinn Central Hospital: the pregnancy app reduces inessential visits to the doctor

This March, a new pregnancy app developed by Estonian midwives became available. The head of midwifery at the Women’s Clinic of the East Tallinn Central Hospital, Vivian Arusaar said the idea for the mobile app was inspired by pregnant women who were using various apps in languages other than Estonian. Unfortunately, the information in foreign apps was often incompatible with the Estonian healthcare system and pregnancy monitoring plans.

Vivian Arusaar and Silja Staalfeldt-Rahumägi, midwives at the East Tallinn Central Hospital women’s clinic and the originators of the app idea, said that the flow of information about pregnancy and for expecting mothers is high. As such, it can be difficult for women to filter out the essential information, as some false information have been known to circulate even in most reputable forums.

“Actually, pregnant women at our clinic have been using various foreign originated apps, either in English or Russian for a long time, but these are incompatible with our healthcare system and our consensus-based pregnancy monitoring plan,” said Staalfeldt-Rahumägi.

Arusaar added that midwives were often asked questions about tests and procedures that are not performed in Estonia. Staalfeldt-Rahumägi said there is a great deal of information that midwives look to give pregnant women at appointments, such as the right time to start with parent coaching. Patients don’t necessarily remember such things from appointments and thus the information could be somewhere for reference. In addition, there was interest from the women themselves, whether there were any Esto-nian-language apps, and that led to the idea to develop the app.

Arusaar said that the Estonian Health Tech Cluster played a role in the decision of creating the app. Namely, the cluster was consulted and it was confirmed that there is market demand for such an application and it should be pursued. Thus, the process received a strong push from the cluster. Arusaar said that above all, they try to refer people to the right sources, such as the Riigi Teataja or a website of any state institution that releases reliable high-quality information on the subject. Since pregnant women in this day and age love to take notes and compare their pregnancies, they want the information to be handy at any time – and the app provides that opportunity. Information can be shared with girlfriends and if there are any questions at the appointment, the notes can be immediately viewed on the app.

Since pregnant women in this day and age love to take notes and compare their pregnancies, they want the information to be handy at any time – and the app provides that opportunity.

“For example, the app provides a long list of typical complaints and details on the reason for the complaint. It provides recommendations for alleviating the complaints and can also give an indication about when the situation is a medical emergency,” said Staalfeldt-Rahumägi. Arusaar added that of course the app provides standard information as well, such as a pregnancy calendar with information on what takes place during each stage of the pregnancy as the foetus develops.

The greatest benefit for pregnant women in Estonia, according to Arusaar, was the fact that an Estonian-developed app supports pregnancy monitoring and takes into account developments in the Estonian healthcare system and legislation. Naturally, the information on the period of the maternity leave, compensations and the like have all been adapted to the Estonian environment.

Staalfeldt-Rahumägi noted that it was worth mentioning that the app provides close to 20 automated reminders in different phases of pregnancy, alerting the expectant mother to what procedures should be performed, such as an ultrasound during the first trimester and reminding the patient to inform the midwife if it has not been performed. Another reminder concerns the need for notifying the employer about the maternity leave. These notifications are sent out automatically at certain stages in the pregnancy.

“It is not at all exceptional for the woman to call her midwife and ask her to calculate when she should go on maternity leave and then the midwife does so. Now the woman herself can easily make the necessary calculations,” said the midwife.

Arusaar also noted that the actual tar-get group for the app extends beyond pregnant women and includes those who are still planning their pregnancy. “The app allows us to determine the expected fertile window,” she says, but warns that this is not a reliable contraceptive method and that women should choose other, more reliable ways of birth control.

Arusaar said the development of the app was based on teamwork. A team of four East Tallinn Central Hospital employees worked on the development (two midwives and two IT-specialists) but of course various phases needed more specialists to cooperate. For example, a lawyer, a data security manager and various doctors provided advice and put in hours of work to make sure everything was top-notch.

“The newly developed app will definitely reduce physician visits as it is a source of good-quality information and can help to allay a patient concerns. It is possible to find false, even life-threatening advice on search engines, but everything in our app is verified and reliable. We hope that patients will take more responsibility for their health from here on,” said Staalfeldt-Rahumägi.

Both, Arusaar and Staalfeldt-Rahumägi confirmed that the app is like a continuous process that will never be fully finished. As time goes on, new features will be added.

The pregnancy monitoring app is available in Estonian and Russian and meant for use in the Republic of Estonia. The app is free of charge and can be found from app stores by searching for “Rasedus” (pregnancy) for Android and iOS.