Midwife Develops iPhone Application for Expectant Parents

by Melissa Garvey, ACNM Writer and Editor

If you’re an ACNM member, you may remember Sandie Mulcrone, CNM, from the Spring 2008 and Spring 2009 issues of Quickening. I first interviewed Sandie after she successfully pioneered her way to a new hospitalist position at Advocate Christ Medical Center in Oak Lawn, IL. One year later, Sandie contacted me to share how she started her own business to improve women’s access to breastfeeding equipment. This summer, she’s at it again with yet another pioneering idea: iBabySono.

iBabySono is an iPhone application that allows expectant parents to store, sort, display, and share their baby’s ultrasound photos via iPhone, Facebook, and other online channels. Parents simply download their ultrasound pictures, then use iBabySono to upload the images and create virtual scrapbooks, calculate baby’s age, post images to Facebook, and send e-mail attachments to friends and family.

“Expectant moms and dads are experiencing one of the most exciting times of their lives,” says Sandie. “This is their future, a little person who represents their hopes and dreams. iBabySono lets them share that excitement and that joy with everyone they love from the earliest possible stages of their baby’s development.”

iBabySono is $2.99 in the iTunes app store and comes with a $10 discount for use at Sandie’s business, Perinatal Home Medical Supply.

What are some of your favorite apps for expecting and new parents or families?

The Evidence is In: Texting Helps Teen Moms

by Melissa Garvey, ACNM Writer and Editor

In February, ACNM signed on as an outreach partner with Text4Baby and I posed the question, “Do you expect Text4Baby to make a meaningful difference in the lives of women and their babies?” I found the answer this week on MTV’s 16 and Pregnant. Watch the clip below for an inside look at how Text4Baby is, without a doubt, making a difference.

MTV Shows

Text “BABY” to 511411 to sign up for free.

What Mammography and Continuous Electronic Fetal Heart Rate Monitoring Have in Common

by Melissa Garvey, Writer and Editor

Earlier this week the U.S. Preventive Services Task Force (USPSTF) issued revised breast cancer screening guidelines: women in their 40s who have no unusual risk factors for breast cancer should not receive routine mammograms for early detection of breast cancer and should instead begin routine screening at age 50.

This is proving upsetting especially to women who were diagnosed with breast cancer at a young age, which is understandable. At the same time, I can't help but wonder…is routine mammography for women in their 40s who have no risk factors for breast cancer akin to continuous electronic fetal heart rate monitoring (EFM) for all women with low risk pregnancies?

Fetal heart rate monitoring during labor is essential, but continuous EFM may send up red flags where none are needed. EFM readings vary by machine and clinician. Jump on an abnormal reading too quickly and you may end up with an unnecessary cesarean section—major abdominal surgery that carries heightened risks for both mother and baby.

In fact, ACOG recently revised their EFM guidelines and put it into perspective in a press release containing this insightful statement:

“Since 1980, the use of EFM has grown dramatically, from being used on 45% of pregnant women in labor to 85% in 2002," says George A. Macones, MD, who headed the development of the ACOG document. "Although EFM is the most common obstetric procedure today, unfortunately it hasn't reduced perinatal mortality or the risk of cerebral palsy. In fact, the rate of cerebral palsy has essentially remained the same since World War II despite fetal monitoring and all of our advancements in treatments and interventions."

So, what about these revised breast cancer screening guidelines? Here’s a snapshot of the National Breast Cancer Coalition (NBCC) analysis of the revisions :

“Mammography can miss cancers that need treatment, and in some cases find disease that does not need treatment, leading to overtreatment with toxic therapies. Harms for healthy women who do not have cancer can include unnecessary imaging tests and biopsies, unnecessary exposure to x-ray radiation, and psychological trauma and anxiety.”

and…

“All breast cancers are not equal. Some patients will have fast-growing, aggressive tumors while others will have slower-growing, less aggressive tumors that are less likely to metastasize and, therefore, have a better prognosis. Screening is more likely to identify the slower-growing, less aggressive tumors because of longer asymptomatic periods. This “length-time” bias can make screening appear more beneficial than it is.”

Notice any similarities to continuous EFM?

What do you think? Are these revised guidelines a step toward backing off of our nation’s overuse of technology and interventions? Or was this a bad public health move?