By Christina Orlovsky
For many mothers-to-be, pregnancy is a time of excitement and expectation, as they eagerly await the arrival of their newborn. For many more, however, it is also a time of uncertainty, anxiety, and unanswered questions. This is especially true in diverse communities across the United States – the only developed country whose maternal mortality rate has been steadily rising over recent decades. In fact, the most recent CDC statistics show that there were 20.1 maternal deaths per 100,000 live births in 2019, up significantly from 17.4 the year prior.
This grim statistic is also accompanied by further data that shows disparities among racial and ethnic groups, with Black, American Indian, and Alaska Native women two to three times more likely to die from pregnancy-related causes than white women. They are disproportionately affected by pregnancy complications like preeclampsia, pregnancy-induced hypertension, and gestational diabetes. These inequities underscore the need to include diverse populations in research on maternal care to reduce these disparities and improve the outcomes for pregnant people of all races and ethnicities.
That’s where PowerMom comes into play. An innovative smartphone app-based research study conducted by Scripps Research, a leading institution for research in the biomedical sciences, PowerMom was born out of a commitment to transform medical research through digital data. A community for a community, PowerMom’s mission is to uncover patterns in healthy pregnancies and discover answers to questions moms (and soon-to-be-moms) have about their bodies and their growing babies. With the help of thousands of study participants, PowerMom strives to answer important questions about what makes a healthy pregnancy for the diverse pregnant population in an effort to ensure the health and well-being of all moms and babies for generations to come.
Here, Tolúwalàṣé (Laṣé) Ajayi, MD, FAAP, the lead researcher for PowerMom, shares what inspired her passion for this powerful research and how PowerMom aims to help achieve equity in maternity care for all pregnant people.
Q: What inspired you to pursue research in maternal health?
LA: This was a personal passion project of mine. When I was pregnant with my first daughter in 2017, I learned from experience just how different each pregnancy can be for everybody. Also, because of my background in pediatrics, I am also well aware of the health disparities that happen within pregnancy care, and even how I was treated with my own pregnancy. Again, I'm a pediatrician. I work within a health care institution. I received care at my own institution, and I was blatantly discriminated against. I didn't have an outlet. I felt that even though I am educated and versed in this population, I didn't have a tool to allow me to be heard. I realized that PowerMom can be such a powerful tool to really gather data so we can have healthy pregnancies for everybody.
Q: What are some of the disparities that are occurring right now in research and just with pregnant women at large?
LA: There are a couple. With research at large, we know that there's a large disparity in who gets funded to do clinical studies. There's a large disparity in the type of principal investigators who are selected from racial, ethnic, and LGBTQ backgrounds. Those who are funded to do clinical studies and those who are conducting the clinical studies really affect who then enrolls in clinical studies in general. The result is a disparity within the population who's conducting the study, and then those who actually participate in the study.
Q: How does this affect pregnant women at large?
LA: In general, pregnant people were not included in research because we have been seen as – and I say "we" because I just had my second daughter – a protected population. Finally, when you look at the disparities within the type of pregnant people included in research, you see a large underrepresentation within Black, Hispanic, Native American, and other ethnic and racial minorities.
Q: How is PowerMom working to effect change in these important areas?
LA: PowerMom’s unique digital platform breaks down barriers to accessing research, allowing more people to participate from anywhere. This way, we can gather data – through surveys and data collected from wearable devices like a Fitbit or Apple Watch – from diverse participants and build a community representative of a full spectrum of racial and ethnic groups. In this way, we are putting the participant first – meeting them where they are. When a participant sees that a study is being directed at them and for them, they're more likely to engage. They're more likely to want to put forth their data and be included, because they're seen as partners, and as equals within the study.
Q: How does all of this empower pregnant people?
LA: We are empowering women with their data. We are providing them with a tool they can share with their health care provider and say, “This is different.” We are giving them a record they can keep track of their baseline and their changes. It’s a tool that allows them to advocate for themselves and actually have a conversation. By having that conversation, not only are they helping themselves be educated, but they’re also helping their health care providers be educated. They’re helping health providers say, "You know what? Maybe the way that we're doing these things isn't the best way, or it isn't really a way that addresses everybody. How can I change my practice so I can actually help my patients better?"
Q: How do you see PowerMom growing in the future?
LA: Right now, PowerMom is largely observational: gathering data, seeing what works, how we can approach women, and what's happening in women's lives. Next, I would like to power PowerMom to do interventions. How can we then use technology to address things like preeclampsia? How can we use interventions to reduce gestational diabetes, to treat pregnancy induced hypertension, to then intervene to treat these conditions earlier? That's where I see PowerMom growing in the near future.
Christina Orlovsky is a medical copywriter for Scripps Research. She specializes in the creation of health-related content and has more than 2 decades of experience in feature writing, marketing, and copywriting for national print and online publications and health care organizations.
In collaboration with WebMD, PowerMom is a smartphone app-based research study that enables expectant mothers to share data about their pregnancies with scientists. For more information or to enroll in PowerMom, visit https://powermom.scripps.edu/ .
This article is part of WebMD/Medscape’s contributor program, which lets people and organizations outside of WebMD/Medscape submit articles for consideration on our sites. Have an idea for a submission? Email us at [email protected].