Many of us in family medicine practice full scope including obstetrics and urgent/emergent care. This is one of the most rewarding aspects of the specialty, but also one of the most challenging with very unpredictable hours and significant medical-legal risk. Routine vaginal deliveries can quickly deteriorate into one of many frightening obstetrical emergencies. Recent data from the CDC shows a sobering statistic that maternal mortality in the U.S. is increasing not decreasing. The number of reported pregnancy-related deaths in the United States steadily increased from 7.2 deaths per 100,000 live births in 1987 to 18.0 deaths per 100,000 live births in 2014. Multiple media outlets have recently been reporting on this trend include a 6-month expose by National Public Radio and ProPublica that highlights numerous stories and the CDC data. The three most common causes of maternal mortality worldwide and in the U.S. have not changed: postpartum hemorrhage, venous thromboembolism, and severe hypertension of pregnancy. The Safe Motherhood Initiative is a response of sorts to these disturbing trends. The SMI is an initiative of ACOG District II in New York State. This group links hospitals across the state together and provided healthcare bundles and education aimed at reducing mortality from these three most common lethal pregnancy complications. They have even released a medical app for iOS and Android that brings together these materials.

Many family physicians and even some obstetricians and midwives have completed the outstanding Advanced Life Support in Obstetrics (ALSO) course. This two-day course covers many of the above emergencies. Unfortunately, ALSO has no medical app, but rather good but not great pocket cards. Here on iMedicalApps, we have reviewed other ob/gyn apps that include some information on OB emergencies. One of my perennial favorites has been the excellent combination app by Dr. Mark Brancel, PrenatalOB/UrgentOB/NewbornCare. However, since these guides became a web-only affair, I have not found them to be nearly as easy to use as their previous iOS dedicated app formats. This new app from the Safe Motherhood Initiative helps to fill this void.

Evidence-based medicine

The Safe Motherhood Initiative app is the product of ACOG District II in New York State. The information in the app is a combination of expert opinion, ACOG position statements, and algorithms supported by evidence-based medicine, clinical practice guidelines and standard of care medical practice. The app contains easy to follow (but not necessarily easy to view) checklists, algorithms, and teaching slides targeted at the top 3 most common causes of maternal mortality.

What providers would benefit from this App?

Students, residents, nurses, family medicine, midwives, ob/gyn, emergency medicine, and any provider who performs obstetrics.

Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.

  • Price
    • App is free.
    • Perfect to review while waiting for deliveries, emergencies; good for teaching.
    • Covers the 3 most important conditions related to maternal mortality.
    • Available for Android.
  • Dislikes
    • Needs internet connection for much of the material.
    • Limited to 3 conditions only.
    • Some of the material is difficult to view on a smaller device screen.
  • Overall

    The Safe Motherhood Initiative app targets a growing problem in the United States and a pervasive problem worldwide–maternal mortality. The app brings together the most current evidence-based recommendations from ACOG on obstetric hemorrhage, venous thromboembolism, and severe hypertension in pregnancy into a point of care app.  This app, if used during prenatal visits and on the labor deck, will save lives. I only wish it covered more obstetric emergencies.

  • Overall Score
  • User Interface

    Heavy reliance on internet condition to pull up/view material limiting usability.

  • Multimedia Usage

    App is brimming with checklists, PDF’s, teaching slide decks, algorithms and links to the Safe Motherhood Initiative website.

  • Price

    App is free.

  • Real World Applicability

    The Safe Motherhood Initiative puts evidence-based tools in the palm of your hand on the labor deck and in the prenatal care clinic. The app targets the 3 most common causes of maternal mortality. However, this limited number of topics and heavy reliance on PDFs limits the apps usability.

  • Device Used For Review

    iPhone 8 running iOS 12.0

  • Available for DownloadAndroidiPhoneiPad