An Emerging Model of Pregnancy Care: The Introduction of New Technologies in Maternal Wellbeing

An Emerging Model of Pregnancy Care: The Introduction of New Technologies in Maternal Wellbeing

Claudia Carissoli, Daniela Villani, Giuseppe Riva
DOI: 10.4018/978-1-7998-2351-3.ch002
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Pregnancy is a very special time in a woman's life, a time of important and complex step that can lead to the fall the previous personal balances and looking for new. This phase potentially critical, is often accompanied by anxiety, negative emotions, worries and stress about themselves, the couple's life, the baby. Among the many interventions available for the welfare of pregnant women, new technologies are playing an increasingly important role, thanks to its spread, the lower costs and its peculiar characteristics (interactivity, sociality, customizability, ubiquity, multimediality, velocity, etc). Smartphones and tablets in particular are proving excellent tools to accompany women on this journey toward a healthy motherhood.
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Pregnancy is a complex phase in a woman’s life, a period in which she changes her status from daughter to mother in just a few months. Becoming a mother requires a profound reconstruction of self (Barclay et al., 1997). This process of change is not bounded by a particular time frame, and it can even happen before the end of the neo-maternal month (Rubin, 1984).

In addition to biological changes, pregnancy leads to a search for a new identity that has to be positioned at the individual, couple and social levels (Stern et al., 1998; Bibring, 1959; Ammaniti et al., 1996; Monti et al. 2006).

In this sense pregnancy is a psychologically complex period in a woman's life, and every pregnancy could be seen as a phase of potential vulnerability. Indeed, this metamorphosis is characterized by physiological and psychological changes that can enhance anxiety or other negative emotional states and favor risky behaviors, such as the lack of attention to personal hygiene and prenatal screening, poor diet, alcohol consumption, smoking and drug use (Lindgren, 2001).

A wide consensus exists about the role of maternal psychological state in influencing the development of the child and the course of the pregnancy: negative emotions, such as anxiety and stress, are often associated with a redoubt variability in the fetal cardiac frequency, greater motor activity (which can cause spontaneous abortion), various pregnancy complications, pre-term birth and low birth weight (Hoffman & Hatch, 2000; Dunkel-Schetter, 1998; Dayan et al., 2002). Davies and colleagues showed that the level of maternal cortisol, measured between 30-32 weeks of gestation, is a predictor of a difficult temperament in children at two months of age (Davis et al., 2007); it is also inversely related to scores of cognitive and motor development in children at both three and eight months (Buitelaar et al., 2003). Anxiety detected at 32 weeks gestation was predictive of severe behavioral problems in children at 4 years of age (O'Connor et al., 2002).

This situation appears even more critical in cases of anxiety or depression disorders during pregnancy that are related to postpartum depression (Grant et al., 2008; Austin et al., 2007) and to negative effects on infant mental development (Tronick, 1999). Postnatal depression has been clearly associated with negative health consequences for both women and their babies (O’Hara and Swain, 1996).

Specifically, impaired maternal-infant interactions have been linked to vulnerability in infants and children (Murray et al., 1996), to attachment insecurity and delay in cognitive and emotional development (Hipwell et al., 2000; Murray et al., 1992; Cogill et al., 1986; Cummings & Davies, 1994), and to social and interaction difficulties (Murray et al., 1999).

As well-being of the mother is critical for optimal pregnancy outcomes, it is important to regulate maternal stress and provide expecting mothers with coping strategies to increase their quality of life and to maximize infant health and development.

Key Terms in this Chapter

Mobile Application: Software developed to be installed and run on mobile devices such as smartphones, PDAs or tablets. They can be both fun and useful, and they can be executed (run) on a mobile platform.

Progressive Muscular Relaxation: A relaxation technique of stress management developed by Edmund Jacobson in 1934, based on tensing and releasing tensions in the 16 different muscle groups. PMR (progressive muscular relaxation) programs include four sets of exercises: arms relaxation; face and shoulders relaxation; bust and legs relaxation. All exercises are based on two principles: contraction and relaxation, with the aim being to achieve a profound and aware state of calm.

E-Health: A general term for the use of information and communications technologies (ICT) in the healthcare promotion and medical fields.

m-Health: This term indicates the use of mobile and wireless technologies in health fields.

Guided Imagery/Visualization: A relaxation technique used to induce positive mental images, feelings and thoughts. Guided Imagery can be used by everyone: it is able to overcome barriers of education, class, race, gender and age. Because it involves all senses (not just sight) it is perceived as more pleasant and efficient. This practice is particularly powerful, as well as simpler than mindfulness meditation for most beginners.

Web-App: This term is used to indicate any program stored on a remote server and delivered over the Internet through a browser interface. They are usable only with an Internet connection and use HTTP as communication protocol.

Smartphone: An advanced mobile phone that includes mobile communication, a camera, a video camera, GPS system, a music player, Internet access, sensors and a range of multimedia capabilities in a single device. Several accessories are being developed to transform smartphones into “medical machines.” They can become meters of blood glucose level, blood rate of oxygen, blood pressure and so on.

Empowerment: Consists of a process of increasing personal resources and awareness of them to promote individual wellbeing and environment adaptation.

Mindfulness: A type of meditative technique that emphasizes an observant and nonreactive stance toward one’s thoughts, emotions and body states. It involves purposeful attention to daily activities (e.g., mindfulness of eating).

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