Implementation and Use of an Integrated Digital Antenatal Care Model: A Single-Centre Pilot Study

Pregnancy care has long followed a familiar rhythm: a series of scheduled visits where a woman travels to a clinic, waits in a room, and meets a doctor or midwife to check her blood pressure, listen to the baby's heartbeat, and discuss how she is feeling. This routine is designed to catch any signs of trouble early, but it demands significant time and effort from the expectant mother, often involving long commutes, time away from work, and the stress of navigating busy hospitals. For many, the sheer logistics of these frequent appointments can be a barrier to consistent care. In recent years, technology has offered a potential shift in this dynamic, suggesting that some of these checks could be done from home. The idea is not to replace the human connection of a medical visit, but to move the routine measurements into the daily life of the family, allowing the clinical team to review the data remotely and step in only when necessary. This approach, known as telehealth or remote monitoring, aims to keep the safety net of medical care intact while making the experience less burdensome for the family.

Researchers at a large hospital in Western Australia decided to test whether this vision could work as a complete, integrated system rather than just a collection of separate gadgets. They built a digital platform called the Connected Maternity Care model, which brought together several tools into one smartphone application. The system allowed women to measure their own blood pressure, track their weight, and record their mood. Crucially, it also included a wireless device that let them listen to their baby's heartbeat at home, a task that usually requires a visit to the clinic. The app sent all this information securely to a dashboard where midwives and doctors could review it. If a reading looked unusual, the app would alert the woman to check again or contact the team, and the clinical staff could see the data in real time. The model also replaced about thirty percent of the usual in-person visits with video calls, creating a "hybrid" schedule that mixed home monitoring with virtual and physical appointments.

To see if this system worked in the real world, the research team invited 209 pregnant women to join a pilot study. The participants were women with single babies who could read English and had access to a smartphone and the internet. Over the course of the study, which ran from mid-2021 to mid-2022, the women used the app to record thousands of measurements. They completed over 2,500 recordings of the baby's heartbeat, more than 1,000 blood pressure checks, and nearly 1,700 mood ratings. The system was active enough that it generated hundreds of automated alerts. Most of these alerts were minor, simply prompting a woman to take another measurement or contact the service for reassurance. Only a small fraction, about four percent, required a doctor or midwife to step in for a clinical review. This suggested that the system could filter out false alarms while still catching the moments that truly needed attention.

The women who used the system reported that they liked the experience. In a survey, the average rating for their overall experience was very high, and nearly all respondents said they viewed the home monitoring positively. Many appreciated the ability to hear their baby's heartbeat between visits, which gave them a sense of peace and connection. They also valued the educational information the app provided, which covered everything from nutrition to labor preparation. When asked about their preferred style of care, a majority chose a hybrid model, wanting to keep some video visits and home monitoring while still seeing their care team in person for key appointments. The technology itself worked well for most, though a few women faced technical hurdles, such as difficulty syncing the app or finding the baby's heartbeat signal, which caused them to stop using the system early.

The study also looked at the health outcomes of the mothers and babies to ensure that this new way of caring was safe. The babies were born at an average of 39 weeks, and the rate of preterm birth was low. Most deliveries were vaginal, though some required assistance or a cesarean section, which is typical for any group of pregnancies. The health of the newborns was generally good, with most scoring well on standard health checks immediately after birth. A small number of mothers and babies were readmitted to the hospital within a month of giving birth, but the reasons were consistent with what is seen in standard care, such as wound infections or breathing issues in newborns. The researchers noted that because this was a small pilot study without a control group, they could not prove that the digital system caused these good outcomes or that it was better than traditional care. They could only show that the system was feasible to use and that the women found it acceptable.

The researchers concluded that this integrated digital model is a practical way to deliver antenatal care, successfully combining home monitoring, education, and remote communication into a single workflow. The study demonstrated that women could use the technology to generate a steady stream of health data, and that the clinical team could manage the alerts without being overwhelmed. However, the authors were careful to point out that the study had limitations. The participants were mostly English-speaking women with smartphones and internet access, meaning the results might not apply to everyone, particularly those facing language barriers or financial hardship. The study also took place during a time when telehealth was already expanding rapidly due to the pandemic, which may have influenced how easily people adapted to the technology.

Ultimately, the findings suggest that a hybrid approach, blending home monitoring with traditional visits, is a viable path forward for maternity care. It offers a way to reduce the burden of travel and waiting while maintaining the safety of regular medical oversight. The researchers emphasized that this model should not indiscriminately replace face-to-face care, as physical exams and direct observation remain essential for many situations. Instead, the goal is to create a flexible system where technology handles the routine checks, freeing up time for the care team to focus on complex needs and ensuring that every woman, regardless of her circumstances, has access to the support she needs. The success of this pilot points toward the need for larger studies to see if these benefits can be sustained and made available to a wider, more diverse population.