To maternity and beyond
There are many tools out there that help us take a glimpse into our reproductive biology. These tools include everything from basic logging of your day-to-day information to community boards that allow one to take a look at what others have to say and share on this topic. But, for the most part, the world of capturing data on the reproductive biology is divided into period trackers, ovulation trackers and pregnancy apps. There are a lot of apps that one can choose from depending on their properties whether the app should be free, easy to use, discrete, if it offers a lot of information, allows to capture important notes and has reminders. Unsurprisingly, most of these apps start with the same question “when was your first day of your last period”, yet they are worlds apart from each other.
So, on the one hand, there are apps collecting all sorts of information leading up to a pregnancy, and on the other hand, apps that only deal with pregnancy, baby and breastfeeding. There are some apps available for postpartum care but they don’t offer as much information on other topics, and most of the time focus on getting back in shape. In other words, when looking in the details of what one reproductive biology can accomplish not one app has the capability to capture it all.
Looking into the details of period tracking apps that help capture dates and remind the user of dues and delays, or generally speaking, help to monitor the reproductive biology. Some of the apps will also give information on ovulation period and thus help with either avoiding the pregnancy or getting pregnant if that is what is wished. Pregnancy apps also capture and give updates data day-to-day, show fetus progress mostly with depicted information and what’s happening to mom, and any other important information.
Unfortunately the world of menstrual tracking apps and pregnancy apps is in somewhat separate places, despite the fact that they all capture one reproductive biology.
There are many apps available to choose from that deal with period tracking or pregnancy. According to a study by the journal Obstetrics & Gynecology Clue and Glow are the leading apps in this area.
Clue is well designed, minimalistic and easy to control, and most importantly not pink! It allows one to capture a “positive pregnancy test”, which is then marked on the Current Cycle, however, this doesn’t govern other options from this point on, instead, the cycle is just stretched out until a start date for next cycle is entered. So there is no option on the app to capture the fact of “Pregnancy”, and although “positive pregnancy test” can be entered, the current cycle remains as it is, waiting for your next cycle to start any day, even if no more period data has been entered for a long time.
Glow has period tracking, pregnancy and baby apps available, with both free and paid versions. Both versions offer appropriate information as well as community hub where people can exchange their personal experience and ask questions. Glow is for period and ovulation tracking and Glow’s “Eve” is a period tracker and sexual health app. Glow’s “Nurture” offers pregnancy related information that seems to be based on the book “The Day by Day Pregnancy Book”, there are new topics available every day and the paid version offers additional information on specific topics in greater detail. There is also Glow “Baby” that gives parenting tips and allow to track baby’s milestones, breastfeeding and more.
User details can be shared across the apps and the status page gives an overview of all the apps and allows user to set their health status e.g. “I’m pregnant!”, which turns off period predictions, however, from that point on, it suggest to the user to use the Nurture app. The distinction between the Glow and Eve is very subtle, as a user might want to avoid pregnancy and still follow up on sexual health, therefore it is unclear why the separation between the two apps. In my humble opinion, Glow seems to be overcrowded with information, interactions and allows ads in the free version. Further, there is no information on how the user’s data is used inside the app, although this information is accessible on the web. One has to mention their security breach detailed here.
In summary the world of reproductive biology apps is broken into worlds of “when is your next period” apps or “when you can get pregnant” apps or “you are pregnant” apps or “hey, let’s forget that you had the baby” apps. In general, what is offered is an insight into what happens before and during a pregnancy, but thereafter the apps become less focused on the mother and instead on the baby. Which is confusing for new mothers as it assumes that they would return to their usual pre-pregnancy apps without a blink of an eye. Babies are very important, but what is also important is to point out that this separation appears unnatural, unnecessary, counter-intuitive and should be addressed.
Understandably, each app handles two specific chapters of a reproductive biology and on their own each app gives a great amount of information for the specific chapter in life. However, what’s missing is how a pregnancy can affect the reproductive health during and after it occurred. The many varied outcomes of pregnancy, e.g. miscarriage, abortion, birth, just to name the few, that could have both short and long lasting effects on the health, aren’t a part of what’s considered.
For example, are there any consequences or risk factors to gestational diabetes? Gestational diabetes poses a great risk during pregnancy if left untreated and may result in stillbirth. Moreover, research shows that women who have gestational diabetes are at an increased risk of developing type 2 diabetes later in life. What happens if one has gestational diabetes with every pregnancy? In cases where gestational diabetes is detected during 1st pregnancy, women are observed and tested on all the subsequent pregnancies from the very beginning. This information is saved with the pregnancy apps, but how is this information replicated in reproductive health apps?
Furthermore, let’s consider the case of how breastfeeding affects the menstrual cycle and how to track this information on the apps. The absence of the period while pregnant and maybe breastfeeding could be many months, considering full term pregnancy of 40 weeks and if the woman decides to breastfeed, in case of exclusive breastfeeding it could take up to 6 or 7 month for the period to return. Altogether it could be up to 17 months before the menstrual cycle is returned. All this can lead to questions like:
- Will abstaining from entering monthly cycle data during this time have an influence on the average menstrual cycle?
- If the information of lochia is entered to the period tracker will that cause a havoc and interfere with the data on menstrual cycle?
- Does the absence of a period mean the absence of ovulation?
One app for one reproductive system would not go amiss!
Clue is clean and clear and arguably the best app for tracking a period, it gives details about what’s happening with the monthly cycle and allows to enter various extra details over time. It also allows a user to personalise notifications so one can keep them fun and whimsy, so no one knows what they mean. User can also switch the desirable tracking options on or off, and every one of these options comes with an extra information page explaining every option with list of references. It’s also worth mentioning that Clue does not share the information with dubious companies and instead it has partnered with universities that works with all the anonymously stored information and are part of scientific research, which is always a plus. But where it’s lacking is the correlations between pregnancy and reproductive biology regarding complications or outcomes.
While I’m really happy with the progress made in femtech that deals with women’s health, including cycle tracking, pregnancy and breastfeeding apps, e.g. Clue and Glow just to name a few, there is still a steep road ahead.
All the meaningful and important experiences that come with a pregnancy or birth are captured separately, stored to look back at, as if only for sentimental reasons or to remind yourself how difficult, painful and beautiful it was; and not as a chapter in life and part of reproductive and menstrual health. We all share our experiences, whether in private with our friends and family, or as part of either our online or a local community of the mothers and pregnant women who want to know and understand what awaits and who is out there to help. But when it comes to combining all the knowledge and experience with usefulness of it for yourself or your future health monitoring, that is when it’s missing the connection and subsequently the value.
Expanding the capability from “pregnancy test: positive” to “status: pregnant” could help the active user to engage with the period tracking app and not have to leave it for a long period of time. By adding more capabilities for the pregnancy options like entering any gestational issues e.g. gestational diabetes, obstetrics cholestasis, blood pressure, etc., not only would keep the user engaged with the app but also allow to track these data and allow calculating correlations in the future. The aim is to connect the pregnancy period with the period trackers as they are both part of reproductive biology.
This is just my point of view as a user and in no circumstances a critic to a beautiful and not at all pink app “Clue”, as well as Glow. But I think a stage of becoming a mother and it’s transitions to and from it should be captured homogeneously and not separately, or at least allow capturing major issues to begin with could be a good start of the journey.