Helpful or hurtful? Research weighs pros and cons of pregnancy trackers

Search “pregnancy tracker” in the app store and there are tons of hits for apps that will help you track symptoms, the fetus’ movement, and even their growth by comparing the baby to different types of fruit.

Using applications for tracking health isn’t unusual, especially during a time like pregnancy. But these apps don’t necessarily prepare users for different pregnancy outcomes or allow them to record personal moments during this time, according to research from Northeastern University.

Professor of game design Casper Harteveld teamed up with assistant research professor of art and design Giovanni Troiano and fourth-year Ph.D. student Ghada Alsebayel to look at the pros and cons of apps designed to track pregnancies as a starting point to see how apps can impact health and specifically women’s health.

“These apps are becoming mainstream,” said Alsebayel, who is getting her doctorate in human computer interactions. “People are using pregnancy tracking apps to help inform their habits and how they manage their pregnancies. But when you look at the literature, most studies look at these apps from a health perspective, meaning they measure their capacity for improving health behavior … and prioritize health outcomes.”

The researchers decided they wanted to instead look at the experience the user had using these apps in order to get a sense for how they could be better designed in the future. So they looked through reviews of different pregnancy apps to analyze people’s thoughts.

“From a medical perspective, if your pregnancy goes well and you don’t have any medical issues, then the health outcome is achieved,” Troiano said.

“From a human computer interaction perspective, health outcomes are a bit more broad. Is it just that you didn’t have any major sickness or health issues? Or is it also a process that, as a user, fulfilled your need to understand your pregnancy? That’s what we were interested in understanding.”

For their paper, the trio looked through over 4,000 online reviews over six popular pregnancy apps and found that many users complained of not being able to share their pregnancy’s progress with friends and family as well as the app’s assumption that every pregnancy would end in a live birth. The findings are published in the journal Proceedings of the ACM on Human-Computer Interaction.

The group also published a workshop paper that used the same method to gauge user perspectives from a focused data subset to see questionable design practices in commercial pregnancy tracking apps.

“Pregnancy apps are covering a really unique moment in the lives of human beings,” Harteveld said. “People cherish (that moment) and also are really concerned about it. Trying to see what an app can do from an ethical, experiential perspective and scrutinize that is an important thing to do.

“A lot of researchers tend to create their own products and see if it works. What we did is examine the products that are out there, how are people experiencing them, and what can we learn from that to do better, and especially when it comes to such a really sensitive and extremely important moment in people’s lives.”

Pregnancy tracking apps do more than just track a fetus’ growth, Alsebayel said. Many also offer educational features so users learn more about their pregnancy and healthy habits they can adopt during this process. Users can also use the apps to track their baby’s movements later in pregnancy.

Some apps also have tips on labor techniques and infant care for after the birth. The researchers found that people relied heavily on the former, with one reviewer describing it as “a doula in their pocket” which helped guide them through childbirth.

Alsebayel said this is just one way they found people using their apps beyond the intended use during the research. Users also used it to track their personal progress during the pregnancy, adding photos of their growing baby bump and wanted features that’d allow them to record the sound of the fetal heartbeat to share with friends and family.

In this, Alsebayel said the team identified unmet needs and areas where apps can improve.

“Pregnancy is a significant event for not only the woman who’s carrying the pregnancy, but other people in her life,” Alsebayel said. “So people were asking for ways to exchange information … in tracking their pregnancy. But that also introduces different challenges regarding privacy. We want to ensure that we can share in a meaningful way, but also not compromise the privacy of the user.”

While the study was beneficial in gaining insights on users’ thoughts, Harteveld said there were limitations around demographics. The researchers weren’t able to tell social demographics from user reviews.

They did, however, see some users complaining about a lack of representation and cultural sensitivity in apps. Some noted they could not change the race of the illustrations meant to represent their baby while others found the apps assumed the birth went well.

“One problem which was … not accounted for in the design was that it presumed the pregnancy ended positively,” said Troiano. “So what about the experiences where you know somebody is losing their baby? That was not accounted for and it was a persistent reminder in some cases. (The) pregnancy didn’t end positively and the app still sends a reminder about the baby. It’s not just annoying. At some point it was described as having negative effects.”

The paper ultimately comes up with guidelines to help app developers to be more mindful of this and serve users who experience other health outcomes, such as a difficult birth or a miscarriage.

“We advocate for improving and we call for designers out there … to be way more mindful when they design pregnancy apps,” Troiano said. “They need to be more inclusive of diverse experiences. There can be adverse effects.”

This story is republished courtesy of Northeastern Global News news.northeastern.edu.