More monitoring, less care

This article was posted on a pregnancy information board I follow:

Israelis develop wearable device for non-stop fetal monitoring

It got a few likes, no comments so far, but it was posted on a Sat night… At times like these, I want a ‘dislike’ button.

Technology seems to be disproportionately distributed in two main areas: social media and maternity care. As my dear friend likes to say, “when will the techies give up developing more ways to talk to each other and start working on developing a robotic maid!?” And I will extend that to, “when will medical techies stop developing more technology for pregnancy and start applying their energies to people who are actually sick??”

The device in the article is meant to allow a pregnant woman to be monitored 24/7 from home. According to the article, the fabric strap will register data such as fetal and maternal heart rates, fetal movements, and many other bits of information:

“Now you can see both you and the baby, the heart and all the data. What you are going to get in the app eventually is visualization that can tell you where the hand is, you’re going to see if the baby is awake, you can hear your baby’s heartbeat anytime you want. And, obviously, everything about you as the mom, if you are relaxed, how you sleep, your activity, your heart activity, everything about your pregnancy will be put into data,” he explained as he demonstrated the device for a mother-to-be, Michal.

Michal is then quoted as saying that this will help her be more connected to her fetus and be less dependent on doctors.

I doubt that. What I do think it will do is make pregnant women and doctors more dependent on flashing lights and electronic alerts than on their own instincts, training and care. I think it has the potential to lead to more unnecessary interventions, and concerns rather than reassurance and contentment. A device that allows care providers to keep even more distance from their patients is not a positive thing. Pre-natal care, at least in Israel, is already anything but “caring”. Most women go through their entire pregnancy never once being physically cared for by a nurse or a physician. She goes to a nurse in her health clinic for regular prenatal check ups where she pees in a cup, has her blood pressure measured in a machine (not with a cuff that requires the nurse to actually come in contact with you.) She may have blood drawn, but that would be with a different nurse. She will see her doctor a handful of times, during which her fetus is checked with ultrasound and that’s about it. In fact, women who don’t want an ultrasound at every doctor’s appointment are told that it’s not worth coming in at all! No one measures her belly, no one palpates her baby, no one touches her arm to comfort her or even takes the time to see if she needs comforting.

And what’s worse is the lack of continuity of care! When our dear pregnant woman shows up for her birth, she is cared for by the midwives on shift and the head doctor will pop in once a shift. I am in no way criticizing Israeli midwives. Most of the ones I’ve personally been in contact with have been caring, knowledgeable, competent providers. But they are operating at a deficit. They are working under conditions that do not allow them to connect and spend time with the birthing mothers. They have never met before the birth and therefor have only as much information as a medical chart can provide. And that is substandard maternity care in my book, reflective in a huge black hole in the health care system, not in the midwives themselves.

This device allows doctors an even greater measure of distance, and the “authority” to pronounce the needs of a pregnant woman based even less on actually caring for their patients. What it does perpetuate is the ridiculous concept that pregnancy is an illness, rather than a normal function of a healthy life. I agree that there are high risk pregnancies where a monitor like this one could be a lifesaver, both physically and emotionally, but it’s not being targeted to high risk OB’s, it’s being marketed all women, in the same category as a band to play soothing music to your fetus. as if the lovely sounds of your voice, your heartbeats, the internal slurps and gurgles of your healthy body aren’t enough.

I would love to see this technology applied in the medical fields of geriatrics, diabetes care, oncology, cardiology… situations where having a monitoring device like this would allow a person with real medical risks to live a more normal life without the constant disruption of doctors visits. Maybe such a monitor would have saved my friend’s diabetic father from losing his toe by detecting the infection sooner. Maybe it could have allowed my grandfather to spend his last days at home with family instead of connected to all the machines that were not supporting him, only keeping the doctors informed of his status. That would be progress!

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