Every pregnancy journey is unique: from conception to the actual pregnancy experience, and then the delivery and postpartum period, each phase comes with its own unique set of challenges. After a particularly tumultuous conception journey, I entered the first trimester of my pregnancy full of anxiety as well as hope. Since visits to the OB were few and far between, I asked friends and family for pregnancy app recommendations. Though helpful, all of the pregnancy apps that I tried had very generic content and left me with many unanswered questions. While it was fun to know my baby had progressed from the size of an apple seed to a lemon, I wasn’t sure if losing weight in the first few weeks of pregnancy was expected or something to be concerned about. I felt that there were significant unsupported gaps in my pregnancy care, and there was a dearth of resources that provided proactive, personalized information to fill these gaps.
Except for some severe bouts of heartburn, the second trimester of my pregnancy was relatively stress-free. As I googled expected symptoms and "pregnancy-safe" heartburn remedies, it struck me that my experience represented the open-loop care gaps that many medical specialties, including obstetric care, suffer from. My OB was stretched for time and like many other providers could only spend an average of fifteen minutes per visit conducting clinical tests and addressing concerns. As a patient, my main option was to maintain a written journal with detailed notes and documentation of the symptoms that occurred between visits, which I would provide to my OB the next time I went in for a check-up.
It would have helped to have a conduit between my OB and the care team; a seamless way to communicate with my OB during those “in-between” times. A digital platform where my doctor and I could communicate would have both alleviated my anxiety and given my care team a way to tell me if any of my concerns needed a follow-up, ultimately saving those precious 15 minutes of in-person care time for more direct care.
In my third trimester, much to my own dismay, I took and failed a glucose test– an indicator of gestational diabetes. I did not have a personal or family history of diabetes, so this came as a complete surprise. As I shuffled between a diabetes educator, a nutritionist, and my OB, I truly felt the fragmented nature of our current care system: all of these resources were distinct and each presented a different emphasis. The educator walked me through the extremely painful process of pricking my fingers four times a day and logging my glycemic values on a spreadsheet. My nutritionist recommended a list of approved foods and taught me to quantify my carbohydrate intake. My OB explained the implications of this diagnosis and warned me to closely comply with the nutritionist’s guidelines or risk having a significantly large baby. Understanding the larger picture about gestational diabetes and its long-term implications for both me and my child was ultimately my responsibility and highly dependent on how much time I had for research any given day.
As a working mother-to-be, this analog tracking and data capture multiple times a day was challenging on many levels. I relied on a manual spreadsheet to create a food and glycemic log. Despite working with three separate providers, I often felt unsupported. I wasn’t sure what information would be relevant, and as I meticulously logged anything I could think of, I kept wondering: Who is reviewing my carefully documented spreadsheet, and how frequently? Who will get notified if I log a concerning glycemic trend, and how?
After a fortunately uneventful and successful delivery, the clinical focus for my care team shifted to the baby and her needs. I marked my calendar for all our pediatrician visits, but my postpartum visit felt like an inconvenience and a formality. There was limited guidance on what I could expect, and few recommendations for appropriate tests or procedures to confirm that my gestational diabetes remained under control. It became evident that the care gap I experienced during my pregnancy also extended into the postpartum period.
When we started designing the Delfina Care system, it felt like a full circle moment. As we build a new care system that supports moms like me, I reflect daily on how it would have closed the gaps in my own pregnancy journey. Our Delfina team is now pioneering a closed-loop, continuous and customizable solution to create a safe, healthy, and supported journey for every pregnancy.