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The under-recognised role of digital midwives and how it could change the NHS

By Misbah Mahmood, digital midwife, Leeds Teaching Hospitals NHS Trust

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Ahead of her session at Digital Health Rewired in March 2023, Misbah Mahmood reveals how the role of the digital midwife is changing and the key part it plays in digital transformation for NHS trusts.

The role of a digital midwife has traditionally been under-recognised, but that is now thankfully changing.

In March 2021, the Royal College of Midwives launched a position statement calling for every trust in the country to recruit, or train, digital midwives. And, in the same month, NHSX launched a new national digital midwife role.

I was among the first generation of digital midwives and was recruited into my role five years ago, initially as a six-month secondment. Since then, I’ve joined a huge online community of digital midwives and today I’m part of a team of seven.

My role has substantially evolved over the years and I’m keen to highlight not only its unique importance, but also, how much it resembles the work of digital nurses and chief clinical information officers (CCIO).

Regardless of the roles we hold though, one thing is clear – we all need to work together to deliver digital transformation.

How digital midwives play a unique role

There are some differences between digital midwives and other specialities. As a digital midwife, we focus specifically on delivering digital maternity transformation. We are a subject matter expert and recognised digital leader.

As part of the Maternity Transformation Programme, digital midwives “use their clinical expertise to streamline [traditional midwifery] processes and provide digital solutions for safer, more personalised care.”

What’s in a title?

But we shouldn’t get bogged down with titles. Most of the work of digital midwives resembles the digital nurse and CCIO roles closely and is equally important. On a day-to-day basis, I spend my time on similar tasks, but in a maternity context.

For example, I engage with suppliers and stakeholders about the scope of digital transformation projects. We work towards national initiatives, update computer systems, elicit feedback from service users, and help teach and train clinicians.

Most of my skills are transferrable to other digital roles. For example, data analysis and considering how systems will affect service users and clinicians. I have project thinking and management skills and have carried out large-scale digital implementations.

I also try to understand how digital change can work in practice. For example, logging in and out of five different systems where half the data is missing is never going to be fit for purpose.

Many of the challenges I face are also common to digital roles in other parts of the hospital. Interoperability is something CCIOs, digital nurses and midwives all face in our job.

Working in collaboration with other NHS digital specialists

As such, it’s essential for digital midwives to avoid working in a silo. We need to work together with CCIOs and digital nurses to ensure seamless data sharing and delivery of digital care.

It’s important to realise that, when a woman or birthing parents’ data is managed through a Maternity Information System (MIS), this is only a single episode in that patient’s journey.

Once the patient (and baby) leaves the maternity services for postnatal care, they are no longer a maternity-specific patient. They move from the maternity ward, and their data also transfers to more general nursing and clinical information systems.

The power of digital in maternity services

Working together has grown more important with the growth of the digital agenda in the last five years. Increasingly NHS trusts are dealing with the introduction of artificial intelligence, for example.

Patient expectations of managing their own health is also growing with the introduction of remote monitoring and virtual wards. Patients today can unlock their car with their mobile phone and even access their bank account, so why is it so difficult to access their notes online?

It’s much easier to transfer a woman or birthing parent to another trust if the clinical record is stored digitally, ensuring better and quicker care planning.

IT teams alone are often unable to keep up with demand. Midwives today, for example, are heavily dependent on laptops to do their job. Part of my team’s role is helping ensure midwives have the right hardware whenever they need it.

 Pioneering the future for digital midwives

I’ve been incredibly lucky that my trust pioneered the digital midwife role at a time when it had less recognition. Today I’m one of two digital midwives at the trust, aided by two digital support midwives and three data quality support.

I was lucky to have the opportunity to complete a one-year Florence Nightingale Leadership Scholarship, which led me to be mentored by the deputy Chief Midwifery Officer. Today’s digital midwives have even more opportunities thanks to a PG Cert for Digital Maternity Leaders at Imperial College.

The course has two levels: a foundation and a PGCERT level. I’m honoured to be completing the first cohort of the PGCERT.

Improving patient outcomes

The work we’ve done over the last five years as digital midwives is already transforming patient care. For example, one of the projects I’m involved in is delivering self-referral to maternity services, with prioritisation through EPR.

Pregnancy outcomes improve the earlier a patient is seen, and through our self-referral system, patients who are of a later gestation can be prioritised sooner.

In the future, by collaborating to collect and use data, and expanding our digital role, we hope to further improve patient outcomes to deliver the best possible care.

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Everything you should know about PCOS

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PCOS is one of the most common causes of female infertility, affecting six per cent to 12 per cent of US women of reproductive age but, according to the CDC, it’s a lot more than that. This lifelong health condition continues far beyond the child-bearing years. Here, we look at everything you should know about it.

 

What is PCOS?

PCOS is a condition in which the ovaries produce an abnormal amount of androgens, male sex hormones that are usually present in women in small amounts. The name polycystic ovary syndrome describes the numerous small cysts (fluid-filled sacs) that form in the ovaries. However, some women with this disorder do not have cysts, while some women without the disorder do develop cysts.

Polycystic ovaries contain a large number of harmless follicles that are up to 8mm (approximately 0.3in) in size.

The follicles are underdeveloped sacs in which eggs develop. In PCOS, these sacs are often unable to release an egg, which means ovulation does not take place.

The three main features of the condition are:

  • irregular periods
  • excess androgen
  • polycystic ovaries

If you have at least two of these features, you may be diagnosed with PCOS.

What are the symptoms of PCOS?

The symptoms may include:

  • Missed periods, irregular periods, or very light periods
  • Ovaries that are large or have many cysts
  • Excess body hair, including the chest, stomach, and back
  • Weight gain, especially around the abdomen
  • Acne or oily skin
  • Male-pattern baldness or thinning hair
  • Infertility
  • Small pieces of excess skin on the neck or armpits (skin tags)
What causes PCOS?

The exact cause of PCOS is not clear. Many women with the condition have insulin resistance. This means the body can’t use insulin well. Insulin levels build up in the body and may cause higher androgen levels. Obesity can also increase insulin levels and make PCOS symptoms worse.

PCOS may also run in families. It’s common for sisters or a mother and daughter to have it.

Genes, insulin resistance and inflammation have all been linked to excess androgen production.

What are the complications of PCOS?

Women with PCOS are more likely to develop certain serious health problems. These include type 2 diabetes, high blood pressure, problems with the heart and blood vessels, and uterine cancer.

Women with the condition also tend to have difficulty getting pregnant.

How is PCOS treated?

There’s no cure for PCOS, but the symptoms can be treated.

According to the NHS website, if you have PCOS and you are overweight, losing weight and eating a healthy, balanced diet can make some symptoms better. Medicines are also available to treat symptoms such as excessive hair growth, irregular periods and fertility problems.

If fertility medicines are not effective, a surgical procedure called laparoscopic ovarian drilling (LOD) may be recommended.

This involves using heat or a laser to destroy the tissue in the ovaries that’s producing androgens, such as testosterone. With treatment, most women with PCOS are able to get pregnant.

When should I seek help?

Experts recommend to see your doctor if your body has skipped periods, or you have other symptoms like hair growth on your face or body. Also, you should see a doctor if you’ve been trying to get pregnant for 12 months or more without success.

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Driving women’s health innovation: the launch of the Springboard Enterprise women’s health cohort

By Natalie Buford-Young, CEO of Springboard Enterprises

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Springboard founder Kay Koplovitz speaking at the Springboard Annual Gala

In the ever-evolving landscape of healthcare, addressing the unique needs of women has long been a neglected area.

However, with the emergence of initiatives like the recent announcement of White House Women’s Health Initiative and the ARPA-H Sprint for Women’s Health, there’s a promising shift towards fostering innovation and putting more resources towards advancing women’s health.

At Springboard Enterprises, we are proud to contribute to fuelling growth in this sector.

Springboard was founded in 2000 as the first official accelerator to mentor and accelerate the growth of women-led ventures. We have now officially launched our women’s health innovation program to identify and accelerate the growth of women-led companies innovating in health areas that uniquely, solely or predominantly impact women.

The announcement of the 2024 Women’s Health Innovation Program Cohort marks a significant milestone in the journey towards redefining healthcare solutions tailored specifically for women. This cohort comprises ten women’s health companies, each led by founders and CEOs committed to revolutionising women’s health. 

According to a report by Silicon Valley Bank, investment in women’s health has experienced an astounding 314 per cent growth since 2018, starkly contrasting with the overall healthcare investments. 

This incredible growth has really shown the abundance of opportunity, which was especially evident during our competitive process for our inaugural program. With countless innovative companies to choose from, we ultimately selected ten standout candidates after much deliberation.

  1. Navigate Maternity: Founded by Ariana McGee, Navigate Maternity has created a system that allows clinicians and care teams to remotely monitor prenatal and postpartum patients. The goal is to improve outcomes and avoid inequitable care through real-time data.
  2. Bone Health Technologies: Under the leadership of Laura Yecies, Bone Health Technologies (BHT) has developed the Osteoboost belt, the first and only safe and effective treatment for the 63 million people in the US with Osteoporosis or Osteopenia as well as a comprehensive digital therapeutic platform and services – a personalised digital health and telehealth solution for optimising bone health.
  3. Visana Health: Co-founded by Shelly Lanning, Visana Health pioneers a comprehensive virtual women’s health clinic, offering integrated care across various women’s health conditions. By adopting a holistic approach to healthcare delivery, Visana Health strives to empower women through personalised and longitudinal care.
  4. Herself Health: Founded by Kristen Helton, Herself Health is dedicated to addressing the unique healthcare needs of women on Medicare, ages 65 and up. Through a patient-centred approach, the company links women’s health goals with their life goals, taking into account a patient’s physical, mental, social, sexual, and spiritual needs and targeting common concerns like bone health, weight loss, and emotional wellbeing. The company hires top providers and trains them in the intricacies of person-centred geriatric and women’s care, delivering value-based care focused on patient outcomes.
  5. Marma: Co-founded by Meredith McAllister, Marma addresses critical gaps in maternal health by providing personalised nutritional guidance throughout the journey of motherhood. Marma works with patients to understand their unique needs and provide individualised, holistic nutrition advice at every stage of motherhood.
  6. Kegg: Founded by Kristina Cahojova, Kegg empowers women with accurate and personalised fertility tracking solutions. By harnessing cervical fluid data, Kegg enables women to make informed decisions regarding their reproductive health.  Already in the hands of 25,000 women in the US, the company now has the world’s largest dataset on vaginal health and the unique ability to use machine learning to help drive predictive healthcare for women at scale.
  7. Cntrl+ Inc: Founded by Karen Brunet, Cntrl+ Inc. is a pioneering life science firm specialising in female wellness. Their company has innovatively crafted an over-the-counter reusable solution addressing female stress urinary incontinence. They are dedicated to exporting and distributing this product globally, offering an effective and environmentally friendly solution for women.
  8. Multitude Health: Founded by Casey Langwith, Multitude Health alleviates the pain of irritable bowel syndrome (IBS) through an app-based clinical program that teaches members cognitive behavioural therapy skills, plus a tightly integrated therapist-led peer community to restore a healthy brain-body connection.
  9. Myri Health: Founded by Dr Pinky Patel, Myri Health introduces a comprehensive postpartum resource app, catering to the diverse needs of new parents. By providing personalised rehabilitation, evidence-based resources and a community platform, Myri Health seeks to support the postpartum journey.
  10. Ursamin: Founded by Shannon Aylesworth, Ursamin offers a SaaS-based care coordination platform for patients living with multiple chronic illnesses. By fostering a team-based approach to care delivery, Ursamin aims to improve outcomes and reduce administrative burden for providers and patients alike.

The diversity of solutions to advancing women’s health exemplified by the participants of the Springboard Enterprises women’s health cohort gives us a preview into the transformative potential of innovation in women’s health on various fronts.

At Springboard Enterprises, we play a pivotal role in catalysing innovation and driving meaningful change within the healthcare industry. By empowering women-led companies and amplifying their impact, we move closer towards achieving equitable and comprehensive healthcare solutions.

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The 5 best period tracking apps of 2024

Whether you’re looking for a way to monitor your ovulation or you simply want to map your periods, look no further than these five apps

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Period tracking apps have gained significant popularity in recent years. As awareness around menstrual cycles has increased, so has the demand for tools to help monitor and manage them.

Data suggests that more than 50 million women worldwide use apps to track their menstruation. But is an app really necessary? Can’t a reminder on your phone’s calendar do the same thing?

Well, tracking your menstrual cycle is crucial for several reasons. Firstly, it helps you better understand your body and aids in predicting and managing fertility. Knowing when you’re ovulating can be invaluable if you’re trying to conceive or avoid pregnancy.

Secondly, it can help you manage your menstrual symptoms. Many women and girls experience fluctuations in mood, energy levels and physical symptoms throughout their cycle. By tracking how you feel, you can anticipate when symptoms might arise and identify patterns, which in turn will help you take proactive steps to manage them.

Tracking your menstrual cycle can also provide insights into your overall health. Irregularities in the menstrual cycle could be indicative of underlying health issues such as hormonal imbalances, thyroid disorders, or polycystic ovary syndrome (PCOS).

We know choosing which app to download can be overwhelming. That’s why we’ve put together a list of five of the best ones we’ve come across.

Note: all are free to download, but some charge extra for premium features.

Clue 

Clue is a Berlin-based, women-led menstrual and reproductive health app that harnesses the power of full cycle intelligence to help you understand your body’s inner workings, beyond bleeding.

What do people who use Clue love the most? No pink. No myths. And no taboos. Clue is an intuitive, science-based, data-driven cycle health tracker with 100+ different tracking options and a powerful algorithm to help you live a life more in sync with your full cycle – not just to predict your period (although it does that too!).

Loved by over 10 million monthly active users across 190+ countries, and available in 20+ languages, the Clue app intuitively guides you through each cycle, change, and choice. From general cycle health awareness and education to fertility, pregnancy, and even navigating perimenopause.

New in 2024, is Clue’s My Health Record feature which uses de-identified data for good, to help close the diagnosis gap for female health conditions.

You can enter confirmed diagnoses for up to 21 different health conditions including endometriosis, polycystic ovary syndrome (PCOS), premenstrual dysphoric disorder (PMDD), uterine fibroids, bleeding disorders, anxiety disorders, and more. With this feature, the Clue community is collectively building an unprecedented dataset linking confirmed diagnoses and tracked cycle data to enable impactful research on the most commonly misdiagnosed and under-researched female health conditions.

The Clue app is free to download and you can unlock deeper insights and additional personalised modes like Clue Conceive, Clue Pregnancy, and Clue Perimenopause  with the premium subscription, Clue Plus.

For more, visit helloclue.com.

Flo

Flo’s mission is to build a better future for female health by helping to harness the power of body signals. Flo’s team of 100+ doctors and health experts create evidence-based medical articles, tips and recommendations designed to improve your health.

The app uses AI so you can easily know when you ovulate, track your period and view future cycles. In Flo, you can track more than 70+ symptoms and events for more personalised tips, relevant content and even more precise cycle and ovulation predictions.

Flo also offers Pregnancy Mode which provides you with the information you need during pregnancy. You will be able to receive insight each day into how the baby is developing, what happens in your body as a mum-to-be, which supplements and foods you should include in your diet and which you should avoid, how to recognise the approaching labour, what you could expect from the postpartum period and much more.

Within the app you can also discuss sensitive topics, questions and get support from other Flo community members anonymously.

Flo ensures that your data is safe with end-to-end encryption, secure access (Face or touch ID), anonymous mode (no name or email) and control over what you share. Your data won’t be shared with third parties.

For more, visit app.flo.health.

luna

luna is on a mission to be the go to digital health and wellbeing resource for teens.

Taking a holistic approach to health and wellbeing, luna’s objective is to educate, empower and support teens in all the tricky situations they find themselves in – from period leaks to skin problems and toxic friendships.

On luna (‘we are luna’ on the App Store), teens can track their periods, moods, skin, sleep and pain symptoms, and they’ll receive personalised insights and recommendations based on that.

Alongside period tracking, teens can ask anonymous questions, and learn about topics tailored to them. Behind the articles, videos and answers to questions is a team of doctors and safeguarding experts, who make sure content is medically accurate and appropriate for a teenage audience – there’s no user generated content on luna, so parents know their teen is in safe hands.

This app is designed to help teen girls own and understand their cycles, ensuring they know what steps to take when they feel something isn’t normal for them personally – luna equips them with the right tools to open lines of communication with parents, and seek support when they need.

There are also lots more features designed to spark joy and keep the app sticky – whether that’s a mood-boosting quote based on what members log, quizzes to help cement learning, or polling on topics they might want to share their thoughts on.

All of these features mean luna is much more than just a teen-friendly period tracker and is an app that parents and daughters alike will love.

For more, visit weareluna.app

femble

femble is the next-generation AI-powered female health assistant, designed to be an assistant in every woman’s pocket. This innovative platform combines cutting-edge artificial intelligence with a wealth of scientific knowledge and insights from practitioners to offer personalised guidance and support.

Imagine having a health assistant in your pocket, one that knows the ins and outs of women’s health, blending all that expert advice into recommendations just for you. Femble does just that. The app combines the insights of different health practitioners into one accessible platform, always ready to give you a daily nudge towards feeling your best.

Whether it’s navigating the complexities of sexual health, addressing mental wellbeing, or managing gut health, femble is tailored to meet the unique needs of each user. With a focus on supporting women to take control of their health, femble provides accessible, accurate and actionable advice to help users make informed decisions about their wellbeing.

It’s more than just an app; it’s a female health assistant in your pocket, a trusted partner in the journey toward optimal wellbeing.

For more, visit femble.co

WomanLog

There are dozens of complex processes that take over a woman’s body every day. Why not be aware of them and be prepared for everything?

WomanLog is an easy-to-use period tracker app that helps you do just that. With an encyclopedia of more than 200 symptoms that may occur during a woman’s menstrual cycle, it is much more than a digital calendar that tracks menstruation cycle, sex life and contraception.

The app has three modes: period tracker, pregnancy and menopause mode. WomanLogBaby app helps to track every step of baby’s daily activities while “Intelligent Assistant” with cutting-edge Artificial Intelligence and Machine Learning technology offers even more detailed analysis.

WomanLog also provides an extensive library of articles on sexual wellbeing, menstruation, the ins and outs of pregnancy and other health-related issues.

The Latvia-based start-up is among the leaders in the global market for more than 10 years. Translated into 30 languages, it has more than one and a half million monthly active users worldwide and more than 20 million installs.

Data safety in the key point of every app, and WomanLog is the leader with the highest security level that meets all the GDPR standards.

Moreover, the web version of WomanLog, available without even signing-in, features online calculators that count the days left until your next period or fertility windows within seconds.

For more, visit womanlog.com.

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