Sarah Sachs was confused. Three days before, she had successfully delivered a healthy baby through C-section, after an uneventful, low risk prenatal course. Now her provider was discharging her with a blood pressure cuff and instructions to monitor her BP from home through the Babyscripts app.
With no preexisting BP complications and a healthy pregnancy, the dangers of postpartum hypertension and preeclampsia had never crossed Sarah’s radar. But when her L&D nurses noted that she had elevated BPs in the days following her delivery, they knew Sarah had to be on alert for potential problems.
“I was about to be discharged, but part of my discharge included talking to someone about my blood pressure and getting a cuff and monitoring my blood pressure,” Sarah told us. “They walked me through using the cuff, downloading the app — I was confused but I followed through. I didn’t know about postpartum preeclampsia. I wasn’t aware it could be a problem.”
The next day, four days postpartum and one day post-discharge, Sarah was readmitted to the hospital after recording a critical blood pressure reading of 170/105, and diagnosed with postpartum hypertension.
With medication and continued remote monitoring, Sarah was able to manage her diagnosis and stabilize, and at her six-week postpartum appointment, she was normotensive.
“If I hadn’t been using the app,” Sarah told us, “I wouldn’t be here.”
Sarah’s story is sadly not an unusual one. Women without prior diagnoses are not typically monitored for blood pressure complications in the postpartum period — and yet the maternal mortality rate for this specific issue is particularly high, perhaps for that reason.
“Healthcare workers are super in tune with mothers who present with problems,” one of Sarah’s nurses shared, “But it’s women who never experienced any complications during pregnancy that can slip through the cracks after they’re sent home. With Babyscripts, we can monitor those moms to prevent adverse outcomes.”
Sarah didn’t meet the criteria for Babyscripts’ remote monitoring because she didn’t have a hypertensive diagnosis, but her care team looked at her elevated BP readings and decided she would be a good candidate for the solution anyway.
It was a small decision that made a huge difference for Sarah.
“We came back from the hospital around noon on Saturday, and I took my blood pressure. On Sunday I had a headache, I took my blood pressure again and I got an alert from the app saying it was higher than they’d like it to be. I logged in to the app, took the survey of my symptoms, and continued to monitor.
“I spoke to a midwife after the first elevated reading and that conversation reassured me — because I had taken my blood pressure after pumping it was not unusual that I have pain and an elevated reading.”
But Sarah continued to record high readings. Every time her blood pressure was higher than it should be, the Babyscripts app prompted Sarah to take a survey, and she received a follow-up text. The app apprised Sarah and her provider of the urgency of her situation.
“I received a call from my doctor, and he was concerned. He had been receiving my data from Babyscripts. He told me to call him at the hospital if my blood pressure reached or exceeded a certain level.
“I would never have gone to the hospital without this app. I never would have caught this, and I probably would’ve died, everybody keeps saying.”
Sarah was not a high risk patient. Even at discharge, despite her slightly elevated blood pressure readings, there was no serious concern — not enough to keep her at the hospital (potentially at a high personal financial cost).
Yet if Sarah had waited for her follow-up appointment to check in on her health, it would have been too late to catch her hypertension. And many women never even make it to their follow-up appointment — life with a new baby, and in a pandemic, is not particularly conducive to a hospital visit six weeks after birth. Add to that any kind of social barriers to care, problems of distance, lack of family support, other children at home — there are myriad reasons to keep women away from checking in with their provider after childbirth.
Keeping women in the hospital after childbirth, especially if they are not ostensibly at risk, is not a viable or efficient solution. Seeing them — maybe — one time, six weeks after delivery, is not effective either.
A remote solution like Babyscripts — that can keep women connected to their provider after childbirth from the security and comfort of home, and has the ability to facilitate interventions — is an imperative for a society in which 60% of maternal deaths occur in the postpartum period.
Sarah Sachs can tell you why.