Under a program called text4baby, a text message reminds a pregnant… (Baltimore Sun photo by Kim…)
Aiming to cut down on the high number of premature births in Maryland and across the nation, a new program will offer words of advice for pregnant women and new mothers in a place that will be hard to miss: their cell phones.
The free text messages will be sent every week, and will include information about such things as seeing the doctor, avoiding alcohol and cigarettes, and eating properly. And while it's just rolling out in Maryland, the program, called text4baby, has more than 18,000 women signed up for what's expected to be the largest nationwide health initiative using mobile phones.
Lead sponsors at the National Healthy Mothers, Healthy Babies Coalition say they hope to improve the statistics: A half-million babies are born prematurely every year in the United States, many of whom then suffer from lifelong maladies. About 28,000 die before their first birthday.
"We're trying to address the problem," said Elizabeth Jordan, a professor at the Johns Hopkins School of Nursing and a board member of Healthy Mothers, Healthy Babies. "We have over 300 messages we send based on the mothers' weeks' pregnant or the baby's age."
The program is paid for with in-kind donations and support from the mobile technology company Voxiva, as well as cell phone companies, health insurers and health product manufacturers. Government and nonprofit groups such as Healthy Mothers, Healthy Babies partnered to ensure the messages are accurate.
Jordan said anyone can sign up and benefit, but the targets include Spanish speakers and vulnerable women, such as those with lower incomes or without much access to computers or books.
What most of the women do have are cell phones. About 90 percent of Americans have a mobile device, and the industry says they sent 1.5 trillion text messages last year, making phones one of the most widely used technologies. Sponsors also say text messaging is especially prevalent among women of childbearing years and minorities, who face higher infant mortality rates.
There are other examples of text messaging in the health care arena, including doctors at Johns Hopkins Children's Center who text patients with chronic illnesses to remind them about appointments or to take their medications on schedule, which is a major problem.
Pediatrician Delphine Robotham communicates with patients this way and has been encouraging other pediatricians to do the same. A Hopkins pediatric HIV expert, Dr. Allison Agwu, also has been using texts to remind patients of appointments, and plans soon to launch a formal study of mobile-device use.
Jordan said the program for mothers will be promoted across the country, including in prenatal clinics in Baltimore, and through advertising. The texts will carry messages about the importance of eating breakfast, taking vitamins with folic acid and when to get checkups. If the women have no health insurance, numbers are provided so they can be connected to care.
Slightly more than a quarter of the 112 infants who died in Baltimore in 2008 were born prematurely and had low birth weights, according to a report from the Baltimore Health Department, which plans to participate in the program. Education, age, marital status and race played a role, the report said.
About 14.6 percent of babies born to black women in Baltimore are premature, up 25 percent since 1990. In Maryland, the prematurity rate is 13 percent, slightly above the national average of 12.7 percent and almost twice advocates' national goal. The high rate places Maryland 36th among the states, according to the March of Dimes.
Premature births carry costs for the families and the health system. Private health insurers and the government through Medicaid spend $26 billion annually on low birth-weight and premature babies, or about $50,000 per child, according to the U.S. Centers for Disease Control and Prevention. The costs for a healthy full-term baby are about $4,550.
"It's our hope that text4baby will complement the outreach strategies we are developing for expecting mothers as part of our comprehensive Birth Outcomes Initiative," said Brian Schleter, spokesman for the city Health Department. "It's our goal to have all of our clients sign up for this helpful service as a part of our efforts to improve birth outcomes in Baltimore City."
Text4baby got a boost recently when Aneesh Chopra, the U.S. chief technology officer, used his office to raise awareness for the program.
Chopra said the program, the first free mobile health service on a national scale, will be effective because text messages are instant and Americans have become accustomed to getting information this way. A new study from the Pew Research Center shows that more than a quarter of Americans get some form of news on their cell phones.