MSU researchers develop app to improve postpartum health for rural and at-risk mothers

April 9, 2025

A new mom in Flint experiences excessive postpartum bleeding, but is told over the phone that she’s probably fine. Later, she is rushed to the emergency room.

An expecting mom in rural Northern Michigan starts to feel dizzy and nauseous late in her pregnancy, a warning sign for preeclampsia, but the nearest hospital is two hours away and she doesn’t have transportation.

A young mother in the Upper Peninsula feels overwhelmed by the addition of a third child to her family and experiences a substance abuse relapse.

Women all over the country find themselves in situations like these. It’s no secret that the United States lags behind its peers when it comes to comprehensive maternal health care. Startling statistics indicate a maternal mortality rate 55% higher in the United States as compared to the second-worst developed nation. This rate is twice as high for Black mothers.

Prenatal care can be hard to access in rural areas or for those with other health challenges, a history of substance abuse or mental health difficulties. Standard obstetric care requires only one postpartum check-up for mothers six weeks after birth, forgoing other opportunities to support mothers through their babies’ first year. Many pregnant and postpartum women endure unnecessary risks to their health and the health of their babies due to a lack of support and knowledge.

The National Institutes of Health (NIH) is seeking evidence-based solutions to address this gap through its 12 nationwide Maternal Health Research Centers of Excellence. There is hope for change: in Michigan alone, 76.4% of pregnancy-associated deaths are considered preventable. But these efforts are now threatened by funding cuts.

The proposed nationwide cuts to NIH funding have been temporarily blocked by federal courts, but some projects are getting terminated anyway. While the cuts supposedly only target facilities and administrative costs–for things like buildings, computers, and crucial administrative support–some programs around the country have already been shut down with little warning. For the pregnant women and new moms served by the NIH Maternal Health Centers, these cuts could spell disaster.

One of these Centers, the MIRACLE Center, is run by investigators from the Michigan State University College of Human Medicine and community partners in Flint. Three statewide research projects are underway at the Center with a focus on improving outcomes for rural and Black mothers, two of the most underserved population groups.

One of these projects to prevent maternal morbidity and mortality seeks to empower women with knowledge and resources via an app. The combined efforts of a clinical psychologist, an epidemiologist, and a community-based organization leader are coming together as a three-pronged community-academic research partnership to form the app MI MOM.

“You’re very alone [after birth],” said Claire Margerison, PhD, the epidemiologist and biostatistician involved with the project. “People are overwhelmed and often don’t know where to turn or when to turn to someone. That’s the biggest thing that we’re able to do with this.”

Thanks to Margerison’s study of public health data sets, we know that pregnant and postpartum women in Michigan are seeking emergency care for substance use, mental health distress, and self-harm. In fact, 29% of pregnancy-associated deaths in Michigan are a result of substance abuse. Clinical psychologist and research professor Steven Ondersma, PhD, notes that typical interventions for substance use and mental health reach only a fraction of the people who need it. That’s where the app comes in.

“There is a tremendous unfilled need for clear, well-organized, not overwhelming information about important facts [related to pregnancy and postpartum],” Ondersma said. “Urgent maternal warning signs, what to do if you are feeling down, what to do if you're not safe, what to do if you don’t have access to services you need.”

Apps like MI MOM are easy to access and leverage technology to reach more people than other approaches. Without scheduling an appointment or a translator, moms will be able to get personalized information about their concerns and symptoms. The MI MOM app will meet all these needs and more.

Thanks to the Computerized Intervention Authoring System (CIAS), another NIH investment, the research team can design the app alongside community members without writing a single line of code. From resource guides to medical facts to live chats with community health workers, the app will function as a lifeline for underserved moms.

Athena McKay, MSA, executive director of Flint Innovative Solutions and the third pillar of the project, has worked closely with a Community Advisory Board (CAB) for over two years to guide the design of the app. The CAB consists of nine people, including community leaders and medical professionals, who meet monthly to give feedback and share ideas for the project. The fact that funding cuts could prevent the app from launching as planned is devastating.

“This is overwhelmingly urgent,” McKay said of the need for accurate, instantly accessible maternal health information. “It is crucial that funding continue.” One mom involved with the project had a near miss when she was newly postpartum that could have resulted in fatal blood loss had her sister not convinced her to seek emergency care. “If she’d had this [app], it would’ve helped avert a near disaster,” she said.

Mothers and their support persons have participated in the app design through two events called Appathons. Women, support persons, and maternal health experts throughout Michigan are invited to test the app and give their feedback to ensure all of the time and money invested in the research project actually meets the needs it set out to meet.

With the clinical trial app launch scheduled for later this year, NIH funding cuts at this point in the project would create more waste than it prevents. “To have funding cut at this point, we would lose crucial data and prevent something that is about to launch, throwing away all investment up until this point,” said Ondersma.

All three principal investigators agree that they need to be able to collect data after launch to validate the app as a helpful tool before it can be implemented in other communities. If NIH funding gets cut–projects like MI MOM would become unsustainable, leaving Michigan mothers alone with their distress once again.

By Kayla Crum