Last year when she was pregnant with her daughter, Jaqwendolyn Gaynor developed health complications that made her high risk. As her due date approached, her symptoms grew worse.
“I had no sensation in my arms or legs. I was having weakness in my legs, like collapsing and losing mobility of my legs,” she says. “I was diabetic and on an insulin pump. Also, I started swelling up, showing signs of preeclampsia.”
Without timely treatment, preeclampsia can become severe, even fatal.
Gaynor saw a high-risk pregnancy specialist. But getting to and from her appointments wasn’t always easy.
She lives in a small town outside of Savannah. It’s about an hour each way to the closest medical care.
Gaynor, 36, also works full time and has an older child. As her condition deteriorated, she says, all of the driving took a toll.
“And I was just so tired and exhausted from everything, I was honestly about to cancel my baby shower,” she says.
Worse, Gaynor worried she could lose the baby. She had experienced previous miscarriages.
“I had the mindset and the determination that I’m not going to allow this to happen again.”
So, when she heard about a program offering remote patient monitoring, she jumped on it. It’s called Operation M.I.S.T.
“Monitor, Intervene, Survive, Thrive,” says Macon physical therapist and doula Katherine Sylvester, who founded the remote monitoring program after her own pregnancy challenges.
The program outfits patients with a wristwatch-like, non-invasive band device that records their vital signs 24 hours per day.
“We monitor heart rate, blood pressure, oxygen saturation, temperature, sleep quality, stress, as measured by a metric called heart rate variability. We’re really just establishing women’s baselines,” Sylvester says. “And not comparing women to other women, just comparing them to themselves.”
The encrypted device sends continuous streams of data to the Operation M.I.S.T. dashboard. If any data fall outside a patient’s typical range, the system automatically alerts an on-call medical team that reaches out to the patient to assess whether they need immediate care.
Sylvester says the goal is to catch pregnancy complications that may arise between a patient’s routine OB-GYN visits, improve maternal and infant health outcomes, and help avoid unnecessary and expensive childbirth interventions.
But technology alone isn’t enough to prevent maternal mortality, she says.
“It’s technology paired with a person who can investigate your symptoms — that is the best combination, I believe,” Sylvester says. “Especially for women who live an hour away from the hospital, who would rather not go in if they don’t know that something is wrong.”
Sylvester is one of many researchers around the country experimenting with maternal health wearable devices.
They’re tracking all kinds of potential health risks, including gestational diabetes, asthma, and high blood pressure — such as the remote patient monitoring devices created by researchers at the Atlanta-based company Rimidi.
They also track hemorrhage, a top cause of pregnancy-related death in Georgia and nationwide. Hemorrhage after childbirth is also the leading cause of maternal mortality globally.
Pregnancy-related deaths have risen in Georgia and most could have been prevented, according to the CDC.
“I was so used to settling with what was given to me that when I started standing up for myself, I noticed I was ruffling a lot of feathers. I started being treated like ‘the angry Black woman.’ Operation M.I.S.T. taught me how to advocate for myself.”
-Jaqwendolyn Gaynor
Many maternal health experts are banking on advances in wearable technology to help catch warning signs and connect pregnant and postpartum patients to medical care before it’s too late.
“Maternal health is one of these really interesting and lucrative fields because generally speaking, we don’t put a lot of technology with pregnancy or delivery,” says Dr. Suchitra Chandrasekaran, a maternal-fetal medicine specialist and associate professor in the Emory University School of Medicine Department of Gynecology and Obstetrics.
She is the lead investigator on a study for the National Institutes of Health, evaluating wearable devices with dozens of pregnant and postpartum patients.
Her team is looking into how best to utilize wearable technology in obstetrics, whether patients accept wearable devices, and how they perform in a real-world healthcare setting.
“We need to make sure the data is truly vetted and validated with numbers that can be kind of protocolized and used nationally or globally,” Chandrasekaran says. “I think for many physicians, it’s a question of, is this evidence-based? Is this going to make a difference? And if so, then how do I use it? And for that to happen, we need solid studies to understand that process.”
But as more wearable devices come to market for in-hospital or in-home use, Chandrasekaran says she envisions a future where they could help address gaps in maternity care.
“Because then we can really hit regions that don’t have access to care immediately,” she says.
In Georgia, more than one-third of counties lack maternity care, according to the March of Dimes.
Jaqwendolyn Gaynor says as a Black woman in rural Georgia — a state with some of the worst rates of maternal mortality in the United States, particularly for Black Georgians — she felt safer knowing her remote wearable device connected her to a dedicated team of physicians, nurses and other clinicians.
And it worked for her.
Soon after her daughter Giavanna was born and Gaynor and her husband drove home from the hospital, the device flagged a medical issue. The specialist on the other end of the phone urged them to return to the ER right away.
“It chokes me up every time because, you know what? These people really saved my life,” she says.
“I was so used to settling with what was given to me that when I started standing up for myself, I noticed I was ruffling a lot of feathers. I started being treated like ‘the angry Black woman,’” she says. “Operation M.I.S.T. taught me how to advocate for myself.”
Today, especially after such a difficult pregnancy, Gaynor and her husband are overjoyed to have expanded their family. And their tween son loves being a big brother.
Giavanna turned 1 in June.
A device to detect early maternal hemorrhage
Atlanta scientist and engineer Kelsey Mayo is co-founder and CEO of Armor Medical Inc., which has designed a device to detect early maternal hemorrhage.
Mayo survived her own hemorrhage-related near-death experience in 2019, when she had an ovarian cyst rupture.
“By that time, I had been bleeding for about 10 hours and not known it. I ended up getting a blood transfusion and having an emergency surgery to remove my right ovary. I survived. I almost didn’t,” she says. “That is something that I came through and just said, I must try and do everything possible to get an innovation to market that makes it so nobody has to go through this.”
The lightweight device is worn on the wrist like a watch. It contains a laser and camera that measure blood flow under the skin.
“And so we detect changes in blood flow that happen in the earliest stages of a hemorrhage. And we can tell if somebody is at risk in real-time throughout their labor, delivery and postpartum. If we notice something is wrong, we alert the providers. “
The device is designed to be used in the hospital. It would mark a change from the way postpartum hemorrhage is typically diagnosed, which includes monitoring vital signs and visual estimation of blood loss.
“We are seeing hemorrhage diagnosed way too late when the only interventions available, if they’re available, are things like blood transfusion, emergency hysterectomy. We can do so much better,” says Mayo. “Patients can lose a quarter of their blood volume before you will even see a change in heart rate or blood pressure.”
Last year, Mayo and her colleagues won a spot in the National Institutes of Health Rapid Acceleration of Diagnostics Technology (RADx Tech) for Maternal Health Challenge.
Now Armor Medical is preparing to launch a new round of clinical studies on their device — a key step towards securing FDA approval.
Mayo says she expects to bring the device to market for use in the healthcare system by 2026 or 2027.
This story is part of our series Missing Moms: Inside Georgia’s Maternal Health Crisis. Jess Mador’s reporting is part of a fellowship with the Association of Health Care Journalists supported by The Commonwealth Fund. It is produced in partnership with the Georgia Health Initiative.
