Can Texting Save Women's Health -- and That of Their Infants?

Digital technology is transforming the world, helping to overthrow dictators in the Middle East and embrace gay rights at home. But if last week's proposed budget cuts are a sign of what's to come, we may also need social media to save women's health.

I got to thinking about this idea a couple of weeks ago, when I read an article in the New York Times by David Bornstein about text4baby, a service that sends free text messages to women who are pregnant or whose babies are less than a year old, providing them with information and week-by-week reminders to improve their health and the health of their infants. The program has been extraordinarily popular, boasting about 135,000 users to date with a goal of reaching 1 million women by the end of 2012.

What makes text4baby particularly appealing is that it targets precisely those women who are most in need of advice on healthy behaviors during pregnancy and post-childbirth, but least likely to obtain it. Low-income, minority women are far more likely than other women to delay prenatal care until the third trimester of their pregnancies, or go without it altogether. And that's because while this information is widely available, these women typically lack Internet access, a formal education and/or health insurance.

But they do have cellphones. According to the Times article, 80 percent of Medicaid patients send and receive text messages regularly and 61 percent of text4baby users live in Zip codes where the median income is less than $50,000. For these women, getting a quick, friendly 160-character text message providing them with 1-800 numbers for information on topics like how to quit smoking, the benefits of breastfeeding and how and when to obtain immunizations for newborns has the potential to be extraordinarily effective in reducing infant mortality (which is surprisingly high in the U.S.).

In a follow-up article, Bornstein extolled the administrative efficiency behind text4baby. What stood out to him was the broad partnership of community health organizations, wireless carriers, businesses, health care providers and government health agencies that came together to make this program happen without any of the usual bureaucratic inertia that can weigh down a cross-cutting initiative of this type.

But what stands out to me is less the collaborative ethos behind this innovative use of technology, than its economic necessity. As my colleague Sandra Fish wrote over the weekend, the GOP-run House of Representatives has just voted to cut not only all of Planned Parenthood's $75 million in federal funding for family planning, but also the entire $317 million Title X budget.

As Sandra notes, Planned Parenthood and other health care providers currently receive Medicaid money for health services to low-income people. But under an amendment from Rep. Mike Pence (R-Ind.), approved last week in a 240-185 vote, Planned Parenthood wouldn't be allowed to receive any federal dollars, including money from Medicaid. Title X, for its part, provides things like family planning services, breast and cervical cancer screenings, and other preventive health care to low-income women.

Other casualties of the cuts in 2011 spending including federal funding for teen pregnancy centers, which are to be eliminated entirely. In addition, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) -- which provides food, counseling and other support to millions of low-income pregnant women, new mothers and infants -- stands to lose $747 million. Similarly, the Title V Maternal and Child Health Block Grant, which funds health services for women and children in state and local programs, also faces cuts of $50 million.

Which is a long way of saying that we all better pray that things like text4baby have a long shelf life, because in today's political climate, they may be all pregnant women and new mothers have to rely on.

And of course, it's not just women's health that stands to benefit from technological creativity. My colleague David Gibson wrote recently about a new program sponsored by the New York City Department of Health that uses GPS technology to help you locate the nearest free condom -- and provides tips for using it correctly.

In other circumstances, one might be tempted to chuckle at the "NYC Condom Finder" app. But in a city where two of every five pregnancies are terminated -- and sexually transmitted diseases are rampant -- it's no laughing matter.

One can also imagine something like text4baby being instrumental in helping teenagers confront sexual health issues. In an era where young people are turning increasingly to social media to communicate over and above e-mail, one can imagine using texting and Facebook to promote awareness of, say, the benefits and risks that attend the Gardisil vaccine, which prevents cervical cancer and can be taken by girls as young as 9.

So, by all means, Department of Health and Human Services and whichever women's health clinics survive the current moment (all two of you), strike while the iron's hot. Invest in some cellphone technology and get cracking.

You -- and the women you serve -- are going to need all the help you can get.

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