How the Apple Watch's Fetal Heartbeat Monitor Actually Works

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How the Apple Watch's Fetal Heartbeat Monitor Actually Works

The heartbeat on stage was cool; the technologies that allowed that heartbeat to be shown off were even cooler​.
September 14, 2015, 8:00pm

Last Wednesday, tucked neatly into a two hour presentation, Apple showed off a dramatic and theatrical new feature of the Apple Watch. As an audience of journalists clapped, Dr. Cameron Powell, co-founder of a medical technology company called AirStrip, demoed the sound of a fetal heartbeat pumping out of the Apple Watch. The demo was real—AirStrip's new product does integrate with the Watch to record a fetus's heartbeat—but it wasn't showing off an upcoming consumer feature of the Apple Watch, either.

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When Dr. Powell showed off that fetal heartbeat on stage, my own heart sort of skipped around a bit, because my own experience of hearing my baby's heartbeat was very stressful, and I couldn't see a good or useful way to give that data to expectant parents without causing them undue stress. Any at-home testing where the parents could hear AirStrip's new product would work with the Apple Watch and Sense4Baby, a home fetal ultrasound monitoring system company that AirStrip purchased last year.

Previously: The Internet of Things Isn't Ready for Babies

The scenario Dr. Powell described—a doctor in his office with an Apple Watch, mom-to-be at home on her couch with an Apple Watch and a home fetal monitoring system—was, it seemed, just around the corner. Hence, the heartbeat inside the belly, beaming out from the Watch.

AirStrip was founded in 2004, and for years has focused on wireless, mobile medical monitoring technologies for in-hospital use. With a slew of native apps for Windows, Android, and iOS, AirStrip's monitoring and data visualization products are used for monitoring patients who often create a lot of data—EKGs, blood pressure, and so on. AirStrip's products and applications have FDA and HIPAA (the laws that protect the privacy of your medical data) clearance, and transfer their data from patient to doctor securely. But for now, they're only used in hospitals.

I gave birth to my first baby nearly two years ago, and toward the last third of the pregnancy, I began to suffer from preeclampsia, a hypertensive disorder whose main symptom is high blood pressure in the expectant mother. Though preeclampsia is now, with modern medicine, rarely life-threatening to either mother or child, it is a condition that must be monitored on a very regular basis as it can increase in severity on short notice.

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So, every few days during my last trimester, I trotted—well, I waddled: preeclampsia can also cause a lot of fluid retention and swelling—over to my doctor's office or the hospital, where monitors were put on my stomach to check the fetuses' heart rate and also to check for contractions, a usual sign of labor.

The process was time consuming, stressful, and presumably (I had good health insurance) expensive. What AirStrip is promising now, and what will be its new offering in concert with the Apple Watch, is at home, stress- and travel-free monitoring that is securely transmitted from patient to doctor for women experiencing high risk pregnancies, and other people suffering from long term conditions such as diabetes.

The potential is obvious: "For many women who aren't fortunate enough to live near facilities with access to monitoring equipment, these constant trips are time consuming and costly to both the patient and the hospital," said Dr. Jacques Moritz, an obstetrician at St. Luke's Roosevelt in New York City who delivered my daughter in 2014. "Women who don't live in big cities are sometimes traveling an hour each way only to be told that their baby is doing just fine."

These checkups are often very necessary in high risk situations, but the promise of in-home, dependable, mobile monitoring could bring cost and time down exponentially. AirStrip partners directly with hospitals—over 300 to date, including a recent alliance with Memorial Sloan Kettering.

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The heartbeat on stage was cool; the technologies that allowed that heartbeat to be shown off were even cooler

"What we're seeing here is the potential for bringing the same level of care" that you receive in major hospitals "to those areas which are underserved," said AirStrip CEO Alan Portela. With long-term, persistent conditions like heart failure, he said, "you know there's a big chance that they'll be discharged from the hospital, but that they'll be readmitted again" soon after. "So you send them home and monitor their heart for a month from there." It's more than simply heart rate, too: AirStrip can communicate with a scale to read weight gains or losses, which are often signs of a worsening condition.

All of this—the monitoring of heart rates, blood pressure, weight—is a lot of data. It's consistent, constant monitoring and farming of data that not only transmits to the doctor or team of people serving the patient. It's potentially also a very powerful tool to use to draw conclusions about the condition of the patient over a series of days or weeks or months, as well as an anonymized mass of data from which research into specific conditions can be gleaned from.

The state of health insurance and medical records in the United States is a complicated one: patients don't collate their information over the years as they bounce from one doctor to another, and just as often these days, from urgent care facility to emergency room to pharmacy. The digitalization of our medical data offers a chance, unseen before in history, to collect that data in centralized, secure places, allowing our medical professionals access to it for better care.

For now, just a few private companies are working as successfully as AirStip on these kinds of solutions. But the potential—especially for the good of the patient—is extremely high. The heartbeat on stage was cool; the technologies that allowed that heartbeat to be shown off were even cooler.

Being pregnant, and having a child, is inherently stressful, and the risk of having access to too much data—a baby's heart rate fluctuates constantly, and I'm not a doctor, I don't know how to interpret what I'm seeing—is one that AirStrip takes seriously. The company assures me that the equipment is for clinical use, and it's one that could take that inherent stress down a notch or two.