Randomised trial, 2025
Can an app help first-time mothers through early labour?
A randomised trial with 391 first-time mothers in Sweden tested a birth app during pregnancy and early labour. Here is what it found, and where the evidence ends.
Karin ÄngebyRegion Värmland and Karlstad UniversityMore about Karin - women randomised
- 391women randomised
- groups: app, app plus midwife calls, standard care
- 3groups: app, app plus midwife calls, standard care
- answered one month after birth
- 86%answered one month after birth
What the study asked
Does a digital app, used during pregnancy and early labour, reduce worry and distress for women giving birth for the first time? The researchers also asked if extra contact with a midwife made a difference, and how long women stayed at home in early labour.
How it was done
391 first-time mothers in Sweden were randomly placed in one of three groups: the ELSA Birth App, the app plus phone calls with a midwife, or standard antenatal care. Women answered questionnaires during pregnancy and one month after birth. The app was developed by the company Birth by Heart and builds on the Birth Without Fear method, which teaches breathing, relaxation and other ways to manage early labour.
391 first-time mothers
randomly placed in
The app
The ELSA Birth App during pregnancy and labour
App plus midwife
The app, plus two follow-up contacts with a research midwife
Standard care
Usual antenatal care at their clinic
What the research found
Distress in early labour was about the same in all three groups. Time spent at home in early labour did not differ significantly either.
Fear of a future birth went down from pregnancy to after birth for women in both app groups. In the standard care group, the reduction was smaller and not statistically clear.
Fear of a future birth, before and after
Average score on the Fear of Birth Scale (0 to 100, higher means more fear), in pregnancy and one month after birth. Each line is a change within one group, not a comparison between groups.
Show as a tableHide the table
| Group | In pregnancy | After birth |
|---|---|---|
| The app | 45.6 | 32.8 |
| App plus midwife | 44.9 | 31.2 |
| Standard care | 47.0 | 38.5 |
Table 4 in the paper. Women whose labour started on its own (234).
What it can mean for you
Feeling unsure before your first birth is common. Learning what early labour can be like, and knowing when and how to contact your maternity unit, can help you feel more prepared. Ask your midwife clinic what information and support they offer for early labour.
Where the evidence ends
This is one trial in one country, with first-time mothers only. The app did not change the main outcome, distress in early labour. The fear-of-birth result needs to be confirmed in more studies. The trial tested the ELSA Birth App, not Omaia.
About the researcher
- Name
- Karin Ängeby
- Role
- Midwife, PhD
- Affiliation
- Region Värmland and Karlstad University
- Field
- Early labour and digital support for first-time parents
How this connects to Omaia
Karin’s published studies were not about Omaia, and their results say nothing about Omaia’s effect. We share them because they show the knowledge the research group brings to the planned Triple Helix programme.
- Omaia did not fund, design or run these studies.
- Karin owns the findings and approves how we describe them.
- Omaia’s own evaluation is the planned Triple Helix programme.
Source and citation
Journal of Medical Internet Research, 16 October 2025
Testing the ELSA Birth App During Pregnancy and Labor for Primiparous Women: Randomized Controlled Trial
Karin Ängeby, Margareta Johansson, Elin Børøsund, Cecilie Varsi, Leonardo Horn Iwaya, Anna Nordin
Ängeby K, Johansson M, Børøsund E, Varsi C, Iwaya LH, Nordin A. Testing the ELSA Birth App During Pregnancy and Labor for Primiparous Women: Randomized Controlled Trial. J Med Internet Res 2025;27:e72807. doi:10.2196/72807
- Type of evidence
- Randomised controlled trial, single study
- Evidence level
- Strong
- Open access
- Yes
- Registered
- NCT05122390
- Reviewed by researcher
- October 2026
- Language
- English
- PubMed
- Open in PubMed
- Licence
- CC BY 4.0
A correction (24 Oct 2025) updated one author’s affiliation. The results are unchanged. See the correction
Earlier work this paper builds on
Papers by the same research group that the paper cites.
Early Labour App: developing a practice-based mobile health application for digital early labour support
Iwaya LH, Nordin A, Fritsch L, et al. Int J Med Inform 2023;177:105139.
A mobile application for early labour support: feasibility pilot study
Fritzson M, Nordin A, Børøsund E, Johansson M, Varsi C, Ängeby K. Women Birth 2023;36(6):495–503.
Women’s labour experiences and quality of care in relation to a prolonged latent phase of labour
Ängeby K, Sandin-Bojö AK, Persenius M, Wilde-Larsson B. Midwifery 2019;77:155–164.
Early Labour Experience Questionnaire: psychometric testing and women’s experiences in a Swedish setting
Ängeby K, Sandin-Bojö AK, Persenius M, Wilde-Larsson B. Midwifery 2018;64:77–84.
This page is based on the paper above, published open access under CC BY 4.0. Omaia is a non-medical wellbeing service. It makes no diagnosis, gives no treatment, and does not replace contact with a midwife or doctor. Research to Knowledge is approved by the researchers before publication.