The findings underscore the need for more rigorous and diverse clinical studies evaluating digital interventions.
In a narrative review examining the digital marketplace, investigators screened 587 apps identified through major app stores using perinatal mental health–related search terms. Only 38 met inclusion criteria as tools specifically marketed to perinatal individuals in the United States.1
Among those, just 3 apps—approximately 8%—had peer-reviewed evidence evaluating effectiveness. One demonstrated moderate-quality evidence, whereas 2 had insufficient supporting data. Six additional apps were undergoing randomized controlled trials.
The findings highlight a widening gap between consumer availability and clinical validation, according to Erin Chang, an MD-ScM candidate at the Warren Alpert Medical School of Brown University, who discussed the results in an interview.
Most perinatal mental health apps are not regulated as medical devices by the FDA, leaving clinicians and patients to evaluate quality independently.
Chang emphasized that although formal regulatory frameworks are still evolving, transparency about evidence should be a near-term priority.
Standardized labeling, she suggested, could disclose whether an app has been clinically evaluated and clearly describe the level of supporting evidence. She also noted growing concern surrounding artificial intelligence (AI)–driven mental health tools, particularly as reports emerge suggesting some AI chatbots may worsen existing psychiatric symptoms.
“As the technology develops, regulations will likely evolve alongside our understanding of risks and benefits,” she said.
The review was unable to meaningfully evaluate disparities related to language access, health literacy, socioeconomic status, or racial and ethnic diversity—largely because of limited available data and inclusion of English-language apps only.
However, Chang noted that the absence of evidence itself is clinically important.
Without inclusive research, digital tools risk reinforcing existing inequities in perinatal mental health care, particularly among populations already facing barriers to treatment.
The findings underscore the need for more rigorous and diverse clinical studies evaluating digital interventions.
For clinicians seeking evidence they can trust, Chang highlighted several priorities for future app-based research:
Longer follow-up is particularly important, she noted, because meaningful mental health outcomes often unfold across the full postpartum period.
Patients increasingly turn to mental health apps independently before or during pregnancy, placing OB/GYNs in a key advisory role.
Chang recommends clinicians take a balanced approach when patients ask whether an app is safe or effective.
First, providers should evaluate the intervention offered, prioritizing apps grounded in evidence-based strategies such as cognitive behavioral therapy, mindfulness practices, or validated screening tools.
Equally important is setting expectations: current apps may help support self-management but should not delay access to in-person or telehealth mental health care when symptoms are significant.
“Digital mental health care is evolving rapidly,” Chang said. “Right now, these tools can be supportive—but they are not substitutes for clinical care.”
As demand for accessible perinatal mental health support grows, digital tools may play an increasingly important role. However, the review suggests the marketplace is advancing faster than the science.
Experts say prioritizing rigorous evaluation, transparency, and equity will be essential to ensure these technologies improve—not complicate—perinatal mental health care.
