The proposed system was written in PHP7 [20] and HTML5 [21] and run on a remote server with an Apache HTTP Server 2.4. Users could access the system using web browsers on their smartphones or computers. Actually, MySQL database was used in the system.
Data security is very important to internet systems. HTTPS is used to establish an encrypted link between the server and the client. We usde OpenSSL [22] for secure transfers, which was an open-source implementation of the Secure Sockets Layer (SSL v2/v3) and Transport Layer Security (TLS 1.0/1.1/1.2) protocols.
First of all, there would be the main page of login, as shown in Fig. 4. After logging in, the top of the page would show the days of postnatal period, and login frequencies of users. Each function on this control panel would be introduced and explained.
In the blood pressure and pulse record section, the postnatal women needed to enter the date and time, systolic and diastolic records, pulse records as shown in Fig. 5. The right side would be a line graph [23] and each time the entered record would become a point. The upper limit of the systolic pressure (140 mmHg) and the diastolic pressure (90 mmHg) were indicated by the red line, suggesting that the attention should be paid to check whether the red line was exceeded or not. Another one was the pulse records where the upper limit of the pulse (100 bpm) and the lower limit of the pulse (60 bpm) were indicated by the red line. From the pulse records, the user could see the health status. Actually, one-minute pulse record standard would be 60 to 85 beats, the highest should not be higher than 100 beats. Attention should be paid to check whether the red line was exceeded or not.
The system generally determined three conditions. The first one was to confirm whether the systolic pressure (less than 120 mmHg) and the diastolic pressure (less than 80 mmHg) were normal. The second one was the systolic pressure greater than 120 mmHg but less than 139 mmHg or diastolic pressure greater than 80 mmHg but less than 89 mmHg were the warning periods and the third one was to check if the systolic pressure greater than 140 mmHg or diastolic pressure greater than 90 mmHg were still the same for a few days or not. If the condition still did not improve, then the user should go to the hospital directly to see the obstetrician.
In the blood pressure pie chart [23] statistic, the postnatal women could choose the appropriate period, like 7 to 90 days of data and she could choose her own date range, as shown in Fig. 6. These statistics were indicated by different colors: green means good, yellow means normal and red means high blood pressure. The regular return visit would be 6 weeks after delivery for natural births, 10–12 days and 6 weeks after the delivery for caesarean section births, and the blood pressure statistics could be provided to the doctor to evaluate the postpartum blood pressure and adjust the medication.
In the section of body weight of the self-record system, the postnatal woman needed to enter the daily weight records, as shown in Fig. 7. In general, the postnatal women would return to their pre-pregnancy weight 6th week after the delivery. BMI was used as a reference to assess the weight change before as well as throughout the pregnancy.
The medication record management, is shown in Fig. 8. On the left side would be the medicine management and the system had built in some anti-hypertensive drugs, if not enough, users could add their own. On the right side would be the medication record, and the users could make a record when taking medication by entering the name of the medication, the date of use and the time of use, and even with the calendar to achieve the function of medication reminder. At the bottom would show the detailed record of each medication.
Figure 9 shows the exercise instructional video [24]. As shown in Fig. 9, on the right side was the introduction of postnatal exercises. There were suitable exercises for postnatal women from the first day to the 15th day after delivery, and after 15 days, each of them could be used. Meanwhile, through the live demonstration video, users could follow along with the video exercise, and the background voice introduction could make the exercise correct and efficient. Basically, it started with simple and easy-to-use items. Initially, there was only one type of item for the first time, and then gradually added one by one item every day. On the left side was the record of exercise time, and the user could select an exercise which was associated with the video, and then select the date and time period, and then could start the exercise by clicking the play button to start the time. Once the exercise was over, the user could click the end button, then a record of exercise would be completed.
The assessment of risk factors [25] is shown in Fig. 10. There were 8 items listed in this assessment form, which included risk factors for hypertension. It was studied that the hypertension could be caused by several factors such as heredity, smoking habits, excessive body weight, excessive sodium intake, and insufficient exercise. So, an evaluation would be carried out to analyze how many risk factors the user has. It is noteworthy to mention that the more is the risk factors, then the more likely the user would get hypertension. This system thus would provide a simple assessment: if there are more than 3 items of risk factors, then it is the time to pay attention; if there are more than 5 items of risk factors, it would be very dangerous. So, it was suggested that the user should possess the less number of risk factors or they should reduce the number of risk factors if they have more.
The smart chat room is shown in Fig. 11. The system was designed with an intelligent chat room, where all the common questions of postnatal women were organized into a database. For example, queries such as “Can I take a shower and wash my hair after giving birth?”,” How soon will I have my period after delivery?”, “How soon can I resume sexual intercourse after delivery?”, “What are the common contraceptive methods?”, etc were available. We added a lot of keywords to these questions, so that these keywords could be linked to the answer of the question. As long as the user asked a question with these keywords, the system would intelligently reply with the correct answer. If there was still a question that cannot be answered the system would first reply “This question is more complicated and will be answered by a professional nurse-midwife later.” At this point, the nurse-midwife managing the back office would think about how to answer, and then she would answer to the user directly through a manual process.
Finally, the postnatal health education information would be the most important professional knowledge for the postnatal women, as shown in Fig. 12. Thus, this study was organized as follows, the first one was about postnatal physiological changes. The second one was about breastfeeding. The third one was about postnatal exercise. The fourth one was about postnatal stress and stress relief. The fifth one was about available resources, i.e. some websites of postnatal care and benefits given by the statements that were organized for postnatal women's reference, and the last one was about common questions and answers.