This RTI International project involves the University of California, San Francisco obstetrics/gynecology and bio-engineering departments for the development of a "smart diaphragm" device, that would detect early signs of pre-term labor through changes in collagen composition in the cervix. The first stages of the project involved iterations of various prototype devices. The team has developed a device version 3.0 that is ready for initial site evaluations. Qualitative and quantitative acceptability/feasibility study of device v3.0 will focus on the storage, placement and use of the diaphragm in conjunction with a cloud-based telemedicine solution in both the US and in Sub Saharan Africa. Key objectives include determining: (1) whether women are comfortable using a diaphragm-like device at home to lower their risk of preterm labor, (2) if there any cultural barriers to using this technology to assess maternal health during pregnancy, and (3) the acceptability of the monitoring and triage strategy among clinical providers. With the final iteration, each patient will be able to track the progression of her pregnancy at home without the need for clinical supervision. Data will be relayed daily to a server via a mobile app. If preterm birth risk elevates, an alert will be sent to both patient and clinician. The engineering team is also exploring the addition of pH and temperature sensors to detect infection-initiated preterm birth.