Q&A: Why startups should work with the healthcare industry to improve maternal care

Photo courtesy of Mahmee

Compared with other wealthy countries, the U.S. lags when it comes to maternal health outcomes. Maternal mortality rates have generally worsened since 1987, reaching 23.8 deaths per 100,000 live births in 2020. The mortality rate for Black women was nearly three times higher than the rate for white women.

Melissa Hanna, CEO and cofounder of maternal health startup Mahmee, sat down with MobiHealthNews to discuss how their platform aims to improve pregnancy and postpartum care, the company’s recent $9.2 million Series A raise and the growing digital maternal health landscape. This interview was edited for clarity and length.

MobiHealthNews: Can you tell me a bit about how Mahmee works from the patient perspective?

Melissa Hanna: New and expecting parents can join Mahmee for free. And the core aspect of that experience for anyone who’s joining includes the unified health record for mom and baby. So, they’re able to link together health record information from the mother’s medical history and pregnancy history to the childbirth experience, and baby’s birth story and first year of life. So, we really focus on conception through the baby’s first year of life and documenting all of the aspects of care and health that happened during that time.

Another part of that is access to the national Mahmee network of providers that are using our software across the country. [They] are primarily community-based birth and infant care professionals. So those are folks that may be midwives, doulas, lactation consultants, home visiting nurses or home health providers, nutritionists, therapists, social workers. They’re all types of community-based professionals that patients are likely to interface with at some point during their maternity experience but are often not considered core members of the patient’s care team the way that OB-GYNs and pediatricians are.

And Mahmee’s trying to change that. We’re trying to make it easier for parents to integrate those community care professionals into their regular course of care since we know that it’s really those community-based professionals that have the greatest chance for providing high-touch preventative care. 

The final piece is the ability to track vitals and track mental health and other key aspects of the pregnancy and postpartum journey that can be early signals of complications and risks. So, really being able to keep all that in one place – manage your care team, manage your health, own your health record for you and your baby – are the three pieces of that puzzle. 

MHN: So, there are obviously problems with traditional maternal healthcare in the U.S. What do you think are some of the biggest issues that you’re hoping Mahmee will help fix?

Hanna: The first is very high fragmentation. This is a very fragmented market, where there’s just a lot of different kinds of professionals often working in a variety of clinical and outpatient settings that provide a variety of different services to new and expecting parents. And in many cases, they don’t have the digital tools and data sharing capacity to work together and collaborate on that care. So, there’s just a lot of different pieces of a puzzle spread out, and the patient becomes responsible for linking everything together and having the burden of re-sharing their story with every new person who joins their care team. 

That fragmentation is not going to go away. This is a highly privatized market. There’s a lot of people that work “out of network,” and I don’t see that really changing any time soon. And, to resolve that high fragmentation, we built technology that links people together in a way that allows them to communicate and collaborate so that it feels like they’re working together, even if they all work in different organizations in different environments.

The second thing is systemic racism and bias in healthcare. This is something that has existed since the foundation of this country and the formation of the obstetrics and gynecological industry. And we need to acknowledge that we have not paid attention to the needs of Black and brown women, specifically Black and Indigenous women. Broadly, we have not been actively listening to mothers for a long time, which is why our maternal mortality stats are where they are, because we are waiting for things to happen rather than actively preventing them from occurring with more clinical and psychosocial support.

The way that we are addressing systemic racism and bias in maternal and infant healthcare is by first building out a national network of culturally competent providers and professional birth professionals that understand how to meet patients where they’re at, and recognize that lived experience is an element of the entire journey of pregnancy and postpartum. 

We need to acknowledge that lived experience. We can’t always match a patient with someone who looks like them or comes from their community, but we can match patients with providers who acknowledge the systemic racism and bias that that patient may have experienced – in their lifetime and in their healthcare experience overall – and begin to address and unpack that. 

MHN: You recently completed your Series A. How do you plan on using that investment?

Hanna: We are absolutely expanding our team to be able to serve more patients and providers through our platform. So, that’s the number one thing, growing that team in every direction. We are posting jobs every few days. 

It’s really important that we continue to improve the digital experience for patients and providers on Mahmee. That includes things like releasing a native mobile product and improving accessibility and user experience across the board. So product and engineering is a big area for hiring in the company. We’ve already brought some new folks on, and we’re going to continue growing there. And then, of course, we also have our nurses and care coordinators in-house. 

MHN: Digital health funding has slowed so far this year, but it seems like there are several startups that are interested in maternal and reproductive healthcare and improving that experience. Do you think investors are more interested in maternal health right now? And if so, why do you think this inflection point is happening right now?

Hanna: That’s a great question. I do think that we are coming to an inflection point. I actually don’t think we’re there yet. 

Based on our fundraising experiences in 2021 and 2022, it’s clear to me that most investors still are unsure of how to evaluate impact and assess the value of maternal and infant health-focused solutions. There is still very frequently in the investment landscape a pull toward consumer-facing solutions that sort of eschews the healthcare industry itself.

MHN: Like an app where someone will track [their pregnancy] every day for themselves, as opposed to working with a provider.

Hanna: Yes, exactly. There’s a lot of more traditional consumer approaches popping up in maternal and infant healthcare, claiming to be able to resolve some of the fundamental challenges that this field is facing. But where I see a misalignment in the market is that the fundamental challenges that this field is facing are systemic. You can’t fix the healthcare industry without working with the healthcare industry. 

It’s not that direct-to-consumer solutions are ineffective. In fact, sometimes, they can be exactly what the patient needs to complement their healthcare journey. However, the challenge is that this particular vertical is currently plagued by extremely costly systemic issues, including but not limited to systemic racism, waste and reactive medicine, fragmentation, regional disparities in care, maternity deserts lacking the critical service providers that are needed for safe and healthy childbirth. So there’s no amount of baby tracking or maternity tracking alone that’s going to solve some of these challenges. 

I don’t want to be too self-righteous about this; it’s been extremely hard to work in this industry. It doesn’t move easily or quickly in any direction. Much of that has to do with the fact that women’s health and women’s lives and rights have been taken for granted and overlooked, or in some cases, outright ignored. 

Over the past 12 months, we’ve seen more momentum, more movement in the space generally. I noted that I don’t think that we’re at the inflection point yet. I think there’s still more excitement and positive growth in this market to come. It doesn’t help us if we’re the only ones in the market. I think that there’s some exciting movement here happening overall, and I just don’t think we’re at the pinnacle yet of people really understanding what’s possible.

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