I always knew there were gaps in the U.S. maternal healthcare system, particularly for people of color, but I didn’t fully understand the depth of the issue until I lived it myself.
After giving birth at the height of the COVID-19 pandemic, I came home from the hospital and quickly developed a blinding headache that wouldn’t go away. Then came chest pain and increasing shortness of breath. Eventually, my legs got so swollen that there was a visible fluid line right below my knee, and it hurt to put on shoes or flip flops. We didn’t know it at the time, but I had developed preeclampsia—a serious condition that accounts for tens of thousands of maternal deaths around the world each year.
My options at the time were few. My doctor had scheduled me for a checkup six weeks after giving birth and couldn’t fit me in for days. It was a weekend and no one was calling me back from the triage line. The pandemic had stretched the healthcare system thin. It was terrifying and heartbreaking. As a first-time parent, I did not want to part with my baby or go to a hospital and risk getting exposed to COVID-19. As a woman of color who has studied the racial disparities in maternal and infant health, I was scared. Our country’s maternal mortality data paints a grim picture for pregnant Black women, and I didn’t want to become a statistic.
But I’m also someone who believes in the transformative power of technology and I couldn’t understand why there was not a remote solution for patients in this kind of situation. It’s why we created The Journey Pregnancy app. Many tech products and startups begin this way—filling a need their creators or founders see in the market. Startups are great at activating technology’s potential by offering speed, efficiency, data, and control. But the challenge of maternal mortality demands something different, especially for women of color who face underserved emotional and medical circumstances. And for a tech community that instinctively tries to iterate human inefficiencies out of the equation, it may mean taking a hard look at the value that real humans bring to healthcare tech and services in the age of innovation.
A hybrid approach
Tech generally does a good job of innovating to solve problems and is quick to offer an app to fill all sorts of needs. With pregnancy, for example, a quick internet search will show that there are countless pregnancy apps on the market, all helpful and well meaning efforts to address different aspects of the pregnancy journey.
However, when we launched a research project funded by the National Science Foundation to study pregnancy apps, we found a peculiarity: Of the hundreds of apps that tell families how big their fetus is on a weekly basis compared to fruit or animals, the pregnancy app industry as a whole remains largely focused on fetal health, in spite of a growing maternal health crisis. There are few tools for the people who are actually pregnant to manage not only their pregnancy health but various factors that can impact the quality of their care.
All mothers need this support along their pregnancy journey. But for people of color, the lack of this support creates a stark and deadly imbalance. I’m biracial and, on my mom’s side of the family—my white side—going back three generations and one hundred years, there was only one instance where a pregnant mother had a risk and there was a negative outcome for the baby. Going back the same number of generations on my dad’s side—my Black side—I can count on two hands the multiple late-term pregnancy losses, stillbirths, cases of preeclampsia, and hypertension in pregnancy.
Studies suggest that this happens for a variety of reasons related to inequities in our healthcare system—including variation in quality healthcare, underlying chronic conditions, structural racism, and implicit bias. And while pregnancy apps can help by tracking health info and confronting bias with hard data, part of the solution may be in bringing humans back into the equation.
That’s why, in addition to our app, we offer a service that involves a certified pregnancy wellness coach who, aided by the app, follows along with your health trends and vitals. This type of thinking is hardly new for tech products dealing with sensitive, emotional issues. Dating apps, powered by their algorithms, have introduced human coaches to make up for tech’s blind spots.
For pregnancy apps, trained experts can fill a variety of needs regarding mental and physical health, nutrition, and exercise. But, crucially, a real person can also foster emotional connections and trust, addressing the unique fears and anxieties that come with being pregnant as a person of color. A real person can both hear your concerns and make you feel heard. As experts, they can also help these mothers advocate for themselves more powerfully—combating human bias with a specialized human solution.
Becoming more human
What the maternal mortality crisis, and its impact on people of color, reveals about pregnancy tech is that many products would probably benefit from doing a gut check to make sure a product is meeting real human needs, challenges, and circumstances. Here are a few initial steps to bringing more humanity to our industry’s approach:
- Serve people first: Startups that tackle complex issues are more successful when the leadership and founders themselves have directly been impacted by the problems they’re trying to solve. If a company sees an economic opportunity but has not directly dealt with the issue itself, that’s where a human disconnect may start to occur. This is especially true for health-related issues that impact different races, cultures, and economic backgrounds differently.
- Earn trust at any cost: To be trusted, a product should always do what it says it will. For pregnancy apps, trust also means jumping through the complicated hoops of assuring health data privacy. But for communities of color, these apps need to go a step further—earning trust by acknowledging the inequalities that exist and delivering services that address them. Doing this, especially when it means adding skilled experts, can be expensive for any startup. But trust, not just efficiency and speed, should be the goal.
- Work together: Startups tend to perceive their solution as the solution. However, entities looking to address health-related issues like maternal mortality understand that these are multifaceted problems. Dealing with health disparities, social determinants of health, and our evolving healthcare system with its own built in biases takes partnership between payers, providers, and innovators to address. Having a human-scale impact that protects more pregnant women of color is less about competition or disruption and more about collaboration.
Maternal mortality is a difficult and multi-layered challenge, but it’s also an area where innovative companies can make real strides for communities of color. Just don’t forget that a real person, with the expertise and ability to promote change, can be a powerful resource—one that goes beyond algorithms and data.
Courtney Williams is the CEO of Emagine Solutions Technology.
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