Over the past year, we’ve seen a robust nationwide conversation emerge about the realities and inequities of maternal health care; startling revelations, statistics, and stories around a broken system have finally begun to gain traction. It has created an opportunity to invest in the solutions that take the welfare of women into account. This is why we invested in Mahmee. Our CEO, Lindsey Taylor Wood, chats with mother-daughter team Melissa and Linda Hanna about the state of maternal health care in the United States and how Mahmee is working towards making it better.
On Mahmee’s Maternal Health Care Offerings
Lindsey Taylor Wood: What is Mahmee and how is it revolutionizing maternal health care?
Melissa Hanna: Mahmee is a digital maternal health care company that uses predictive analytics to provide personalized, on-demand support to new mothers and infants. Mahmee members can book appointments — both in-home and virtual — with a growing network of highly-qualified postpartum care providers, including registered nurses, board-certified lactation consultants, registered dietitians, certified massage therapists, sleep trainers, emotional wellness counselors, and more. Mahmee also features a private messaging hotline, online support groups led by experts, and a personalized dashboard of content and advice that evolves with mom and baby through every age and stage.
On Postpartum Support
LTW: A woman in the US is discharged between 48 and 72 hours after giving birth and her next contact with the healthcare system isn’t until 6 weeks later. Follow-up care rarely takes into account that she just went through a major body event. How does Mahmee solve for that?
MH: Our core competency is postpartum care. Solving for this 6-week gap is a key part of our strategy, and for us, that means proactively checking on our moms and staying in regular contact during these first six weeks. If any concerns arise during this time, we are often the first to identify and escalate them to the appropriate physician who can provide additional medical attention.
...we are often the first to identify and escalate them to the appropriate physician who can provide additional medical attention. Tweet
Linda Hanna: Most women don’t have any real idea of what they’re going to feel like after an event like a birth, regardless of whether it’s a vaginal delivery or cesarean or a complicated vaginal delivery with instrumentation. Women need to understand more about what’s happening to them physically, how to recover, what tools they’re going to require, and how and where to get help.
It starts with educating women, as well as their partners, on the experience. Many people go, “I don’t need any help, I’m gonna be fine,” but you don’t actually know that yet and there is no safety net.
We need to educate them on what services are available, how they are being made available, what’s considered a covered benefit, pricing, and what the regulations are. And that’s exactly what Mahmee does.
On the Urgency of Maternal Health Care
LTW: You mentioned that if you can get to mothers within 48 hours of them giving birth, the benefits they get from Mahmee’s signicantly increases. Can you say a little bit more about that?
MH: The sooner that we can get to families, the better.
There's a suite of services and a suite of products and features that make up the Mahmee experience that should be available to every mother. Tweet
There’s a suite of services and a suite of products and features that make up the Mahmee experience that should be available to every mother. And the utilization of Mahmee services and care more than doubles if moms receive support and education early on because they are better educated at that point as to what kinds of services/help are out there and how to make the most of it. As an example, if you don’t know what a lactation consultant does, you are not likely to visit one later on if you begin to have trouble with breastfeeding.
We also educate women on how to make use of all of the offerings we have available, like professional coaching on nutrition, emotional wellness, returning to work, dealing with extended family and partners, for example. Virtual support groups are another example of a service we offer that is pretty new to the market. Many moms are used to attending local, in-person mom groups and meet-ups, but have never attended a video chat group. Our virtual support groups are moderated by experts and are age and topic specific, so moms can connect with others who are going through very similar experiences anywhere in the country.
We know that every family, clinical situation, and medical concern is different, so and for us, it was about putting together the suite of tools that could serve these families such that they can use them in a way that’s best for them.
On “Mothering the Mother”
LTW: You mentioned that a new paradigm for maternal health care and women’s wellness is needed, part of which includes ‘mothering the mother.’ What does that mean?
LH: It goes back to what Mahmee is all about. It’s actually the inspiration for our name: Mom-Me. Mahmee. It’s about helping and supporting a woman and mothering her as she evolves into a mother. Our patriarchal society just expects a woman to give birth and automatically know what to do. But she needs to be cared for and attended to during that process. As a nation, we’ve done a poor job of understanding what that means. This is most evident in our rising maternal mortality rates. Mahmee is reframing what her maternal health care must look like to recognize the full spectrum of her needs.
On Women’s Mental Health
LTW: What are some of the things that we should be talking about more when it comes to maternal health care?
MH: Women’s healthcare, in general, is substantially under-regulated. This is across the board. Maternity is just the glaring error of it all. And there is so much work that we need to do on postpartum depression and women’s mental health in general.
LH: I agree. We’ve always wanted to have more mental health counselors on our team. It is vital for moms to have postpartum support counselors. And a lot of people don’t even realize that they actually do need to talk with somebody. Mostly because everything about their whole life has changed so significantly. Everything.
On Their Biggest Pet Peeve
LTW: Do we value babies more than we value mothers?
MH: Culturally, yes. This is probably one of my biggest pet peeves and one of the driving forces of continuing to build this company. It’s what reminds me every day that there is something seriously wrong because the stats are undeniable.
...there's no other way to look at it than to say "We must not be taking care of them [mothers]." Tweet
While we have paid attention to infant health and changed the way that we operate infant nurseries and NICUs over the past several decades, the rates of maternal mortality have continued to climb. And there’s no other way to look at it than to say “We must not be taking care of them [mothers].” It’s an infrastructure issue; the industry is so poorly set up. There’s no way to look at the situation and say we’re doing a good job.
On Prioritizing the Mission
LTW: Do you feel like part of the role of Mahmee is actually democratizing some of this?
MH: It definitely is. It’s just that, the original sin in all of this is so far back in the history of society. There are layers and challenges that feel insurmountable. Any given policy is not going to solve this. You have to take a fight-on-all-fronts sort of approach. Which frankly is not attractive to investors, and it’s not sexy from a tech standpoint. People say, “Do one thing and do it well, do something that can scale. Just pick one feature and build that out for as long as you can so you have a good user base and then start to introduce other features.” This is just not that game. You can’t play that game in maternal health care.
In order to actually provide equitable access to care, which is our mission, you have to look at the many layers that are flawed in the system. I try not to dwell here, but the original sin is treating women as second class citizens in this country. And across the world.
The original sin is treating women as second class citizens in this country. And across the world. Tweet
LH: That’s absolutely what it is. [But] there’s a whole collection of women in my field who spend their time working on policy, going to government and going to Congress. At every level, they’re fighting the good fight.
On Maternal Health Care & Race
LTW: The New York Times recently reported on the black-white divide in both infant and maternal mortality. Black infants in America are twice as likely to die as white infants. A college educated black woman is more likely to die in childbirth than a white woman with an eighth-grade education. What are your thoughts on how lived experienced informs outcomes?
LH: No one believes them. Everything that they say is less valuable. It’s like “Come on, you’re not in that much pain. That doesn’t hurt that much, does it really? Are you sure it hurts that much?” Or “The baby’s cried that much? I don’t think the baby’s cried that much.” “You look like you slept. Haven’t you slept for a week? You look like you slept. You look good.” Or whatever. Any number of things that don’t value their complaints.
LTW: Breastfeeding can be a contentious topic: from the narrative around breastfeeding among black women to the clinical realities and benefits of breast milk. But I know that Mahmee is committed to tackling it. How are you thinking through that?
MH: This is more complex than most people realize. Breastfeeding rates are lowest among low-income black mothers, and this is primarily due to sociocultural and economic narratives and norms. We’re actually working in the city of Pittsburgh on this issue right now. We’re part of a federal grant with the specific purpose of changing the rhetoric around breastfeeding for black mothers. In some black communities, the stigma around breastfeeding formed from painful memories of slavery when women of color cared for white women’s children—acting as wet nurses, for example. Despite the cultural emphasis and marketing around breastfeeding in general, it’s not something that is well-promoted or understood among black mothers.
Further, the proliferation of infant formula at the start of the 20th century led many to misunderstand breastfeeding to be an activity of low-income mothers. They misunderstood that if you can afford formula, you should use it instead. This has a huge and direct impact on infant mortality. Not getting early access to the microbiota and antibodies in breast milk has a high correlation with severe infant health concerns such as Necrotizing Enterocolitis (NEC), one of the leading causes of infant mortality.
It’s important to note that we understand not every woman will or wants to breastfeed. But we need to talk more openly about the clinical and psychosocial benefits of breast milk feeding for both mother and child. This is an important distinction that we make at Mahmee. We try to accommodate it in our messaging. But we come up against the dominant cultural narratives that present “breast is best” to an extent that is completely infeasible for the modern mother.
For example, we were banned from speaking at a lactation conference because our materials contained a photo of a baby drinking from a bottle. But in reality, many babies are actually fed breast milk through a bottle, and there’s nothing wrong with that. How else can women return to, and excel in, the workplace, if society is also expecting them to put a baby on the breast every 2-3 hours? There’s definitely a disconnect and one that I think we need to continue to find ways to address.
LH: It is important to add that cognitive biases also affect the amount of attention and care that women of color receive. The disparities in delivery of care and pain medication between white women and women of color are well-documented. Simply put, the needs of women of color are not being met by our healthcare industry.
On Bias in the Industry
LTW: As that relates to Mahmee, do you find you attract a certain type of physician or practitioner that is more inclined to understand bias and believe women?
MH: We do a lot of teaching and training with physicians. We don’t staff our company with physicians, we partner with them. And we relay information. We escalate concerns if something comes up within our patient community. We can be that conduit and that translator; educating the mom on how to advocate for herself and explain her concern in a way that’s going to get attention.
Part of that is working with our patients and teaching them how to speak about their own bodies. It’s our way of correcting for the error in the system. These women weren’t listened to when they went in and cried, or said they were in pain or said they worried about their baby. Someone said “No, you’re fine, you’re gonna be okay. You’re tough.” That is really the real bias that is in the industry. And it is so systemic. These are the same people who would say walking out of the hospital “No, I’m not racist. I did everything I could to help all of my patients.” You know? We have to be honest about black and brown, specifically African American women; this is a race issue. They have been systematically ignored and overlooked and discredited.
We have to be honest about black and brown, specifically African American women; this is a race issue. Tweet
LH: And there’s also a language barrier. If they have a language barrier they’re not to be believed either.
MH: Yes, we have a lot of wealthy, international families that come to the US and have children. It’s real. It’s happening. They are just as frustrated as our African American families because someone thought they were dumb. They say, “They didn’t even listen to me. They waved me off when I tried to explain what I was feeling.
On Their Best Piece of Advice
LTW: You’ve had decades-long experience working in maternal health care. If you could impart one piece of advice, what would it be?
LH: Don’t ever be afraid to ask questions. Don’t think anybody’s judging you. The pregnancy and postpartum period is a very special time, full of intimacy, privacy, and depth, but people can’t read your mind; even your partner, who you adore and love and live with. Ask and you will get support and help and guidance.
Melissa & Linda Hanna are the mother-daughter duo behind Mahmee, an app modernizing access to postpartum maternity information and care. Their combined experience in tech entrepreneurship and maternal health care uniquely positions them to be leaders in the maternal wellness space. Prior to launching Mahmee, Melissa served as an Assistant Director of the Eugene Lang Entrepreneurship Center at Columbia Business School. Linda has worked at several prestigious hospitals in LA and has implemented birthing, breastfeeding, and baby care programs in hospitals across the country. She has been a registered nurse since 1978 and holds a BA in Nursing and an MA in Nursing Education.