In 2016, Poppy Seed Health founder and full-spectrum doula Simmone Taitt came face-to-face with the complexities of the maternal healthcare system. She had just suffered a miscarriage, but instead of receiving step-by-step medical and mental health support from her healthcare team, she found herself forced into the driver’s seat, turning to Google to seek out medical follow-ups that were not offered to her. Taitt ended up calling her own care plan—an HcG blood test and a sonogram—into her doctor’s office herself, and spent the rest of the day on the internet searching for things to make her “feel better”—not physically but emotionally. “I felt alone and isolated and it wasn’t until I stumbled upon a doula board that I finally felt seen, heard and included,” she says. Like Taitt, I also experienced pregnancy loss and received inadequate care. After experiencing light spotting which turned into heavy bleeding, I spent several hours chasing my medical team before being told there were “no doctors available to see me until tomorrow.” I miscarried my eight-week pregnancy later that evening before I could see my OBGYN.
It’s no secret that there is a national health crisis in the U.S. where women of color are largely ignored and dying during childbirth. Black women are two to three times more likely to die from pregnancy-related causes than white women, according to the Centers for Disease Control and Prevention, with gaps in care during the pre-conception or prenatal stages often setting the tone of a woman’s overall pregnancy journey. Recently, a March of Dimes report gave the U.S. a “C minus” in maternal and infant mortality, with nine states earning a “Fail”. Repeatedly, unconscious bias in the medical field sees life-threatening issues being diminished or ignored.
“There’s a lot of things that happen [to birthing people] that are normalized that actually, outside of this context, would be considered abuse,” explains birth advocate and founder of Mama Glow, Latham Thomas, of the attitudes seen in laboring rooms across the country. “Dismissiveness, tone policing, curtness, micro-aggressions, coercion, even physically forcing body parts or prying someone’s legs open for a cervical exam or slapping someone’s thighs to indicate they need to move.” Often, Black and brown birthing people are silenced by their medical teams, made to feel they are doing or asking for too much if they request help, and are more likely to receive a lack of competency in information and care from providers regardless of their health insurance status, says Taitt. “I have spent time with the best health insurance, no health insurance, and marketplace health insurance—it didn’t matter where I was on the spectrum of health insurance,” she says, “I was not given equitable access to the same resources or care [as a white woman].” (According to the Kaiser Family Foundation, in 2019, only 52 percent of Black women had employer-based insurance, compared to 66 percent of white women.)
So if we don’t prioritize our health, who will? Born from their own experiences, it is Black women—specifically, a group of pioneering female-identifying founders of color, including Taitt and Thomas—who are pushing to reimagine America’s maternal care system, ensuring all birthing people are supported from pregnancy to postpartum. Here, we talk to five women leading the way.
Leveraging technology for connected care teams
Dubbed a “data-driven care coordination and personalized support system,” Mahmee, co-founded by Melissa Hanna and her mother Linda Hanna, a veteran maternal and lactation health care expert, quickly caught the attention of investors like Serena Williams and Shark Tank’s Mark Cuban after it launched in 2014. Williams, who shared the life-threatening complications she experienced while giving birth to her first daughter in 2018, was especially drawn to Melissa’s focus on ending the maternal mortality crisis among Black women in America. “Birthing people continue to fall through the cracks of the fragmented healthcare systems,” she explains. “Preventable issues are not being caught fast enough because current technology restricts providers from sharing electronic health records beyond the walls of their facilities, limiting their ability to incorporate the voices of other providers, community organizations, and allied health professionals to inform decision-making.”
Mahmee, which was born over a mother-daughter dinner when Melissa noticed her mom receiving dozens of text messages from OBGYNs and pediatricians seeking additional information about their shared patients, provides personalized, ongoing postpartum care to new moms and infants through direct communication with their myriad healthcare providers. Women can book appointments—both in-home and virtual—with registered nurses, midwives, OBGYNs, doulas, board-certified lactation consultants, registered dietitians, certified massage therapists, sleep trainers, emotional wellness counselors, pediatricians, and even social workers—all of whom use Mahmee to connect to each other and their patients.
“Founding Mahmee was critical when I noticed the gaps in maternal care and began thinking through the best way to leverage technology to do so,” says Melissa. “Usually, babies and moms have their own separate teams and it takes many weeks after labor to figure out what their joint needs are. For the first time ever, Mahmee has created connected care teams for the complete mom and baby dyad.”
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Despite being complex tech to build, Melissa knew that her multi-stakeholder platform would be a “highly scalable, billion-dollar business.” (The global mother and child healthcare market was valued at $504.9 billion in 2020 and is projected to reach $1796 billion by 2030.) But like most female founders in this space, convincing early-stage investors it was a worthwhile venture was more complicated. “For much of the company’s first half of life, it was an uphill battle for people to believe that we could be a solution and a practice that could unify the industry,” remembers Melissa. “Honestly, I walk into rooms and there are certain people that cannot fathom I could build a billion-dollar company—and I know I’m not the only founder that’s faced this. Racial and economically-oriented bias in women’s health is systemic; there is often a mindset that this [idea] is not possible or feasible—a cynicism around whether this innovation will take hold.” Such skepticism is one of the many reasons women’s health as a sector has lagged, she adds. “There’s not been the adoption of technology and digital solutions designed for us that we would otherwise expect from any other vertical, or any other industry in our lives.”
Today, Mahmee powers the entire virtual care program for the Los Angeles County Department of Health Services, is in contract with the DC Department of Health Services, and works with providers across the U.S. (everywhere from Kansas to Missouri to Texas) who are all using Mahmee to connect to each other and to their patients.
Similarly, for apps like Poppy Seed Health, technology continues to play an increasingly important role towards racial health equity, offering support to birthing people through 24/7 access to doulas, midwives, and nurses. Early on, founder Simmone Taitt identified texting as a robust tool to (literally) meet people where they are, leveraging the power of technology “to build the most diverse and inclusive network of advocates across the country to mirror the members that we support.” Laser-focused on filling the emotional and mental health support gap during loss, pregnancy and postpartum, Poppy Seed Health allows members to connect with a doula, midwife or nurse in under a minute. (Membership to the app is $29 a month, however access to a Miscarriage and Loss hotline is free.)
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Naturally, when I fell victim to the rabbit hole of Google after my own positive pregnancy test, Poppy Seed Health became a vital resource both for my mental health and my physical wellbeing during those initial weeks when friends and family weren’t yet privy. Texting directly with a doula or midwife to classify what was “normal” (“should I be peeing this much?”) broke down my own embarrassment and shame around whether these questions were silly—an indoctrinated idea after centuries of women trying to navigate a patriarchal medical system. When I sensed something was wrong one weekend, I received calm, comforting advice on my text thread, and encouragement to ask my doctor for exactly what I needed. Post-pregnancy loss, I was welcomed with compassion, care, and education on next steps: including healing time, what to expect, and emotional support resources.
“We deliver radical empathy and unflinching support to anyone who needs it,” says Taitt, adding, “I am sick of the gloom and doom in the narrative of being a Black mother in our country. I wanted to use my personal experiences combined with my deep tech background to build something new, because this is the time for radical empathy and radical change.”
With knowledge and community, comes power
Offering a mix of individual services including birth and postpartum doulas, breastfeeding support, and corporate workshops to ensure pregnancy feels less like a “crash course” and more like an empowering transition, doula and mother-of-two Celia Roach founded thræd as a tight-knit virtual community for women at all stages in the pregnancy journey.
“There is a lack of support for birthing families: mom-centered care, elders sharing wisdom, basic body knowledge and trusting enough in our bodies to lead with intuition during this life-changing time,” says Roach, who trained to become a birth and postpartum doula and certified lactation counselor after the birth of her two sons in 2019. Thræd’s focus is to provide support for mothers at all stages and ages, with varying needs, from teens to mature moms.
Similar to the mission of Erica Chidi’s LOOM, an educational sexual and reproductive health platform that offers resources to center the mother’s experience during pregnancy, Roach wants to ensure mothers have access to an educational foundation and supportive community. As a birth worker herself, Roach knows first-hand how doula support—with the educational, physical, and emotional buttress they provide—is associated with improved maternal and infant health outcomes. “Knowledge is power. Getting this thread of information, resources, and support out to birthing families allows them to exercise more autonomy over the entire childbirth continuum, prenatally through post-birth—which is life-changing,” she says. “Doulas help save lives.”
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Indeed, multiple studies have found better outcomes for birthing people who have doula support and access to childbirth education, including lower rates of maternal and infant health complications, lower rates of preterm birth and low birth weight infants, lower rates of C-sections—which are associated with higher rates of maternal mortality and other medical interventions—and higher rates of breastfeeding. In addition to improved physical health outcomes, doula support is linked to reduced rates of postpartum depression and anxiety as well as increased positive feelings about the birth experience and ability to influence one’s own pregnancy outcomes. “As a doula, it is our job to prevent unfavorable outcomes through equipping birthing families with the educational and informational support they need,” says Roach.
Arguably as important, but often an afterthought of the U.S. healthcare system, is the fourth trimester. Up to 65 percent of maternal deaths happen in the weeks after delivery, writes Chidi, a time where birthing people are generally disconnected from their traditional medical care teams. (The American College of Obstetricians and Gynecologists has long recommended that a woman’s postpartum visit take place an entire six weeks after birth.) Not surprisingly, those most affected often don’t have insurance coverage.
Nana Eyeson-Akiwowo and Marcia Cole, co-founder of The Fourth Phase, are working diligently to provide new moms with the tools they need to physically heal post birth, while also erasing stigmas that currently exist about how “easy” recovery should be. Their first product, an afterbirth care gift box, is curated with a new mother’s physical and emotional recovery in mind—for both C-section and vaginal births. Each box features 12 organic, sustainably-sourced products: everything from a belly wrap to a nipple salve to postpartum underwear and pads.
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“There was no conversation around what I was supposed to do for myself after I brought this baby home,” explains Eyeson-Akiwowo of her own postnatal experience. “I know everything I was supposed to do for this baby, but no-one is explaining to me, ‘How long am I supposed to bleed? What am I supposed to look for in this blood? How do I manage this incision? I didn’t know that I should put a belly band on,” she says, describing the Fourth Phase box as a salvation for new mothers. “They were coming home both empty-handed and without the knowledge of what this time period meant for them.”
Most recently, Eyeson-Akiwowo and Cole started a Change.org petition to include the term ‘Fourth Trimester’ in the Merriam-Webster dictionary. It worked. “Whenever anybody hears the word ‘postpartum,’ they don’t think about post-delivery, they immediately think, ‘oh, she’s depressed.’ And I’m like, ‘No, there’s so much more happening to my body before the depression even kicks in. I’m just still trying to get my uterus to contract!”
Healing and moving forward together
When Mama Glow’s Latham Thomas speaks about her own personal birth story, it is filled with softness and delight. She delivered her now 18-year-old son at one of New York City’s only freestanding birth centers surrounded by friends, family, midwives—and food. “It just was joyful, it felt very natural,” she recalls. “It should feel [like that]; it’s like this ancestral wisdom kicks in and part of you is overtaken by the experience.” She credits the presence of doulas and midwives as the reason she had such a memorable, positive birth.
Mama Glow, a maternity lifestyle brand that supports women along the childbearing continuum (from the fertility period, during pregnancy, after birth, and into new motherhood), offers a premium doula service for expectant mothers. Since its inception, the company’s collective of teachers, community leaders, and mentors has leveraged a critical race theory lens on how they approach doula work, offering a globally recognized doula immersion program educating doula-trainees from around the world to become the next generation of leaders who will help transform the modern women’s healthcare system. “Our doulas who are non-black individuals are prepared and doing their work to be in allyship and in community with us,” Thomas explains. “They are respectful in being in spaces where they witness us in our healing and in our pain. And they also learn how to be in relationship with us in ways that they were never taught.”
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Having cultivated partnerships with some of the nation’s leading health organizations, Mama Glow is deeply committed to education and advocacy around midwife-led care, which results in women being less likely to experience preterm birth, fetal loss before and after 24 weeks, and neonatal death. In most other industrialized countries, a “registered midwife” or “licensed midwife” serves as a woman’s primary maternity care provider (rather than an OBGYN) and attends births in hospital, birth center, or home settings. In the U.S., midwives are often relegated to non-hospital settings, are seen as an obstacle to the patriarchal, white-led profession of medicine, and are oftentimes outlawed. “There are some states where you can’t even practice as a midwife,” says Thomas. Alabama and Nebraska, for example, not only don’t license midwives who perform home births, they also specifically prohibit the practice. And despite a long history of midwifery in the Black community, adds Thomas, Black women currently represent less than 2 percent of the nation’s reported 15,000 midwives. “At this country’s inception, it was all Black women and indigenous women delivering the babies—so how did we get to 2 percent? Criminalization and credentialing, which wipes us out of a pathway of generational wealth, of health equity, and of community building.”
Now, more than ever, Thomas’ mission is to ensure all women, especially Black women, experience a safe, sacred pregnancy and birthing experience. “There’s this idea of an archetype and narrative about strong Black womanhood. ‘I’m a strong Black woman’ or ‘She’s a strong Black woman….’ — and hat is killing us,” emphasizes Thomas. “The idea that you [the medical community] think we are strong is actually killing us. We’re not. We’re not stronger than anyone else. Resilience? Yes. We have ancestral resilience, we have built in resilience, just like we have built in ancestral trauma. We have resilience as a people. And we have hope and grace and this incredible sense of fortitude from within. But that’s spiritual fortitude. We do not have more physical fortitude than anybody else.”
So what does that path forward look like? It’s very layered, says Thomas. To start, Black women need to be part of the solution, with organizations historically led by white individuals diversifying their hiring practices—recognizing that hiring Black women to administer care will improve care for all expectant mothers. Another avenue is investment: whether that’s seed round funding from venture capital firms, having healthcare executives open their networks to underrepresented founders, or offering continued education to current staff members, placing dollars and time into Black women will be the difference-maker. “[Organizations need] to do the work that it takes to get them on the right path, instead of the tokenization of Black employees which continues the cycle of harm,” says Thomas. In the meantime, Black women are pushing forward to shake up the healthcare industry, providing value to those who look like them, and beyond.
Janell Hickman-Kirby is a freelance communications strategist, copywriter, and beauty editor based in New York. Her writing has appeared in BRIDES, Cosmopolitan, O, The Oprah Magazine; ELLE, Harper’s Bazaar, Refinery 29, Coveteur, Well + Good, Allure, Doré, Marie Claire, and others.