This App Aims To Save New Moms’ Lives

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The U.S. has the worst rate of maternal deaths in the developed world. Thousands of women — especially black women — experience pregnancy-related complications just before or in the year after childbirth, and about 700 women die every year from them, according to the Centers for Disease Control and Prevention.

Tech startup Mahmee wants to change that. Founded in 2014, the company works to help women during the weeks and months after they’ve given birth, via a mobile app that’s designed to better connect new moms with health care and support, offering tools like surveys to assess their postpartum emotional and physical health. The goal? To reduce maternal deaths and complications.

Mothers can sign up on their own and get access to a team of experts including maternity coaches, nutritionists and lactation coaches — and if their health care providers are connected to the system, they can share information with them. To date, the company has more than 1,000 providers and organizations in its network.

In July, the app received $3 million in new funding to grow its team — a portion of which comes from Serena Williams, the tennis star who made headlines last year after she almost died shortly after giving birth to her daughter. Williams’s experience helped shine a light on maternal health concerns, particularly among black women.

Melissa Hanna is CEO of Mahmee and a co-founder, along with her mother, Linda Hanna. Linda is also a longtime nurse and lactation consultant. NPR’s Lulu Garcia-Navarro spoke to mother and daughter about their app and how they are addressing what the two see as a gap in postpartum health care.

This interview has been edited for clarity and length.

Tell us how you came up with Mahmee?

Melissa: The idea for Mahmee came about from watching my mom work in this field for years and years and realizing that there was a limited set of tools available to professionals like herself to create the impact that she wanted to have on mothers’ and babies’ lives. And after watching her build out very successful programs for hospitals and health systems and all sorts of different experiences in the inpatient setting, we started talking about what could be done in the outpatient setting when patients are home with their families.

What are some of the common complications new mothers might face — and how could Mahmee help them?

Melissa: In the past 12 months, we’ve had patients who’ve experienced severe blood loss and postpartum hemorrhaging. We’ve worked with families and with mothers that are experiencing prenatal anxiety and supported them in preparing for their childbirth experience in the hospital. There have been patients who have experienced postpartum depression; in some cases, some very severe postpartum psychosis symptoms.

One case in particular comes to mind. A patient who was experiencing suicidal ideations and hadn’t reached out to anyone for help yet…she wasn’t sure if this was a normal part of being a new mom. She had a 2-week-old baby. After taking the postpartum depression survey that was available to her on her Patient Dashboard, [she] scored really high and [was] immediately flagged for additional assistance. And so Mahmee was able to step in and engage with her, verify these symptoms, and immediately escalate this to the OB-GYN’s attention who had no idea she’d been struggling.

Studies have shown that women of color are three times more likely to die of childbirth complications than white women in the U-S. Why is that, and what is Mahmee trying to do to close that gap?

Melissa: What we’re seeing now is the crisis of maternity and infant health care come to the surface because the stats around black mother and black infant mortality and morbidity are so inexcusable. There’s a huge discrepancy in how patients are cared for.

I think that a very important part of this whole story that often gets overlooked is how broken the overall system is, and how fragmented it is for any parent who’s trying to navigate this process with a number of different providers [across] different health ecosystems. You’ve got your OB-GYN taking care of Mom, the pediatrician taking care of baby, and a number of other professionals who are often out-of-network for new families. And then you add into that a layer of systemic racism and bias …it just becomes these insurmountable odds for families [of color].

Linda: One of the biggest drawbacks for [this population is] that they don’t believe anybody is going to listen or actually care. We actually do care. We want to know how you’re feeling and we want to be able to step in when somebody even reports just a feeling that they’re having. We don’t tell people, “oh, that’s normal, or that’s a common feeling,” but actually address what they’re feeling.

For hospitals and health care providers that sign up, how does it work? Does Mahmee offer some sort of bias training to its physicians?

Melissa: At Mahmee, we practice what we call “culturally competent care,” which means that from day one our team is getting trained on how to actively listen to families’ concerns, and specifically to read between the lines of the things that are being shared by new mothers. Patients are concerned that they’re not going to be believed anyway if they express what’s really going on. And so at Mahmee we are very conscious of the fact that this is what’s happening around the country, and this is something that patients are living with every day. It means that we have to overcome that by providing a degree of care that is above and beyond … really coming to patients where they’re at.

How did Serena Williams become an investor?

Melissa: We connected with Serena Williams through Arlan Hamilton, who’s a longtime investor and advocate for Mahmee.

Linda: I insisted that I wouldn’t actually take money or have anybody investing who didn’t really understand myself and Melissa first. And I’d like to meet everyone. She agreed, and I think she’s a very busy woman. Then she saw us on the screen — we were doing a video call — and she saw that I was a Caucasian woman and my daughter was a mixed race girl, and she almost started crying. Then we got the privilege of meeting her in person, which was incredible.

Copyright 2019 NPR. To see more, visit https://www.npr.org.

LULU GARCIA-NAVARRO, HOST:

When small towns lose their hospitals, people with health emergencies often need a helicopter to get them to critical care. But air ambulances aren’t required to respond to every call, and precious time can slip away while first responders scramble to book a flight. Sarah Jane Tribble reports from Fort Scott, Kan., on what can happen when people in rural America call for help.

SARAH JANE TRIBBLE: Robert Findley had closed up his popular auto body shop on a cold February evening. He went out to get the mail and slipped on the icy driveway. When he came back inside, he laughed it off as he told his wife Linda about the fall. He ate dinner, went to bed. The next morning, Linda called for help.

(SOUNDBITE OF ARCHIVED RECORDING)

LINDA FINDLEY: Yes, I need an ambulance.

UNIDENTIFIED 911 DISPATCHER: And what’s going on?

FINDLEY: My husband fell yesterday and hit his head. And now he’s went to sleep this morning, and I can’t wake him up.

TRIBBLE: Fort Scott’s EMS crew took one look at the 70-year-old’s eyes and suspected a brain hemorrhage. Robert needed to get to a hospital with a neurology center – the closest is 90 miles north in Kansas City. Fort Scott’s hospital closed in December.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED EMS WORKER #1: We are triage red. Can you dispatch the nearest air ambulance?

TRIBBLE: That’s the EMS worker asking for a helicopter medevac. So the dispatcher in Fort Scott dials Air Methods.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED AIR EVAC DISPATCHER: Did you want to remain on the line while I check with my closest available or would you like me to give you a call back?

UNIDENTIFIED EMS WORKER #1: I will remain on the line.

TRIBBLE: Air Methods is one of the biggest air ambulance operators in the U.S. It has helicopters at bases in towns near Fort Scott. The company’s dispatcher begins searching for a medical crew that can get to the Findleys fast. Within a minute, she’s back with an update.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED AIR EVAC DISPATCHER: My Nevada crew is not available and my Parsons crew has declined. I will be reaching out to…

TRIBBLE: Earlier this summer, Linda Findley sat at her kitchen counter and listened to the 911 call.

FINDLEY: I didn’t know that they could just refuse. I don’t know what to say about that.

TRIBBLE: Air ambulance companies aren’t required to report response times or say why flights are turned down. There is also no requirement that the closest aircraft will come.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED EMS WORKER #2: Fort Scott to EMS 1.

UNIDENTIFIED EMS WORKER #3: 10-4.

TRIBBLE: I asked someone else to listen to that 911 call. Joe House is a paramedic and leads the Kansas Board of Emergency Medical Services. House says it’s pretty typical. Flights can be declined because of bad weather and safety issues. The crew that says no might be on another call or recovering from previous trips, House says.

JOE HOUSE: If we could somehow wave that magic wand and have a singular center that can send the closest available resource to the patient when they need it, that would be phenomenal.

TRIBBLE: Rural communities nationwide are increasingly dependent on air ambulances. As local hospitals close, towns must figure out how to provide emergency care. Minutes can make the difference between life and death.

RICK SHERLOCK: In medicine, time is tissue. It’s the amount of brain tissue damage that occurs in a stroke. It’s the amount of sepsis that can set into a system or trauma that can set into a system.

TRIBBLE: That’s Rick Sherlock, president of the industry trade group the Association of Air Medical Services. He’s pointed to Fort Scott as a town where air service has helped fill the gap in rural health care. Back in Fort Scott, it takes Air Methods about seven minutes to find a pilot. The pilot says it will take 38 minutes to get to Robert Findley.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED PILOT: In route to the helipad, mile zero.

TRIBBLE: So Fort Scott’s EMS crew drives to the helipad next to the closed hospital. That’s where Linda found a paramedic manually pumping oxygen into Robert’s unconscious body.

FINDLEY: They told me in the ambulance that it would be a little bit before the helicopter got there. I should come home, pack things and head that direction.

TRIBBLE: We don’t know how long it took, and we don’t know if that time mattered. Air Methods wouldn’t talk about Findley’s case. Officials in charge of Fort Scott’s emergency operations say they aren’t sure how long the crew on the ground waited.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED EMS WORKER #4: Vitals are all stable. I’m just supporting the ventilation. We’ll see you here in a few minutes.

TRIBBLE: Linda Findley believes the local paramedics did everything possible to save her husband, but she has questions about how long the air ambulance took to get there. Just days after being flown to Kansas City, Robert Findley died.

I’m Sarah Jane Tribble in Fort Scott, Kan.

GARCIA-NAVARRO: And Sarah Jane Tribble is with Kaiser Health News. Transcript provided by NPR, Copyright NPR.

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