What’s Next in Maternity Care?

Which nation in the “developed world” spends the most on maternity care? You guessed it—the United States. And which has the highest maternal mortality rate? Same answer, and the numbers aren’t even close.

“We are spending the most and getting the least,” says Melissa Hanna ’09, founder and CEO of Mahmee (pronounced “mommy”) “And even though we have a slowly but surely declining infant mortality rate, it’s still too high.”

That’s why Hanna founded Mahmee, a secure online platform designed to bring together a network of education and support services that expecting and new mothers and their babies need in order to thrive—from early pregnancy through the first year of an infant’s life. Hanna calls it “bundling care,” and she notes that the same model has been used successfully to manage other health-related conditions that require attentive, long-term maintenance, such as diabetes and chronic heart failure.

“Being pregnant is not considered being sick,” she says. “But I like to say having a baby is like a hormonal boomerang. Your body is prioritizing the baby over you, and so, if you think of the experience of childbirth as being this acute, physical trauma on the body, on the hormones, on the brain, why don’t we treat that as something that a person should be recovering from? If we did, it would totally change our approach to health care for women.”

Part of the problem, Hanna says, is our disconnected health care system. “One doctor, the pediatrician, is responsible for the baby, and a completely different doctor in a completely different office, using a completely different system of tools and software, is keeping track of the mother’s health. Mother and baby are connected in the womb and then outside of the womb for months after, and yet the way that we take care of them is so separated.”

In addition, most Americans don’t have the family support systems that mothers rely on in more traditional cultures. “We’re all transplants,” Hanna says. “We move around the country, away from our parents, away from our grandparents, so we end up having children in environments where we’re very isolated.”

When systemic change finally comes, Hanna believes, it’s probably going to look a lot like what other countries have done for years. “I think when we look to the future, we can look to other countries like France, like England, having a model of sort of nurse-midwifery and in-home health care,” she says. As an example, she points to the growing demand for doulas. “We end up creating a whole new industry—the industry of being a doula, which is basically being a home health assistant after delivery. That has become part of the market share in the United States, and I think that’s going to continue.”

Online services like Mahmee, which connect expecting mothers with networks of other mothers and health care experts, are also an important part of the future, Hanna believes.

“In the next few years, we’re going to see a big shift, where people start to take their Lamaze classes online, where mothers join video chat support groups,” she says. “Our company is starting to offer those, as an example, and I know that we’re not the only ones. I think that’s going to be a big way for women to connect and support each other online.”

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