Birth By Us

The U.S. is plagued by disparate birth outcomes, disproportionately affecting women and birthing people of color, specifically Black people who are currently 3-4 times more likely to die in childbirth compared to their White counterparts [1]. Since they are aware of these statistics, many hospitals have tried to solicit patient feedback through internal surveys and federal surveys such as HCAHPS that measure patient perspectives on hospital care. However, these current systems of survey administration are fragmented and asked after birth rather than throughout the perinatal journey, lack proper incentives, and do not operate from a holistic lens of what quality should look like. Additionally, with response rates averaging around 30% at best, maternal care providers and systems still lack the critical insights on effective strategies they should implement to help eradicate this crisis.

Additionally, from the over 50 preliminary interviews and focus groups we conducted from February 2021 - February 2022, we have learned that Black women and expectant parents, who are already systemically oppressed and underserved by these institutions, are left feeling disempowered and fearful. These conversations have also revealed that many Black parents felt that they lacked access to the support and resources (specifically culturally competent resources) needed to achieve a healthy and safe birthing experience, further exacerbating the issue.

A positive birth experience can set the tone for a lifetime of care with an institution and we hope to help birthing people regain that crucial trust in hospital systems. Birth By Us is an app that empowers mothers and birthing people to shape their own birthing experience while giving providers the insights and data on quality of care.

Birth By Us provides comprehensive check-ins at sequential points in pregnancy and postpartum through our quality questionnaires to give birthing people personalized health insights and top-tier resources. Upon completion of each questionnaire, our app analyzes and uncovers users top concerns, yielding tailored visit preparation and recommended resources. In addition, users will be able to create their own birthing plan and birthing village (including partner and doulas), connecting all members of their support team in one place and keeping everyone updated on birthing goals and key health stats. 

Birth By Us takes the guess-work out of improvement by turning patients’ feedback into comprehensive, routine quality reports placed side-by-side with valuable resources to help providers make impactful changes. We uniquely break down patient feedback to uncover facets of care related to implicit and unconscious bias among other holistic metrics. We also help providers make individualized and personalized care possible by supplying users with shareable health progress reports, flagging concerns and notes from their doula, which can be easily uploaded to electronic health portals and discussed at care appointments. 

Current efforts to eradicate disparities in maternal health are largely focused on working towards large-scale policy changes or the creation of community-based/grassroots organizations supplying maternal care. While we acknowledge that these efforts have pushed the issue in the right direction, technology can provide sustainable and expedited avenues towards solving two crucial pieces of the maternal health crisis: implicit bias recognition and patient education dissemination. This is exactly where Birth By Us steps in. We innovatively introduce technology with payoffs for both parents and providers, combining data analytics with robust resources to help everyone achieve their best possible outcome.

We believe Birth By Us will positively impact parents’ lives by equipping birthing people with the tools and knowledge needed to be their health advocate and achieve their best birthing experience, contributing at large to a reduction in maternal health disparities. Additionally, Birth By Us helps partners by allowing them to take a more active role in the communal process of birth, understanding their birthing partner’s body and transitions, all while learning how to best support their own physical and mental well-being through curated resources. Finally, Birth By Us will aid providers in serving their patients with the best quality care by highlighting key areas of improvement along with best practices to continue.

As pre-medical Black women, we intimately understand this problem and that if nothing changes, we may fall prey to the very issues we aim to solve. In addition, we have spent a lot of time reaching out and listening to the stories of parents and providers, which have further shaped our understanding of the issue and familiarity with our community.

Although our app aims to support and serve all birthing people, our goals are focused on addressing these disparities. As a Black women owned company, Birth By Us is aware of the maternal health crisis and will direct our efforts to reach birthing people who historically have limited access and knowledge about a healthy birth. As such, we plan to pilot in hospitals and hospitals and birthing centers that serve majority Black populations. 

The foundation of our team is built upon honesty, transparency, shared vision and passion. This allows us to be supportive, considerate, and attentive to our shared roles as co-founders so that we can bring our vision to life. 

Mercy is a co-founder of Birth By Us and an MIT pre-med student studying computer science and molecular biology. She is an advocate for safe birthing practices with a passion for Black maternal health and is excited about the role technology will play in resolving the Black maternal health crisis. She is highly skilled in Python, SQL, project management, and website design; skills which have already served us in the organization of our ideas and focus groups along with the creation of our website. Additionally, she has previous experience in health informatics research and front-end consulting, which will help in the necessary data analytics for the insights that we collect. Linkedin: https://www.linkedin.com/in/mercyoladipo/

Ijeoma is a co-founder of Birth By Us and a pre-med graduate student at UC Berkeley studying Public Health in Maternal, Child, and Adolescent Health. Prior, she spent her time at Brown University researching disparities in maternal health and is thrilled for the growth digital healthcare can bring to reproductive health, creating innovative and sustainable avenues to achieve health equity. She also has specific expertise in R, biostatistics, and three years experience in health informatics, which will help us in analyzing the health data that we are collecting. Linkedin: https://www.linkedin.com/in/ijeoma-uche

We are confident in the potential impact of our solution at every scale, but we face barriers to making this a reality. For one, there is the financial barrier associated with creating the application as we need to work with a software engineer to complete the back end and data architecture for our platform. 

Additionally, with the data heavy notion of our platform, we are excited by the opportunity to measure impact in innovative ways. However, we acknowledge that the body of research on quantifying equity is sparse and so, we would love to receive the support of SOLVE in building and monitoring an impact measurement practice. 

Finally, another barrier we face is getting into hospital systems. Through networking and customer discovery programs like MIT’s NSF SPARK I-Corp Program, we have made strides and conducted interviews with hospital personnel, but there is still lengths to go We hope to leverage SOLVE’s access to mentorship, coaching, and expert advice to enhance our relationships with these key systems and gain the expertise necessary to run our pilot and scale our solution.

Maternity in our healthcare system is fragmented.Institutionalized racism is a known cause for disparities within our healthcare system but there is currently no data to accurately measure the effects of it in order to start mending the issue. Our data will quantify aspects of patient quality like no other system has before in order to conceptualize institutional racism and lead to plausible clinical based solutions. Our solution will unite and improve all current clinical specific quality metrics and efforts, to help lead to better birthing and postpartum outcomes.  

Through our focus groups with parents, we have found that many used apps during pregnancy, but were left unsatisfied by the resources offered and apps on the market today. We innovatively introduce technology with payoffs for both parents and providers, combining data analytics with robust resources to help everyone achieve their best possible outcome. 

Additionally, in these interactions, we found that many parents conceptualized quality differently than providers and existing literature. Parents we interacted with placed more weight on experiences over other facets like specific birthing outcomes, and felt unprepared and lost without  adequate resources. With this in mind, we crafted a sustainable tool that not only provides patients tailored resources to become their own health advocate at every appointment and beyond but also gives providers and hospitals systems reliable feedback. In addition, we have been working with Dr. Elizabeth Janiak of Harvard’s T.H. Chan School of Public Health, UC Berkeley’s MCAH Center of Excellence, and  MIT’s department of Women and Gender Studies to redefine quality based on patient values and are creating a framework for quality that spans domains of safety, equity, and patient centeredness.

For the next upcoming months our key milestones include (1) creating a high functioning prototype/MVP, (2) building an advisory board with experienced maternal health professionals and other key stakeholders, and (3) networking to gain access to hospital administrations across the nation. 

(1)Creating a high functioning widely accessible prototype will include building a team of software engineers, researchers, and healthcare professionals. This will allow us to construct a sustainable tool that streamlines targeted resources and communication that will help our users and their partners. Our goal is to have top-tier resources that empower the BIPOC community as well as the LGBTQ+ community. We hope to gain financial support from SOLVE in order to fast track this process to produce the best application currently available. Through our pilot of this prototype, we hope to impact over a hundred individuals (birthing people, partners, providers, and more) by giving people the tools needed to achieve their best birth experience. We plan to achieve this by hiring an app development intern to aid our current app developer, Mercy, in the creation of this prototype. In addition, we plan to freelance resources directly from people belonging to marginalized identities such as BIPOC, LGBTQ+ etc so that their lived experiences are honored and help others like them.

(2) Building an advisory board consisting of birthing people, researchers, maternal care professionals, and more will allow us access to the experience and expertise of trained medical professionals to help create a standardized and effective quality questionnaire that will be used in hospitals and birthing centers across the US. We hope to utilize SOLVE connections and financial resources in order to incentivize and construct our advisory board. We believe that an advisory board will allow us to greatly improve our impact and reach by helping us ensure that our resources and questionnaires are sound and relevant, and providing us with exposure through their own connections. We plan to achieve this by leveraging our current connections and network in order to outreach to those who we feel will be a good fit for our board.

(3)Finding our “champion” at each hospital and clinic will be vital. Since our maternity services are fragmented, finding the right leader will give us the opportunity to expand our impact within each hospital system and across all birthing facilities in the U.S. and eventually, internationally. We hope to gain guidance from SOLVE on how to do this in the most efficient and effective way possible. Through networking with hospital administration and directors/leaders of Obstetrics and Gynecological services, we will be able to create tangible impact by connecting with a local clinic/hospital where we can pilot our solution.

We will measure the impact of our solution primarily by analyzing the trends of patient satisfaction rates, patient quality of experience, and birthing outcomes in each hospital system that we are serving. Additionally, low response rates for qualitative questionnaires have been known to be a barrier to understanding the components affecting one’s experience. Therefore, we plan to measure the progress of our impact by comparing the average amount of responses we receive from our users with the hospital/system average. 

Some other measurable indicators we are using to track our progress towards our pilot are listed below:

• Collect 50+ resources related to the BIPOC birthing experience by July 2022

• Collect 20+ resources related to the LGBTQ+ birthing experience by June 2022

• Contact 20+ hospital administrative personnel by June 2022

• Outreach to 10+ individuals inviting them to be a part of the Birth By Us advisor board by April 2022

• Solidify an advisory board of at least 5 people by June 2022

• Launch a pilot with at least 30 birthing people by December 2022

Mission: Our mission is to empower all birthing people with the personalized information needed to equip them to have a safe and holistic birthing and postpartum experience while rebuilding their trust in hospital systems. 

Impact: We aim to reduce the effects of systemic and institutionalized racism in maternal health by identifying and addressing unconscious bias, one of the top four CDC recommendations to reduce maternal health disparities. We will achieve this by improving patients’ education and resources.  

Outcome: Our tool will be able to improve patients' involvement in the healthcare plan, decrease their anxiety around the unknown, and feel empowered to speak up as their self-advocates. It will also help providers and birth workers understand why these disparities exist and direct them to feasible and impactful solutions. Our long-term outcome is to decrease pregnancy complications, low birth-rates, and maternal deaths in the US. 

Outputs:  The immediate indicators that will help us track our progress will be the number of hospital partners, number of enrolled active BIPOC users, average user response rate to our questionnaires, and quality metric measures. 

Activities: In order to achieve our outputs we will continue to build community connections with BIPOC birth workers, network amongst the leading physicians and researchers in maternal health, raise capital, and build a motivated and diverse team of experts/key stakeholders. Additionally, along the way we will be collecting statistical data (i.e demographics) to analyze and evaluate our efforts to assess areas of improvement and pivot towards achieving our goals. 

Our solution relies on technology as we are creating an integrated mobile application. In this app, we will have custom benchmark questionnaires that the user takes in order to evaluate the quality of their pregnancy journey (how are they feeling – mentally, emotionally, physically –, have they experienced any adverse outcomes, etc.) as well as the quality of care that their provider is giving them. These answers will inform the insights we give providers along the way while allowing us to track and analyze patterns in user experience, and recommend them correct modules and resources to help them improve their experience in real time. 

We leverage technology in our solution by placing these questionnaires with digital resources on every aspect of the pregnancy continuum all to be accessed from any device.

As a Black women owned company, Birth By Us is aware of the maternal health crisis and will direct our efforts to reach birthing people who historically have limited access and knowledge about a healthy birth. As such, we plan to build an advisory board composed of representative stakeholders who primarily focus on health equity and have personal connections to the population we are serving, as we pilot in hospitals and birthing centers that serve majority Black populations.

Additionally, community involvement is a key component of BBU’s foundation. From the beginning of our processes we have sought to intentionally engage with our stakeholders through active listening in both interviews and focus groups. Beyond this, we believe in the value of building authentic relationships with parents and providers to create needed trust, especially since we are working with communities with higher rates of medical mistrust. We plan to continue these efforts and values as we expand our team to gain a wide range of perspectives and expertise to provide culturally competent and holistic resources to our users.

From our customer interviews both with maternal care providers and birthing people, we have discovered that our biggest value propositions lie in three main areas. Firstly, we are quantifying and measuring provider progress on factors associated with health equity, which has never been done before and provides an opportunity for hospital systems and birthing centers to show actionable commitment to change. Secondly, we provide tailored visit preparation based on users’ answers to our questionnaire, highlighting main concerns to bring up to their provider. This also aids providers by saving them time on patient education and ensures that both parties' concerns are addressed given the limited time nature of hospital appointments. Thirdly, we offer birthing people the opportunity to provide feedback to their provider. Many hospitals do not have formal systems for patient feedback and every birthing person we talked to said that they wish they had a platform that would have allowed them to give anonymous feedback during their pregnancy journeys. 

In summary our key customers/beneficiaries are maternal care providers and birthing people to whom we provide the value propositions detailed above. For the birthing person, we provide these services through an integrative mobile application and for the provider, we display analyzed data on quality of performance on a desktop website. 

Currently, we hypothesize that individual maternal care providers/groups of maternal care providers such as a birthing center or organization of obstetricians will pay for our platform. From there, they will be given an access code to give to patients, ensuring that all birthing people will be able to access our solution for free. We have begun to test this hypothesis in the NSF Spark I-CORP Program through interviews with stakeholders in different settings. 

Bringing our solution to life will require the coordination of several resources in order to conduct our pilot in this upcoming fall. Key resources include finances to conduct the pilot, an advisory board of top maternal care and quality experts along with birthing people who can bring their lived experiences. We also hope to engage with doulas who have been shown to have significant impact in resolving the maternal health crisis. Finally, we hope to bring in other groups and social supports (churches, WIC offices, etc.) that are connected with our end user population to help us scale once we are at that stage.

Currently, there are 6,000+ hospitals and birthing centers, and approximately 70,000 maternal care providers in the United States. Through a subscription model, we plan to sell our application directly to hospitals and birthing clinics so that all patients can have full access to our resources free of charge. To do this, we stratified hospitals into four size classifications each with its own price range based on number of live births, which are subject to change with further advising.  

In addition, we are applying for health equity grants to fund our pilot and are considering raising investment capital as well.

We are confident in the current and future success of our solution. So far, we have raised $8,000 ($7,000 from MIT Sandbox after evaluation from the MIT Sandbox Funding Board, and a $1,000 seed grant from the MIT PKG Center’s IDEAS Social Impact Challenge).