The Role of Innovation in Addressing Inequities in Maternal Morbidity and Mortality

August 17, 2023

News coverage of the maternal mortality crisis that especially affects Black and Indigenous  birthing people, has placed on front street what many of us already knew:  The United States health care system wasn’t designed with our health in mind.  This is evidenced by story after story of Black and Brown women whose lives were unnecessarily lost.  The names of whom we still remember…Dr. Shalon Irving, Kira Dixon Johnson, Amber Rose Isaac, and Yolanda “Shiphrah” Kadima among others. The most recent Journal of the American Medical Association (JAMA) publication further illustrates that maternal death rates remain the highest among Black women, and that those rates have doubled – meaning they’ve gotten worse over the last twenty years. 

Disparities in maternal and reproductive health outcomes largely stem from structural racism that reinforces the inequitable distribution of economic, social, and health care resources. Additionally, capitalism and our nation’s drive for maximizing profit have fueled our country’s economy while undermining key aspects of the healthcare system and health equity. Specifically, the drive to maximize profit at the expense of population health is woven throughout our country’s history of reproductive oppression, disparities in access to health care, and restricted access to paid parental leave.

Research shows that a wide range of approaches (e.g., doula care, community-based midwives, etc.) could improve reproductive and maternal health outcomes and health equity while also potentially reducing costs to the patient and to the health care system.  Indeed, a growing number of Black and Brown innovators are establishing health care businesses that are poised to center the health care needs and preferences of communities that have been most harmed by systems of inequity.  The recent Health Innovation and Solutions Sessions, hosted by the American Medical Association, Afropunk, and New Voices convened conversations with leading investors, decision makers, and, most importantly, solution creators to explore how centering equity will help advance health innovation and drive change towards eliminating reproductive and maternal health inequities. Although not an exhaustive list of innovators, the Health Innovation and Solutions Session highlighted several innovative solutions to advance equity and reduce morbidity and mortality, especially among Black and Brown birthing people.  Innovators highlighted in the Solutions Session included:

Roopan Gill, MD, MPH, FRCSC, the co-Founder and Executive Director of Vitala Global. Vitala aims to revolutionize sexual and reproductive self-care through co-designed, holistic, and localized digital solutions that meet women and girls where they are, empowering them to be agents of change.

Mary Fleming, MD, MPH, FACOG, the co-Founder and Senior Vice President of Health Equity for Cayaba Care.  Cayaba Care’s maternity program is designed by OBs, fellow moms, and maternity care experts who have a depth of experience in providing care tailored to Black and Brown communities and high-risk individuals. Its goal is to achieve equity in maternal health.

Audrey Wu, the co-Founder of Ruth Health. Ruth Health is a nationwide virtual clinic for pregnant and postpartum patients. Their subclinical care delivers justice and joy through the pregnancy journey by providing accessible and affordable crucial services to supplement the OBGYN—including pre + post bodywork (pelvic floor therapy), lactation support, C-section recovery, text message doula support, and self-recovery videos on babywearing, breastfeeding, etc. They are backed by UnitedHealthcare, YCombinator, and Venture Capital.

Although not a part of the Health Innovation and Solutions Sessions, there are a number of other community-led and community-based models that advance health equity.  For example, Commonsense Childbirth has a mission is to inspire change in maternal child health care systems; to re-empower the birthing mother, father, family and community by supporting the providers, practitioners and agencies that are charged with their care.  They also offer training and certification programs for healthcare professionals, para-professionals, maternity care systems and medical institutions interested in creating perinatal safety for at-risk populations. Birth Center Equity is another organization who is on a mission to make birth center care an option in every community, by growing and sustaining birth centers led by Black, Indigenous, and people of color (BIPOC).

While they may address different reproductive health problems, these solutions have the following key factors in common: they redefine care by centering and prioritizing women and birthing people of color, and they serve to address the gap between the general health care market and one that exists to serve the needs of Black and Brown birthing people.  Through their work, they are a catalyst for empowerment and change in a health care ecosystem that was not built for us. Investing in companies such as these are not just market opportunities, they reflect the potential to ignite positive impact on reproductive and maternal health equity.  The key here is that equitable health outcomes for Black and Brown communities are not an afterthought – they are core to the business model. 

About Author:

Crystal Pirtle Tyler PhD, MPH brings over 15 years of experience advancing reproductive and maternal health equity. As the Chief Health Officer at Rhia Ventures, she oversees the organizational strategy and translates the needs of the women and birthing people most affected by systemic inequity into programming that fosters equitable reproductive health products and services. Crystal serves on the Board for the Society of Family Planning, the Black Women’s Health Imperative, and Orchid Capital. She has published in Obstetrics and Gynecology, the Journal of Adolescent Health, Contraception, the American Journal of Obstetrics and Gynecology, among others. Crystal completed both her Ph.D. and MPH in Epidemiology at Michigan State University and the University of Michigan, respectively, and her Bachelor’s degree in Women’s Studies at Spelman College.