This Week in Startups - E1019: Mahmee CEO & Co-Founder Melissa Hanna is helping new moms navigate thru postpartum care, shares insights on getting Serena Williams & Mark Cuban to invest, improving the experience for mothers of color & adding structure to a fragmented industry

Episode Date: January 17, 2020

0:58 Jason intros Melissa Hanna 1:40 What is Mahmee? What challenges are they solving for? 4:54 How does Mahmee acquire customers? Who pays for the service? 7:37 What is the current cost of having a child in the US? What are some glaring postpartum care issues in the US? 15:28 How did Melissa get Arlan Hamilton to invest? 18:42 How did Mark Cuban invest in Mahmee? 21:02 Why are black mothers 3-4x more likely to die from childbirth? Why is there such bias in healthcare? 28:31 How can Mahmee increase the birth experience across the US? 33:24 How does Melissa balance balancing the current confines in which they have to work with looking towards the future and what is possible? 38:42 What are the complexities of the healthcare space that make it hard for startups? What is the opportunity? 45:47 What are some Mahmee success stories? 51:54 Better ways to deal with postpartum depression? 57:01 How did Serena Williams come onboard via Serena Ventures?

This Weekend Startups is brought to you by Help Scout. The customer service platform built for starting and scaling up. Eligible startups get Help Scout for only $50 a month for 12 months. Visit Helpscout.com slash startup to learn more. Masterworks.io. The first company allowing investors exposure into the blue chip artwork asset class. This weekend startups listeners can skip the 5,000 person wait list by going to I.masterworks.

Dot.I.com. And Tax File. The best way to do your taxes is by not doing them at all. Tax File connects individuals and businesses with trusted CPAs that file for you. All you have to do is sign up. Visit TaxFile.com slash Twist to get 15% off your tax return today. That's T-A-X-F-Y-L-E.com slash twist. Hey, everybody, welcome to this week in startups today on the program, a founder who is trying to save moms from dying and or getting hurt in childbirth.

It's a real phenomenon here in the United States. You would think in the developed world we would have solved this problem. But there's a lot of unnecessary deaths and unnecessary injuries in childbirth. And I'm really excited to have Melissa Hannah, Hannah, no, Hannah. Hannah. two ends from Mommy, which is spelled phonetically m a.h.m.m.com. Welcome to the program. Thank you.

Tell me, what does Mommy do? In this case, your company, Mommy. Yes. Not a generic mom. So our company, Mommy, is a comprehensive maternal and infant care management platform. We're a software and services company, and we partner with a variety of different kinds of health care organizations to ensure that moms and babies across the country get access to comprehensive support during pregnancy all the way through baby's first year of life. And this is taking the form of it manifests itself

in an app like enterprise software on the back end for the doctors and nurses. Yeah, it's a full service solution. There is an enterprise software experience that we integrate into our health system or hospital partners. There is a consumer-facing app as well. And there's also a provider app. So there are three primary components that allow for the digital integration of mother and baby's health records across an ecosystem, whether that's an entire health system or even just like a community. How many moms in the United States are doing the protocol correctly? Because I think compliance is a big issue. Because some people don't know what to do. I know when we had our kids, we had to get this big education and go to classes. How many people are doing it according to the

proper protocol and how many people are, you know, showing up when they're six, seven, eight months pregnant and then starting a protocol here in the United States? And is that the issue? Is it the prenatal, pre-birth or is it the birth? That's the issue? Where are the challenges? Well, the challenges are in a few different places. I think that we often look at compliance as being the root issue here. But our company doesn't see it that. way, when we are on the ground in different cities working with families, we see that people really want to do a great job being new parents and they are eager to participate in their care, eager to get help from providers, from community care workers, attend their doctor's office visits,

but there are so many barriers to access for a lot of people. And there's other challenges that are just infrastructural in this particular vertical of health care that make it difficult, even for the most informed and well-off families to have a really ideal prenatal and postpartum experience. And we take care of families across the socioeconomic spectrum. And we see that there's very high motivation to get access to care. But if you are dealing with either financial barriers, transportation barriers, language or education, that can be a whole host of challenges right there that are, traditional healthcare ecosystem isn't necessarily set up to support, which is why I think there's such a big opportunity for startups to do work in this space. But then on the other end of the

spectrum, even like I said, for well-off families that you think sort of have all the resources they need to have a great maternity experience, the challenge becomes the fact that the industry itself is still just so fragmented that, you know, you still have to go find your OBGYN and find a pediatrician and find probably a lot of other, um, support providers and say care providers and manage all of that yourself because there aren't a lot of great tools for doing that until now. Does your service go directly to the consumer when they're pregnant and then start them onboarding there? Or do they have to find their doctor and then their doctor introduces them to your service? Well, it works both ways.

So families can sign up on their own. They can get access and start managing their own care experience right from within the mommy platform. But what we found is that are some of our highest referral channels and the ways that people are actually engaging with us are through referrals from their primary care providers. So we open up a lot of different doors for people to find out about us, to get access. But then at the end of the day, we do see that once your doctor recommends that you check out mommy or you utilize it as part of your care experience, that's really the ultimate cell. Who pays for the service? how do you make money by providing this? Is it the doctors pay for the enterprise software, insurance, or the consumer?

Oh, yeah. Well, I think this is what you hear from a lot of health tech companies. We make money in a lot of different ways. I mean, we're still early stage in that we are refining those aspects of the business model and determining, like, where the highest margins are and where we really want to drill down into create that strong foundation for growth. But the reality of a company like ours at this stage is that patients pay on their own, they want to, providers will pay.

Sometimes we have partnerships directly with like a med group or a doctor's office that says, hey, we want to make this available to all of our patients. And then we also partner, and this is really where a lot of the new growth is happening, is this enterprise side, which is that very large organizations are coming to us and saying, we are a chain of hospitals, we are maybe a regional health center, a county or state-funded Medicaid program, and we have the resources to actually implement this for our entire patient population, which could be thousands or tens of thousands of patients. And in doing so, they will see the greatest ROI from working with a company like ours. And what does it cost

them, $100 a patient, $500 a patient to run through the protocols and the application? Yeah. So we offer like a monthly subscription and that's based on risk level. So, you know, anyone can join and there's a completely free experience that allows for managing care, receiving personalized education and support periodically getting check-ins from the mommy care management team. So we don't want to curb access for anyone, but then based on how much, sort of the scope of care that you need, it's not about quality, it's about just how much additional support do you need. That goes up from $20 a month to potentially a very high risk, high need patient that could be as much as $200 a month, but would otherwise cost their health system thousands of dollars that month.

What does it cost in the United States to have a baby right now? I've heard that in the Nordic countries, people have to pay like $200 or something to have a baby. And then here it's tens of thousands of dollars on average. Am I correct? Is what I've read, correct? Yes, the numbers are outstanding when it comes to birth in the United States. It can cost 5 to 10x the amount that it would cost for your total maternity experience in the UK, in Nordic countries. And there are even some wider gaps there as well. But looking at developed nations, it's hands down, it's a well-known fact now that we spend way more than any other developed nation to successfully. deliver children in this country, and we still get the worst results in return. So it really is a paradox. It actually is a name. It's called the perinatal paradox. We pay the most and have the least success. We have the highest. We have the highest maternal mortality rate, and we still have far too high infant mortality and injury rates. So it's gone down. We've invested a lot of time, technology, research into reducing the infant mortality rate. But while we paid all this attention to babies over the past three decades to to provide better care to

new babies. We kind of like let moms go on the side there and did not pay attention to those rates as they continue to rise. And they have decade over decade risen. Moms are dying. Yes. More than they used to. Yes. Babies, we've done a great job of lowering that. Why? What happened? Oh, well, I go back to the structure. of the industry. You hear this phrase a lot that there are gaps in care, that the industry is fragmented. And this is true for a lot of aspects of the U.S. healthcare system. It's especially true when you get into maternal and child health. I'm biased. This is the industry that I've decided to build a company in, so I know it really well compared to other verticals. But I can say

that when I try and explain to people like why it's so complicated to take care of moms and babies. And it's something that everyone can rally around, you know, regardless of what side of the aisle you're on. I think we've all been there by definition. We've all been the baby in this situation. And a large percentage of us have been the mom. Right. So, you know, everyone can say with a rallying cry, we want to do better by moms and babies. But when you look at the reality of what it means to take care of moms and babies, I say like from a data standpoint, let's just take that as a section of this. One patient turns into two. sometimes three, twins, you know, or more so.

And so you have one storyline, you have one data set that you've been tracking that would be this prenatal patient. And everything revolves around this prenatal experience. Now there's childbirth. And now you've got a new patient with a new doctor. They're going to have a pediatrician. Mom's going to have an OB or other primary care provider. So you just split the data set. Now you're tracking two different users in this system.

They each have their own care management teams, folks that are responsible for their care. And there's very little overlap. Unless there really are complications or issues that could affect mom or baby one or the other, the pediatrician and the obese, they're not always talking to each other unless they need to be. And that's just the way it's set up. It's not to malign the care providers. It's just the reality that they're pretty busy. So communication is a big piece of this. And they're very busy and it's a business.

Yes. And that's not their patient. The obese patient is not the baby. And the pediatrician's patient is not the mom. So their liability and their focus is going to be on their patient, which is technically separate. Completely not holistic. They also, after about three months, your baby has their own insurance plan. So now the insurance companies, well, that's a different customer.

And now it's even further become its own data set. So there's not been a lot of integration from a data standpoint. And if we aren't looking at that foundation of how do we recognize within technology, within sort of the digital infrastructure here, the mother baby dyad as they truly are, biologically. They're still connected. But if we aren't treating them that way within our digital tool set, then we're already flawed from day one.

And so that's the first thing that Mommy did was we link mom and baby's health record together. We recreate the dyad view within the technology. So they're looking at a picture of mother and baby's health and wellness together, rather than it's two separate data sets. All right. When we get back from this quick commercial break, I want you to address the shocking, depressing, and just outrageous statistic that you shared with me earlier,

that black mothers are three to four times more likely to die from birth complications here in the United States and why that is and how we can stop something that's just so immoral and unacceptable when we get back on this week's startup. Do you know it costs five times as much to acquire a new customer, as it does to keep and delight one of your existing ones. Of course you do.

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for supporting our companies i really do appreciate that and thanks for making the customers of our companies so so delighted okay let's get back to this delightful episode all right welcome back to this weekend start us my guest melissa hana and uh hannah sorry i'm going to keep doing that i spent my honeymoon in hana in maui well that's nice one n and not my name not your name Hannah. And she is the CEO and co-founder of Mommy, which is spelled MAHM-H-M-E.com, if you want to go check it out. She's been working on her for the past five or six years. And recently received funding from none other than Mark Cuban and Serena Williams. Nicely done. We'll talk about that in a bit. And a friend of the pod, Arlen Hamilton, I believe was your first investor.

Yes. Yeah. She was the first VC check into the company. We had some angels before. for that, but Arlen took the first big step with us. It's amazing. You know, she was on the pod two years ago. Just when she had started making that first, what was it, a $3 million fund or something, she was making $50K investments. And we talked a little bit about it, and she had mentioned you. And it's really great to see which of those companies actually make it to the Series A or multiple,

you know, $3 million round and you've done that. How did you wind up meeting her, Arlen? I was introduced to Arlen through Marlon Nichols. from Cross Culture Ventures, now at Mac Ventures. I pitched him and his team early on and got the response. A lot of founders get, because you're too early. But then with the follow-up of, I've got some folks I want to connect you to, and really followed through on that and got us connected to Arlen,

and then Arlen invested. And then later, actually, Marlon became an investor. Now he's a very active board advisor and investor in the company. How amazing was it to meet a black venture capitalist woman, which is one of, I think, five in the industry at the time. And I know all five of them because they've all been on the pod. How did it make you feel to meet a peer like that and have them make that bet on you? Well, I think it's important to say that at the stage that we were at when we met Arlen, I mean, she did not appear as a peer to meet. I mean, I was still shaking in my boots to pitch anyone.

Right. So I was, all I remember was being so nervous that I don't remember what I said to her. But she seemed intrigued and she wanted to keep talking. And we stayed in contact as she was starting to put together that fund and start to write checks out of there. And that being backstage capital. So within a few months of building out that relationship and getting to know the other folks that she was bringing onto her team, they made an investment. in the company, we became one of the first, like the backstage 100, one of the first 100 companies that she put checks into. So, yeah, I was, I was very nervous to meet her, especially

because I had heard that she was a force to be reckoned with and that she was going to be doing some very big things in the industry. And over the years now, we've gotten to know each other very well, and it's been amazing to build this company alongside her. Yeah, she's a force. That's for sure. I mean, she just took her spot. Like, she's like, I'm going to raise a fund. and I'm going to invest and give me money. Hasn't let anyone stop her. Yes. Yeah.

I mean, it is truly amazing what she's done. And yeah, now to see the company's now starting to come to fruition, I think that's going to be like the magic, right? Because when you first start, everybody's just like, well, you placed whatever, 100 bets. Let's see what, let's see which ones come out. And which ones. So to see these companies getting funded now, ours just being one of them that have been able to level up and attract additional investors and some high profile folks.

Yeah. Mark Cuban just gave her a million bucks in between funds and said, hey, listen, let's invest together. That was an amazing moment. And she brought Mark Cuban to this company. And he immediately just invested. I wouldn't say immediately. He's quick. He invested in my second company. Okay. He did commit quickly. But the period of time between the introduction to Mark and the commit was for me like the longest period of time ever. It was maybe a lapse time like 72 hours. It felt like months. Yeah. Because we were emailing back and forth. He's an email guy. Rapidly. Rapid. I've heard this now from other founders who've worked with them at the time. Three in the morning email. Yeah. Yeah. With an analysis of your strategy with really tough questions.

And then you reply at 4 a.m. and then you get a reply at 6 a.m. And you're like, Mark, where are you right now? Do you sleep? Yeah, exactly. And the answer is no. He is so passionate about entrepreneurship and founders that he is one of the most responsive people I've ever had on a cap table. So imagine then being on an email thread with Mark and Arlen and the three of us going at this and debating all aspects of this company. And I'm like, first of all, I've known Arlen now for a few years.

I know she gets it and she's never been afraid to just dig into the details and really grill me on stuff. And now I've got Mark in the Cimal thread. Billionaire owner of the Mavericks. Right, but he really cares about this. He got it. And he immediately just jumped into the stuff that really matters about what we're doing. And wasn't there for the fluff, wasn't there for the, you know, like the superficial part about being in like FemTech and women's health. And the fact that, yeah, there's a lot of money coming into this market now.

A lot of companies getting early stage funding. He really got the business model. the great part about Marcus he wants to win you know he just and he's told that to me many times when I've asked him like why are you doing this angel investing like you're so post doing this kind of level of investing and he just gets jazzed by being part of an early team that wins he put 300,000 into weblogs Inc my second company and he I must have you know I'm not kidding three or four hundred emails from him a year like almost daily just talking about blogs and media and everything and was one of the most helpful and supportive investors I've ever had in my career. When we left for the

break, we started discussing and we teed up this horrific statistic, black mothers three to four times more likely to die because of birth complications. To what do you attribute this? And I asked that question with just horrible trepidation of, you know, like, please don't tell me this is just like they're being ignored by doctors and being treated as like second-class moms. That is what it is, though. It is systemic racism and institutionalized, well, really, oppression. I mean, the bias that is experienced by black and brown women in this country, and specifically by black mothers that are going through the,

this going through the maternity process, going through this episode of care is so it's such a stark contrast to what white women are experiencing that there's, there have been a lot of studies to try and explain the health outcomes. Because what we're talking about here, and you say three to four times more likely to die, that's a health outcome. And so, you know, first researchers try and figure out, well, is it a biological thing? Is it something different about their experience being pregnant? Or is it something different about, you know, and looking at these populations and trying to figure out if it's something there.

Is it socioeconomic? Is it regional? And when you control for all of these things, it comes down to systemic racism and bias, not being heard, not being listened to. Being dismissed. Yes. Literally a mom, based on the color of her skin, having her concerns dismissed. Right.

And as someone who's building this company and is also myself, a black woman, I'm mixed, but I know that being mixed does not matter in this story. I present as black. And that puts me in the same boat as anyone else who is very likely to face racism in the health care industry. And when you look at the stories across the board, you see that it's not about your education level. It's not about your income. It's about what others are perceiving about you. And it's so wrong. So a lot of what we do is within our own company is understanding, like, how bias works and works against women within the maternity industry.

we look at how we can listen better to what families are reporting and what women are reporting in their experience, how different people describe different pain types, complications, social and emotional experiences. Not everyone says, hey, I'm depressed. Most people don't actually say that. No, I mean, that is one of the big challenges about postpartum depression is that people feel shame or they don't want to burden people with. their depression, whether it's even pregnancy or non-depression, they don't want to burn people, and the people they don't want to burn are the people who want to help them most. Yes. Yes. It's really important to, we call it like listening between the lines. And this comes from training, not just in health care, but in training on how to really be an

advocate for the patient. And a lot of what we're doing in our relationships with health systems, when we partner with a customer, or we would call it like a health organization partner, is that we're acting as that intermediary. We're saying, look, we're better at this than you guys are. Let us help manage these relationships with patients and surface very quickly for you. Who needs help when? Someone who might have historically not been paid attention to

or might have been disregarded. You know, I'm really uncomfortable right now. Something doesn't feel right down there or I'm worried about the baby or something like that. Might have been brushed off. Oh, you're tough. You can handle it. Don't worry.

You know, wait a lady, you just had a baby. Yeah, that's what it's going to feel like for a while. we are able to really ascertain what's actually going on and determine who needs to be seen right away. And we're able to get patients in the next day to see their doctors. That's fantastic. I know when we went through our births, my wife is an Asian woman and they don't have it. I think the bias is not obviously as bad as black women experience, but they experience bias as well. Women experience bias, period.

And I had to hold the line a lot of times with the doctors to slow down. and to explain it to me twice. And I had to just step in and say, I'm sorry, I don't understand what you're saying. I'd like you to slow down and explain it to me again, and I'd like you to explain it to me in simpler terms because I don't understand what you're saying. And, of course, I say it, white guy says it in a commanding voice,

and all of a sudden, oh, of course, sir, let me. And my wife has the same question, and they just roll right over her. And it was infuriating to me. And we went with female doctors because I felt like the male doctors were so, brisk, so like just wanting to get out of there so quick. And that to me seems like one of the problems, you know, labor is a long process. And one of the things that a female doctor told me,

I would say which one, obviously, was that a lot of times the male doctors were not as patient and just didn't want to stay in the hospital that long. So they would just induce. They're like, listen, I, you know, I don't want to be here 20 hours for labor. I want to get this done. So I'm going to push the person to induce this labor and get it done in a shorter period of time. In America, are we rushing and pushing people to go too fast in the childbirth process? I think that is one aspect. There are some studies that have come out that have looked closely at inductions and C-section rates and specifically by hospitals or by regions. There's work being done now, even looking, sort of drilling down to physicians and understanding patterns there. There are a lot of conflicting.

are probably going faster than others. Yes, that does happen. And I'm not sure that it actually splits on a gender line that definitively, there are probably some female doctors as well that are handling patients in a different way. I will say, though, that there are a lot of conflicting interests within the U.S. healthcare system. And those are amplified within a complex space like maternal and child care. So, yes, if you've got a doctor who gets paid for the delivery and is trying to get as many deliveries done as possible, then there may be a change in approach in order to optimize for that. Now, I see these as being, this is why I talk about the infrastructure of the industry, I see these as being like market effects that just, you know, kind of pull back the curtain on how the industry is poorly set up for good health care outcomes.

because we know people need time. If you're paying by the baby and by the birth, well, of course, the factory wants to go faster and have more babies come out of it. Whereas if you just paid by the day and didn't matter or by the hour, then it would change the incentive system. Yes. They actually might even be incentive to go longer. But there's also other players that could facilitate a better care experience like midwives,

doulas, other birth professionals, birth educators, and postpartum support professionals, including lactation consultants, who can all participate and all should be able to participate in providing more supportive, more like common mother-focused care during that time, rather than only putting it on the doctors and on the hospital setting. The problem is that the insurance industry, for the most part, doesn't insure that kind of care in a standard fashion. Some programs do. Maybe your employer has tacked on additional benefits, for you to get breastfeeding help or for you to have a doula, help you prepare for your labor and delivery.

And all that stuff is great, but it's not happening at scale for most of the patients across the country. So when you look at what could actually enhance the maternity experience and produce better outcomes overall, you know, we are spending all this money, but we're not actually spending it in ways that directly benefit the patient. So costs are going up on the things that we're already paying for. It's getting more expensive to stay in a hospital. is getting more expensive to have specialty care.

And a lot of those medical elements of labor and delivery are covered. But what about the labor, sort of the labor process in preparing to go to the hospital? You know, if you have support during that time, if you have a doula or you have a birth worker who's coaching you and preparing you for that, you can have a much more successful experience in childbirth, same with postpartum. Even if, for example, we see hospitals that are saying, look, We got to get patients out of here in 48 hours. We don't get paid for the third day.

So you have two days here, and we're going to discharge you as long as you are well enough to go home. Now, that may be the hospital's imperative from a financial or operational standpoint. What we do as a company is pretty much come in and say, we get that you may not be able to change that. We'd like to see these patients be able to rest and recover a little longer. Yeah. But if you've got to send them home, at least send them home with a program with support that continues that experience for them. So you literally aren't just sending them out the door. And that's a lot of the pitch that we make is we say we cannot change the entire system on day one.

We have to work within some of the unfortunate confines of the industry as it stands today. It is the most, I would say the three most difficult verticals for any founder to take on are housing slash construction, education, and then the toughest of all is healthcare. And how will, when we get back this break, I want you to tell me how you know you'll have been successful in this business to make it sustainable in order to keep being able to get funding. And what are your internal goals and metrics that you tell the team to rally around when we get back on this one of the start. Listen, in 2018, VCs invested a total of $100 billion in the United States. but did you know there is a $1.7 trillion asset class that is uncorrelated with public equities and has outperformed the S&P

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It's so hard to get people to change behavior. How do you know you'll be successful? Can you make this work just on the subscriptions, or do you have to make the enterprise work? And I know it's early days, but how do you rally your team around those key metrics that are success? And have you figured out what those are yet? Oh, that's a great question, because I'm always living in the future of this company. I think as a founder, like that's the struggle is you have to be here for present day operations, but also be, you know, three to six months.

ahead on where you want to take the company next. And in balancing those things, I look at sort of, as I referred to before, the confines that we have to work within right now, understanding that the industry has created an opportunity for a company like ours to be successful because it's so messed up, honestly. Right. So we have to first take what we're being handed, which is an industry that is fragmented, that is poorly structured, that doesn't have very strong digital tools or,

really opportunities for data analytics, looking at that first and where we'd see success in the near term is in creating these demonstration projects across the country with the most eager candidates. Now, the unfortunate reality of what that looks like from a sort of a sales or like customer pipeline perspective is that there are a lot of folks that realize this is a problem and want to do something about it. But the folks who are most eager are the ones who are dealing with the crisis directly. So as we build out our pipeline, we get a lot of inbound from a lot of folks and we're constantly sorting through. And people will say, well, we need help here. What can you do for us? Well, there's a lot that can be done. There's a lot that's possible in

innovation within this space. How serious are you about making that change? And so finding those folks who are very serious usually means that they have the biggest crises on their hands. They have sort of this intersection of the need for a financial, or operational restructuring of their health care services, right? That's where they're losing money. They're spending money taking care of patients that after they've gotten injured or sick or are on death store because they weren't providing enough oversight and care management in advance of these situations, right?

So that's where mommy can come in and actually provide proactive monitoring and support to a maternity population and prevent things from getting very serious and very risky and costly. So we look for organizations that are in need of that sort of ROI, and we know we can create it for them because it's just about introducing proactive care management to their systems. We also realize that a lot of our customers are dealing with PR crises, that they're coming to us because something has happened, and they now need to show that they are correcting that problem within their organization. Right. So, yeah. Mother dies, God forbid. and they were at fault because of, I guess, the leading causes, blood loss, sepsis.

Yes, sepsis, yes. These are the things that we are actively monitoring for. Yeah. And all of the other costly complications that don't result in death, but can really drive up the overall cost of the operation of delivering maternity and pediatric care within your organization. We shouldn't, like, just across the word, we should not be waiting for people to get, sick to take care of them. We need to find better ways across the country, across all aspects of health care to invest in wellness. And there are so many companies that are committed to doing this, not just ours. It's just really hard to break into the industry. So to answer your question about,

well, what does it then look like to be successful over time? It's about how do you get past that first batch of folks that are incredibly enthusiastic and incredibly in need of your innovative offering and start to change hearts and minds across the industry. We know that it won't happen overnight. And in fact, this is a years-long process. But the metrics we look for internally are around having that sort of the multi-bottom line effect where not only are we able to make money doing the thing we're doing in a sustainable way, but beyond that for the organization partners,

they are seeing a financial return on investment working with us, that it's also providing that benefit they need in PR, right, in a storytelling fashion, that it's actually creating profitability and new lines of revenue for them. Because if we're actually doing right by prenatal and postpartum patients for our health organization partners, that retains customers to their organization. People will come back for the second of their baby. Exactly. If they feel they've been treated respectfully and there's a process and they will listen to.

So we're very invested in that in showing that this. kind of care management approach, this proactive engagement isn't just about the dollars and sense of that particular episode of care. It's about creating a long-term relationship that is that is respectful, that is compassionate and introduces dignity into this process. Paying attention to what patients actually need is what keeps anyone happy, any customer happy. I mean, this has been the very, this has been at the core of the problem in America is that the customers are not treated as customers because in some cases their insurance is paying, not them. And so the health care providers are like, well, your insurance is paying.

That's the customer to us. That's what we're billing. You just happen to be the vehicle by which they pay us. Yes. Yeah. These are the complications of this industry, the complexities, not the complications, but the complexities that make it hard for any startup to navigate this space. And early on, we had to figure out, like, well, what are the metrics that matter?

Because the organizations don't always know. They just know that they have a problem on their hands. And they are sort of reaching out, grasping into the market to say, can anyone help us? Does anyone have something that could be the semblance of a solution? Where do they perceive the problem as that they're just not communicating well or that the patients are not informed enough about the process? They don't know what a doula is. They don't know what LaMaz class is. They don't know what lactation is.

And if they just walk them through that compassionately and, you know, in a systematic approach, those people would have their anxiety go down. They would feel like more informed consumers and then tell people, I had a great experience here and you get more customers. Yeah, I mean, all of those things. I think that the buzzword is engagement. That is what a lot of our partners are looking for. And it's what a lot of startups are selling too.

Patient engagement means a lot of different things, though. And what a lot of our folks, folks that sort of we get inbound interest from are looking for engagement metrics because they think if only the patients would respond to us or if only we could find a way to communicate more actively with them, then that would solve the problem. And that sort of suggests that underlying stereotype, like that it's a compliance issue. Oh, the patients just don't know any better or they're not showing up. They're not following up. They're not calling back. When the reality is that there aren't a lot of really great protocols in place to do this proactive care. in the first place. So it's patients, for us, we have very high engagement. That's not our issue.

That's for us that it's because of the relationships we build with these patients. It's one of the nice things about apps and the mobile smartphone is that it's always with you and it notifies you of things. And if you just think about any exercise app or Uber or, you know, a finance app on your phone, you feel well taken care of by those companies. They tell you when the car's coming, they tell you when your food's coming, they tell you when it's arrived, you can give them feedback and rate the food or rate the driver or, you know, get an easy return. Yes. And none of that exists. None of that's happening.

Yes. It exists in the most important thing a human could possibly do, which is create another life. Like an Uber driver or a postmate's experience is monumentally more well thought out than the average birth. Right. Well, imagine then being across from, well, an investor in this exact kind of dynamic where what I knew us to be pitching and building in our earliest days wasn't actually like some genius brilliant, you know, Nobel Peace Prize winning thing. It was like, hey, can we do that in this vertical? Like that the ROI, that the opportunity to have an impact. But like beyond, I use, I say, ROI a lot because I think it's not well discussed that this is a multi-billion dollar industry. Maternity and infant health care comes out to the tune of about $160 billion in spending annually across the board, public and private, whether you're Medicaid or you've got insurance to your employer, wherever it's coming from. We're spending a lot of money and we're not getting

great results for it. So I always come back to like, could there be a better signal that this is an opportunity ripe for disruption if the numbers are so far off. There's a ton of money sloshing around and a horrible experience. Exactly. And so just introducing what we call care management, but what anyone else would call like customer relations, customer service, and doing it in a way that is personalized,

that understands your particular story and your needs and speaks into those is incredibly powerful. And in this particular industry, when you layer that kind of stuff, that you just referred to over this particular industry, you actually save lives. And so that's the final thing that we're counting. Like literally, we count how many people we facilitated a life-saving intervention for. Now, we're not the ones sending out the ambulance. We're not the ones that are taking the patient's blood pressure. We're the ones listening and getting to the patient as quickly as

possible to identify whether or not they are at risk for a very serious complication. And if you think about it, talking to a doctor versus chatting over SMS with a doctor, or a messaging platform or just answering a question in a survey, you're likely to get a better result from not talking to a doctor. Yes. But just chatting with a doctor or answering a survey, correct? Right. When we talk to people, I mean, I'll give you really the best example of this.

And I've shared this story in a few places before about a patient where we intervened and escalated this case to the physician's attention. Tell us this when we get back from this final break. You a small business owner, you're self-employed, and you just want to get your taxes done, and you want to get them done by a professional you can trust. You don't want to make mistakes on your taxes, obviously. You want to nail it. You want to slam dunk it.

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about one of the stories of literally saving lives. Yes, literally saving lives. Quite literally. This story was escalating. this patient's concerns to the physician's attention in a way that prevented a very serious life-threatening situation from occurring. And it was this simple act of having a conversation with this patient about something that mattered to her. And in this case, was a mom with a five-day-old baby. She had been onboarded the day before by her pediatrician. She had otherwise had a

healthy pregnancy. And from the looks of her health record, which we get that integrated as part of the mommy experience, a pretty healthy delivery. There was a little bit of, well, say, a little bit of blood loss and a little bit of tearing, but nothing overwhelming. They sent her home after 48 hours in the hospital. So she's looking good on paper. But on day five, after 24 hours of being a member of Mommy and marking as part of her profile that she wanted some breastfeeding help, someone reached out to her from our team and asked her how things are going. She asked some questions back. It was all very casual. It was around holding the baby properly, breastfeeding, and And then shared, you know, my left hand and my left foot keep twitching uncontrollably.

And it's making it hard to hold the baby properly because, you know, my left hand keeps shaking. Should I be worried about that? It's just like an is this normal kind of question. Yeah. Well, that's not normal. And we never want half of your body to be shaking and twitching uncontrollably. And this is the kind of thing that our team is specifically trained to listen and identify very quickly. Now, we don't need to diagnose her.

It's not our job to do that. As care managers, we are there to engage with the patient. identify the risks and then make sure they're getting routed to care as quickly as possible. We said, you know, hold the phone. We have to get your OB on the phone for that. I mean, really, this was literally pick up the phone, call the OB's office and say, you know, we've got a concern here based on what she's just shared. Connected the patient back to the provider and the doctor said, you know, this is pretty serious. I had a feeling that this could be the beginning of septic shock. Yes, because this was nerve damage. If your body is twitching, those are your

nerves were responding to something. Well, as it turned out, she had a pretty severe infection that developed in the few days after having her baby. This is when bacteria gets in the blood. Exactly. Yeah. It is a literal killer. Yes. This is one of the things that mothers and babies die from in the days and weeks following childbirth. And so the doctor's like, oh, I had no idea. I mean, she looked fine when I sent her home. Right. So you imagine the doctor's like, you know, processing this information saying, okay, are you sure we? Yeah, we just talked to her. A message with her. We picked up the phone,

spoke to her on the phone, verified the symptoms, sent this digital record over to the physician's office. The doctor said, send her into urgent care, I'll meet her there. She was admitted overnight, put on three courses of antibiotics, and treated in the hospital. Now, there's still a baby in this story, right? So part of what we do is now work with the partner and the rest of the family to figure out how we're going to care for this baby while mom's in the hospital. So that's the other part of the story that I think it's lost when we talk about, you know, tech startups and health care. You can't just be the hero that caught the patient that was sick. You also have to facilitate the continuance of care.

You have to continue that patient and the rest of the care teams work with that family. In this case, we had to notify the pediatrician and say, hey, mom just went in for a few days into the hospital. This may change the care plan for the baby. Yeah. Especially if this baby was being breastfed. Baby's not being breastfed right now. Right. We're back on formula.

Right. Exactly. Exactly. Yeah. And so providing that support. and then working on the transition home. She came home a couple days later. She wanted to go back to breastfeeding.

So now we're back on providing breastfeeding support. So all of this is happening. And that balance between live support and automated education is really the beauty of what we do, is understanding that this is a high-risk patient. We're going to spend the time on the phone. We're going to be messaging directly. We're not just going to be like having the system send out articles to her. Yeah.

And if you just think about the power of a computer of software checking in, with a list of things that people can answer, you know, those lists save lives. That's why they have checklists on airplanes. And one pilot talks to the other and says, okay, check this, check that. That's why doctors in surgery have checklists and they talk about, is this clean, is that clean, and we're going in with this. And software is a great way to do because a doctor is going to remember to call every single patient or the nurse or the receptionist.

Are they going to forget a question? of course. If you do it on software and they don't answer the question, you can email them, you can text them, you can annoy them until they answer the question. If they don't answer the question, then you can call them. Right. And this is the key thing is that we know we're not annoying patients. We don't feel bad about this. We are really very focused on staying engaged with and in communication with the patients, understanding that this is part of a bigger picture. And if we are having challenges there, then there are other ways to provide support and figure out what's going on. And in fact, sometimes it's a red flag, you know, on its own, on its own that a patient isn't engaged.

And we have to figure out what's going on. Sometimes I actually don't really like my doctor or I don't feel like my doctor's listening to me. So if I. So they're avoiding it. Right. And we see this especially within communities of color that there is a distrust and it goes both ways and that you will sometimes have a patient say, well, I don't want to tell my doctor that I'm struggling because I don't want them to call. And we hear a story. People call child protective services on a mother who's struggling. And it's like, why did you do that? There's, there's, there's, there are assumptions being made. woman says, I'm feeling depressed or suicidal ideation, you might actually have the child taken away.

Yes. As opposed to the white woman who would have a psychologist sent over with some. This is the reality of what's happening. And I think this is not being addressed often enough. It doesn't come up enough. It's hard to talk about. Like, look, we're talking about it. And it's hard. And we're already like uncomfortable, just you and I talking about it makes us uncomfortable talking about. What if you're the people who are experiencing? What if you're the doctor and the patient? They're going to have a tremendously hard time. And what percentage of women experience some form of postpartum depression? It is very significant.

It's, yeah, it's higher than, well, we believe it to be higher than what is reported in most studies. And that's, I think, a misunderstanding of what postpartum depression is, what it looks like, and the way that patients report their experience of it. You know, it's, you just went through a hormonal boomering in having a child. Right. You're going to, you're going to feel a certain way afterwards. You know, it's, it, um, there are, there are certain, uh, manifestations that are, that are normal as part of the course of recovery, um, that are emotional, physiological, behavioral. Um, but then what happens when you go beyond that zone? And how quickly can we intervene and provide a supportive experience to help you get, um, you know, sort of back to normal again? Um, that is where a lot of the, the challenges are right now is that we're not screening people often enough. We are not, um, intervening often. We are not, um, intervening often. enough or soon enough. And there's so much stigma around it that mothers aren't necessarily

comfortable coming forward. It's very embarrassing to come forward and do it. I know people who've had this in their homes and had their wives say, I didn't want to bother you with it. And I didn't want to make a big deal out of it. And it is something that can be addressed and how you ask the question. And like you said before, that acute listening and listening between the lines is what it takes. if you're in a rush, you're not going to get the information. You have to, in a way, almost lead the witness and say, did you know that, you know, studies show 30, 40% of women? I'm making up a number here. I don't know the exact number.

Experience postpartum depression. Here's how it might manifest itself and it's easily curable. Have you had any of these feelings? Like, if you ask it that way, you've just given permission for them to understand that they have a one in three chance and it's no big deal because we can handle it. Right. It's about having that dialogue versus everything being procedural. So it's all about having conversations with patients and understanding how to meet them where they're at. We do a lot of, well, one of the components of the enterprise tool for a health system partner is a set of screenings and the checklist, all of that sort of stuff.

So they can kind of configure what they need, what they're missing. A lot of times we go into places, it's not like they don't have anything. They'll say, okay, we've got some behavioral education programs from others. As long as we diagnose them, as long as we know they need help, we can get them into help. But we don't have a good way of identifying them fast enough. Okay, great. Well, why don't you introduce those digital screenings and start inviting everyone to participate and do the screening through their phone, you know, within, we do a five-day, seven-day, ten-day,

14-day postpartum check-ins. And then beyond that, to make sure that we're catching people as they're experiencing these different phases of the postpartum recovery period. It's kind of crazy and a little bit sad still that that is still revolutionary to a lot of hospitals and health systems. So that's what we're at right now. Yeah. And there's a lot.

I mean, in fairness to them, there's a lot going on. And they're probably starting with what they think is the most important. They think getting the baby, you know, into the world safely is the number one job. That might be actually correct. And it just might be that these, you know, the seventh, eighth, ninth thing on the list, they just don't get to, or they don't have the resources to focus on. It might not actually be malice. It just might be they're overwhelmed or they're under-resourced.

I mean, I would like to think that. I don't know if I'm correct or not. I think that there's a sort of a linear progression when you're introducing innovation like this into an enterprise. They're not going to tackle everything at once. They're going to say, wait, what was our roadmap? We were already going to focus on this. And it can sometimes be the challenge of the company. the startup to figure out a way to support that project.

We'll also say, we also do this for you. Yeah. Hey, we're throwing in this. Let's introduce that too. Right. Yeah. And that's part of the sales experience. Like for me right now, I'm learning how to be, you know, an enterprise salesperson.

That's not my background. I mean, I come from law and business, public policy. I was an ed tech startup before this, but I wasn't on the sales side of that. And now I'm learning how to sell this in, understanding that there are some very serious problems, but not everyone's tackling the same stuff at the same time. So you have to introduce your solution in a way that is immediately beneficial to these very large organizations while also saying, by the way, did you know technology can do this for you too? Right. And wait, there's more. Right. Exactly.

Why might be able to interest you? Yeah. Well, I mean, going back to the Uber example or, you know, the postmates example, you know, like just being able to tip or being able to ask for service and get a refund or I wasn't taking the account. exact route. That took a little while for consumers to even learn that, oh, I got an email back. And if it didn't look on the map, that was why they sent the map was because if you send the map to people and they see it visually in their email and the receipt, they can go, wait a second. I went all the way around Paris and then came back into the center of the city. That doesn't look like the straight route. And it's like, hit reply if you want to change this, right? Tell me about getting Serena Williams as an investor and what that's like, because we had the mind-blowing Mark Cuban experience.

Oh, yeah, yeah, that was crazy. Serena is, I know Alexis O'Hannon, he's been on the prod, and he's been very vocal as well. And she has as well as a Netflix special about she almost died in childbirth. And then she went back to play tennis six months later and just starts crushing everybody. I mean, unbelievable. But, I mean, she almost died and she's very public about this. Was that the reason she invested? How did she get in touch with you?

And what's it like to have? I think arguably the world. world's greatest athlete. I mean, either her or LeBron, right? Who's, I mean, actually, she's got many more championships than LeBron, so I guess she is. It's probably her LeBron, Tiger. I mean, I think that. I think objectively, she's dominated her sport more than anybody. She's amazing. And she's an icon. For LeBron and Tiger Woods to invest. No offense. Yes. Come one, come all.

Well, no, I'll say this, that the process of getting to know Sereney. and Serena Ventures, her fund, her team, and understanding what led her to make an investment was in itself an amazing experience. The silly thing about how it all got started is that we received an email. I got an email and he was like to the general inbox maybe. Info at. Yeah. And at that time, her fund hadn't announced, they didn't have like a website.

They didn't, people didn't know. the issues in stealth. She'd already made about 30 different investments and was very active in seeking deals and working with companies. But at that point in time, they didn't have a website. So I get this email. It's like, hey, we're interested in what you're doing. We heard good things from some other people. Can we set up a call? And I went to go look at the website, like, you know, attached to the email address. Nothing showed up. And I thought to myself, okay, this is just, this is totally a prank. Like, I don't even, there are other funds that have similar names or, you know, things like that. So it did not occur to me that it might actually be Serena Williams.

It just, looking back and I was like so absurd. Don't tell me you deleted the email. I just ignored it. I didn't. I just, yeah. Well, I was like, okay, this is, I'm not going to respond. At that time, we had a lot of interest coming in. The round was sort of picking up steam.

It wasn't anywhere near being done yet. We were still bringing folks in and getting to know different investors. But I didn't know that anyone had referred us to her team. So anyway, a couple weeks later, Arlen Hamilton sends an email and she's like, hey, did Serena Williams reach out yet? And I'm like, oh, my gosh. Oops. Yeah, total big oops. So I said, oh, I'll get right on that.

Is that, Arlen? Find that, you know. It's like way down in the inbox. with Serena Williams. Yeah. She's like, oh, I recommended you a couple weeks ago to that. Oh, no. And so I replied back on that original email.

I'm like, why yes? You know, we'd love to schedule a call. She's got a team. I mean, but I didn't, there was no information. There was no information who was on her team. There's like no LinkedIn accounts. They're like, I work for a Serena Williams. Nothing like that.

So it was totally in stealth mode at that time. Since then, the fund has a website. They've gone public with all of their investments. People now are very aware that she, is an active investor in tech and in, you know, companies like ours. But at that time, it wasn't there. So we did a couple of calls with her fund manager and with other folks. I'd actually already met Alexis by that point.

So, but I hadn't met Serena yet. And then there was an opportunity, I guess, they were getting close to making a commitment. And I said, well, I want to talk to Serena. Yeah. And that was apparently, that was like a little bit of a surprise. Like, well, we already told you we're interested in, you know, she's busy. I mean, she's very busy. She's very busy. It was tennis season.

Like, I mean, it's, you know, until it's, she was doing other stuff. And I want to understand why she wants to invest. Yeah. This isn't, I imagine this isn't just about her own personal story. I mean, if she's making an investment in a company like ours to, you know, with the amount that she's interested. Right. Exactly. Like, this is a company looking for investors.

So, yeah, and so that was like, okay, we'll set up a video call. So I got to have this video call with Sterey Williams. That was her first interaction. I've since met her and spent time with her. And she's just phenomenal. You completely faint when you were on the video call. Yeah, I was, oh, gosh. That's got to be nerve-wracking.

She's so iconic. She is. And she- What she like in person, what you really like? She's down to earth. She's passionate. She is. She's down to earth.

And, I mean, she asked all the questions. that you'd want an investor to ask about a company like this at this stage. And it felt so real that I was speaking with someone who wanted to be an investor in this company, not just whatever. I mean, not that I had particular notions going in, but I wanted to just understand what the relationship could be like with her and her team. And that they saw the business model opportunity here, that they saw the mission of the company as being more than just a headline

that would make great press kind of thing. know, someone taking on the maternity health care crisis, you know, that this was bigger than that. And she was all of those things. And her team as well. I mean, we've had the privilege of working with the folks that she works with. And they've made so many introductions, even just the other day, another introduction to someone at the federal level in, yeah, U.S. government. and these are the things that actually start to build a company like ours out of our starting point in Los Angeles and create the platform for a nationwide rollout. Yeah.

It is, you know, people talk about celebrity investors. The thing that they're able to do is get attention for a company. And attention can lead to employees, customers, and future investment. and the network, I mean, if you need to contact anybody, if they get an email from Serino Williams, they're opening it. Yes. Especially if there's a website.

Yeah. So I think they see it's up on the screen right now. They seem to have figured out how to get a website up and running. It looks pretty great. Oh, she's an investor in the wing, too. That's pretty awesome. Yeah. Are you a member of the wing?

Yes. Well, there's, yeah, I just. Yes. I would say actually a few of the different companies in the portfolio are the kind of companies that we have wanted to partner with, like, and haven't necessarily had direct ties. Just when you talk about network, it goes beyond just the sort of the sales and partnership opportunities there with potential customers. It actually goes down to other companies that share a mission like ours, whether they're

focused on women's health particularly or women's focused communities like the wing, or really beyond that and just wellness, you know, understanding that health care needs to be bigger than just insurance companies and hospitals. It's a lot more than that. And that's where a lot of the new value is going to come from. All right. The big unlock for you is obviously getting medical clinics, hospitals, medical providers to pay you to implement the software.

And so if anybody's listening, there's a couple hundred thousand of you, and you know somebody who works at one of these clinics who works in the business of being born. In the health system. Health system, they can email you. Melissa at mommy.com. Yeah, that's it. You got the first name at Mommy? Nobody else in the company took it.

CEO got to have it. Oh, I was the first person for a real long time. Exactly. Always founders were like, how do I get in touch with the person? I'm like, first name at company name, tend to go to the founder. Yeah, really? No, of course, our CTO is like, well, we need to start switching up the email so not everyone just first name. You know, you go through that whole phase.

Yeah. The first people get first name. Yeah. So if you want to reach anybody at Facebook or Google, it's going to be Sergey at Google.com. and then everybody else gets first name, dot, their last name, or first name, last initial. Yeah, I invite people to reach out if they're inspired by the mission. We are hiring, I mean, that's the biggest thing. We are currently hiring in marketing, sales, community partnerships.

We love folks that are mission-driven, even if they aren't necessarily directly tied to this cause or have experience with this, but they are interested in mission-driven companies and get behind something like this. We want to bring folks in that get that this is, you know, is a mission-driven company. Software product. We're hiring on, yeah, I mean, well, I'd say on all fronts, I mean, this, we've been on a shoestring budget for so long, and having this kind of funding has opened up a ton of doors for us. So we will be going to multiple states this year with regional partnerships in different communities. We're going to continue expanding outside of Los Angeles, work our way up to the Bay Area.

Great. We won a competition last year through UCSF that was an innovation pitch competition and looking at some work up here. You're going to get the Zuckerberg-Chann Foundation involved because they did the hospital up here and so did Benningoff and they both listened to the pod. Yes, well, we would love to do work here. I know there's a lot of initiatives that are happening in the Bay Area already, but one of the big challenges that we've seen so far, which is why we're interested in coming up here,

is around care coordination. So you have all these great on-the-ground community programs that the hospital wants to be tied to, wants to send patients into, because the hospital can only do so much within, you know, within inside the building. People go home. They need care at home. They need care within their community. Mommy becomes the glue that connects these pieces together. Amazing. The founder, Melissa, Hana. No, Hannah. Sorry, my dyslexia. Hannah. two ends and the company is mommy and it's phonetically spelled because that's a great way to get a killer domain. M-A-H-M-E-E dot com. Thanks for coming on the pod. Thanks for doing something important for moms and for fighting the good fight. And I wish you continued success. Thank you.

All right. We'll see you all next time. Bye-bye.