Mammha Provides Screening and Care for Moms Struggling with Depression and Suicide
After years of advocacy work focused on pregnancy-related depression and suicide, Maureen Fura created a tech-enabled mental health screener for moms that pairs with a network of trained peer-support specialists.
This week, from March 6–9, 2022, join us in Miami Beach for StartUp Health @ ViVE to meet the Mammha team and dozens of other Health Transformers from the StartUp Health portfolio.
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Challenge
If someone asked you about major health risks for the mother during and after pregnancy, what would you say? Hemorrhage? Infection? Blood pressure-related issues like preeclampsia? Would self-harm and suicide even come to mind? Yet self-harm (suicide or overdose) is one of the leading causes of death for new moms and the numbers are rising. A study released in 2020 found that rates of suicide attempts during pregnancy and after childbirth nearly tripled over the previous decade, from 0.2 to 0.6%, and those numbers are likely to be under-reported since maternal mortality statistics reported by the CDC don’t factor in suicide death.
Even though perinatal mood and anxiety disorders (PMADs) are the most common complication of pregnancy and childbirth, less than 5% of women are screened for depression during their pregnancy and postpartum period. More women will suffer from a mental health complication during their pregnancy and postpartum period than gestational diabetes and preeclampsia, yet their doctor likely won’t mention it as a possibility. Perhaps the doctor doesn’t know what to say. Perhaps he or she doesn’t know where to point their patients for help if a mental health issue comes up. Maybe they don’t want to scare the mother with these statistics, fearing that they’ll make matters worse.
So even though a woman receives more medical attention during a pregnancy than she does at any other time of her life — while simultaneously being at higher risk for mental health complications — she is neither screened for maternal depression or given any help if she brings it up herself.
On the off chance her doctor does raise the issue, finding and affording the right intervention, like therapy or a support group, presents its own challenge. Mental health issues are often time sensitive. The feelings, thoughts, and situations come fast and care needs to be prompt. As Adrienne Griffen, executive director of the Maternal Mental Health Leadership Alliance, puts it, “We cannot wait for women to raise their hand and ask for help because by the time they do that, they needed help many weeks ago.”
Origin Story
Maureen Fura, CEO & Co-founder of Mammha, lived this story. She can clearly remember the morning she found out she was pregnant. It was the morning of the first suicidal thought she ever had.
“I was in graduate school and a newlywed. My husband and I were living in the small coastal town of Monterey, California. I had never had a mental health issue in my life. I woke up one morning and I could see myself hanging from a tree. Suicidal thoughts just started to come, ideations, really fast. I knew something was wrong. An hour later, I took a pregnancy test.”
She knew this wasn’t normal. She knew something was wrong and so she voiced her concerns to her OB at her very first prenatal appointment. Her doctor said, “You should be happy. You’re having a baby.” This pattern repeated itself over and over again as Fura looked for a doctor who could help her.
“I told every doctor, every OB I talked to how I was feeling. I waved a red flag and felt like my concerns and cries for help were ushered out of the exam room.”
Eventually Fura found a therapist who named what she was experiencing and she got the help she needed. She felt like a survivor and wondered “am I the only one?” She wasn’t. She found another mom who experienced similar maternal mental health complications and together they began to interview and record other stories, a project that became the documentary Dark Side of the Full Moon. Fura discovered the lack of care she received was the rule, not the exception, in postpartum healthcare.
Raised by a mother who taught her to always look for ways to lend a hand, Fura became a maternal mental health (MMH) advocate, helping found the National Coalition for Maternal Mental Health and spearheading the first National Awareness Campaign for MMH. She lobbied congress for seven years, increasing the visibility of the problem and the number of MMH-related deaths.
But even as awareness grew in the medical community thanks to these efforts, she kept hearing doctors remain at a loss as to what they could actually do to shift the problem.
“A change in knowledge isn’t equal to a change in behavior. People knew women were dying but they still didn’t know what they could do to stop it.” Fura wanted to do more than educate about the problem. She wanted women to get the care they needed when they needed it. She wanted them to have what she didn’t get to have during her pregnancy. She wanted something that was easy for doctors to use and easy for women to access, something tangible to close the MMH gaps in patient care. And so, Mammha was born.
Under the Hood
Mammha started as a natural evolution of Fura’s advocacy. The idea was simple: provide women with routine mental health screening during the pregnancy and post-partum period and provide doctors the tools to talk about mental health issues with their patients and trusted resources to point them to if an issue arises.
“It’s the only product moving the needle on patient engagement and routine screening,” Fura explains. “Doctors don’t want to screen because what if the patient says something is wrong? They don’t know how to have that conversation and they don’t know where to send the patient for help. Mothers might be fearful to bring up an issue, or feel like they don’t have the words.”
Mammha streamlines the process for both parties. The moms quickly screen themselves on their phones using the Mammha HIPAA-compliant mobile and web-based platform. The doctors get their results, along with talking points on how to follow up with the mother. And perhaps most significantly, there is immediate support on what to do next. If a patient screens positive for mental health concerns, they are instantly connected with a Mammha Care Coordinator who connects them with low- to no-cost resources and provides them with ongoing support, check-ins, and care.
Providing a trusted, trained care coordinator turned out to be the missing piece in the puzzle. Doctors feel more safe screening patients because they know the Mammha care coordination specialist will be a liaison to the services their patients need. Moms feel supported because the Care Coordinators are certified peer-support specialists — women with lived experience and training in supporting other women.
“The Care Coordinator follows the patient through to wellness,” says Fura. “Sometimes it’s six weeks, sometimes it’s 10 months. It’s not always therapy or medication. Sometimes it’s needing a support group. Sometimes it’s just needing someone to talk to who knows what you’re going through. The level and type of communication depends on mom.”
Mammha currently partners with Children’s National Hospital, the top NICU in the country, as well as other hospitals in Florida, California, and Washington DC. NICU moms screen the highest for depression and anxiety, making ongoing support especially important for them. To that end, the March of Dimes is funding a new pilot program with the goal of bringing Mammha into all 70 family NICU centers across the US. The program launches this March in three hospitals in Virginia.
In 2021, Mammha was one of eight finalists selected by HITLAB for the Women’s Health Tech (WHT) challenge. Additionally, Mammha won Johnson & Johnson’s Washington DC QuickFire Challenge to address maternal mortality. Innovators from across the globe were invited to submit potential science and technology solutions aiming to address racial and socioeconomic disparities that impact health in communities like the District of Columbia.
Their success, Fura explains, is because the team at Mammha has been in the shoes of the women they are serving.
“Mammha is made by women for women. That’s what makes it really effective. We have physicians informing us that have had this experience themselves. We know what levers to pull, what to say. We know how women find their way to care. That’s what’s really making the difference.”
It’s all about friendship, shared experience, lived wisdom, and love.
Why We’re Proud to Invest
Like so many of the best health innovation startups, Mammha was born from personal experience. Before she founded this company, Maureen Fura was a patient and then a passionate health advocate. Every tool she builds, every feature she rolls out, is based on intimate knowledge of the pain of real patients. We’re proud to support a founder who has walked in the shoes of her users and has dedicated her life to helping them.
We’re also excited about Mammha because it addresses a massive unmet need. This isn’t a tweak, an upgrade on current practice. This is stepping into a gaping hole in the healthcare system — postpartum depression screening — and providing a life line. Mothers are dying. Obstetricians are desperate for tools that until now just haven’t existed.
We’re bullish on Mammha because Maureen Fura has built a foundation of national partnerships, which has led to rapid early growth. Fura spent years in Washington DC advocating for women’s health, and she’s been able to leverage those connections to get Mammha implemented more broadly. Their recent partnership with the March of Dimes is a perfect example of this and showcases Fura’s ability to bring together disparate pieces of maternal health.
Finally, we’re excited to support and invest in Mammha because it puts genuine community at the center. The killer “app” in Mammha isn’t a line of code. It’s the growing family of trained peer-support specialists ready to hop on a call with a struggling mom. In this way, Mammha uses new technology, but does so in a way to tap into, and amplify, the oldest tool in the toolbox. It’s all about friendship, shared experience, lived wisdom, and love. And when you create a network of peer-support, you also start to tackle the problem of access, bringing help and care to places that are low on healthcare resources. It turns out that the greatest increases in pregnancy-related suicidal thoughts were seen among Black, low-income, and younger individuals, so issues of access and equity need to remain top of mind. And that’s precisely where Mammha shines brightest. Join us as we welcome Maureen Fura and the Mammha team to StartUp Health.
Learn more and get in touch with the Mammha team.
From March 6–9, 2022, join us in Miami Beach for StartUp Health @ ViVE to meet dozens of Health Transformers.
Investors: Learn how you can invest in Health Moonshots through the StartUp Health Moonshots Impact Fund.
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