Mayank Kejriwal is trying to fix something most people outside academia never see, and most people inside it quietly accept.

He is the CEO of Grail, a company building AI tools for scientists, but the real story is not the tool. It is the problem he thinks science has become.

Kejriwal trained as a computer scientist, earned his PhD at UT Austin, and went on to teach at USC. He stayed in academia long enough to see a pattern that bothered him. Scientists were spending too much time writing, formatting, and packaging their work, and not enough time thinking. The tools were not helping. The incentives were not helping either.

So he left and built something himself...

The American healthcare system is full of software. It is not always full of care.

That was one of the clearest lessons from my conversation with Melissa Hanna, the co-founder and CEO of Mahmee, a company that provides prenatal and postpartum support through doulas, lactation consultants, nurses, mental health providers, and nutritionists. The services are bundled together and, in many cases, covered by insurance. The support begins during pregnancy and continues through a child’s first year.

At first glance, Mahmee sounds like a healthcare startup built around coordination. In one sense it is. But Hanna’s story is really about something harder. She started with the belief, common in startups, that a broken system could be fixed by better software. Over time she found that software mattered, but it was not the thing standing in the way.

The original problem that pulled her in was simple and disturbing. The United States has some of the worst maternal and infant health outcomes in the developed world. For Black women, the numbers are far worse. Hanna said Black women face maternal mortality rates three to four times higher than peers with similar clinical and economic profiles who are not Black. Native American and Indigenous women also face sharply elevated risks. These are not small gaps at the margins. They are structural failures.

Hanna began by treating the issue as a data and communications problem. Why were patients falling through the cracks. Why were providers not sharing information. Why were systems not talking to one another. Those are reasonable questions, especially in American healthcare, where fragmentation is a defining feature. Patients move between doctors’ offices, hospitals, insurers, specialists, and community providers, often with little continuity between them.

So Mahmee’s first life was as a software company. For roughly five years, the company built tools to connect providers and surface information that was not being captured elsewhere. Hanna and her team focused on the providers who often sit outside the formal medical stack, doulas, lactation consultants, nutritionists, nurses, and mental health professionals working in communities, private practices, or local nonprofits.

Those providers often knew a great deal about what was happening with a patient. A doula might hear details a patient never shares with an OB-GYN. A lactation consultant might see warning signs that never make it into a medical record. A mental health provider might understand a patient’s risk in ways that do not show up in a standard clinical workflow. But much of that information was effectively invisible to the larger system.

Mahmee built software to change that. The company created electronic health record tools, care management systems, communications features, and scheduling and billing software aimed at these community based providers. In doing so, it found real demand. Thousands of providers signed up across 44 states. The footprint was broad. The product was useful.

But scale did not follow.

That was the hard part. Each provider might only serve dozens, or perhaps a hundred, clients a year. The software worked, but the market around it was too small and too fragmented to produce the kind of reach Hanna believed was necessary. She used an analogy from The Founder, the film about Ray Kroc and McDonald’s. You can have a very good milkshake machine, but if the burger stands are too small to use it at scale, the machine alone does not solve the problem.

That was the pivot.

Hanna realized the real barrier was not simply that community based maternal health providers lacked software. It was that they lacked a place inside the formal healthcare economy. Insurance often did not cover their services. Payment models were broken. The people who were often best positioned to support mothers before, during, and after birth were sitting outside the system that paid for care.

At that point Mahmee stopped being a pure software company. It became a tech-enabled healthcare services provider. Instead of just selling tools to doulas and lactation consultants, the company employed them and built a coordinated care organization around them. The software remained important, but it became infrastructure for a services model rather than the product itself.

This is a more interesting kind of startup story because it runs against a habit in tech. Founders often want the clean answer. There is a messy industry, and software will organize it. Hanna found that the mess was deeper than that. The system was fragmented not just technically, but financially and institutionally. Data could not solve a funding problem. A dashboard could not make insurers reimburse the people who were doing essential work.

That matters because maternal care is not a niche. Hanna put maternal and infant healthcare in the United States at roughly a $200 billion market. Yet for something that large and consequential, the experience is often poor, costly, and isolating. Many women move through pregnancy and birth without enough support, without clear information, and without much sense of agency over what is happening to them.

One of the strongest parts of our conversation came when Hanna described a patient story that made this concrete. The woman was in her early twenties, already had one child, and lived in a rural area with limited hospital and doctor access. During her first pregnancy, she felt judged throughout the process. She was young, a woman of color, and she came away from the experience feeling that she had no control. Labor was difficult. The care felt harsh. She was in pain, asked for help, and felt talked down to rather than supported.

When she became pregnant again, she was afraid. She wanted the baby, but did not want to relive the first experience.

Through Mahmee, she learned something basic that had been missing the first time. She had choices. She could ask questions. She could slow a conversation down. She could say no. She could ask about pain management options beyond the narrow set that had been presented to her before. She could participate in the process rather than just endure it.

That may not sound radical, but in practice it often is. The modern medical system moves quickly, especially in high stress environments like labor and delivery. If a patient is not informed and supported, decisions get made around her rather than with her. Hanna’s point was not that doctors and nurses do not matter. Quite the opposite. In high risk pregnancies, they matter enormously. Her point was that support, education, and continuity of care change the experience and often the outcome.

This is also where her critique of the system is most useful. She does not reduce everything to one cause. Systemic racism and bias, she said, are real and they amplify disparities. But she also pointed to two other drivers, fragmentation and the chronic underfunding of preventive care. If support is only available at moments of crisis, then people will continue to arrive at those moments without the preparation, context, and trust they need.

Hanna also spoke frankly about the difficulty of funding a company in this area. Building in healthcare is hard. Building in women’s healthcare is harder. Raising venture money for maternal health can mean explaining the problem to investors who have never had to think about it in concrete terms. Part of the job, she said, was reframing the opportunity so people could understand it as both a human problem and a business one. Another part was finding investors for whom the issue already felt personal, because they or someone close to them had been through a birth experience that was worse than it should have been.

What stayed with me most was the shape of the lesson. The original thesis was not wrong. Technology does matter. Mahmee still builds software. It still uses connected tools and remote monitoring. It is now looking at how AI might fit into care delivery. But the mature version of the thesis is more grounded. Better care does not come from software alone. It comes from software plus people, software plus payment systems, software plus trust, software plus someone who is actually there when a patient needs help.

That is not as neat as a pure software story. It is more true.

There is a tendency in startups to assume that every broken institution is waiting for the right app. Sometimes what is actually missing is a workforce, a reimbursement model, and a way to bring overlooked people into the center of the system. Mahmee’s story is about discovering that the missing layer in maternal care was not just information. It was support that had been treated as optional, informal, or outside the reimbursable core of medicine.

Hanna’s company now tries to make that support part of the default package rather than a luxury add-on. The goal is not only to improve outcomes, though that is clearly part of it. It is also to change what pregnancy and postpartum care feel like for the person going through it.

That may be the real measure here. Not whether a startup found product-market fit in the usual sense, but whether it found a way to make a system less cold, less fragmented, and less likely to fail people at a moment when failure carries enormous cost.

—

Transcript

John Biggs (00:00.161)

Welcome back to Keep Going, podcast about success and failure. I’m John Biggs. Today on the show, we Melissa Hanna. She’s the CEO and co-founder of Mahmee M-A-H-M-E-E, which is a fascinating startup. You guys work with doulas and you work with care during birth, right? So why don’t you tell me about that? Welcome.

Melissa Hanna (00:30.561)

Thanks, yes. Well, Mahmee provides wrap-around prenatal and postpartum support. We do that with a team of doulas, lactation consultants, registered nurses, mental health providers, and nutritionists. And it’s all included in one bundle.

that’s actually covered by insurance. In most cases, we work with most major insurance companies and the services start during pregnancy, go all the way through labor and delivery and until baby’s first birthday. So it’s a pretty comprehensive package of support for new and expecting parents.

John Biggs (01:05.006)

So I mean, just tell me why you started this. What was the impetus?

Melissa Hanna (01:09.909)

Well, the business has been through a number of evolutions, but the impetus and the vision and mission have stayed true and consistent all the way through. We’re on a mission to make the US the best place in the world to give birth. Right now, the US is not close to having that title. So it’s a big, hairy, audacious goal, you could say, that we’ve taken on. We’re not doing it alone.

John Biggs (01:30.21)

Mm-hmm.

Melissa Hanna (01:36.705)

There are a of folks that are really passionate about this space. We work with a number of different health system and health plan partners and doctors, researchers across the country, and of course, a broad network of providers. But I started the business because I was hearing a lot about maternal and infant health statistics, the morbidity and the mortality rates in the United States.

And I kept hearing numbers that just felt very wrong, like they could not be correct. The US is in last place with the worst maternal mortality and also an egregiously high infant mortality rate compared with all other developed first world, wealthy nations, however you want to describe that. We have the best tech, the best know-how, the most passion for providing health care to a diverse population. If you look at

you know, just what the United States looks like and the resources we have to provide care to people and to hear that moms and babies are being failed every day across the country was really shocking to me. And I thought that just can’t be right. The more that I dug into it, the more I realized there was a real structural challenge in solving this. And it became more and more interesting to me. And I started pursuing it as a software problem, as a data problem.

Could we connect the dots together to figure out why people are falling through the cracks of the system? Why systems aren’t talking to each other? Why providers aren’t talking to each other? Is this a communications issue? What kind of software tool set could help provide a better experience both for the patients and the providers working in this space? And then learned over time that that was not actually going to be the answer. And therein lies the story of a pivot.

John Biggs (03:22.892)

Mm-hmm.

John Biggs (03:26.284)

Okay. And so, and this is especially egregious here in the States for the people of color as well, right? I think I interviewed someone years ago about women’s health and she pointed out that that was just abysmal.

Melissa Hanna (03:32.491)

Yeah.

Melissa Hanna (03:40.223)

Yeah, it is, it’s true. Black women have an on average rate of three to four times a higher rate of maternal mortality of death during or shortly after childbirth. this, and that’s just the average. There are some communities where it is much higher than that compared with peers with similar clinical profiles, similar economic profiles that are not black.

And so, and that’s the case also for Native American and indigenous women as well. So these two populations really are off the charts in terms of mortality rates and morbidity rates, which is the rate of injury where there could be a near death situation or sort of a near miss where something could have gone wrong and luckily didn’t happen, but there still was an injury that occurred. In all of these cases, it’s really hard to talk about

these stats without talking about systemic racism and bias in healthcare. That is a root cause of these disparities in care. What I found in doing this research over several years as I was building the tech company that Mahmee started as was that there were a number of different contributing factors and that systemic racism and bias was an amplifier. ultimately, high fragmentation, excuse me,

high fragmentation and really a lack of proactive care, just like the dollars not being allocated to preventative care, the way that we need them to be, were two of the other major drivers of this. So I started looking at this from the standpoint of, how do you solve for fragmentation? You start to think about information superhighways and information exchanges and connecting.

systems together, even if you can’t necessarily connect the institutions together. And then when it comes to dollars being allocated toward more effective solutions, you think about payment innovation in healthcare and how do you actually redirect funding toward the solutions that have the greatest impact on the community.

John Biggs (05:54.19)

So I think this is a really interesting point. mean, what you said, and I want to hear about this pivot very specifically. The language that you used before for the first iteration was kind of the language that I hear all the time from like entrepreneur who wants to do something in like, don’t know, STEM toys or education. And it’s very much like, can do this. It’s a software problem, right? And it sounds like you quickly discovered it wasn’t a software problem. So tell me about that pivot.

Melissa Hanna (06:21.759)

Yeah, I wish I could say that I quickly discovered that because it’s a little bit more painful than that. But I will say that this business being in the healthcare industry has had a different sort of profile and different time horizon than businesses and other verticals that are VC backed and sort of, you you come to an idea, you put it in the market, maybe the first version doesn’t work, you test it again, and then all of a sudden you’re like, this is actually taking off.

John Biggs (06:25.174)

Okay.

Melissa Hanna (06:51.553)

We actually, we did have that experience with our software solution. And I can talk about that in a second, but suffice to say that we saw growth within the software play that we originally developed. But what was happening behind the scenes is we started to understand that the market wasn’t actually mature enough. The market wasn’t established for scale. So even though we launched something and we did have that moment of like, this is going to be big. When we started to see the development of that business,

the signs were there and they were small and they were sort of early because the market wasn’t developed yet to say, this might not get as big as we want it to get. And that was the critical insight. So I said, I wish it would have happened sooner, but it took years really to understand first what the software problem was in the market. And I talk about the fragmentation and sort of like the payment challenge.

I’ve got emojis there, I don’t know. But I have to avoid talking with my hands too much. The software challenge was much more apparent because the United States has so many different kinds of healthcare institutions and so many different ways that healthcare is paid for.

John Biggs (07:54.126)

Yeah, that’s done. It’s a bad one. Yeah, okay, great.

Melissa Hanna (08:18.145)

That means there’s a lot of different kinds of providers that can provide that care, whether those are retail providers taking cash pay, whether those are integrated delivery networks in large systems like the Kizers and Geisingers of the world that have a much more integrated set of hospitals and doctors’ offices and urgent care facilities and all of that, and plans associated with their brands.

And then you have sort of your freestanding medical facilities of all different types and you take your commercial insurance or you take your Medicaid insurance to these organizations and you hope that insurance is going to pay for most of the care you receive. So there’s like so many different ways that people get health care in the United States that we first had to figure out, could you build software that could connect these systems together? So we did that actually for the first five years of this company’s life.

And what we realized was that in order to find the missing data that would tell a different story and provide an opportunity to actually improve clinical outcomes within this population, we had to distribute software to a number of independent providers that really didn’t have those tools yet. So we’re talking about those doulas, those lactation consultants, mental health providers, nutritionists, nurses that are working in the communities. Often they’re working in private practice or maybe even a

local community center, a nonprofit with some grant funding and providing those in between moments of support between going to your OBGYN and your pediatrician’s office for clinical care from your doctor, maybe your baby’s doctor. There’s all these other people you’re talking to along the way. And a lot of those people had really important insights, but that data wasn’t actually manifesting. wasn’t surfacing in the system. And so that was the key. That was the first insight was, okay, we to get them online. We have to actually

create tools for these kinds of providers. And we did. We created an electronic health record. We created a care management system, a communications tool set, a number of different features that allowed for these providers to provide care in the community. And as sort of part and parcel of that, we realized, OK, now I to figure out how to actually create more of that market, because a lot of the rich and valuable data was actually coming from these folks. You kind of tell your dual in your life story. You tell your Latish consultant,

Melissa Hanna (10:37.067)

you know, the aspects of, you know, your experience that you might not feel comfortable talking about with your OB-GYN. Even though we want you to feel comfortable talking with your OB-GYN, it might not be happening. And so someone else might be getting that story. What can we do to empower that person with that key information about your health and wellbeing to be able to participate in improving your care? And so we had to find a way to actually fund these providers getting into the healthcare stack is what I call it. Really getting them to be able to

John Biggs (11:05.88)

Mm-hmm.

Melissa Hanna (11:06.987)

participate fully as players on that patient’s team. So we had the tech for them. We had to figure out how to actually finance this. When we realized that the payments model for these types of providers was severely broken, that became a major blocker. said, wait a minute. OK, there’s all these people out here that can provide this care and have this really valuable insight and this really powerful way that they can have an impact in the industry. But they’re not participating in the health care stack. And we can’t seem to figure out how to get

payments flowing to them because insurance wasn’t covering a lot of these services. So the tough realization here was that being a pure software play was not going to maximize the impact, the ability to achieve the mission of the company, the valuation of the business, right? Because there was this blocker in terms of how these services are actually funded to allow for greater participation.

in healthcare. Otherwise, you’ve got, you know, all these doctors, hospitals, all these folks that care about you and are providing care to you, but they’re missing a piece of the pie over here. And these folks are just out of the system. We ultimately became a tech enabled healthcare services provider. We took the tech that we had built initially and we started to employ those providers and actually build the scalable healthcare organization that had all of those independent and slurry wraparound service providers in house. Because without that,

John Biggs (12:14.36)

Mm-hmm.

Melissa Hanna (12:34.123)

We just had a market that wasn’t scaling on its own. We had to become the scalable player. And now we have become that.

John Biggs (12:41.806)

Did it ever get so frustrating that you just didn’t want to just didn’t want to continue?

Melissa Hanna (12:48.363)

There certainly have been moments. Yes. The mission is, it’s sort of like a well to drink from, to restore yourself because as long as this continues to be an issue in the United States, for myself and for many others, certainly the folks in our company and I think a lot of our peers across the industry, this is just something that people can’t stand, they can’t live with.

And so yeah, it’s hard. It’s hard building a startup, right? It’s hard to build a startup in healthcare. It’s hard to build a startup for women’s healthcare. All of those things are true. But you look at the stats, you look at the economics of the industry, we’re talking about a trillion dollar market that is healthcare in the United States. Maternal and infant healthcare is approaching a $200 billion market. It’s tracking to be on par with the size of the global video games industry.

John Biggs (13:44.413)

Okay.

Melissa Hanna (13:45.57)

to an investor, it’s like, you could back video games or you could back maternal health care. And a lot of people are like, I hadn’t thought of it that way. That’s part of the problem. And I feel like as long as I’m sitting in the seat, I get to sit in and seeing the big opportunity from a clinical impact and also from a financial impact perspective, like, this is where I want to work, this is where I want to build. But yeah, definitely there are hard days where I think, gosh, when is this going to change and mask across?

across the country, especially because there are opportunities globally to take these insights elsewhere too. But there’s a lot of work to do here and as such there’s a lot of value built here.

John Biggs (14:25.196)

What about investment? mean, I’ve heard historically it’s been difficult as a female founder to get investment and then specifically talking about maternity, some dude in a vest on Sand Hill Road probably doesn’t know a lot about that. So what did you have to do?

Melissa Hanna (14:43.285)

Well, I think it’s a lot of reframing the opportunity so that people can find an access point into it. It seems big and far away. Someone else is having a not great healthcare experience in some other city, some other state, some other community that you’re not a part of, and that can make it difficult for the value proposition to resonate with investors. Ultimately, I both had to learn how to

reframe it for accessibility for those investors and also find the investors who it did immediately resonate with that knew someone who had gone through an experience that could have been better and wondered why it wasn’t and find investors who had had their own personal experience that was not what they expected it to be and started asking their own questions about like, why does it suck to have a baby in the United States right now? Like this should not be happening.

John Biggs (15:37.912)

Mm-hmm.

Melissa Hanna (15:39.682)

It shouldn’t cost this much. It shouldn’t feel this isolating and it shouldn’t be this medically difficult. You know, there’s so much risk associated with the care, lots of medical intervention that is not necessarily appropriate in every case. But in other cases, you you’re glad that there are people with, know, specialty, specialties that can save your life if that’s what it comes to, but not

every birth should be a life-saving instance of care. And so, you know, a lot of people that I met along the way were asking those questions because they had experienced it or they knew someone who had experienced it themselves. I’d say that’s a good portion of our cap table. Ultimately, though, we were able to bring in really strong investors from Sand Hill Road and from Wall Street and bring folks across the country to this work.

as the business was growing and demonstrating what it was capable of doing.

John Biggs (16:46.594)

When you were building this, did you expect to be able to ship some software and then just have the business? Did you expect this along a thing? mean, sounds like when you, it’s like trying to rebuild a, rehab a house or whatever. And then all of a sudden you find a bunch of like broken wood somewhere that you have to fix, right? So it sounds like you started digging and hit some rough spots.

Melissa Hanna (16:55.585)

Yeah.

Melissa Hanna (17:11.231)

Yeah, that’s fair. I don’t think that I ever imagined it to be an overnight success. I did feel very confident, and I still do, that technology is a very critical component in solving this problem. And that’s why we’re ultimately a heavily tech-enabled health care service provider. We develop software every day. There are things every day that we’re doing to...

refine the operation and ask questions about how we provide a better patient experience, how we provide a better provider experience through technology itself and through even connected devices that we use for real patient monitoring. So there’s a number of different components to this that just continue to persist because the core thesis was right, but the market wasn’t ready for it. Actually, you use the analogy of sort of a house you buy in.

Yeah, you find some things wrong with it. The analogy that resonates for me, the movie, The Founder, and sort of the Ray Kroc, McDonald’s story, like trying to sell milkshake machines and being like, this could be huge. This is a really great piece of tech and everyone should have it for their burger stand. And then, you know, going out to try and sell to burger stands and realizing that none of them had the scale to need this like.

John Biggs (18:09.742)

Mm-hmm.

Melissa Hanna (18:35.349)

you know, this great piece of equipment. It was just like not where their heads were at to buy that equipment. And then, you know, him coming across the McDonald’s, you know, stand and being like, wow, okay, they’ve got something here. Like this could actually scale. Realizing that, you know, you couldn’t sell the piece of technology until you could find the business that could scale and use it and really, you know, realize the value of it. That resonated when I watched that movie because...

John Biggs (18:57.357)

Mm-hmm.

Melissa Hanna (19:03.391)

That’s kind of how I felt going out there trying to convince your sort 1Z, 2Z, doula, lactation consultant outfits, like, you guys need to get online. You need to have a complete set of medical software tools to book and schedule and communicate. Have you guys heard of HIPAA compliance? And they’re like, what? And I’m like, you guys, you’re going to be subject to state and federal regulation soon enough. And I got laughed out of so many rooms because people were like, no, this is not.

John Biggs (19:26.926)

Mmm.

Melissa Hanna (19:30.057)

where we’re at, we’re not going to need this. We fly under the radar of the rest of the healthcare industry. And I was like, but do you want to? Like, is that where you want to be? Because the care that wraparound service providers offer is so essential to the broader experience that noon expecting parents are having as consumers. I was like, that’s going to be like really valuable. And a lot of people were just like, yeah, no, I don’t need your app. And

And what’s interesting is I did find a lot of people who did, and we ended up having thousands and thousands of providers sign up across the country. We were in 44 states with providers using our software to provide care in their communities. And from a footprint, we were like, okay, geographically, like this is great. But from an actual like scale capacity standpoint, like each provider was taking care of like dozens, maybe a hundred patients a year.

Right? So like each person kind of could only do so much on their own, even with a great piece of tech. And we were getting that feedback like, yeah, okay, I see what you’re doing here. Yeah, it is right. It is nice to have these kinds of tools and the ability to book and schedule and pay, you know, charge people and track my patients care longitudinally over the course of their maternity episode. Oh, this sounds nice. And I’m loving using it for my 50 clients. And I’m like 50 clients. There’s like

you know, almost 4 million babies born in the country every year. How are we going to actually get to scale? And we ultimately, this vertical integration, bringing people together and saying, well, maybe on an individual basis, y’all are doing the most. You’re doing what you can and it feels impactful. But what if we joined forces and created a team-based model of care? Then what happens? And the amplifier of that really is

John Biggs (20:59.63)

Mm-hmm.

Melissa Hanna (21:27.499)

people are doing 10x what they were doing before. Each provider is able to do so much more. And the data is living this out. We’re taking care of thousands and thousands of people a year because of this shift in operations. Ultimately, that’s what we did.

John Biggs (21:45.486)

Tell me a story about somebody whose life you changed because of this.

Melissa Hanna (21:49.062)

There’s we get letters every day. We get emails. We get cards in the mail with baby photos There’s so many There there’s there was a mom recently that it was this was a Unique one in that we get a lot of like first time, you know, I couldn’t have done this without you. This was amazing Thank you so much first time parents, but

It really strikes me and it strikes the team when we get a message from someone who is not a first time parent, who has been through this before and is already carrying the burden of their previous experiences. And this was a young woman, early 20s with a toddler who became pregnant in a

again in a very rural part of the state. There’s like one hospital there, one doctor’s office. And she found out about Mahmee being available through her insurance plan. And she didn’t know what it was, but she told us that based on what happened to her the first time around and how difficult of a medical experience it was for her.

The pregnancy was otherwise pretty smooth and she was very healthy and very excited to be pregnant. But once she started to get into care, she felt so judged many times over. This was a woman of color who had said, I just didn’t even know what to expect, but I had doctors asking, are you ready for this baby? You’re really young. She was still in school and she was just...

She said she had no agency in her initial pregnancy experience. And the labor and delivery was very difficult and she was in pain and everyone was like, well, this is what happens when you get pregnant. Like, what did you think? Labor and delivery is not easy. She wanted medication. There was just a lot of bias that was creeping into this experience in a story that was an otherwise medically well patient. And this is not to say that anyone around her wanted to make her feel bad, but

Melissa Hanna (24:13.587)

In these high stress moments and when patients are going through their own emotional and physiologic birth experience, it can be a lot. And then people start saying stuff and they don’t even realize sometimes what they’re saying to you. I’m not going to defend her medical care team from her first pregnancy, but hearing this woman’s story, it just sounded like people didn’t know how to control themselves as she’s screaming in pain there and being like, my God, the baby’s coming in. like.

Okay, yeah, well, we’ll go get the doctor for you. And just this attitude around it. The second time around, she wrote in was to tell us that she didn’t know how many places along the way between her pregnancy experience and her labor and delivery experience, and even in postpartum, she had agency. She didn’t know that there were moments where she could say, hey, this is how I want it to go. Like, can we try this? Can we slow down here? Can you give me a second to do some deep breathing?

what are my options for pain medication versus, you know, sort of haranguing her for asking for any at all. She didn’t even know necessarily what the different choices are. And it isn’t just epidural or bust, right? There’s a lot of different ways to manage pain. There’s a lot of different junctures where a medical decision needs to be made. And if the patient isn’t fully empowered and educated in what those decisions might be, the doctors and the nursing team will very quickly start to step in and sort of direct you toward those decisions. And so,

John Biggs (25:14.478)

Mm-hmm.

Melissa Hanna (25:39.296)

She wrote in and her message was, I didn’t know that there were moments where I could say no. I didn’t know there were moments where I could just take a beat and participate in it and direct others around me. And this one was very powerful because it speaks to how outcomes actually do change because there are people who have clinical risk. We take care of a very high risk population, patients that come in with a history of diabetes.

A history of hypertension, cardiac concerns, multiple high risk pregnancies, right? These are stories where there’s already going to be like a whole medical team around this patient. But we’re talking about a young woman who has no other history, no other concern, but said, I was so terrified to get pregnant the second time. I thought to myself, my gosh, like I want this baby, but I don’t want to have to go through what I did before. Ultimately, that narrative is one that we love hearing because it talks about sort of the silent majority.

of what women are going through in this country, which is to say that if you don’t have access to education, support, a provider or a team of providers like you get at Mahmee who can empower you to be able to say no, to be able to know what your choices are and how to direct and participate in your own pregnancy and labor experience, there’s a whole other storyline that may happen that may lead someone to say later, my gosh, that pregnancy was so difficult, or I really didn’t enjoy.

labor and delivery when it should be a wonderful and empowering and you know, Exciting experience to meet your baby So that’s that’s one where someone said you changed my life and what she meant when she said that was was very clear that it wasn’t just about that Eternity experience it was that someone for the first time in her life said, you know, you have the power you actually have the agency here and and you’re in control of you and

John Biggs (27:16.418)

Yeah.

Melissa Hanna (27:36.637)

you have a right to speak up for yourself. And it was, my gosh, we were all moved by that.

John Biggs (27:42.84)

Well, that’s beautiful. Yeah. thank you for this. has been a, like, it’s fascinating to see a move from like, I don’t know, pure software play. I’m going to solve this thing. And then all of a sudden you realize there’s so much to solve and comes down to just people, right?

Melissa Hanna (27:55.809)

Yeah, that’s it. It ultimately comes down to how we care for each other. There are many different ways that people are addressing health care issues across the United States. I’m really excited about all of the ways that people are now imagining AI as a component of these solutions. We’re doing that work as well. What we found is that it’s always been and it’s always needed to be the combination of people and tech.

And so whatever that combination looks like as we go forward, it’s that blend of the two because caring for each other really is where you have transformative experiences where someone says like, it only took one person. It only took one person being by my side to help transform the narrative for me. And everyone deserves that. And it shouldn’t be something that’s a luxury. It shouldn’t be something you have to pay through the nose to get. And that’s why I’m excited about what we’re doing because

it’s possible now to give this experience, to make this experience available to a lot more people.

John Biggs (29:01.326)

The service is called MAHMEE.com. Melissa, thank you for joining us. been great. All right. This has been Keep Going. I’m John Biggs. We’ll see you next week.

Melissa Hanna (29:09.409)

Thank you so much.