Our work at Delfina tackling the maternal health crisis has always been motivated by the pregnancy journeys of our patients and their families. Becoming a parent last year while we were building Delfina Care has given me a profound and visceral motivation for our work to bring clarity to pregnancy care. This is my family’s journey.
When we found out my wife was expecting last year, we could not have been more grateful and excited. A few weeks in, she got COVID. Our baby name-storming games quickly turned into late nights close-reading the literature on COVID outcomes in pregnancy. Other than a more frequent visit schedule and planned induction at gestational week 39, there were no other evidence-based interventions that could clearly help her. We would simply have to wait and see. To cope with the months of anxiously waiting in the dark, my wife designed an awesome nursery. We went on long romantic walks to garage sales to find the most random items for the baby. I found a productive outlet in an extremely thorough babyproofing of our house, which my wife was initially excited about - though less so when it took place at 3AM.
A few months in, she told me we had to drive to the emergency room. Based on her severe cramping, she was acutely concerned for her pregnancy. One in five pregnancies end in miscarriage. Was that about to happen? We are fortunate to live a few minutes away from one of the best hospitals in the country, where she works as an OBGYN physician. I have never been more anxious than when we were sitting in triage, waiting for one of her colleagues to tell us if her pregnancy was OK. Our Apple Watches were both pinging us notifications for tachycardia. I cannot imagine how she was feeling. And unlike mine, her anxiety came on top of baseline nausea, fatigue, and back pain. Thankfully the exam ended up being normal and we were sent home with reassurance. On the ride back, she and I reflected on how that wave of relief came from the degree of clarity we got from the data rendered by the exam.
Despite our level of access to exceptional care and our privileged position as MDs, we still found ourselves repeatedly frustrated by the lack of clarity in care for her pregnancy. What was her particular risk for gestational diabetes? How is our baby growing and could we do anything to help? Are there any evidence-based interventions that might work for her to keep her metabolism healthy? Even though she was one of millions of patients asking themselves these same questions, we found surprisingly little data to answer them. If we felt frustrated by the vague answers from the limited literature and existing pregnancy apps, how difficult must this experience be for families with much less access to care than we have?
I was first drawn to medicine because of the deep relationships between physicians and patients. Obstetrics is a field where that bond feels truly special. I have seen the therapeutic impact of that bond from Andean practices in Peru to community clinics in California. I witnessed it consistently with my wife’s care during the ups and downs of her pregnancy. Data itself cannot replace the thoughtful analysis, communication, and care she received from her providers. It cannot replace the strength and resilience of patients like her. What I believe data can uniquely do is enhance the therapeutic bond of medicine with the clarity it offers us as patients and providers. As our pregnancy-related anxiety now fades in the rearview mirror while we enjoy life with our son, I am doubling down on our mission. With data as our catalyst, we will strive to empower all families with the clarity they deserve in care.