Irth- Birth Without Bias

Irth is a technology-based solution by and for communities of color designed to help create an antiracist and equitable future by actively minimizing human bias in healthcare. Irth, as in Birth but without the B for bias, is a dual-market review and rating platform designed to identify and address patterns of bias in perinatal care by analyzing the ratings and narratives of Black and brown birthing people and turning them into meaningful data and actionable anti-racist strategies for doctors and hospitals. 

Our Yelp-like app captures prenatal, birthing, and pediatric experiences of care. Now parents of color can find crowd-sourced, peer reviews to inform provider selection, bringing transparency to the medical system--a critical accountability model with global applications. Next, Irth turns qualitative patient narratives into real-time insights for health systems, creating community-driven feedback loops to improve care. Irth helps providers learn from the living, to ultimately, save lives. 

Bias-free health care is a human right. 

Yet, compelling research from Stanford University and other organizations demonstrates that implicit bias concerning race, class, gender identification, marital status or sexual orientation can impact the care and treatment a patient receives. According to the CDC, Black women in the U.S. are 243% more likely to die during or after pregnancy and childbirth. Globally, maternal mortality is worst in Black and brown countries in Sub-Saharan Africa and Southern Asia, where issues of income and class impact care and community knowledge and consumer forces are not being leveraged. 

U.S. hospitals are investing in costly anti-bias or similar cultural competency training. But there is no public accountability, monitoring mechanism nor any patient-centered evaluation built into these efforts. In addition, legislative efforts such as Maternal Mortality Review (MMR) boards, while important, continue to address the problem from the grave, with only back-end analysis of what went wrong.

Irth learns from the living to identify practice behaviors before they lead to adverse events. Irth’s data will identify harmful practice behaviors, better inform current anti-bias training efforts, and serve as the foundation for a suite of educational tools, provider credentials, and a new community-centered hospital accreditation. 

Irth is a Yelp-like review and rating platform where birthing persons, fathers/partners, doulas and hospital-based nurse midwives can leave reviews of doctor and hospital experiences across the perinatal spectrum. 

Irth is available as a native app in the Google Play or Apple app store. 

Users can also search for doctor and hospital reviews by physician name, hospital name and city and state. 

Patient reviews can be filtered by the race, ethnicity, socioeconomics, sexual orientation, or other identities of the reviewer. 

Irth's review is a structured questionnaire process, combining ratings and open-ended questions, including questions about consent, respectful care and physical privacy. Users are specifically asked about negative and positive practice behaviors including: dismissiveness of pain levels, requests for help were refused or ignored, and if diagnostic tests were delayed. This allows Irth to serve as an early warning detection system for hospitals, surfacing practice behaviors, such as dismissiveness of pain levels, that have disproportionately led to maternal deaths.  

Irth also reveals experiences of interpersonal racism by asking specifically about rude comments, lack of eye contact, and questions or comments based on racist stereotypes. 

Our back end database is built with Ruby on Rails and uses Postgres. 

Irth is a tool to enable Black and brown women and birthing people to have a safer and more empowered pregnancy and parenting experience. In the most recent Listening to Mothers national childbearing survey, 21% of black mothers and 19% of Hispanic mothers hospitalized for childbirth reported perceptions of poor treatment due to race, ethnicity, cultural background, or language. Irth’s approach utilizes a critical community-centered model with trusted Black-woman-led leadership and expertise. 

Prior to launching Irth in the app stores, our team spent two years working on the ground literally and virtually, in five pilot cities to test, pilot, and receive input on Irth's user interface, survey questions, and back end systemic change goals. Irth has been built WITH community. 

The development of this platform leveraged previous community engagement insights gained from the founder’s eight years of on-the-ground experience surveying and co-creating community-partnered interventions in communities of color in Detroit, Philadelphia, New Orleans, and two other U.S. cities via community participatory research work from 2008-2016. That work included a $425,000 grant to develop a replicable model for accrediting communities as “friendly” to birthing and breastfeeding mothers. That model included a rigorous community assessment via surveying by community members and centered community voices in designing interventions. 

As the app continues to roll out across the country, we are building essential partnerships with community based organizations and leveraging our network of doulas, midwives, lactation consultants, and other birth workers to ensure that the lives of the patients we are trying to help are those centered in the development of the solutions. 

Racism and bias in healthcare are pervasive and deadly. Irth is a technology-based solution by and for communities of color designed to help create an antiracist and equitable future by actively minimizing human bias in healthcare. Through review collection and analysis, Irth learns from the living to identify practice behaviors before they lead to adverse events.  Irth’s data will educate the field on experiences of bias, identify harmful practice behaviors, better inform current anti-bias training efforts, and serve as the foundation of a suite of educational tools, credentials, and a new hospital accreditation—all rooted in the lived experience of care.

We are in the growth stage because our app was developed and beta testing in five U.S. cities prior to launch. Following the nationwide release of Irth on the Apple and Google Play app stores this Spring, we initiated a series of pilot partnerships with hospitals, the first of which is already underway with Ascension Health/St. John’s Hospital in Detroit. Following the pilot in Detroit, we are also in advanced conversations for pilots in New York State, Los Angeles and Philadelphia, among other cities. 

These pilots will help test and refine the process of using Irth reviews to assess current community sentiment, develop actionable steps for hospitals to address findings, and serve as a community-centered tool for embedding equity into patient safety practices and quality improvement measures.

Irth is a game changer forBlack and brown birthing people in the U.S. by  leveraging technology and crowd-sourced, peer reviews to address racism and bias in maternity and infant care. 

It's front-end Yelp-like review and rating platform allows parents of color to find and leave reviews of Ob/GYNs, birthing hospitals and pediatricians (up to baby's first year), bringing much-needed transparency and public accountability to the medical system. 

On the back end, Irth builds the first national repository of experiences of care from Black and brown birthing bodies, turning those qualitative experiences into quantitative data to provide real-time, patient-reported insights to hospitals and providers. 

Irth is particularly innovative because: 

1. It provides a community-centered monitoring mechanism for current anti-bias efforts within health systems. 

2. It understands racism looks differently in New York than it does in Mississippi, providing hyperlocal details on perceived experiences of racism instead of one size fits all solutions. 

3. Leverages consumer forces and activates Black and brown parents as agents of change in the fight for birth equity.  

Irth is in demand. In our first week of launch we had over 3,000 downloads. Now, we are currently averaging 500 app downloads per week. 

Our goal, with funding for marketing, is to serve 500,000 users per month in one year. 

In five years we expect to have expanded to the UK, where Black maternal mortality rates are starting to mirror U.S. trends, and serve millions of Black and brown parents in the U.S and U.K. 

In our hospital pilots we are measuring impact by first assessing the quality of Irth reviews, setting goals to reduce the frequency of negative practice behaviors in the app and creating an ongoing process to continually assess, monitor and track reviews for improvements and gaps. 

Our goal is to develop new community-centered indicators, all rooted in the lived experience of care. 

For example, with our Detroit hospital partnership, our initial assessment showed a high frequency of pain levels were dismissed, physical privacy violated and requests were help were refused or ignored. Working with the hospital's interdisciplinary working group, we set goals to reduce these incidents to zero and then further analyzed reviews to develop strategies to address. In four months, we will do another targeted review collection and reassess. 

Our indicators are customized, co-created and locally relevant. 

1 Full Time

1 Part-time 

6 Contractors 

Kimberly Seals Allers is an award-winning journalist, five-time author, international speaker and strategist for maternal and infant health. A former senior editor at ESSENCE and writer at FORTUNE magazine, Kimberly is a leading voice on birth, breastfeeding and motherhood at the intersection of race, class and policy.

 Kimberly’s fifth book, The Big Let Down—How Medicine, Big Business and Feminism Undermine Breastfeeding was published by St. Martin’s Press in 2017. 

For nearly a decade, Kimberly has created and directed innovative community-partnered projects in New Orleans, Birmingham, Detroit and Philadelphia, among other cities, working to improve birth, breastfeeding, and maternal health outcomes. She recently served as editorial director of the Maternal and Child Health Communication Collective, a national consortium of over 80 organizations, working to shift the narrative of maternal and infant health, funded by the W.K.Kellogg Foundation. 

Kimberly is also the author of The Mocha Manual series of books, published by HarperCollins (2006-2009) and founded an award-winning pregnancy and parenting destination for Black parents in 2007. Her first book, The Mocha Manual to a Fabulous Pregnancy was nominated for a NAACP Image Award and turned into a DVD sold at Wal-mart. The Mocha Manual to Turning Your Passion into Profit and The Mocha Manual to Military Life round out the top-selling series. 

I am applying to Solve to join like-minded individuals to build an anti-racist future using technology as a lever for change. Although, we are currently focused on maternal and infant health, we want to scale our models to others area of women's health globally and learn from others who are also thinking globally by first solving locally. 

I'm hoping Solve can help us access the technical expertise, partnerships and potential funding opportunities to join us in bringing equity to maternity and infant care. 

Racism is a barrier to the health and well-being of Black and brown women and birthing people. Irth is uniquely qualified for the Robert Wood Johnson Foundation Prize because it centers the lived experience of communities of color as critical to changing the dynamics of the health system. 

Irth is committed to building an anti-racist medical system and achieving health equity by leveraging consumer power to bring accountability and transparency to the medical system. It also turns the qualitative reviews and ratings of Black and brown women and birthing people into quantitative data to work directly with hospitals and providers to identify blind spots and develop anti-racist strategies and practices. Irth counters the notion that anti-racism is a one size fits all approach and offers hyper local community insights to transform health systems. 

Irth uniquely celebrates and centers the voices of women and birthing people that capturing their experiences of maternity and infant care and leveraging their collective narratives as data for change.