Equitable Health Care Is a Birthright

According to a White House statement issued in 2021 on its first Maternal Health Day of Action, the U.S. has the highest maternal mortality rate of any wealthy nation in the world. For Black women, the reality is even starker: They are more than three times as likely to die from pregnancy-related complications as white women.

It was statistics like these that inspired journalist and activist Kimberly Seals Allers to found the nonprofit app Irth (as in “birth without bias”). Its mission is simple: to give expecting and new mothers of color a way to help one another find medical providers and facilities that will take proper care of them and their babies. In Irth, members can rate doctors and hospitals, share their experiences, and tap into the power of community.

A mother of two, Allers is no stranger to bias in the health care system. When she gave birth to her daughter as an unmarried graduate student, she was shocked by the discrimination she faced at the mostly white-staffed hospital.

“I left feeling disrespected, traumatized, and dismissed,” she says. “Everything I had read was standard care I had to fight for: I had to fight to have my baby with me; I had to fight to breastfeed. I had been reading mommy blogs that were concerned with whether the food was hot, or if you could get a private room. I wasn’t prepared for this.”

So Allers began advocating for maternal rights, working in communities from Detroit to New Orleans to collect women’s stories and spur health care reform on a local level. After her second child became interested in computer science as a teenager, the two teamed up on what she calls a “mommy-son project.” They created Irth to empower mothers who needed something better than a whisper network.

Irth encourages members to consider early indicators of maternal health risks, such as providers being dismissive of patients’ pain levels, scolding or yelling, or failing to make eye contact. On the backend, analysts review the data, and if troubling patterns emerge, the team brings it to the attention of the offending providers. Irth is currently piloting a program with four hospitals to help them proactively use its crowdsourced reviews to improve care.

When New York City–based doula Jennifer Michel-Wilson does initial consultations with clients of color, she always suggests they download Irth.

“I tell them: Even if you don’t sign with me, this is a very valuable tool. I’ve been working in this field for 20 years, and I am constantly alarmed to see how Black and brown people are treated by their health care providers.”

Michel-Wilson points to health care workers’ disinclination to listen when a Black woman says she is in pain, and the disproportionate number of C-sections that are not medically necessary performed on women of color.

Lakeima Brown is a mother who downloaded Irth at Michel-Wilson’s suggestion. Brown had been planning to deliver at the hospital where she and her husband work, but after reading reviews in Irth she changed to a facility in Queens with private rooms, cheerful lighting, and higher Irth ratings.

One of the first things Brown did after delivering her baby: share her own story in the app. “The power of sharing your experience is it can help other people—be it one or a hundred.”

Allers says acknowledging the unique role of doulas—a profession she feels is often written off as a part of the white maternity complex—was crucial to her. “Studies are showing that when Black women have doulas, their birth outcomes are drastically improved.”

Because of this, doulas are recognized in the app with a special badge. “They see a lot—not just their clients,” Allers says. “Their Irth reviews for a hospital could represent a thousand experiences.”

“So many hospitals are doing anti-bias training, but it’s not always working,” says Allers. “There are hospitals that think they are doing great, but we have said, ‘Hey, 300 people in the past six months report that their pain levels were dismissed.’”

The app also aggregates infant or maternal deaths. Allers hopes these reports will spur politicians to take action, but reducing mortality rates of Black mothers and babies “is not the benchmark for us,” says Allers.

“I don’t believe death should be the trigger for analysis. A way to prevent deaths is to have an early warning detection system,” Allers adds. “We should have a good experience while bringing life into this world.”

Irth — Birth Without Bias

Moms of Color Rate Hospitals

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