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We are the Maternal Health Learning and Innovation Center, a network of maternal health equity experts and organizations working to make real change for women and birthing people in the U.S.
Our podcast is a series of episodes connecting around culture, lifting voices and stories, exploring innovations in maternal care and discussing ways we can center equity in the way we approach our health and wellness.
Learn more about us, explore our resource center and find support for all maternal health professionals at MaternalHealthLearning.org.
For more podcast information and content, visit MaternalHealthPodcast.org.
Kelli - 00:00:06:
Welcome to the Maternal Health Innovation Podcast Season 3. I'm your host, Kelli Sheppard, Communication Director at the Maternal Health Learning and Innovation Center. This podcast is created by the Maternal Health Learning and Innovation Center. Episodes are released weekly, so be sure you are subscribed. On this podcast, we listen to maternal health innovators about ways we can implement change to improve maternal health in the US. In this episode, we'll be discussing different applications created to help end Black maternal mortality and morbidity in the U.S. Through partnerships with doctors, doulas, and Insurance Companies, these companies are leveraging tech to bring transparency, accountability, and education to women and birthing people and their doctors so that the parent and the baby can receive the care they need. Let's talk with Anne Wanlund, a visionary force in the field of Maternal Mental Health. As the Co-Founder and CEO of Canopie, a digital company dedicated to revolutionizing perinatal care by integrating mental health support, she is making strides in transforming the landscape of maternal well-being. Thanks for joining me, Anne. Can you tell us about the inspiration behind founding Canopie and what led you to focus on Maternal Mental Health?
Anne - 00:01:42:
Yeah, so my background is in maternal and child health, but global health. So up until a few years ago, I was totally unaware of really a lot about our US healthcare system. I could tell you anything about Tanzania, Rwanda, a lot of countries in East Africa. I could not tell you how the US healthcare system worked. I moved back to the US when I was pregnant with my first son and there are a few things happened. One is I realized how much I didn't know about motherhood because I hadn't experienced it yet. Despite having worked on maternal and child health programs for so long and really, you know, that being something that I just felt so passionately about. But the other thing is that the hardest part of pregnancy and postpartum for me was really my mental health. And I had no idea, what kind of a toll it would take on me or my relationships. Until around one month postpartum, I went in for my son's well child visit, and I was screened for postpartum depression. Even though I was screened at that visit, I could not talk without crying. There was no follow-up and there was no support. And I just thought, oh my gosh, like it was a light bulb moment for me. This is clearly such a huge public health issue. This is clearly a huge problem and it's affecting me. And I know it's affecting so many other people. How have I just been screened for something about myself at my son's visit and there's no follow-up. There's nothing happened after that. My care was entirely in my own hands. And that's really the, that was the inspiration. It was just this total realization that there was a huge part of motherhood and maternal health and well-being that we were missing, clearly at a systemic level. But then there was also this awareness that, you know, after about six weeks, a mom is invisible to the healthcare system. We're just in charge of what happens to ourselves next in our care.
Kelli - 00:04:07:
That resonates with me so much. I had a similar experience. So that's really hitting home. I totally agree that there's a major gap there. Major gap. So, Canopie is described as a universal low cost solution for Maternal Mental Health. How does your platform make mental health support accessible to a broader range of individuals?
Anne - 00:04:32:
Yeah, so when we really looked into this problem, we realized that there was so much you could do early on in pregnancy that it just wasn't happening. If you were lucky enough to be screened and followed up with by someone, it was after you had been diagnosed or received a diagnosis and less than 20% of people are screened nationally for postpartum depression, let alone all the other perinatal mood and anxiety disorders that you can experience, including anxiety, perinatal anxiety. And so we felt like the biggest gap and the biggest need was really on the prevention and early intervention side, because a lot of people understand that maternal mental health conditions are treatable. But what people don't realize is that about half of them are preventable, like so many things in maternal health. We're focused on treatment, we're focused on intervention, we're focused on these complex things. But what we really need to be doing is a much better job during pregnancy, as early in pregnancy as possible to get people resources and support. The other thing is that, you know, we also realized that the mental health screenings that we do miss a lot of people, especially, you know, these scales have not been widely tested across every demographic group. And sometimes people are confused about how to answer questions, or sometimes they're worried about what might happen if they answer honestly, that they're not feeling that great about their experience right now, will my baby be taken away? So we knew also that we had to start looking at screenings more comprehensively. So we look at social determinants of health data. We look at risk factor data. We ask you how you're doing in many different ways. And that way we can create a much more inclusive mental health and wellbeing initial capture, data capture that allows us to support people the whole way through. Cause we know a lot more about what people are going through rather than just a score on a scale, one point in time. Our platform is really following people throughout pregnancy and postpartum.
Kelli - 00:06:58:
Speaking, because you just touched on part of the scale where people don't necessarily understand the questions or their concern that if they're totally honest about how they're feeling, that somehow puts their child's wellbeing out of their hands. So, and that is a big concern in the Black community is what I'm trying to say. So my next question, Canopie offers personalized self-help plans and expert led sessions. Could you elaborate please on how these components work together to address perinatal mental health challenges effectively?
Anne - 00:07:33:
Yeah, so we spend a lot of time thinking about the barriers, like what is keeping you from getting help? What is keeping anyone from getting help? And we can't do that for anyone unless we look at the people who have been left out or disenfranchised by our healthcare system and who don't have a lot of reason to trust that you put something in front of them and it's going to help them. And especially when it comes to mental health and wellbeing. And so the way we decided to approach this issue was, we try not to use any language that could be stigmatizing or could be used as like a diagnostic kind of like, we try not to even use depression or anxiety. We try to use words that describe how you might be feeling or maybe talking about relationships or bonding or sleep or baby development as a way to then introduce other concepts that can help without making people, you know, admit something or talk about something in a particular kind of way, or, you know, those are all shame and stigma are barriers for everyone, but they are barriers most for people who have no reason to trust that they are going to get help from whatever being provided to them. So that absolutely affects Black moms more, Latina moms more, moms of color. So we spend a lot of time thinking about the kind of cultural barriers or systemic racial barriers, like whatever they are to introducing and talking about these concepts. We also have stories that we've recorded from many different moms and parents from different backgrounds in English and Spanish. And we make sure that our teachers, providers, clinical psychologists, whoever they are, who are delivering the material have lived experience in one of the ways in which perinatal mental health is more complicated and more unique. So whether that's a Black mom who's a perinatal clinical psychologist, whether that's someone who's dealt with fertility issues, we're looking at how do we make our experience really, really, really inclusive and that you couldn't possibly go to one of our classes or experience something in our app that doesn't resonate, that feels like, oh, this isn't for me.
Kelli - 00:10:07:
Trust, I hear trust a lot. Is that's a major, that's a huge hurdle. It really is. And you kind of touched on this answering that previous question about basically how collaborative it is between a client and a provider. So how do you ensure that the connection is seamless between the Canopie users and their healthcare providers?
Anne - 00:10:33:
Trust and accountability, I think that's really the heart of Canopie because we do that as much as we can with the moms, the expecting and new moms that we serve through the way we approach the content classes, our support, how we respond. But then also on the provider and partner side, we are fully transparent in how the data that we're reporting, our performance data, engagement data, and our outcome data. We're tracking all of it and we're reporting back because we don't want to be doing this work if we're not effective and we're not actually serving patients. And members more effectively and we're not enabling better, more targeted care. And I think that what one of the things that I feel really proud of is a lot of times, you know, remote monitoring companies or, you know, companies that are doing digital health are really approaching it first from the physical health standpoint. But I think by gaining access to how a mom is doing by looking at her emotional health and well-being and the other factors in her life that might be affecting how she's doing, we're able to provide a much... deeper and more nuanced picture of someone's health, overall health. And that actually also allows us to show the provider what else might be going on with that person that they had no idea, like, oh gosh, I need to figure out some better way of supporting my mom in this way because I didn't know she was struggling with transportation or whatever it is.
Kelli - 00:12:10:
That's excellent. So technology plays a crucial role in the modern world, including healthcare. How has Canopie utilized technology to improve the overall perinatal care experience for expectant and new mothers and parents?
Anne - 00:12:30:
Yeah, well, I love to tell the story of Canopie’s first download, which was in the middle of the night, because when we are struggling, it was at 1am, when we are struggling, it's not when providers are awake. So we knew that the very first thing we had to do was figure out how to offer support asynchronously day or night. In short, tidbits, not long periods of time that you have to schedule. I mean, child care, logistics, transportation, scheduling costs, those are all huge barriers and every incremental layer on top of any of those things. We wanted to just break down as many barriers as we could first, so that any time of day or night, anywhere in the world, you could access support through our sessions, through stories, through the features that we have in the app, through any kind of thing that you could possibly do in the middle of the night. We wanted to make that possible. And then from there, we've been able to offer more other kinds of services that you might schedule, you might be able to plan for. But if you are in crisis, or if you feel like you need help right now, we never wanted there to be some barrier, whatever it is, to getting that help.
Kelli - 00:13:56:
And so that leads me to the sense of community on Canopie. So we noticed that Canopie focuses not only on individuals, but also on building supportive community structure. How does your platform foster these connections between users and other like-minded individuals? And why is community support vital in Maternal Mental Healthcare?
Anne - 00:14:21:
So community is one of those things where if it's done right, it can be so powerful and so helpful. And if it's not managed carefully, it can actually have really detrimental impacts on your mental health and wellbeing. And in particular for new moms, because we are some of the most self-critical and naturally judgmental people in the world, because that's how we evolved to be, that's how we are. We all feel so strongly and have these deeply held beliefs about what it means to be a mother and what it means to be a good mother, that it's impossible not to judge ourselves or others during this time. And so for us, the community was really about creating safety. It's about creating a sense of judgment-free questioning rather than advising. It's really about having a common framework for how to relate to someone else in a way that will keep them and you safe and feeling protected and not judged. And those are like really the core principles that we espouse in our community and really giving people a chance to connect. And I think moms might be either the first or second loneliest population in the US. We are really lonely. We feel alone. And I think it's because we also have heard and internalized from society these messages about you know. We can do it all alone or ourselves, or we don't need to, you know, we shouldn't ask for help all the time or any of the time, or we should be able to do it all. And it's just not true. It's just not how humans were evolved. I mean, that we're supposed to raise our kids in communities. So the more that we can create that sense of community and connection for people in a way that's fair, that is protective and safe and supportive, you know, that is addressing a really core problem in our society, which is we struggle to be open about where we're struggling.
Kelli - 00:16:42:
All of that just, it rings to me. It really does because something about our culture now, society now has instilled in women that we're supposed to be everything to everyone, and then somehow still take care of ourselves. I could tell so many stories about that. I love that Canopie has that judgment-free zone where we judge ourselves enough. So I'm really excited to hear that, you know, there's a platform where respect is appreciated, honored, and required. What's some of your favorite success stories or testimonials from your users that have benefited from Canopie? Feel free to share.
Anne - 00:17:31:
Oh gosh, there's one in particular. So we measure our outcomes in our program and we have really good outcomes. We have 80% of people who go through our program have a clinically significant improvement in their mood. But a few months ago, there was a mom, we were reaching out to a bunch of different Canopie moms for feedback. And she sent back a really long letter about how she had tried everything and nothing was helping her feel better. And she was at her lowest point and she started using Canopie. And she watched as she was feeling better and better and better each day. She actually felt her mental state improving and she brought Canopie back to her therapist and said, this is what worked for me. I think that a lot of times we assume that digital tools are only valuable for less severe situations or less acute situations. But that honestly hasn't been our experience at all. It's really we have to offer people a range of options and no judgment about what's going to work for you. I mean, it could be this, it could be that. We're pretty agnostic, but super proud of our program, our core kind of asynchronous program, because we've seen it work a lot. And by the way, everybody on the team cried a lot reading her letter. So we really, really love that.
Kelli - 00:19:06:
Right. People just really never know the impact that they have, you know, until someone shares, of course. So I'm really glad that that person took the time to let y'all know how impactful y'all were, how. she took you to her therapist to let her know, or the therapist, you know, them, know that, hey, this is working. That's awesome to me. How can a potential user get access to Canopie?
Anne - 00:19:37:
So a user can access Canopie by downloading it on the App Store or Google Play Store. We also have a web app. If you don't want to download anything, you can just go to our website and open it on your phone, on your browser. So no need to download. And for some partners and insurance companies, it's covered and there's kind of this full program.
But anybody can access our asynchronous program and virtual support. So I encourage anybody who is interested in kind of supporting their well-being during pregnancy or postpartum to check us out.
Kelli - 00:20:16:
Awesome. Thank you, Anne. I appreciate you.
Anne - 00:20:19:
Yeah, I appreciate you too, Kelli. Thank you.
Kelli - 00:20:22:
Thank you, Anne, for taking the time to join us today to share your experiences. And thank you all for listening. For more podcasts, videos, blogs, and maternal health content, visit the Maternal Health Learning and Innovation Center website at maternalhealthlearning.org. We want to hear from you. Tell us what you want to hear more of, review our podcast, and share with like-minded innovators. We have some great episodes recording now. Be sure you are subscribed. Let's keep talking. Tag us in your posts using #maternalhealthinnovation. I'm Kelli Sheppard and we'll see you again next week on the Maternal Health Innovation Podcast.
Disclaimer - 00:21:14:
This project is supported by the Health Resources and Service Administration, HRSA, of the U.S. Department of Health and Human Services, HHS, under grant number U7CMC33636, State Maternal Health Innovation Support and Implementation Program Cooperative Agreement. This information or content and conclusions are those of the author and should not be construed as the official position or policy nor should any endorsement be inferred by HRSA, HHS, or the US Government.