For Dr. Lasé Ajayi, it’s personal. 

As a pediatrician and adult and pediatric palliative care physician, she’s born witness to the catastrophic effects of systemic racism on pregnant women of color. As an expectant mom, she’s experienced them firsthand. 

Fibroids made her first pregnancy intensely painful. She gritted through the pain for most of it, avoiding both a prescribed opioid and the hospital. Then one night, it got so bad that not even the prescription could provide relief, so she took an Uber to the emergency room. “I was well into my second trimester, so I was visibly pregnant and in a lot of pain. Nobody came out to help me, offered a wheelchair, or anything when I arrived. My Uber driver walked me to the emergency room,” she says. 

Once inside, the intake nurse brusquely questioned her, not about her pain but about where she got the opioid. It wasn’t until the staff found out that she was a physician within that hospital did attitudes change–though not entirely.  As she checked out, that same nurse who had been so accusatory during intake advised her against taking the combination opioid and Tylenol that the physician prescribed, saying “women like her” were more likely to get addicted and risk hurting the baby. 

Her own story and far too many others like it motivate Ajayi’s work as the principal investigator for PowerMom, a mobile app-based research project from Scripps Research Digital Trials Center. It seeks to build the largest, most diverse community of pregnant people in order to uncover patterns in healthy pregnancies and reduce the stark disparities in care that lead to Black women being three times more likely to die from pregnancy-related causes than white women. 

How is PowerMom working to reduce disparities?

We know that we have to work harder to reach communities of color because they don’t typically engage in research. So we cast a wider net and specifically target those marginalized populations through social media, by working with Black and Brown pregnancy influencers and by working with community organizations.  

How are you building trust with participants, especially those from communities that have reason to distrust research?

Having a mobile research platform helps. It is easier to access on your own time and eliminates the need to go to a clinic to answer questions. We also work with our participants on the questions to make sure they are relatable to pregnant people. We make sure they feel comfortable engaging with the platform. And not only do participants contribute data, but they also get to track their pregnancy. Typically, when you participate in research, you’re just giving information. You don’t know what happens to it or where it is going. Our participants get back insights to track their own pregnancy and then have the data to share with their healthcare provider. We also do different substudies, like the Connect study with Woebot Health, which focuses on postpartum depression (PPD), or the PowerMom FIRST study on systemic racism. Then, we use the app to disseminate that information back to the participants. 

How can women use this information in ensure they get the best care in the real world?

It gives the participants a tool to advocate for themselves. Having numbers and facts to share with doctors makes it less likely that a pregnant woman’s concerns will be dismissed. For example, say your blood pressure falls outside the recommended range, but you know, because you’re tracking, that it’s within normal for you, you can share that information with your physician. Conversely, if you see something abnormal for you, you have an objective tool that you can take to the emergency room and say, ‘I know this may seem normal, but for me, this is different. I worry that something’s wrong.’ We also have resources within the app that provide information about exercise during pregnancy, what to eat, how to care for your baby, breastfeeding and more.  

One study found that 44 percent of Black women report depressive symptoms two weeks after delivery, compared to 31 percent of white women. Do you think the statistics about the heightened risks women of color face during pregnancy increase the incidence of PPD?

Yes. We do a good job putting those numbers out there. But without also providing solutions to fix it, the numbers scare people. I had a mom during COVID–it took a lot of effort to have her come in. She was terrified of coming to the hospital to give birth because she knew that women who looked like her die in the hospital. It’s so consistent with my black patients.  Instead of hearing, ‘We recognize that this is hard, and here is help,’ the question we get is, ‘Is this something that you’re exaggerating about?’  We feel like we have to be the perfect patient to get the help we need, and it shouldn’t be that way.

As you work on PowerMom, what has surprised you most?

How similar we are in our differences. Every mom wants to know what’s going on with her body and her baby and if it’s normal for them. So there’s that sense of wanting to know that everything will be okay that transcends every demographic.

What is your big hope for PowerMom?

My big overall goal is that we get as many people as possible on the PowerMom platform, at least one hundred thousand, so we can use artificial intelligence to anticipate who may have a poor outcome and then treat it before it happens. That’s my big dream. 

What would you like to see changed in research or healthcare in general? 

I would like more pregnant women to be involved in creating the research and how it’s conducted–having that partnership with your participants is key. I also want health care reimbursement to be more patient-focused. I want it to be about the mom. A woman who’s had a C-section has to go back to the clinic within 48 hours for that first check-up. She should be able to get care at home and not have to pay for it.