Yasmine El Mouallem talks to many new mothers in her role as a breastfeeding counsellor, on everything from caring for a newborn to managing sleep deprivation, but she noticed one glaring absence: they rarely speak about their mental well-being.
Many of her clients are often so engrossed in discussing the baby or trying to live up to impossible standards of being a perfect mother, that they barely pause to reflect on their mental state, let alone acknowledge potential issues, Ms El Mouallem says.
The Covid-19 pandemic further compounded the challenges of becoming a new mother, making it more mentally and emotionally taxing. During labour, many women had to go without the support of their spouses, family members or doulas, while others were separated from their newborns and were not allowed to breastfeed if they were Covid positive, she says.
Ms El Mouallem, a mother and a certified mental health first aider, realised there was a gap in the local market for mental well-being services for mothers and the idea for female-focused health technology start-up Maternally was born.
Scheduled for launch in June 2022, the app, which was also co-founded by Ramzi Qannati and Vijaysarathi Kallam, aims to provide mental well-being services to women through access to professional therapists, evidence-based articles and a social support network of other mothers. It caters to women's mental health needs from the moment they decide to conceive until two years post-partum.
"Our main goal is to normalise seeking mental health support, highlight the importance of maternal mental health and make it accessible," she says.
"We are not only trying to solve the mother's problem as an individual — if she's facing a problem it trickles down to the child, family, surroundings and work environment."
Managing their mental health allows women to raise healthy, well-adjusted children, which reflects positively on the larger society, she says.
The pandemic cast a spotlight on mental health tech start-ups globally, as disruptions to daily life and work, coupled with lockdown measures, triggered and accentuated stress.
Global funding for mental health tech start-ups reached $5.5 billion in 2021, more than doubling from $2.3bn in 2020, a report by market intelligence firm CB Insights showed. The majority of deals — 68 per cent — were in early stage start-ups, indicating room for further growth in the sector.
Calls for improving maternal mental health care are rising as the problems women face before, during and after pregnancy often go unrecognised, undiagnosed and untreated, according to Maternal Mental Health Alliance, a UK-based charity.
More than one in 10 women develop a mental health issue during pregnancy or in the early years of having a baby, with Covid-19 increasing the risks that expectant mothers face, it said.
If untreated, these issues can have a “devastating impact” on the women affected and their families. Issues range from post-partum depression, to breastfeeding difficulties, miscarriages, failed IVF treatments and obstetric violence.
Maternally will offer three different subscription packages, with prices ranging between $99 and $299 per month, depending on the number of therapy sessions.
After an initial session to determine the mother’s mental health needs, she is matched with the most suitable therapist for online sessions. Access to articles and the support network with other mothers is free.
The start-up aims to remove the stigma around mothers asking for help when they face mental health issues.
Healthcare systems usually focus on the physical aspects during and after the pregnancy, while social taboos discourage some women from seeking help for their mental health issues. Some women don't want to acknowledge an issue and others don't realise there is anything amiss, according to Ms El Mouallem.
"Many mothers don’t want to be seen going to a therapist, some are told it's not OK for someone in the family to see a therapist and I also heard a lot of religious or cultural reasons," she says.
"Many mothers don’t feel accepted sharing this feeling they have, even if it's a problem that can be solved easily."
Online access to professional help should encourage more women to overcome the stigma.
"When a mother feels like she doesn’t have to explain to anyone why or who she's talking to about her problems, this should encourage mothers to seek help ... It's positive thing for their treatment."
Ms El Mouallem understood the magnitude of the mental health challenges that mothers face during her breast-feeding consultation sessions. An overwhelmed new mother once revealed how her baby's constant crying made her feel she wanted to leave her child and spouse. Another mother who returned to work to do the job she loved talked about the guilt and sadness of leaving the baby at home.
Women who went through IVF treatments and others who had several miscarriages also faced challenging conditions.
"If someone has a physical disease, then it has to be taken care of. But if someone has a mental health issue, because we often can't see it or don't understand it, they have to deal with it on their own," she says.
The pandemic further highlighted pressures on new mothers.
"Being a first-time mother and maybe having Covid, if there was no family allowed in the room for support during labour, then the baby was taken away from her after delivery. I can't imagine what they've been through," Ms El Mouallem says. "Then after recovery they're expected to go home and deal with everything."
On top of this, society often has unrealistic expectations of how quickly and easily a mother should recover and take up her new role as a parent.
"She has all these hormones rushing through her, she undergoes labour, then she is expected to look normal, happy, healthy and be able to take care of the child without telling anyone, 'I am tired' or 'I can't do this'," Ms El Mouallem says.
"When she tries to discuss this with the family, she is told to ask God for forgiveness, that God has given her a gift and she's complaining about her situation and that she shouldn't complain."
Other triggers to seek help are the nature of the expatriate life in the UAE, where couples are often thousands of kilometres away from home and the support of their families.
"If they are missing a community support system, definitely mothers need this mental health support. They forget to take a break, to breathe," she says.
"When a mother tries to be a 'supermum' and take care of the baby 100 per cent but also exercise, jog, take the baby out in the stroller, do the chores — it's too much to do in the same time and she definitely needs support.
"She's trying to be a supermum, but it's not supposed to be like this. You're supposed to take care of yourself, to settle down, to go back to yourself or get to know this new person you’ve become."
Maternally will also include partners and extended family in the social networking sessions for discussions on how best to support mothers, Ms El Mouallem says.
The self-funded start-up, which was founded in Bahrain last year, will re-locate to the UAE after winning Dh100,000 in funding from the Sharjah Business Women Council in February.
The funds will be used to develop the app, hire staff and boost marketing.
The start-up plans to break even within 18 months of launching and sign up 2,000 subscribers by the end of 2023.
Co-founders: Yasmine El Mouallem, Ramzi Qannati, Vijaysarathi Kallam
Date started: October 2021
Based: UAE and Bahrain
Sector: FemTech, mental health and well-being
Size: Three co-founders
Investment stage: Boot-strapped/self-funded with Dh100,000 grant from Sharjah Business Women Council
Q&A with Maternally's co-founder Yasmine El Mouallem
1. What new skills have you learnt while launching your start-up?
An important skill was pitching and storytelling. I realised the importance of sharing our story to convey the message and also understand our audience to resonate and engage with them more effectively.
2. How has the pandemic affected your business plans?
During the pandemic, I joined a few colleagues in the field of maternal care and we started a support group where I offered free online breastfeeding counselling and emotional support sessions. The pandemic revealed how high the demand for mental health care is, which not only validated our assumptions on the underlying problem, but also helped tweak some features based on the research we conducted with mothers and practitioners.
3. How important are mental well-being services during the pandemic?
Very important. The pandemic presented two alarming challenges. The first is the large number of people who had a mental health disorder during this time. The second challenge was how maternal mental health often went undetected, and therefore untreated, which was the first reason we started this journey. We strongly believe that it takes more than one company, media outlet, government or even nation to address a challenge of this magnitude. Only by having complete synchronicity from all stakeholders will we be able to move the needle.
On the brighter side, the pandemic also accelerated the digital transformation of the healthcare sector and today teletherapy is widely available and used. I believe that technology will continue enabling a wider part of society to have access to care that suits their specific needs offering flexibility, affordability — in some cases — and availability in their language.
4. What are the credentials of the psychotherapists on the platform and how are they verified?
We will look into partnering with healthcare providers that are certified and/or licensed in the jurisdiction.
5. How does your experience as a mother influence Maternally?
I know that it is expected from a mother to take care of her newborn and prioritise the baby’s needs over anything else. We, at Maternally, want her to know that she is also important, she matters and her mental health is a priority.
6. How is your product different from the plethora of resources available online/offline for mothers?
When we look at the competitive landscape, we identified three different categories in the ecosystem covering mental health care, self-care, social support, and therapy and counselling. Maternally will cover this entire scope as a mother-dedicated app.