800 Lives a Day: How AI Is Rewriting Maternal Health

Episode Overview
In this episode of Financial Forward, Jim McCarthy sits down with Dave Esra, founder of Bobi Health AI, to explore how artificial intelligence and real-time data can transform maternal health outcomes.
Drawing from his experience in vaccine safety studies and large-scale AI deployments, Dave identified a critical gap: despite widespread access to smartphones and wearable technology, maternal health remains underserved, under-researched, and dangerously reactive.
Bobi Health AI aims to change that by creating a comprehensive platform that monitors biometrics, tracks symptoms, and uses AI to identify risks early—providing guidance, education, and access to care when it matters most.
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Key Topics Covered
1. The Origin of Bobi Health AI
•Dave’s transition from military service and corporate leadership to healthcare innovation 
•Exposure to maternal health gaps during COVID vaccine safety studies 
•Recognition of systemic inequities in women’s health data and care 
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2. The Scale of the Problem
•~800 women die daily from preventable pregnancy complications 
•~94% of these deaths are considered avoidable 
•Significant disparities across underserved and minority communities 
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3. The Core Problem: Lack of Real-Time Insight
•Care is episodic—centered around periodic doctor visits 
•Most risk emerges between appointments 
•Patients often face uncertainty during critical moments 
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4. The Bobi Platform (What It Does)
•Collects daily biometrics, symptoms, and medical history 
•Provides AI-driven insights and alerts 
•Educates users on whether symptoms are normal or require care 
•Evolves into an all-in-one maternal health platform 
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5. AI-Powered “Digital Doula”
•24/7 conversational interface for guidance 
•Does not diagnose—but identifies risk patterns 
•Uses inputs like: 
oSymptoms 
oBiometrics 
oBehavioral and emotional signals 
•Helps determine when to seek care 
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6. Mental Health as a Critical Risk Layer
•1 in 5 women experience mental health issues during pregnancy 
•~75% do not receive care 
•Mental health is a leading factor in maternal morbidity and mortality 
Innovation Focus:
•AI detecting emotional state via interaction patterns 
•Triggering early interventions 
•Connecting patients to care pathways 
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7. Addressing Social Determinants of Health
•Transportation 
•Access to providers 
•Language barriers 
•Childcare 
•Economic constraints 
Bobi’s Approach:
•Identifies barriers in real time 
•Connects users to local resources 
•Enables action (appointments, referrals, navigation) 
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8. Global Impact Potential
•Deployment across: 
oUnited States 
oIndia 
oPhilippines 
oCanada 
oCosta Rica 
oPanama 
•Use cases in regions with limited healthcare access: 
oEarly warning systems 
oRemote triage 
oReduced time-to-intervention 
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9. Maternal Health and Systemic Risk
•35% of U.S. counties lack maternal healthcare access 
•Provider shortages in both obstetrics and mental health 
•Financial and operational strain on healthcare systems 
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10. Military and Workforce Implications
•Military families face significantly higher materna

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Transcript

SPEAKER_02 0:00

Hey Dave, good to see you. Nice to see you. Welcome to LA.

SPEAKER_01 0:04

Thank you, sir.

SPEAKER_02 0:05

So uh why don't you tell the audience a little bit about who you are and your life and kind of how you got to where you're at today.

SPEAKER_01 0:15

Oh wow, okay. Where should I start?

SPEAKER_02 0:17

You can start wherever you think is appropriate.

SPEAKER_01 0:20

Yeah, uh my journey is uh I think different uh as a uh founder of a women's health company. Uh so uh uh and uh project manager to have targeted uh industry, finance, uh compliance, um oil and gas energy, uh some different things, and started doing some consulting, more organizational development stuff. Sure. Uh that was kind of my superpower was building organizations, creating building teams, processes, you know, okay. Governance. Okay. Um and I was recruited to help stand up a company that uh would do the drug safety studies for several of the COVID vaccines during the pandemic on pregnancies. Okay, so that makes sense. Right. Yeah, so that led me into well, that helped me really identify the opportunity to do much more for women's health. So um what I saw was vast inequity for for health uh for women and particularly for maternal health. So from a care perspective? Just from a science perspective, from a data perspective, we just don't have uh great in I mean, go to uh talk to any woman who's either has a high-risk pregnancy or is uh going through menopause, and which you know, you know, my my my family, we've experienced these changes and these, you know, these life experiences together uh with Sarah, and a lot of doctors just don't don't know. Right. Right? And so with with the the the COVID vaccines, you're you you cannot uh do uh you know pre-market studies on these drugs for pregnancy. For pregnancy. You really don't know, right, how it's gonna affect the woman or the the the baby.

SPEAKER_02 2:46

Right, too high of a risk criteria.

SPEAKER_01 2:48

Well, yeah, it's unethical, you can't you know it's experiment. So what they do is after uh after they're distributing, they get a cohort of exposed pregnant women and get them to uh participate in a study, and basically they fill out a survey every few weeks on how they're doing.

SPEAKER_02 3:08

Okay. So a really underserved, I hate to call it a market, part of humanity, a very underserved, both from a care perspective, ability to access care, quality care, as well as the study of it. There really isn't a lot of data available to really help us understand.

SPEAKER_01 3:32

Absolutely. And and and women in general, and then you look at underprivileged, underserved communities, uh, you know, black and brown communities, that you know, that the health uh the inequities, the social inequities are are pretty vast. And so um while I was you know working with this company, I I uh at the same time was I had a big project or program rather, several projects at an oil and gas company where we were deploying predictive AI models across their value chain. Okay, very cool project. We made a billion dollars in nine months. Oh my god. Right, so I um really wanted to learn more about AI. Sure. So I signed up for a postgrad at MIT uh for artificial intelligence and uh do the course, had a capstone project to solve a problem with AI. Okay and because of what I learned at this other company, I uh decided to solve for maternal mortality. Oh it's uh 800 women die every day from avoidable complications in pregnancy. Almost totally avoidable. It's 94% of those deaths are avoidable a day. A day. Hundreds of thousands women. And we really do think that it's undercounted.

SPEAKER_02 5:06

That's a huge number.

SPEAKER_01 5:07

It's and it's avoidable, right?

SPEAKER_02 5:09

And in its individuality, it's so traumatic. Let alone in its numbers.

SPEAKER_01 5:16

It's all I mean I have it's nearly every day I have a deeply personal conversation with a woman who's been pregnancy and experienced uh undiagnosed preoclampsia, where you know, or or you know, gosh, miscarriage. I mean, it's everything, it's it's so it's it's wild that we're not doing more. Right. When we have the technology now to solve for this. So that's that's what drives me crazy is everybody has a phone in their pocket, a smartphone, right, a little computer in their pocket, right? Is able to collect vast data sets and even if they have a wearable, right? Now I'm getting into collecting biometrics. Now I'm monitoring real time her health. Right. And so that's what I wanted to do, uh, even with these drug safety studies, is why are we not monitoring these the health of these women real time?

SPEAKER_02 6:24

So you set out to solve that problem. That's right. And you wrote your your thesis or your project at MIT on that subject. Yep. So now you've started to build a company.

SPEAKER_01 6:42

So this is how the story went. I took the design for for Bobby, Baby on Board Intelligence.

SPEAKER_02 6:50

Baby on board intelligence.

SPEAKER_01 6:51

Back then I I was calling it Bob. I took the design for Bob. Marketing team hated the name Bob. Yeah. And I went to the CEO of the company that I was helping doing the studies, said, hey, I you know, I think we should build this out. And he said, I'm not interested. I'll be darned. And it made me think of a story that I heard, and I'm I'm not sure how accurate this is, but what I heard was you you may have uh you may have heard of this guy. His name's Jeff Bezos.

SPEAKER_02 7:26

Yeah. Yeah, of course.

SPEAKER_01 7:28

So the story I heard was he was a consultant for a bookstore. He was helping out a bookstore. And went to the CEO of this bookstore and said, Hey, you know, big, you know, brick and mortar bookstore. Right. I think I think you should sell books online. And CEO said, I'm not interested. I'll be darned. So we know how that worked out. Right. Right. I mean that that's I I thought that I would be a coward if I didn't try to do something. And you know, I had you know, from going to the serving in the military where you know, mission driven, I I'm able to see impact of what I'm gonna do. I had a great career doing a lot of humanitarian aid work, um, you know, leading soldiers. I mean, it was incredible to corporate America where I just failed to connect with a true a true impactful mission. Right. Uh you know, these companies they have you know values, stated values and they state but it it was I I didn't I didn't really see people really driven to you know solve the problem. I mean so I saw an opportunity, you know, even with uh the other prejudice read the studies company to do something that's impactful, something that's meaningful, and I felt called like a call in to do it. So that's kind of what led to starting Bobby.

SPEAKER_02 9:17

Yeah, and you can tell in how you talk about it and how much time and energy you invest in it that it's coming from a good place, right? It's being driven in a good way. So talk to me about um talk to me about what what it is that the technology does. Give me a little bit of a use case or um maybe it's not completely built out yet, but tell me in in case in steady state, what does this do?

SPEAKER_01 9:49

Well, we we we our MVP uh was an app that collects the biometrics uh daily, regularly throughout the pregnancy, uh symptoms, uh medical history, all the things that would enable us to identify early risks during pregnancy.

SPEAKER_02 10:13

Okay.

SPEAKER_01 10:14

And uh provide her, you know, notifications, information, little education on you know how to solve for how to get help, right?

SPEAKER_02 10:24

Like or whether you do need to get help.

SPEAKER_01 10:26

Do I need to yeah, do I need to go in or is this normal in pregnancy? Sure.

SPEAKER_02 10:30

I have to imagine it's scary for a lot of women, especially first-time.

SPEAKER_01 10:34

First time pregnancies, high-risk pregnancies. I mean, you know, the the thing is, is like uncertainty happens between visits, right? It's not every few weeks that you don't, you know, but it's 2 a.m. and I don't feel right. What do I do? Right. Do I go to the ER? And like for me and Sarah, she had a high-risk pregnancy with Cooper. This is your wife. Right. Okay. Do you do we, you know, we both work full time, you know? We're both, we were both serving in the military, and you know, uh, do we go in? Do we you know what do we and and it's just having something that gets so that's the MVP, right? And that's what we deployed in 2024.

SPEAKER_02 11:24

Okay.

SPEAKER_01 11:25

Uh, and and started our beta testing. So we got a couple thousand downloads, okay. And we thought, wow, that's we're doing hot, you know, this is amazing. Uh got feedback, and our feedback was basically we like it, but I now I have like all these different apps that I have to use, right? We have Boby, and then we have one that shows me how big the fetus is, it's the size of a of a you know, a plum or a you know, whatever fruit of the thing. And or you know, education and kick counter and blah blah blah blah blah, right?

SPEAKER_02 12:04

So multiple apps, confusing.

SPEAKER_01 12:06

So they said, can you just create an all-in-one, you know, comprehensive application? And so that's what we've been working on. Um, adding in um some gamification, an education portal, uh so a whole platform. Even a shop, we added like a, because you know, to increase stickiness, we uh the the example that what gave me the idea was uh my son was pregnant. My son's w spouse was pregnant.

SPEAKER_02 12:39

Okay.

SPEAKER_01 12:40

And they she felt like she had a healthy pregnancy and she would not she would not engage with the app as often as I wanted her to. Oh, okay. And when I asked her, like, what's going on, you know, I'm healthy, doctor says I'm fine.

unknown 12:56

All over the world.

SPEAKER_01 12:58

Uh but they would drive an hour to the town or uh, you know, the town down the road to do classes to get free stuff from that, you know, that pregnancy care center. Pregnancy care center, okay. And so we created a boby shop where we put products and you know uh you know, what so they could get points, do the you know, do their daily logins, do some education, they get points, and they can use those points in the shop. So all this to increase stickiness, engagement, right? We want her, and one of the most exciting features that we built was uh we created like a digital doula-like chat bot.

SPEAKER_02 13:43

Okay.

SPEAKER_01 13:44

So she can uh anytime, 2 a.m. I don't feel right, you know, hey Boby, this is how I feel, what's going on, and it's trained to give uh it doesn't diagnose, but it can give really great information about those symptoms. Okay. Uh these symptoms can mean you know, pre-eclampsia, or it can mean uh, you know, infection, whatever it is, and tell her that you need to go in, or hey, this is normal. Here's some tips.

SPEAKER_02 14:17

Sure. Yeah, and just being able to if if you can tie into the the sensors that they have available to them in their phones. So the heart rate sensor, if they're wearing a watch, their pulse sensor. That's right, their their uh their activity levels, you know, whether they're moving around, did they drop their activity level? All of that data you could take into consideration, put that up against the profile of a pregnant woman, and be able to determine or maybe even um uh predict uh you know, a condition.

SPEAKER_01 14:55

So that's what I'm really excited about with this uh or chat, we call it Bobi Connect, um patent pending now. Um is the ability to look at her uh medical history, her biometrics. Uh she can even be she'll even be able to log the biometrics by just telling it like, hey, I don't can you log my blood pressure? It's one 120 over 80. And it'll log for, or hey, I ate a uh ham and cheese sandwich, you know, and logging all that, food diary, everything. So you can just do it with your home. How are you feeling? I'm I know I'm I'm feeling a little depressed, maybe anxious, whatever. We're logging those things and able to collect those patterns. Two things I'm super excited about. One, mental health during pregnancy. And that's that's why I'm here at this uh this conference.

SPEAKER_02 15:46

Okay.

SPEAKER_01 15:46

It's a a brain mapping, it's all neuroscientists. It's a neuroscience conference. Uh and I presented this idea of let's let's use this app to collect all these biomes, like all these real world signals, and through with the bot, be able to, even through tone of voice and facial recognition, collect emotional state, mental health risks throughout the pregnancy. And but we can even flag if if there's a uh risk and and trigger intervention. And can we train the bot to help guide her? So it's one in five pregnant women suffer from mental health issues. Is that right? One in five. Three quarters, three quarters of those don't get care. Oh my gosh. Right? This is a leading cause of maternal mortality and morbidity. And and also affects the the the baby, right? I mean you're you're it's your mental state. There are uh it affects you know the family, you know, the the workplace, like every there's many effects of this. So can we trigger an intervention, help guide her to get care, or even if we're connected to that care network, if there's a flag, we pick up the phone and we call. Right? And with the chatbot, it can even say, if she says, I don't have a ride, this is the second thing I'm really excited about. Social determinants. Oh, you don't have a ride? There's a service in your neighborhood that will give you a free ride to the clinic. Let me make that appointment for you. Wow. Right? Agentic AI. Sure. Right now we can do real action. It's incredible.

SPEAKER_02 17:57

Yeah.

SPEAKER_01 17:58

Um so social determinants, transportation, language ish, language barriers, uh technology, childcare, violence. Sure. We can flag those risks and provide even local resources to help close those gaps.

SPEAKER_02 18:20

Close those gaps. That's fantastic. And I think about, you know, we're sitting in downtown LA, um, and um there are a lot of people that live down here, and then there are a lot of people that live outside of here, right? And whether you're there and it's difficult to get to a clinic, or you just don't have the resources, you don't have insurance, you just don't see a clinic during your pregnancy, or whether you're out in the country and it's physically difficult to get to the doctor, um, or and this is where I really want to expand on, if you're in a different country where those services are not available, maybe a pre-industrial country like um you know, some countries in Africa, or and what this could do for them during the pregnancy period. Talk to me a little bit about that.

SPEAKER_01 19:09

I was testing the the Chabot out, and I I you know by my test account. I'm I'm a pregnant mom, right? I said, hey, I'm I'm bleeding, and it takes me through, well, how much and you know what's going on. And it says you need to go in and get seen. It since that I was in San Antonio, that's where I live, and it said, uh, you know, it said you need to see your provider. I said, I I don't have a provider. And the the bot says, Here are clinics near you that will see you today, right? Gave me gave me a list of clinics. And I said, actually I'm in Uganda right now. And it gave me a phone number and a website for a clinic in Uganda that I could go get see. I'll be darned. Yep. I'll be darn. So yeah, it we we are in, we're currently uh in production in India, the Philippines, Canada, Costa Rica, and Panama as well as the US. Okay. And and mainly right now it's just it's it's for testing the app. We can test it out very uh inexpensively, lower uh customer acquisition cost. Right. Um but we're really excited about being able to move the needle in Uganda, you know, in Nigeria, in these countries where morbidity and mortality are you know, and there just are no services available to the average. Oh my god. Little or no access to maternal health care, right? Or women's 35%. 35%, yeah. So, you know, you could be two hours from care, you know, if you're in rural Texas, it could get you take you a couple hours to get to a private or in Uganda, it could be 10 hours. And it might it might not be like get in a car, it's a dirt trail that you have to get on a motorcycle. Oh man. Yeah. So we're talking to doctors in Uganda who want to use Boby Health as an early warning system, right? Because it the the mom can't really come in, they have to send out a basically a paramedic on a m on a motorbike out to the woman.

SPEAKER_02 21:32

Yeah. And so this app would help them determine this these risks earlier.

SPEAKER_01 21:39

That's it. I mean, it's all about early identification and intervention. Yeah. I mean that that time gap, the longer the gap, the more severe it's going to become.

SPEAKER_02 21:51

Sure. Yeah. So you're here in LA for a conference, and uh it's kind of a cool conference. Talk to us a little bit about the organization that held the conference. conference and uh what you spoke about and what was the reaction that you got.

SPEAKER_01 22:04

Okay, yeah, it's uh the Society for uh Brain Health Mapping. Okay. Something like that.

SPEAKER_02 22:11

They're all brain surgeons.

SPEAKER_01 22:13

Neuroscientists. Yeah yeah um we were invited by the director of women's health research with the VA a Stanford professor um because of you know our how innovative we're you know we are in trying to address these things right um so what I presented is the the idea to use the app to help with the this problem. The this the three quarters of women that don't make it to a follow-up appointment from diagnoses of mental health issues. Okay. Right? So there's a basically a 30-day window from postpartum mental health screening to follow up that we're saying that we would like to own the accountability for that. Okay. So oftentimes some clinics have integrated care where you know she comes in they give the PhD 9 the uh the mental health screening a risk is flagged they just take her across the hall to the social worker right okay not every clinic has those services.

SPEAKER_02 23:27

Okay.

SPEAKER_01 23:28

So I've talked to obstetrics directors and administrators who say if a if a risk if a risk is flagged right their only recourse is to give them a phone number or send them to the emergency department. I'll be darned only those two. That's it because of uh the the lack of capacity to care they don't have the mental health care and the services 35 percent 35 percent of counties that don't have maternal health care maternal health care 75 percent of 75 percent so most women who are are flagged and and think postpartum right like now I've got the baby so you know the social determinants again transportation childcare um you know it i how am I gonna food sleep I mean all the things right um and there is a a a lack of mental health providers in America just like there's a lack of obstetrics doctors in America um we have to I guess get creative yeah so that's what we're saying is is is we can not replace like this is AI not not AI is a replacing the provider or replacing the human what we want to do is make it more efficient and help the providers prioritize and know like when and you know they lose money too like if there's an appointment and they don't show right they lose money so can we get her in can we get can we use telehealth like what what are the options here sure so I was here as a call to action to a bunch of researchers who do research into women's health to you know potentially partner with us to or it doesn't have to be us do something. Do something yeah let's solve for this because I mean you know I spoke uh specifically to the military medicine community okay and and so I heard a lot about menopause um and and granted that's we need to do more research there for sure you know and I heard you know some other things but to me and I I'm a dude and I you know I was a soldier I don't know anything that would affect my readiness more than a maternal health care issue right being you know either mental health during or or post pregnancy or you know issues with a baby right I can I mean right especially if you're downrange right you're you're you know in combat right I mean I need to be I need to be you know focused on the mission right and it's imp I mean it's impossible.

SPEAKER_02 26:51

Right. And so to pick up on this I mean you're you're talking immediate impact. You're talking in the case of the military readiness you know effectiveness you know so by being able to track and monitor that that soldier that's just had a baby and be able to predict that she's going into a postpartum depression situation get getting health care.

SPEAKER_01 27:14

That's right I mean that's that's doing the right thing for in in that case the soldiers right keeping them mentally um and the unit readiness too right and is she is she getting back to the to the to work to the unit to the team healthy right in a in in a timely way right or is that extended is you know you know or you know if it's the family member that it it's still going to affect affect yeah that soldier too so um another crazy statistic for you yeah military families are three times more likely to suffer from severe maternal morbidity really yep and why is that do you have has anyone figured that out we need to do research on that we need to figure that out I mean anecdotally I could I I I could educated guesses right um focus on the mission right I don't want to be seen as weak you know I want to like show up you know even even if something doesn't feel right okay uh I'm gonna suck it up and I'm gonna like the team it's about the team right I don't want to focus it's not about me um it is you know she's away from her uh you know her family her you know there's there's not that uh community or safety net system you know she's not affects the mental part she's a uh separated from that yep uh I mean I oh yeah and maybe even uh maybe I don't know what access to healthcare is or or services are depending on where you're at in the world and what your situation is. Yep. I one of the nurses on our team was uh Air Force a high-risk obstetrics nurse and she she would travel all over uh Europe and Africa uh visiting the embassies for the pregnant women because like you know the care in those are in those countries aren't always up to our standards so cool there's an odd yeah yeah I had a I had an uh interesting situation I married a woman that had a brain tumor when I met her and um two weeks before college started and um that tumor um slowly it wasn't the tumor it was the radiation they used to treat the tumor which killed additional brain tissue um slowly took away her speech and her ability to use her right side but she wanted to have children and um so when we had our son Matt I remember she was we took the classes and everything like you're talking about during and she was very conscious of her pregnancy she probably would get an A plus plus in terms of how she dealt with everything her diet and exercise everything and um I went to these classes with her and learned about the pregnancy and the giving the birth and all that all that stuff and then she was really determined to breastfeed at that time it was that was a big thing and she was hell bent on breastfeeding um we got the baby home and we were at home alone and the baby started crying which babies cry but we went into like day two and a half or three and this baby was Matt my oldest son just wouldn't quit crying and I remember I would try different things to get him to sleep or to quit crying and uh um eventually the hospital called to do a follow-up check and we said yeah he's just crying all the time you know and the hospital came and did a visit well Matt wasn't getting any milk from mom he was starving and I can tell you I'm not an idiot and neither was mom but during those two days or whatever that was it was probably a day and a half to two days of just you know no sleep and constantly crying and crying and crying there's a lot of thoughts that go through your brain like what's going on what's happening now you might say in retrospect why don't you just go to the hospital or why don't you do this or why it it was all those questions stacked up to get I didn't know the answer.

SPEAKER_02 32:10

She didn't know the answer we didn't know the answer. So what a wonderful thing to be able to have access to an app that says what is normal what you know hey been crying for a long time you know might want to check whether he's getting something to eat. So we moved to formula right after that and then that obviously took care of the problem but I think about that mind frame when you're a young parent we were very young and uh you've got a new baby at home and um a whole new it's just you don't know what to do. You know and and we all like to think because we know family and friends that have had babies and they're healthy and they go to school now and they're growing up and all that but we forget that so many of them die. Like so many children die before they're born or shortly after they're born or the suffering of the mother from every day from the mental uh and physical strains on giving birth. Yeah yeah it's just an amazing topic and you're an amazing man for looking into it and uh and and and really working to solve closing this gap. It's uh it's crazy to me that we're not just doing everything like hair on fire that solve it right yeah we're talking about babies you know you know it's and it's in the thousands that don't make it every day right that and it's avoidable it is avoidable right yeah and you have that passion behind you and I think you'll work you'll work toward it so listen Dave thank you very much appreciated the conversation I'm glad you came to LA I know it was a it was a pleasure man I'm glad we got to meet up