Sanaa Sharrieff, a mother based in one of North Carolina’s largest school districts, Guilford County, is certain that where her son was born limited his education.

Her son, Kendrick, an 8-year-old in third grade, was diagnosed with autism last year. But she says she’s had her suspicions about his condition since he was 2 or 3.

Confirmation took so long, she says, because her area doesn't have as much support for health care as other places. And the delayed diagnosis left her without access to resources that would have allowed her son to be pulled out of his classrooms for personalized instruction time.

It meant, pre-pandemic, driving up to his school to help educators deal with his behavioral and other issues, when the “the overstimulation in transitioning was just too much for him,” Sharrieff says. Without the framework provided by his diagnosis, the teachers and administrators just didn’t quite get it.

“It was not there. Literally, prior to everything closing for the pandemic, I would have to go to his classroom every single day and assist with his transitions from room to room or from activity to activity,” Sharrieff says.

Her son’s troubles have improved over the past year and a half. But, she says, it might have happened sooner if she’d had the resources she needed.

The education system has begun to think of itself as a pipeline, from pre-K through to the workforce. But there are those who think that it begins earlier—when a child is born. That’s the moment shaping a lot of health issues that are intimately linked to educational performance.

For example: There’s a disparate rate of preterm births particularly between Black and white communities, and preterm births are affiliated with increases in the likelihood of cognitive or behavioral challenges, says Iheoma Iruka, a research professor in the public policy department at the University of North Carolina at Chapel Hill, whose publications often cover early childhood education. And those challenges are associated with more educational trouble, she adds.

But, Iruka indicates, the challenges linked to preterm births are also less likely to get timely interventions in the very communities that suffer most from birth inequities. Interventions are linked to improvements in gains throughout a person’s life.

The result? Delayed interventions, forcing some students to try to play catch up during their whole education.

It’s a story that Sharrieff, who is a Black mother, sees mirrored in many of the other families around her. Yet she has noticed a difference in the stories she hears from white, wealthier mothers, who tell her their kids were diagnosed around age 3.

“And my eyes are popping out of my head. Like, I've been asking this since my son was 3. How? Why? What's the problem?” she says.

Sharrieff, like many other mothers, feels like she was left on her own to fend for her son.

“That's the space that I come from, just having to figure it out as a mom and do my due diligence and assert as best as I could without the tools and resources,” Sharrieff says.

That experience indicates why leaders of education technology companies and investment firms are starting to see opportunity in expanding their reach into children’s earliest moments of life. In some small ways, edtech may be beginning to catch up, especially through new investments into family-related support systems.

This all adds up to a growing movement, and business case, for “birth equity”—every baby and new parent getting what they need from the very start.

The Education Life Cycle
The problem is structural.

Currently, the U.S. ranks at the top of industrialized countries for women who die giving birth. During the pandemic, that number climbed, especially for marginalized communities. The U.S. Centers for Disease Control and Prevention reports that Black women, for example, make up a disproportionate number of pregnancy deaths. Worse, four in five of these maternal deaths—based on a review of those between 2017 and 2019—were preventable. And the problem may be getting more severe. A recent study has shown a rise in “maternal care deserts”—areas without access to adequate maternal care—even more strongly linking the location of birth to access to care.

Advocates for reproductive and birth justice, social-justice approaches to these problems, have helped to spotlight the role of health inequities in our society, says Crystal Tyler, the chief health officer for Rhia Ventures, which invests into birth equity-related companies. Tyler, a former epidemiologist for the U.S. Centers for Disease Control and Prevention, is among those who believe addressing inequity in birthing conditions is crucial for educational outcomes.

“People should have the right to have whatever pregnancy and birth experience they need,” Tyler says, such as access to quality providers and control over birthing conditions. Advocates argue that this will help to decouple institutional racial bias from life outcomes for children, such as their long-term physical health, economic status and educational success. “So absolutely, all this stuff is related,” she adds.

Edtech Is ‘Oddly’ Nearsighted
Traditionally, the education system has considered these issues separately.

Rather than looking at the education life cycle in its entirety, the edtech industry especially focuses on small segments, like early childhood, adolescence or workforce development, Tyler says. Companies don’t pay attention so much to the spaces that they aren’t dedicated to, she adds: “I've always found [that] fascinating, in an odd way.”

But there’s reason to think this myopia is clearing up when it comes to early education, pregnancy and new parenthood.

For a start, businesses have begun to think about the benefits they offer employees in the larger context, if only because of its connection to worker productivity. Women’s workforce participation rates, in particular, dipped due to the pandemic, as fewer women re-entered the workforce after the initial wave of COVID-19. This led to a reexamination of the spillover effects of issues like lack of access to child care.

The recent undoing of federal protections for abortion care also shone a light on the broader implications of birth-related care, Tyler suggests.

Possible Solutions
Some of these troubles lately have received more attention, agrees Isabelle Hau, executive director at Stanford Accelerator for Learning. But the more interesting question, she claims, is what to do about it.

There are solutions being pursued for maternal mortality specifically, such as the grantmaker Burke Foundation’s “partnerships for community and care in the first 1,000 days.” There’s also been a swell in funding going to “famtech”—a category related to edtech that includes digital tools designed to make family life easier. In education, that can mean a ride app that takes your kids to school, as the HopSkipDrive app does.

When EdSurge talked to Hau in the fall, she highlighted several other attempts to tackle problems related to birth equity. In particular, she pointed to nonprofits that have gotten money to scale. One of them, Healthy Steps, uses Medicaid funding to connect parents to care and support systems.

It's another way of reaching parents, Hau says: “Much more than the education system, one of the best-attended places by the parents is actually the pediatrician’s office.”

And then there’s the for-profit sector, where it’s still early days for thinking about these issues in this way. But there are companies like Mahmee, a platform focused on maternal and infant care. That startup announced in May that it raised $9.2 million in Series A funding. Early fundraising attracted investments from entrepreneur Mark Cuban and tennis star Serena Williams.

It’s an interesting business model, Hau says. Notably though, she adds, it’s tricky to figure out how to get sustainable funding in an equitable way (meaning that parents pay very little) for a business like that. A lot of healthcare in the U.S. goes through the employer. But that means you have to be employed, of course. Mahmee can go through the employer, but it doesn't always, as it works with Medicaid plans as well.

Meanwhile, for people interacting closely with families every day, the priority is working with what’s available now, and connecting other parents to existing resources.

Sharrieff, of Guilford County, works as a parent liaison with the nonprofit Ready for School, Ready for Life, where she connects families to support systems. She explains that her experiences as a parent whose son didn’t receive enough early care have helped to shape her advocacy.

For her, in the end, it’s about empowering families, she says: “I strongly believe that parents are the experts.”