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There is visible labor and there is invisible labor. Victor Hugo
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BIRTH™ Framework

The BIRTH™ framework is a shift in emphasis from a single solution view of the MCH ecosystem to a multifaceted systems approach. It is a move from individualism to dynamic coordination - and the evolution of Square Roots™ into a new kind of organization that discovers, partners, and aligns into one complete system comprised of multiple, complementary factors and components. Developed in coordination with leading labs, hospitals, cities, and community health providers, the BIRTH™ framework codifies best practices for a healthy pregnancy and shares that information with all stakeholders and includes:

  • Birth Plan: The Square Roots™ research team is designing a Birth Plan App. The App framework will offer a decision tree to assist mothers in creating their plan and demonstrating how each decision can impact future options and outcomes. The framework will provide real time education to empower the mother in making the best decisions for herself.
  • Information: Research is the cornerstone of everything Square Roots™ does. Our Advisory Board consists of MDs and PhDs from top universities and medical centers, as well as partnerships with leading scientific organizations like NASA, who are all committed to providing the most up-to-date and world renowned research on best practices. Square Roots™ is committed to providing women with access to the best evidence-based data to make informed decisions.
  • Rating: Ratings help identify & differentiate between communities, organizations, and cities that are taking proactive steps to improve maternal health outcomes. The BIRTH 40™ initiative is our rating system to connect these entities from across the country and around the globe to share best practices, innovative solutions, and current evidenced-based research to improve maternal and infant health outcomes.
  • Technology: Square Roots™ is launching a platform of technology solutions to improve the pregnancy experience for expectant mothers around the world. The platform, which Square Roots™ is calling the BIRTH™ Mark, will create a coordinated environment between maternal care providers and mothers, share evidence-based information with the public, and create a virtual community of mothers while focusing on lowering the cost of care and simplifies implementation of shared decision-making.
  • Human Centered: Square Roots™ is working with cities to create Communities of Care with the human touch to provide the “last mile” of connectivity and sharing the experiences of mothers about what the journey of giving birth means to them. Square Roots™ commits to focusing on how to reclaim birth as a natural part of the human experience, and share the stories and wisdom of mothers who have experienced the journey with other mothers.

BIRTH 40™: The Coalition of Cities Improving Birth in the United States

A comprehensive solution requires connecting what is currently a very fragmented maternal health ecosystem and shifting the narrative of the conversation. Over the next four years, the Square Roots™ BIRTH 40™ Initiative will connect 40 member cities and states in order to streamline the sharing and dissemination of best practices, innovative solutions, and current evidence-based research regarding how to improve maternal and infant health outcomes. The primary goal of BIRTH 40™ is to improve pregnancy outcomes within member cities and states and to empower local governments to take ownership over the health of expectant mothers and their newborn babies within their communities.

This initiative explores new territory within the maternal health ecosystem, as current standards are focused at the institutional and clinical level without placing importance on action at the municipal or state levels. Square Roots™ has already identified 11 U.S. cities and states focused on improving maternal and infant health outcomes after introducing a resolution on maternal health at the 2015 U.S. Conference of Mayors. Now Square Roots™ is targeting other key cities nationally that are on the cutting edge of maternal health as leaders to emulate.

The BIRTH 40™ initiative provides community needs assessments and quantitative measures on the state of maternal and infant health in each member city and state. After the community needs assessments are conducted within each member city, local conferences will be held within those communities to share findings with the community. Square Roots™ is utilizing its BIRTH Framework to give the inaugural 40 cities and states access to better maternal and infant health care systems and resources. We will customize the BIRTH Framework approach within each community based off the findings of their needs assessment. This system will provide member cities and states a technology platform and products to disseminate the most up-to-date information on pregnancy, labor, and delivery from the leading labs, hospitals, cities, and community health providers to community stakeholders and over a million pregnant women within the first year. The BIRTH 40™ coalition will also host summits during the four-year commitment to further collaborate between BIRTH 40™ members to share challenges as well as best practices.

By connecting cities and states with exemplary maternal and infant health outcomes to other cities in need of improvement in particular areas of maternal and infant health, BIRTH 40™ will streamline the ability to converse about common goals and to share and scale solutions to improve pregnancy outcomes. BIRTH 40™ is a continued shift to-wards cities and states as the natural coordinating and implementation points of greatest leverage for change. The programs is hoping to make moms-to-be more informed about the resources and options available to them through-out their pregnancy experience, and empower each of them to take action to do what is needed to give their child a healthy start to life. Furthermore, by taking a community-based approach, we hope that this program will spark a dialogue and create opportunities to share best practices and information with other expecting mothers and families in the community to improve outcomes and shift the culture of giving birth from a clinical episode to a celebration.


In 2016 Square Roots™ in collaboration with Clinton Health Matters launched a pilot program to better the health of mothers and infants in Natchez, Mississippi.

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Ashley, 21 weeks pregnant, participant of Healthy Moms, Healthy Babies program Natchez, MS

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Roneka, 7 months pregnant, participant of Healthy Moms, Healthy Babies program Natchez, MS

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Northa, 4 months pregnant, participant of Healthy Moms, Healthy Babies program Natchez, MS

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Jasmine, 13 weeks pregnant (with her boyfriend Don Rick), participant of Healthy Moms, Healthy Babies program Natchez MS

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Jakayla, 24 weeks pregnant, participant Healthy Moms, Healthy Babies program Natchez, MS

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Mayor Larry Brown, Natchez, MS

The dynamics supporting pregnant women are not working. Maternal Health in the United States is not improving at the rate it should. We at Square Roots™ believe that it is because of the very fragmented medical ecosystem. Maternal health must be reorganized and reoriented around city level resources and populations. In 2015, Square Roots™ laid the foundation for this reconceptualization of maternal health when we pioneered the 2015 U.S. Conference of Mayors to make it the first conference where a resolution centered on maternal health was passed, encouraging cities to prioritize maternal and infant care. Mayor Larry Brown of Natchez, Mississippi supported this resolution, and Square Roots™ funded a pilot program in Natchez to improve the health of mothers and infants through an innovative city services program.

While doulas are often thought to exist outside of a medical framework, they are clearly associated in lowering preterm and cesarean birth rates. Understanding the importance of education and wellness and responding to the needs of the community, Square Roots™ initiated a doula-services program focusing specifically on improving pregnancy and birth outcomes among women at risk of maternal obesity and subsequent maternal conditions in order to improve the quality of life of mother and child. This initial pilot program will be expanded to include other city networks with poor maternal health outcomes that could benefit from improved coordination.

Pregnancy Education & Empowerment Center—Project Goals:
  • A program that is culturally relevant and responds to the needs of the city and its residents
  • Disseminate actionable information to city resident and connect the community with specialists in the field of maternal health both in person and virtually through information portals
  • Provide increased access to healthy foods and healthy, trimester-targeted recipes created specifically for the community
  • Further foster positive health impacts within the communities through sustainable stakeholder partnerships
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