The Jennifer Kamara Podcast

Senan: We jumped in the car and, uh, through my head all of the statistics that you were citing earlier, Jen, like one in five pregnancies ending in a miscarriage.

That's what was running through my head. and we're very fortunate. We live five minutes away from Mayo Clinic where she works. So, uh, and, and again, she's an OBGYN herself. So we have an immense amount of privilege in terms of our access to care and our medical knowledge. And still, despite all of that, this was like the most anxious experience of our life,

Jennifer: Hey, JKP crew. What a great conversation with Xan. He started the company Delfina to bridge the data gap that we have in maternal healthcare and tells me all about what the current state of affairs in maternal healthcare is like.

gives us actionable tips for what are the three things that all pregnant women and families should be taking care of to promote health of mom and baby, as well as what are the three things we should all be asking? Our ob, G Y N. He gives really actionable insights for black women and Native American women who have the worst maternal health outcomes with respect to really owning their.

And I also really get to know who Xon is. He tells me about what it was like growing up in an immigrant family. We talk about his son, his wife. It's a really wonderful episode. And Joy,

Jennifer: Hi.

Senan: Hi Jennifer. How are you?

Jennifer: I'm doing great. It's great to meet you,

Senan: So great to meet you too.

Jennifer: Thanks for coming on. I love the work from home. We work from home as well, so

Senan: It's the best, especially when you have a six month old that makes it all the more fun between Zoom calls. Catch a little extra snuggle here and there.

Jennifer: Oh my goodness. That must be amazing. I can't wait to get into the all of that, but wanted to start out with asking you whether you brought something of comfort that makes you comfortable,

Senan: I did, I did indeed. It is my very Gen Z Stanley that my wife got me for to promote hydration and health. Um, it goes really well on TikTok, I'm told. But yeah, it just, uh, reminds me of the importance of staying healthy so I can be the best partner, dad, ceo. Um, and it makes me think of her when she's on a 16 hour shift as she is today.

Jennifer: I love that you get that memoir of her. And these bottles are becoming so popular these days. I feel like every day I see like three people holding these mega bottles that encourage them to drink more.

Senan: mm-hmm.

Jennifer: so we're all getting healthier and more hydrated.

Senan: all about the 40 ounce. That's the real deal.

Jennifer: beautiful. So is she on shift right now?

Senan: She is. She is. She's currently taking care of other pregnant moms who are delivering as we speak.

Jennifer: Wonderful. Well, we are very, very grateful for her and very topical of what we're gonna discuss, so excited to get into it. Wanted to start off Sinan with getting a sense of how you grew up and how that entailed an interest in medicine and how that evolved for you.

Senan: Yeah, absolutely. So thank you so much for the opportunity to share my story here, Jennifer, and I've, I've listened to your podcast and I'm, I'm just really grateful for this opportunity to share my story as a human being. Uh, get invited on a lot of podcasts to talk about medicine and technology and the mission of Delphina, but really excited to share with you kind of where it all started.

So my family, we were like yourselves. Um, and a lot of folks that you've had on the PO the podcast were also an immigrant family. I was born in California, but my dad was born in Pakistan and my mom was born in Syria. There were typical, hardworking immigrant folks who came here for a better life. And my mom in particular, uh, is a huge inspiration to me as she was one of the first women to leave Syria at age 18 to go off to college and not just any college, but she actually went to m I t and was one of the few women in her class back in the early eighties, uh, studying electrical engineering and computer.

So that was really our family, uh, you know, anchoring experience was that, um, you know, we, my parents after meeting at, in college and moving out to Silicon Valley, uh, to make their own way in the world, that was really our, uh, our anchoring experience as a family. And, you know, my, my parents really prized education.

They really prioritized it for us and for that, I'll always be so grateful to them.

Jennifer: Yeah, I so resonate. My parents as well, really, they always told me, folks can take anything away from you, but they can't take away your education and knowledge and learning. And I would say really instilled this love of learning in me. So, sounds like you grew up in the California. area,

Senan: Mm-hmm. ? Yep. San Jose, California. Born and raised. Age zero to 18

Jennifer: And what was that like? And just even having immigrant parents for you, how did that, like if you were to think of what experiences were incredibly formative to Sinan today as an adult, what were they?

Senan: Yeah. So when I think about that and reflect on it, you know, again, I'm really grateful that I grew up where I did, because it was the nineties in Silicon Valley. It was part of, this was actually the, when I was around fifth grade was the.com bubble boom and bust. And so a lot of that was kind of happening around us and just being exposed to it, having amazing public libraries and you know, the tech museum, we spent a lot of time, me and my two brothers.

So I was grateful to be in a place where I was exposed to science and technology and particularly, you know, as I mentioned in my family, it was really prized. And my mom, you know, spent a lot of time doing baking soda volcanoes with us as little kids, building a frog habitat and just doing things that.

Jennifer: those are the best.

Senan: Yeah, and like when I was deep in my PhD trying to figure out how to predict seizures for epilepsy, those anchoring experiences with the scientific method. They really came into like, they, they're so foundational, they're so ingrained in my psyche, thanks to her. So, you know, that was, I'd say a very positive aspect of growing up in a place in California, um, which also was very international.

A lot of immigrant, other immigrant families from the Middle East and elsewhere. . Now that said, we were, you know, after nine 11, we were Muslim kids growing up in a post nine 11 world and with mixed, you know, cultural heritage ourselves. So we didn't always feel like we belonged, you know, certainly not with a lot of folks in here in the US And then even when we met our extended family from Syria or elsewhere, we just, as much as we love them and we feel connected to them by blood, culturally, we didn't always feel like we belonged.

Um, me and my two brothers, and I'd say that's persisted to this day, right? We've always been misfits with others to an extent, but it's also a beautiful thing because it brought the three of us so much closer together. I mean, if you look alone at the people who have both Syrian and Pakistani heritage, I think it's like I've heard of one other family on earth.

a mutual friend of mine, shout out to Joe Kim, if you ever listen to this podcast. You know, he, he told me he met someone else and that guy is completely unrelated. But other than that family, we're the only one. And I think. You know, my brothers and I now are just so close. We, we have multiple startups together.

We've lived on each other's couches in almost every permutation for a year. Um, and I just feel this close bond with them. Like we really understand each other for the last 30 some odd years. We feel each other more deeply and intuit each other in terms of how we're doing, how we're thinking about something in a way that, uh, I'm really grateful for.

Jennifer: Yeah. I had a big goofy smile on my face as you were describing that, because I, so I 1000% resonate. I'm half Ukrainian, half Sierra Leonian, they're like probably five other people like me and my brother out there in the world, and like this feeling of, I'm not at home in Sierra Leone, I'm not at home in Ukraine, I'm not at home in the us.

I don't fit in anywhere. But at the same time, I can fit in everywhere because I'm so used to understanding the norms and kind of becoming part of my community. It's like this third culture kid for life, uh, and such a strength and very grateful for the perspective, but it's, it is one a very unique perspective.

Indeed. Did.

Senan: A hundred percent. Same feeling of all three places. Having something that feels both very like at home, like feeling like you belong, but also then trying to talk to someone else even if, whether or not you speak some of the language. Just you being constantly reminded that you are still a stranger in that place.

So, you know, I think now, yeah, sorry. Go ahead.

Jennifer: No, I was gonna say, and not even taking it personally, it's like, yeah, I'm used to this. I'm, I'm a stranger pretty much everywhere. But at the same time, you kind of get these aspects where you can fit in. I wanna ask you where, where do you feel at home

Senan: Now I feel at, at home with my family, right? With my wife and, and my son, wherever that is. Uh, I truly feel at home. And I also do feel, you know, anytime my mom is here, like when my mom briefly visited us, uh, a couple months ago, there is just a sense that home is about people more than place. And the people who have made a home, right?

Like our family, and then our new fla, our new family that we've just formed, and our, our friends who were family in Boston and elsewhere where I lived for 13 years, that feeling of like being with someone and that ha that's happened for me everywhere, right? I've made friends who now live in China and they were here in the US for college, and we've become lifelong friends and I feel when I'm with them in a way, I'm home, even if it's in Ching, China, where I've never been.

But when I'm with this person and his partner and his kid, , it truly feels home. And I had the same feeling. I had the same feeling when I lived in Peru for a year where, you know, I was in a country where I didn't even initially speak the language. Even once I spoke the language, I was truly a stranger to Andy and culture.

And I was grateful to be welcomed in to live with a friend in his home for about a month. And you know, on day one, it certainly felt strange, but on the last day, because of the closeness of my bond with him, it truly did feel like home.

Jennifer: Yeah. That's such a beautiful thing. The other thing you mentioned that I wanted to just ask briefly about, because I know it's important, is your experience. You mentioned you were a Muslim family living in the Bay Post nine 11. This was a tough period. I was close with someone before who also Pakistani heritage, and it was tough for him growing up in California, post nine 11, for instance, has Minaj has talked about it just for you personally, what impact did that have?

Senan: Yeah, I mean, Hassan Minaj is a lot funnier than me, so I won't try to make my stories funny. But, uh,

Jennifer: come on.

Senan: But he's, my, my wife will stop listening to the podcast right now if I start telling my dad jokes. But he, but Hassan Minaj has actually really given voice. I mean, he is a few years older than me, and he grew up in Davis, but, you know, a, a lot of what he talks about is common, I think, to any Muslim kid growing up anywhere in America, in the, you know, kind of early two thousands phase.

Um, and I was, I was 11 when, uh, nine 11 happened, and you. , remember feeling like in initially having the same reaction as any other American kid at this tragedy that befall our country. I was born in the US but then quickly having, you know, I'd never really been much of a target of bullying or anything like that previously.

And then myself and my brothers suddenly becoming the other with a capital O, right. And I think that would happen from time to time in school on the bus. And you know, again, I think thankfully we're from a close-knit, we have, we had each other to rely on as brothers, so it never deeply affected us. And you know, again, we were grateful to live in a place where there was never any imminent physical danger.

I remember there was a lot of violent crime actually against Sikh folks, uh, right around that time. So thankfully, you know, we were never physically harmed by any of this. it came from multiple sides, right? Like there was both a sort of popular reaction. And then at one point the F B I and Department of Homeland Security actually knocked on our door at our house.

They were doing a sweep of all Muslim families in this area. and they said, Hey, like, what are you guys up to? And we were like, we are a American family having dinner and going to work and going to school. And that was just a really anchoring moment for me that, you know, I've been the other, and, and to some extent to this day, uh, as any Muslim person in America, um, you know, thankfully I think things have progressed, but it still feels at times like truly I am still somewhat of another.

And then, you know, when certain things happen, right? Like I'm not a woman or a person with a uterus myself, but when something like the repeal of roe happened earlier, this, you know, earlier in 2022, I do feel it to some extent viscerally having had some experience as an other. So in a way I am grateful for those challenging and, and negative and, and experiences that frankly, kids especially shouldn't really have.

And. A better experience for my own son, but at the end of the day, I'm, I'm grateful I went through them because it gives me some level of empathy, uh, for folks who are now being otherized, whether women or l lgbtq Q folks or Asian American folks, particularly in the aftermath of covid. So, you know, what I hope to do in my career is as I go through and, you know, hopefully make an impact in this specific space, I hope to always reach out a hand and be an ally to anyone who, in any way feels that they are the other.

Jennifer: Amen. Same. I feel like it is such a horrible thing to ostracize other human beings for what one or two people within a group has done. They're good and bad people everywhere, and it's really unfair. So love, love, love that approach. Okay, Siena, moving forward, how did you get an interest in medicine pursuing med school?

Senan: Yeah. So that was the other interesting thing about growing up in the bay early on, um, you know, it was, there were already people that were having, you know, immigrant rags to richest stories. There were a lot of folks who became billionaires right around that time. But at the same time, when we drive around San Jose and San Francisco, we would see so many on domiciled folks who were living under bridges intense.

And that's a striking thing, uh, for, you know, a young kid to see. And I remember seeing in particular one gentleman who had a go. enlargement of the thyroid plan, which is pretty visually striking for those who've worked in, in public health or, or, uh, global health have seen it before. And I'd seen it previously in folks in, in Syria and you know, the, which is a much lower income nation.

So it was just striking to me that one, you know, medicine is truly something fundamental and universal that this particular condition just, which is so visually striking, affects people around the world. So if I became someone who could heal, I could do that anywhere. Two, it's something direct, right? It's something that I realized pretty quickly could enable these people to live a better life, right?

Health is so pivotal to whether they're trying to get educated or they're trying to excel in their career, or they're trying to support their family. The folks that I started getting to know as I got older and older and started volunteering at Kaiser Hospital in Santa Clara, I got to learn how deeply foundational health is to everyone's life.

So I love that by being a doctor, I would be able to potentially make a direct impact on somebody. And finally, I love that kind of sense of non-linearity, that like if you give someone better health for a month or a year or 20 years, all the good that they may be able to do, who knows, right? There's this sense of possibility that someone who may have been written off by society or by family, or even by themselves, when you know something becomes treatable or even curable, it changes the game.

And just as an example of that, my own mother is actually a breast cancer survivor, and she got breast cancer when I was about eight years old. And it was a very challenging ordeal for our whole family that I never even fully realized or appreciated until I was much older. In fact, when I was in med school, I called up my mom and was like, mommy, you never told me the story.

Like, I'd love to hear your patient experience. And you know, she's such a strong woman and she, she made it through it and thankfully she survived it. But at that time, right, this was in the late nineties, so chemotherapy was very different than how it is today. In terms of both probability of success and the off-target effects.

So for her, it was a very challenging experience in terms of all of the side effects she was trying to wrestle with while having young kids and a career. Um, and at the end of the day, what I realized is that if we could one, cure her, which thankfully they did, but two, also alleviate some of that pain of the treatment.

Um, you know, who knows what else we could do right? In terms of making her more effective and productive as a mom, having more time to spend with her children rather than puking into the garden, right? Um, that, that image always stuck with me as like, it's not just about curing and extending someone's life, but also about enabling them to do the things that they're passionate about.

Whether that's building chip design systems or spending time having lunch with.

Jennifer: Absolutely. I grew up in Sierra Leone, seventh poorest country in the world, poorest place in the world to be a mom. My dad was a physician and we had a war and um, he basically was treating folks for free because he was one of 50 doctors. And so from a young age, I also was really struck by the impact of healthcare.

I basically grew up feeling like if you have health, you can do anything. Lots of folks had goiter in Sierra Leone as well, just because it's so low income. And I feel like again, just it should be something that's universally available to each of us.

Senan: It's, it's really shocking, right? When we go to places where, you know, it's iodine in most cases, right? Like it's something that should be so cheap and freely available, um, but it's

not right. And the diet, right? And it's just such a challenging thing to know, right? If you go to wealthy places, if you're in New York or San Francisco and you see how much money is floating around, even for technology related solutions like us, , you know, and prior to Delfina, I started a tech nonprofit called Hickma Health and did a lot of, uh, global health work, which, by the way, I took a class with Paul Farmer at Harvard, which was just pivotal and really transformed my career.

And I actually took it with Jenny Sha Spradling, who you had on this podcast a few months ago. So,

um, it's such a small world. Yeah. And Jenny has done some,

Jennifer: shocked. Yeah.

Senan: I was just gonna say Jenny has, Jenny has done phenomenal work at Free will. Uh, but yeah, please,

Jennifer: Jenny is phenomenal. Wonderful. I am so grateful to have her in my orbit. And I was gonna say, I was so shocked with Paul's death last, last year. It was, it took us all by surprise. And then the other thing that sounds like we have in common, so I considered an MD PhD and while I was considering, I had worked in cancer research and so your, your story about your mom made me think of this because I was specifically optimizing Chemotherapeutics to be more target specific, to minimize side effects because of stuff that you just described.

So, totally makes sense. And your mom sounds like such a strong influence, such a strong woman and a powerhouse in your life.

Senan: I'm really grateful for her. And she also had three boys, which, uh, I'm grateful for her putting up with. Yeah. She had to come home from all that to us having glued each other's hands together while building a at home swimming pool. So she's, she's been through a lot with us. Um, but, you know, and I, and I appreciate you sharing that about your background, and I think there's so many ways to make impact.

I really, you know, I think I anchored on medicine pretty early. Uh, but it really was my experiences in Peru where it was cemented, where I saw, you know, families that had been affected by war there. The Peruvian Civil War in the nineties as my own family was later affected by the Syrian Civil War. And, you know, you mentioned Sierra Leone and Ukraine, and be res in not recognizing what, you know, the people of Ukraine are going through right now, and the people of Sierra Leone have gone through.

So, you know, it's just how much, how much need there is around the world. And while, you know, Delfina right now are starting in the US market, it's always in top of mind, right? How we can build a solution that is globally scalable and use the power of technology. So that one day in the Andes, right in the mountains of Baca, Lebanon, where I worked with Hickma Health, right?

And all of these places around the world will one day be able to solve the maternal health crisis the way we are today in the.

Jennifer: Yeah. And perfect segue, let's talk about the maternal health crisis, but let's back up a little bit to get a lay of the land. So one in five people can miss Gary. One in five pregnancies end up in Miss Gary.

That can happen to any one of us. Then give me a sense for what the state of affairs is currently

Senan: so you're right, it can happen to anyone, Jen, but it doesn't happen to everyone. And it happens to black and native women at much higher proportions. And I think to me, that was always the most striking facet of this maternal health crisis. Where in the United States overall, you're right, the state is dismal, and our numbers nationally are, uh, you know, worse than most other high income nations on earth.

But when we dig into the crisis and we understand where is it really happening, if we do a root cause analysis, it's really, you know, if you look at black patients, for them, the risk is about three x for complications from stillbirth to preeclampsia, which is a severe hypertensive complication requiring hospitalization to permanent brain damage for the baby from fetal hypoxic. And if you think about it, you know, there was actually an article in the New York Times, just on Sunday, a feature on this, uh, highly, highly encourage any of your readers to check it out in the associated study from N B E R, where it, the most striking figure to me was that for a wealthy black mother, there is no protective factor based on her income and the access that presumably that comes with.

Uh, and you know, so for today, let's say if you're a, uh, white mother and your income roughly triples, you know, your risk would just dropped by a factor of two. For a black mother, if your income triples, there's no change. Your risk, it's still much higher. It's still three times higher than a white mother with the same income.

Jennifer: let me ask a question there cuz I was doing, I was reading about how this is largely because physicians don't listen or believe black women. Is that anything to add to that? Any other reasons? Contributing factors?

Senan: Yeah, that's a, that's a well established root cause. That is, that is a shame of us as the medical system. And I remember Serena Williams shared her story very eloquently where she had previously had, and she shared this very publicly, she'd previously had a deep famed thrombosis that resulted in a pulmonary embolus or pe and that is a life-threatening complication in the hospital and often of pregnancy.

And you know, she kind of knew that that was happening. She had her spidey sense as a patient was telling you, Hey, you know, care team, doctor, nurse, I need help. I believe I might be having another one of these in my, uh, you know, pregnancy, postpartum experience. and they didn't listen. They said, yeah, okay, you need some pain medication, just relax, you'll be fine.

And sure enough, she had a life-threatening PE going on that they did not catch until later. And you know, if that can have some happen to someone of her prominence and stature and uh, and resources, we can only imagine what's happening to black women in, you know, Medicaid plans in Texas. And we've been observing these practices and some of the clinicians are, you know, what they're doing is heroic, right?

They're running practices at a loss or barely on mar any margin because Medicaid is not reimbursing enough and they're seeing, you know, dozens of patients a day. But then we have to ask ourselves, given the implicit bias and systemic racism of that, we've all been educated in, right? Like when I went to med school, all of the dermatology pictures were still of white patients.

So this is just unfortunately, an ingrained part of our medical system. Are we setting ourselves up for success? And at Delphina in particular, we ask ourselves a question, can we use technology? and the power of data to improve these outcomes for black women. So our specific view of the maternal health crisis and the inequities that we see is that, yes, a lot of it is because of physician bias, and that will take education and that will take, you know, proactive approaches from a systems perspective to include diverse providers and mitigate that bias.

But it'll also take as we build new technologies, Ensuring that these technologies serve these patients. And for us as a data science company, what it means is ensuring our data sets are all representative. We can't possibly train a predictive model on a population that's entirely white or majority white and expected to randomly perform for a predominantly BA black population in Alabama.

So what we're doing is making sure that as we build technology, it works both from a machine learning standpoint, from a user research standpoint for both the providers and the patients. And I see that as, you know, thinking with a solutions hat on a place where we can move the needle relatively quickly while we implement a lot of the systematic changes and the educational changes that will be needed.

So our providers actually behave differently the next time there's a black woman in front of them who's pregnant and saying, I believe I'm having a pe. They actually listen.

Jennifer: what can black women themselves do to influence their physicians' habits, behaviors more? Not that this, the burden should be on women in general, but knowing this statistic, knowing that change is likely going to be slow and at different paces in different parts of the country. What should black women know?

What can we do?

Senan: Yeah, so a couple of things and, uh, I'm speaking from the vantage point. As a physician scientist, I have never had that experience and I, uh, I can only empathize with the folks who are, are going through that, um, through a pregnancy where they don't feel supported to or listen to. And it's on us as providers and as builders of technology to make sure that we support them in overcoming that.

So having worked with pregnant patients, what I would say, First of all, you know, the, the most important aspect is to, is, is, is mindset, right? If you understand that you do have agency over your own pregnancy, and we, especially as like the next generation of physicians, do want you to feel comfortable and empowered and really in the driver's seat, right?

Whereas, you know, maybe 50 years ago, that is something that has tangibly changed. 50 years ago, the paternal model of medicine was very strong in obstetrics. It was a predominantly male dominated specialty, which is no longer the case, and it was typically the doctor being prescriptive about what needs to happen and then saying, well, it's up to you to do that.

Now we're really coming at it from the other angle, and we want patients to feel empowered to say, okay, this is what works for me and I need my visits to work on this schedule. I need to work with this doula. I need her to be involved in my care. I need to have my delivery planned in this way, whether it's high risk or low risk, right?

It's a partnership between you and whoever will be delivering with you and you know, she needs to meet you where you are. . So if you're saying, I want to deliver at home, we're gonna figure out a way to make that happen. And if you're so high risk that we really believe it would be in your best interest to be in the hospital in order to have an open discussion about that.

If you come to the provider with, this is what's important to me about my pregnancy, this is what I'm looking for from it experientially and in terms of outcomes, you'll find most providers are not just ready and willing, but excited to work with you, uh, in that way. The other two things that I would say is while we're a telehealth company, a technology company, there's no replacement for the amazing relationships that we've seen between the OB providers, so ob gyn physicians and nurse midwives and their patients.

I see it all the time with my wife when we're about town and you know, there's folks that she's delivered without her violating hipaa, these patients swarm her and say, oh my God, my baby so-and-so is doing great. And that is such a beautiful relationship that can be truly therapeutic and in order to maximize the potential of that relationship.

you know, go to all of your prenatal and postpartum appointments. I know in the prenatal side, a lot of patients sometimes have challenges just getting to the appointment because of work, et cetera. Um, but on the postpartum side, a lot of patients don't even necessarily intuit how important that can be for both their and their baby's health.

Right? Doing the postpartum depression screening, talking about postpartum recovery and diet, those are things that, you know, 90% of the time don't even happen. That visit just doesn't even happen. So if I was talking to a black woman right now who was going through her labor delivery, I would say, let's make sure we get your next visit on the calendar, and what can I do to support to make sure that we get to see you in six weeks?

And the last thing, sorry, just one more thing. The last thing I'd say is there is a lot of, a lot that can be done proactively, right? So we typically hear about these emergency situations and really bad, scary things that can happen in pregnancy, but I would just encourage patients to think. Proactively about keeping their health the way they would if they weren't pregnant, right?

So things like diet, exercise, sleep, the studies are just happening now in pregnancy to show just how important those are and how therapeutic they can be. And so if you have positive atomic habits around those that you know you've already built your life around, there's no reason those need to stop in pregnancy.

And if you work with your care team on making sure we continue and support that, that'll have very real positive implications for the outcomes of your pregnancy.

Jennifer: These were great tips. Thank you. Coming back to specifically women who don't feel heard or listened to by their phys, by their ob gyn i, I get the sense that it's also about, from what you were describing also about picking an ob gyn, a provider that you feel comfortable with, and not everyone has the luxury of being able to go and check various ob GYNs.

It depends on coverage. Obviously, lower income folks are more strapped with time and needing to work and all of this, but to the extent possible to pick someone who you feel comfortable with, who you feel listens and is open to you, sounds like that's also of something to try and, and work toward.

Senan: 100%. And I'd actually just love to give a quick shout out to Ashley Wisdom from Health I Hue, which is a great, uh, digital health platform company specifically focused on. Black women patients and improving their ability to choose providers who will deliver care in a culturally competent way. And you know, unfortunately I would say we, we've seen the effects in pregnancy and otherwise where if a black woman has a black physician, we do see better outcomes, meaningfully better outcomes for mom and baby.

Um, in a way that's not the case, uh, for if, if it was a white or other physician. So, you know, that's the reality that we have today. So empowering these patients with choice to be able to say, okay, this is the kind of pa the, this is the kind of relationship I want with my clinician and this is the kind of clinician that I'd like to work with and this is how I'd like to be heard.

I think that starts from day one, and I think it's a relatively privileged vantage point that I have out here in, in Minnesota where most of my wife's patients are. and most of 'em have a very positive experience, have a very strong therapeutic relationship with her and the other OB providers. Um, and for black patients, you know, we do have Somali patients here.

We do have a lot of patients that maybe are marginalized in many ways from being black women to not speaking the native language. And what we're trying to do at Delphina is make sure that when we build this technology, we don't further marginalize them, but instead make it easier to build that bridge and widen the group of providers that they would be excited to connect with and feel supported by.

Jennifer: I have one more question here. I'm so curious. So the data is, uh, black women are the most marginalized relative to all other races. Do we understand why or what's up with that?

Senan: Yeah, so a couple of different factors. And also I would add native women actually in, depending on the state. So overall, yes, nationally in the US black women are the most marginalized and their health outcomes are the worst in terms of pregnancy. However, in certain states, native women are actually, you know, that risk multiply I was sharing, which is roughly three x nationally for black women, it's up to six x for, in the state of Minnesota, for example, for native women.

And so that's shocking. And Dr. Cozza Manel has done great work on this. Um, happy to share some of her work. Uh, so for example, you know, she's done a root cause analysis for y. Patients who live in particular on Native American reservations are, you know, not achieving the same level of health outcomes as Native American folks who live in urban centers.

So a big part of it does seem to be access and these other correlates of race, which in our society, right? In terms of how far do you live from a prenatal care specific clinic with an ob gyn physician, and how far do you live from a delivering hospital, that number is much higher for black women and even higher for native women.

So these correlates of race, like race itself, of course being a social construct, it's the degree to which it correlates with things like. , you know, what is the environmental milieu that you're in in terms of pollution, in terms of, or do you live in a nutritional desert? Do you have access to the kind of nutrition to follow the appropriate healthy diet for pregnancy?

And then the socioeconomic factors, can you afford to make it to your prenatal visits? Do you have, you know, the ability to get off work or childcare, et cetera. And then of course we have, you know, all of the systemic bias that you were talking about, Jen, that's, that's a key part of it, where even if we get them to care, how much are they experiencing, you know, a less a provider paying less attention to them, or not listening or hearing them as much, or having a different prescribing behavior based on their race.

So I think it's getting them into care and then once they're in care, actually listening to them. And then the last piece, which is in between care episodes, do they have the support that they need to be able to have a healthy pregnancy course? And all three of those, I believe, are playing a substantial role in driving the disparities that we see. Okay.

Jennifer: And we will remind black women and native women and minority women in general to remember that you have power and agency over your pregnancy. This isn't a hugely power gap dynamic with your physician and ask for what you need and evaluate whether or not you're being heard. And I know that's, that can be tough to do in actuality, but we can, we can encourage more of that.

Senan: Yes, a hundred percent. I just wanna recognize, again, it's very easy for me to say, and when I ever go talk to my doctor, it's like, here's a dude, MD, PhD. He's gonna say some stuff and then we're gonna probably agree on most things. So if I'm, were not a man and not an MD PhD, if I were a Somali woman immigrant, having my fifth child and trying to talk to a doctor who's just trying to tell me all about family planning.

Right? And I'm here and I have a different perspective and different objectives for this pregnancy or for my family, right? We need to meet these patients where they are. And that's, that's on us as providers. But in the meantime, while we're in this healthcare system, we do want to empower all of our patients to take that step and to say, these are my goals.

Write them down, bring them in. This is my delivery plan. This is what I want to achieve in my therapeutic relationship with you. And I would say to patients, you know, doctors mostly, most of us got into this business for, you know, the reasons that we discussed, like trying to help folks around the world we're all inspired by folks like the late great Dr.

Paul Farmer. So I think you'll find most physicians, when we set up a new micro structure within this very messed up macro structure, you'll find that your strong therapeutic relationship with them will, will go miles in terms of improving the health outcomes as well as your experience.

Jennifer: Yeah. All right. Sinan, tell me about your experience and your wife's experience through labor, which inspired you to start Del.

Senan: Yeah. Thank you for the opportunity to share this story. And I do have to say, as someone who doesn't naturally always share stories like this, I wanna recognize, I appreciate my wife for really encouraging me to, to share our story because she and I talk about it all the time. We always reflect on it, and it motivates me every single day now at work.

So I'm grateful for this opportunity to share it and, and the hope that others find meaning in it. So my wife and I, you know, we found out in, uh, about three weeks or four weeks into her pregnancy that she had covid, and this was in 2022. So relatively late in Covid. She was vaccinated, but there was still very little literature around that could tell us what this really meant.

All the only recommendations from acog, the American College of Obstetrics and GYN were one to have a more frequent visit schedule and two, to have a planned induction at, you know, gestational week 39. instead of waiting to the typical 40 weeks and there was no other evidence for what might help her. So we were just sitting there trying to read literature, kind of scrambling and already felt this sort of sense of dread that, oh no, like are, how are things really gonna go?

Is she gonna be okay? Is he going to be okay? And then a few months in, you know, my wife is a very stoic person. She almost never complained. She had, you know, a lot of, a lot of side effects of pregnancy, but being an obn kind of knowing what's normal and what's not, she soldiered through it, was standing up in the, or helping other people for 12, 14 hours a day.

So when she came to me with a worried look on her face telling me that, you know, based on her cramping, that she was feeling, she was concerned for an imminent pregnancy loss. So that was, as you can imagine, very concerning. We jumped in the car and, uh, through my head all of the statistics that you were citing earlier, Jen, like one in five pregnancies ending in a miscarriage.

That's what was running through my head. and we're very fortunate. We live five minutes away from Mayo Clinic where she works. So, uh, and, and again, she's an OBGYN herself. So we have an immense amount of privilege in terms of our access to care and our medical knowledge. And still, despite all of that, this was like the most anxious experience of our life, right?

Just sweating profusely as we drove, sitting there in triage, waiting for one of her ob gyn colleagues to come and read that fetal monitoring strip and tell us if our baby's doing okay. And I remember actually we got alerts on our Apple watches that like, are you guys doing okay? Do you have a tachycardia going on?

And you know, and that's, this is just me as riding in the shotgun seat right? For her as the pilot in this whole experience that can only imagine how she was feeling. So, you know, thankfully in that particular instance, the baby ended up being totally healthy and you know, the fetal monitoring strip reed was normal.

So we were sent home with this reassurance. And then sure enough, you know, when we were delivering about 12 weeks later, again, while she was in labor, sh you know, we started seeing this fetal monitoring trace that was very concerning. And her clinicians came in and were like whispering around it and were like, we know what you guys are talking about because she works with you all on this floor, and I do for a living.

Uh, but, you know, they were, they were basically doing their best to figure out is this a concerning trace or not. And thankfully in her case, it wasn't so concerning that they had to do a C-section, but it was right on the line. Uh, and thankfully, you know, when he came out, he was normal APGAR scores and, uh, thankfully has been, you know, neurodevelopmentally completely healthy, which were very, very grateful for.

But we were just, you know, like so many other families so close to having a major challenge in the pregnancy and what might have become a lifelong challenge. And it made me aware that like for us, , we, we are so privileged, right? We have access to all of this knowledge and data and care, and for us it was so difficult and so anxiety provoking and so close to being maybe not a great outcome.

So if we need to do better for families like us, we certainly need to do a lot better for families in rural Alabama and Texas who are on Medicaid. So, you know, the, the genesis of Delphino was actually around a stillbirth that I had witnessed when I was on the care team, and it felt very full circle that thankfully in our case, our baby was born alive and healthy.

But so many families around the country and around the world going through this journey together, and all, you know, millions of us feeling this gripping anxiety. So my new goal and my recommitment to Delfina was let me work to give families around the world with the patient at the center, the certainty that only data can bring.

Let's give them that clarity and that data-driven certainty so that if their pregnancy is progressing in a healthy way, they know that and can be reassured. And if it's not, we get them into the right level of care at the right time to have a healthier outcome. Absolutely.

Jennifer: healthcare feels so behind when it comes to data and a patient understanding what's actually going on. I think there's so much more research we need to do in general and to understand your human body period. But when it comes to pregnancy, this feels like the most important journey in healthcare that one goes through, and obviously parents want to know as much as possible, so just work toward getting more visibility into understanding how is Mom doing?

How is baby doing, is just incomparable to be able to have that. What is Delphina doing with respect to bridging that data gap?

Senan: So three things and I, I appreciate that perspective. Cause I think it's, data is one is not gonna solve the whole problem, right? There's so much else that needs to be done at a systems level. We do see the White House starting to bring more money into Medicaid, but as data people, right? Me being an MD PhD researcher and bringing in all of these scientifically minded OB clinicians and all these technologists and data scientists, what we can do to solve this crisis is one, get all the right. Two, analyze it in a way that's clinically relevant, and three, deliver those insights back to the right people to make the impact. So even gathering the data, you're right, healthcare is just such a mess at so many levels. And I say this to someone who's so grateful to spend every day working in it, right?

I work in a field where I'm improving human health when I sit on a plane next to somebody and I tell 'em what I'm doing, I just feel so grateful to be working in this space. And yet it's a mess, . So we want to bring in all of the data from disparate sources that today are in silos, are not accessible even to the physician, let alone the patient.

And a patient would have no idea how our pregnancy is progressing between visits. She would have to either randomly contact the doctor without any new information to provide or send them a PDF about what's going on on her apple. and that's about it. So we came up with this new paradigm where we're gonna pull in data from the ehr, from remote patient monitoring devices, and from a patient facing app.

And from all three of those data sources, we get the largest and most temporally rich data story about that pregnancy. So we've collected the data. Now what do we do with it? I work with a phenomenal, uh, epidemiologist and biostatistician. Her name is Dr. Izzy Fulcher, and she leads our data science division to basically create machine learning models from this data that can predict potential interventional benefit.

For a particular patient and in that way would enable us to personalize their care. So as an example, for a patient who might be at risk for preeclampsia using this new comprehensive data story that we've gotten about her, we would be able to predict potentially as early as week 12 that this patient might benefit from a lifestyle intervention to prevent preeclampsia and implement that throughout that crucial second trimester of pregnancy.

Now, to actually achieve that, that brings us to the third step, which is where our clinicians come into play. We need to be able to inform them in a way that's clinically actionable, safe, and effective. what these insights are and drive the appropriate response to their patients and the patient themselves being informed about their personal pregnancy profile in a way that enables that, but doesn't cause any undue anxiety.

That's our number one call to action at Delfina is, you know, patients are already dealing with all this anxiety and wrestling with so much that they have to juggle. Let's not give them another thing to worry about. Let's inform them and empower them in a way that is appropriate and makes them feel like they're in the driver's seat of their pregnancy, but leveraging that important key therapeutic relationship with their provider, empowered by not just the raw data, but now the key insights that we've generated in that second stage.

Jennifer: As you are describing that, I have a picture of, for instance, I have a garment watch. It measures my exercise and how much I sleep, et cetera. And just getting a fuller picture of pregnancy, curious, knowing how complex human body is and how different we all are. We probably need a large data set to get to any actionable insights.

How big and how are you approaching your data set?

Senan: Yeah, so that's a great point. And I think, you know, we, we get this question a lot about, uh, pick your favorite activity monitor, wearable. Um, and we do believe there'll be a lot of really interesting insights that will further enhance our ability to personalize pregnancy care. For today, what we have are the three bedrock monitors of pregnancy, which are weight measurement, blood pressure cuffs, and glu cometry.

So those are the three metrics that have been studied for years, and we know, uh, from our predictive modeling, they're essential must-haves. In the meantime, we are exploring like, okay, if we were to integrate activity monitors or some of these new FDA approved non-stress test devices, fetal heart monitoring devices, what might that add to our ability to predict?

So we've set up the system by using the three devices that are. Broadly accepted by the ob gyn community and already routinely used in some form or another, whether that's, Hey, here, take one from my office, or go get one from cvs. You know, it's widely used to, it's, it's widely accepted to be using a blood pressure cuff throughout pregnancy to monitor your progression of blood pressure.

So we are going to just enable that with our technology and have a smart device that if the patient puts it on, even if they don't have a phone themselves, right? We do have some Medicaid patients that don't have a smartphone, so if they put it on, we need to make sure that that's cell network enabled.

So if they have cell phone coverage in their geography, we get that data in and are able to render those predictive insights. and ultimately our long-term vision for Delfina is if there is a modality that can meaningfully improve our ability to proactively take care of a pregnant patient, we want to include that in Delfina care.

So instead of thinking in this kind of old school fee for service world where we wait and see, will an insurer reimburse this one particular thing that we want to do or we believe is necessary, we've seen how that goes awry in so many different ways. With perverse financial incentives for both payers and providers, we want to say, look, on a value basis, let's here's a bundle of things that we know work really, really well to improve your pregnancy outcomes.

And let's ride together, right? Let's improve the outcomes for this patient. Let's reduce the cost for the healthcare system, which is in total 120 billion. And that's our business, right? Our business is a piece of that value that we're creating of hundreds of billions of dollars to our healthcare.

Jennifer: And being able to predict and prevent things as opposed to just react to them when they happen because we're not looking at the data. How does a patient, benefit from delfina? Does it have to be covered by insurance? What should pregnant women know about how to take advantage of this data?

Senan: Yeah, so we welcome, you know, we currently are live in California and Texas, uh, and we'll be launching Nationwide over the next two years. So we would welcome any patient that's interested. They can check out delphina.com and sign up for the four families. Uh, link there. Um, w what we, what we've currently seen is that patients who are, uh, you know, who are in Delphina Care are typically more engaged with their pregnancy care experience.

So typically, you know, in some of the populations we serve, you'll see 30% of folks actually engaging with prenatal care at all. , right? Those numbers are 80 plus percent. And again, these are in majority Medicaid populations. So if there's a patient out there who's interested in availing themselves of Del Delphina care, especially in one of those two states, they can get plugged in with one of these providers that is rendering Delphina care as a system of care.

And we will directly empower this patient by delivering insights back to her about her pregnancy. So we would welcome, you know, folks who are interested to, to check out the app and to, to start using it as a way of, you know, like we talked about earlier, Jen, right? Getting in the driver's seat and instead of having to write it all down on a Post-It note, they can basically use this app as a way of driving that personalization of care in a way that's informed by data.

Jennifer: Super exciting. So understanding folks, fill out the form, make sure that their provider is covered or partners with Delfina and then they can

Senan: Yeah, exactly. So we would, we would reach out to, we have providers that are already part of our network and if they have a particular ob gyn that they wanna work with that's not yet part of our network, we would reach out and make sure that we get that loop closed so that provider can get the key insights to drive the improvements in care.

And then on the health plan side, right. So philosophically, we are not looking to charge any patients, but depending on the arrangement that we have with their health plan, we'll always be very upfront about that. If there would be any financial commitment needed from the patients for all Medicaid patients today, it's fully free.

So if you are, you know, using Delphina care and you're a Medicaid patient, you will not be charged that. That must be, we are committing.

Jennifer: Beautiful. I have to ask this your vision of. Personalized healthcare and a patient's ability to be in the driver's seat of their healthcare. You have apps like Inside Tracker where you can go to a blood test and see what your like levels of various components are in your blood and how healthy you are, et cetera, and having that on your app.

You can have trackers like garment, et cetera, apple, et cetera. You have something like a Delphina for pregnancy. Where do you think we are headed toward and what's the potential of fully being in the driver's seat of your own healthcare?

Senan: So I would say there's a lot, there's been a lot of innovation around, especially in metabolic health, right? There's a lot of like companies like levels that are showing, okay, you know, you can empower a patient directly. continuous Glu cometry. Exactly. And, and that's really exciting. And, you know, we've seen the, the approach we take to it is thinking again about are we able to deliver insights off that data?

And we do think continuous glu cometry could be a really interesting way to go. Where in pregnancy, for example, there might be fluctuations on a daily basis that you don't pick up from three or four daily finger stick measurements. And that's a hypothesis that, you know, we have colleagues all around the country that are investigating.

So if indeed it comes to pass that we can see we, if we incorporate continuous glu cometry into our predictive algorithms, we can predict better, you'll find that to be an anchoring part of Delphina care in the coming years. And I'd say you zooming out from Delphina, thinking more broadly, just, you know, I, I have 10 years I worked in neuroscience focused on seizure prediction and epilepsy.

I've seen a phenomenal amount of growth in that space. Academic and industry. Some of my old colleagues that I used to meet up with conference at conferences just to talk theoretically about how cool would it be if in some of these closed loop neurostimulator devices, these predictive algorithms we're, we're working on, uh, would really drive the care.

And sure enough, now they lead some of those companies. So shout out to SEER Medical. Uh, this great company out of Australia actually that has closed the loop for epilepsy, which was literally my PhD thesis just a couple of years ago. So I'm really inspired when I look to fo you know, this, these other fields like metabolics and neuroscience and see how far they've been able to come in just five, 10 years.

And I'm really optimistic that actually in obstetrics here, we have an opportunity for leapfrog development, right? We can actually say because the infrastructure of care is functionally the same as 1950, we have an opportunity here to reimagine what pregnancy care can be and show to all of those old colleagues in neuroscience and elsewhere what actually is possible.

Jennifer: Absolutely. And I get so excited just thinking about what a time it is to be alive in the state of healthcare innovation. We have crispr, we have the cost of genetic sequencing going down. And I think about also having all of these versions available on your phone, for instance, or on a device on your body.

Even being able to take into account, what are your genetics, what are you at risk for? How can we think about this from a preventative lens? How do we minimize the incidence of Parkinson's or Alzheimer's or cancer? Uh, and so interesting to watch how this all unfolds in the next decades to come. Okay.

Let's bring you back to, to pregnancy. Um, a question I am really eager to get your insight on is I feel. Pregnancy in general is a fertile industry for lots of content. You have lots of apps, lots of things to read, lots of advice. That said, our grandparents and humans, thousands of years before have been giving birth.

And so, uh, even before all this content existed. And so if we were to distill it all down to the three critical pieces of advice we would give to families who are going through pregnancy to make sure they take care of these three things for a healthy mom and healthy baby, what would you say are the three things to pay attention to?

Senan: Sleep, diet, exercise, those three affect every pregnancy. Whether you have a healthy pregnancy and, uh, you know, hope thankfully won't have any challenges, it'll still help optimize your health for what is gonna happen after, right? And there we do see patients who actually don't even cross the threshold of full metabolic risk in terms of gestational diabetes, but they do go on to develop type two diabetes later in life.

And it is now thought. The metabolic changes of pregnancy are strongly related, so sleep, diet, and exercise as three pillars of good general health also very much apply in pregnancy and sleep in particular, right? Is one of the top predictors in terms of general stress level cortisol levels, right?

Cortisol being the stress hormone of your body. , right? So if we can, if there was one way to reduce stress, making sure to get adequate sleep, particularly during pregnancy, where just in terms of the sleep demands, right? They're certainly gonna be equal to or greater, what we've seen being necessary. The average being eight hours varies a lot person to person.

So if I had a message for a pregnant patient out there, I would say, you know, diet and exercise, you know, those are probably pretty obvious. But sleep, the role of it in, in pregnancy in particular, we're just starting to scratch the surface and understand. So making sure to get adequate sleep, quality sleep, and I know this is again, easier said than done with all of the chronic pain that can come.

All of the body changes and positional changes, you know, lifelong sleep position needs to change, but, you know, really prioritizing it and trying to find a way to make it work for you. So for my wife, you know, we had n number of different pillows and mattress toppers that we, and for her, right when she, if she can only sleep five or six hours at night, cause she's working a 16 hour day, we gotta make sure those are quality hours of sleep.

So, I would say sleep, you know, uh, don't underinvest in it. It is absolutely, uh, gonna be foundational to a healthy p. Diet. You know, we are only just now starting to learn. I was at a conference last week where folks were presenting different dietary guidelines. There's a study done just three months ago on the Mediterranean Diet, observing that in folks who followed a Mediterranean diet, there was an association with a healthier outcome.

That doesn't necessarily mean it's causal. That doesn't necessarily mean eat a Mediterranean diet and no work, but it suggests there might be something there that we need to look more at. So, diet, I'd say, is something you know, for a pregnant person out there, talk to your physician about it. Talk to them about what you're eating, and making sure you're getting your nutritional requirements for the pregnancy and doing it in a way that feels healthy for you as well as for your developing baby.

and finally exercise. You know, there's this myth out there that, you know, from time I memorial bed rest during pregnancy, it's not a thing, right? Like we know that for most pregnancies, exercise, as you have been doing previously prior to the pregnancy, is safe. Not only safe, but promotes your and your baby's metabolic health.

So talk to your doctor about it. But I definitely encourage pregnant patients out there to continue. I just, I was at the gym this morning and I saw a bunch of pregnant patients and I was like, good job, Mayo. You're getting the word out. We're we're changing. Changing the perception of what exercise in pregnancy can be.

So yeah, sleep, diet, exercise in pregnancy as an all times in life.

Jennifer: Beautiful. And then what three things would you tell pregnant women and their families to ask their physician?

Senan: I'd say ask. So ask for the delivery plan early, right? Make sure you're on the same page. There's so much that can happen along a pregnancy with like the risk evolving. And patients don't sometimes think to, okay, how would this affect the delivery? And the doctors don't think of it either until, okay, suddenly we're in the third trimester and now fyi, you can't do your home birth, you have to do it, or you have to do a hospital birth.

You have to be induced. So really thinking through. . The second thing I'd say is like, ask them about if there is any kind of risk of a complication, ask them to like deeply understand it with you, right? Like there is a lot of alarmism around something like gestational diabetes or I U G R, right? Like growth restriction for the baby, but what does it actually mean?

And for example, there's a lot of ethnic variability along, you know, along the lines of how, what proportion of babies are diagnosed I U G R. So I would just say make sure that you, if your, your physician tells you, oh, you have a risk for this, or you have a diagnosis of this, really dig in with them on what that.

Functionally for you and your pregnancy. And the last thing I'd say is, you know, ask them what data would be helpful to them, right? If they want to know more about your sleep, diet, exercise, et cetera. Especially if you're a patient with gestational diabetes or hypertensive risk, there's no scenario I see where your physician would be unhappy to receive data that could inform their decisions.

Now there is this question of like, if there's a delusion of data and you don't know what to do with it, and that's where something like delphino would come in. But at the end of the day, I think a lot of physicians today, excellent physicians, are sometimes frustrated by, for the month that I didn't see you, I don't know anything about what happened.

So if you come to them with a proactive mindset and data to show, it'll only, uh, it'll be more positive in terms of the therapeutic relationship and what they can.

Jennifer: and data with respect to maybe sleep, diet, exercise. Anything else?

Senan: If you're taking your prenatal vitamin, if they've asked you to take a, an aspirin for preeclampsia risk, so adhering to any medications or supplements that they might have asked you to, and in general, right? How, like how are you doing with work? How are you doing with, uh, you know, your stress levels? Try to quantify as mu uh, that as much as you can because the very best obs if they tell you to try to reduce your stress or reduce your work burden, um, having a number to go off of will help you actually achieve that

Jennifer: Okay. And then as a husband, and knowing that your wife was in the pilot pilot seat, so if we have a metaphor of a movie, she was obviously the main character, but you are a really important supporting character. What's your advice to the husbands out there on how to win the best supporting Actor award in their wife's pregnancy and the family's pregnancy?

Senan: I love that question. Thanks Jen. I am not sure that I won any awards, but I'm happy to share my family's

Jennifer: But you've been through it

Senan: I, I have been through it. Yeah. I wanna recognize for other families that who is the supporting role might look different. But yes, for me, I was absolutely supporting cast. She was the star.

Um, and I think, you know, for me, it, it was actually a really great growing experience in terms of listening. My wife and I always talk about, right, I'm always trying to fix things both physically in the house at 3:00 AM and it's just not all, not every problem can actually be fixed. So just listening to her like, what is needed?

What can I help with and what do you need me to just listen to you complain about? Like, is this sleep issue just something you want to complain about? Or is it something that you want me to help you solve? And. , the therapeutic complaint is also a real thing. So, and I learned that I wasn't very good at that before, and I'm still not great at it now.

I'm still sort of a doer by nature. But, um, going through that in the co-pilot seat, listening to the pilot, like, what are your needs? Do you need me to listen? Do you need me to do something? Do you need me to decide something? Like, go find which bag to take to the hospital, right? And let you free up your mind to make the big decisions around, you know, what do I eat if I'm planning an induction?

Which night is it? So that was, I think, to me, a really. , uh, learning experience as a husband and as a partner, uh, in the sort of jump seat here where, like what do you need to make this successful and a positive experience for you? Um, I'm really appreciative that I got to play that role for her and I just encourage any other husbands or other supporting partners, or even family, right?

Anyone supporting a pregnant person. Just really listen to them because they know their need, they know their body, they know their plan, and it's their pregnancy. So if you listen, uh, and you're there to support, um, I think it really deepened our, our love and our relationship as well.

Jennifer: Yes. Much, much appreciated. All the support. Okay. And then I know we're out of time soon, unfortunately, I feel like we could keep talking for hours, but I'm so curious you guys birthed a boy, your wife birthed a boy. How has this impacted your life as a dad, your perspective and also your relationship with your wife?

How's it going?

Senan: Thank you for asking. Yeah, I mean, it's so different cuz like, he comes first in a way that like nothing ever has before. Right. Not work. Not even her. Right. And, and she feels the same way. So it's just, it's both a beautiful thing, but a challenging thing for us that, you know, in everything we do now, every breath we take, it's, it's really about him.

Right. Um, and I think, you know, for me it's, it's been hard to actually detach my identity as just Sinan and Rahe a human being from like Sonata. I'm gonna do PhD doing Delfina and like Sinan a father. Um, but it, it is important and I appreciate you always asking your podcast guests about this, because I think for me, you know, physical exercise is a big part of it.

I wanna make sure that I have time for those things, but bringing him into it, right. He's already a great swimmer and that's one of my favorite things is going swimming with

Jennifer: you're a swimmer too. I'm four swimmers in my family. Love, love all these connections. We're gonna have to connect offline.

Senan: Absolutely. And when I'm in Austin, it's Austin, right?

Jennifer: Yes,

Senan: I'm next in Austin, I'm very much looking forward to it. But yeah, I'm very grateful for the opportunity to be a father. It's not a role that everyone necessarily gets to play in life, and it's just, it's by far my most important role and, um, I'm just gonna keep striving to do better and I'm, I'm just really grateful to him for, I mean, he's only six months old and he's taught me so much about, uh, patience, forgiveness, love, um, and so I'm just really grateful to be his dad.

Jennifer: Amazing. I am very excited to get to meet you, Sinan and your wife. You both sound like such a power. Couple wonderful experiences. Thank you for sharing them with me, and I'll definitely be following Delphina and when we, go through our journey of pregnancy, we'll definitely be a user. So I'm looking forward to all of it.

Senan: I'm so grateful for that. Jen, thank you so much. I can't wait. Uh, it would, it would be great to all get dinner with you and Marcine when we're down there and, um, and yes, we can't wait for you to use the app, so just let me know and, uh, we'll send you the link.

Jennifer: Beautiful. All right. We'll make it a rock there.

Senan: All right. Thank you so much, Jen.

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