Melinda Gates says AI in pregnancy could help save women's lives

Each day, almost 800 women around the world die due to preventable pregnancy and childbirth-related causes, according to the World Health Organization.

Using artificial intelligence, or AI, to provide maternal health care to women, especially those in rural and low-income areas, could be a "game-changer" in saving the lives of pregnant women, Melinda Gates, co-chair of the Bill & Melinda Gates Foundation, told ABC News chief medical correspondent Dr. Jennifer Ashton.

Gates highlighted a specific tool, AI-enabled ultrasound, that is revolutionizing pregnant women's access to ultrasounds, or sonograms, a prenatal test that uses sound waves to check a baby's development during pregnancy, and check for pregnancy complications.

Ultrasounds are a routine part of prenatal care to which two-thirds of pregnant women around the world do not have access, according to the Gates Foundation.

"If you're a mom, let's say in the United States, when you go in and you get an ultrasound, it's quite a large machine. You go into a special room to have it done," Gates told Ashton, a board-certified OB-GYN and obesity medicine physician, in an interview to mark International Women's Day, March 8. "We were able, with our partners, to come up with a very small AI-assisted ultrasound that literally can plug into your phone or plug into a tablet."

The portable ultrasound device, which typically weighs less than a pound, can display the ultrasound images on the smartphone or tablet, so health care professionals -- whether nurses, doctors or midwives -- can read the ultrasound instantly, allowing for faster diagnoses and faster treatment.

"In these low-resource settings, [pregnant] women often ... can't get into a community health clinic. The lines are long. They don't have the bus fare. They might walk. It might be shut down or not open at the right time of day," Gates said. "A community health worker goes out to these women so she can have an AI-enabled ultrasound and, literally with a few scans of that mom's belly, be able to see, is the child growing properly? Is the mom's health OK in terms of what you can see in the ultrasound?"

Gates continued, "It's a game-changer ... it's a pretty simple device, but again, it really can make a difference in terms of the mom and the baby."

Gates said now that the technology exists, the Gates Foundation is working with partners to try to lower the price of the devices and get more health care workers trained so they can go to more underserved communities.

The AI ultrasound technology is one of several advancements that Gates said she sees as transformative for women's health care, which has historically been underfunded and under-researched on a global level, data shows.

"We know that women can't do well unless they are well, so you first have to start and be healthy to then be able to get an education and to work productively in society," Gates said. "So when you think about how little funding is going into actually saving women's lives, from diseases that are specific to women, to childbirth, which is very specific to women, that just shouldn't be."

Any advancements being made for women's health -- like a one-dose HPV vaccine to prevent cervical cancer and a drape that can reduce a woman's chance of dying from postpartum hemorrhaging by 60% -- can only make a difference, Gates noted, if they reach the women who need them.

The HPV vaccine, for example, was approved in the United States in 2006 by the Food and Drug Administration but is just now reaching millions of women in need in Africa as a one-dose vaccine. HPV is a common sexually transmitted infection that, if left untreated, can invade the cervical cells of the uterus and cause cancer.

In 2022, cervical cancer led to 350,000 deaths globally, with the highest rates of mortality in low and middle-income countries, according to the WHO.

Gates said for more than a decade, female leaders in Africa have asked her for the vaccine on her trips to the continent.

"They're saying, 'We have full communities where we see aunts, sisters dying of cervical cancer. You have this vaccine in the United States, when are we going to get it?'" Gates recalled. "And the issue has been it's an expensive vaccine and it's two doses."

With the lower-priced one-dose vaccine now available, Gates said the HPV vaccine can be distributed in places like schools and community clinics.

"We can give it out in places where they gather," Gates said. "So often a young girl never makes it into the clinic. She may not ever make it in clinic at all until after she's had a child, or she might make it in at the time of birth, and that's too late."

Another women's health advancement, longer-lasting and injectable contraceptives, have the potential to not only transform women's health, but all aspects of their lives, including their economic well-being. According to the Gates Foundation, over 250 million women and girls globally who do not want to get pregnant are still not using modern contraceptive methods.

Gates said if she could make one change to women's health, she would focus solely on contraceptives.

"It would be that every single girl and women on this planet who wants to have access to a contraceptive can have access," Gates said. "We know that when women can time and space the birth of their children, women are healthier. The children are healthier. The family is wealthier."

She continued, "So I would make sure every single woman had access to contraceptives so she could decide when and whether to have a child."

How being a mom, grandmother motivates her work for women's health

Gates, who lives in Seattle, is a mom of three, who became a first-time grandmother last year when her eldest daughter Jenn Gates Nassar gave birth to a daughter.

Gates said she was with her daughter while she was in labor, which made her reflect on the care her daughter received in the U.S., versus what she would have been able to receive if she delivered in a lower-income country.

"I could sit there ... and think about all the places I've been in the developing world where I've been in the delivery room and think, 'Oh my gosh, if my daughter didn't have somebody here taking her blood pressure,' or, 'I know what hemorrhage looks like. I know what the pain of childbirth is like in these settings,'" Gates said. "So, to see that my daughter was getting good care, and still you're concerned at the time of the birth of a baby, it's a bit scary until that baby comes healthy, I could think about all those things."

Even in the U.S., with its advanced health care, the state of maternal and infant health is dire, data shows.

Last year, the March of Dimes, a nonprofit organization focused on improving the health of pregnant people and babies, named the U.S. one of the "most dangerous developed nations" for childbirth. According to the Centers for Disease Control and Prevention, more than 80% of pregnancy-related deaths in the U.S. could have been prevented.

Gates said she believes "no mom" should die in childbirth anywhere in the world.

"Now having two healthy daughters and a healthy granddaughter, it makes me all the more passionate about let's make sure no mom dies in childbirth," she said. "That just shouldn't happen in this day and age."