Startup Millie aims to reimagine the standard of maternity care with a midwife-led model that offers patients both in-patient and virtual care services.
The company currently operates a clinic in Berkeley, California, with plans to open new clinics this year, starting with its second clinic in San Francisco's South Bay in collaboration with Good Samaritan Hospital, part of HCA Healthcare.
Millie plans to expand its footprint and add more services, fueled by a $12 million series A funding round. The company also aims to round out its women’s healthcare services to include wraparound gynecological care, miscarriage counseling and other services. Millie has raised nearly $19 million to date.
Investors TMV and Foreground Capital led the round, with significant participation from Pivotal Ventures and the March of Dimes Innovation Fund. Current investors, including Ingeborg Investments, also participated in the round alongside BBG Ventures, Joyance, LearnStart, Amboy Street Ventures, Mother Ventures, Coyote Ventures and Chai Ventures.
Millie’s approach is grounded in clinical best practices to guide people from conception through prenatal care, labor and delivery, and the postpartum period, according to the company. The collaborative clinical team includes midwives, doulas and physicians and care is provided in-person at a clinic and through Millie's virtual app. The care platform also includes remote patient monitoring tools.
Millie’s hybrid model is inclusive of a digital platform, physical clinics and health system partnerships.
Millie also offers services for broader women's health as well including miscarriage management, lactation support, mental health counseling, prenatal education, postpartum support groups and ongoing gynecological care.
"We see ourselves as a women's health company for the reproductive years," Anu Sharma, founder and CEO of Millie, said in an interview. "What we're well-known for is maternal health and we do that with a midwifery-led approach, but we partner with health systems to provide our patients the full continuum of care, including OB level care and C-section, if that becomes necessary. What we do is covered by insurance, and we're broadly covered by both commercial plants as well as Medicaid plans."
Maternity care in the U.S. is in a state of crisis, experts say, with high costs, subpar outcomes and poor patient experiences. Access to maternity care is steadily declining due to OB-GYN shortages. According to the 2024 March of Dimes Maternity Care Deserts report, more than 35% of counties were designated maternity care deserts.
There are significant gaps in maternal care as well, Sharma noted.
"It's incomplete in that it leaves out entire chunks of care needs that people have. Knitting that together is an exercise and piecing that together a jigsaw. The inter-visit management of care, particularly at higher-risk moments, is pretty lacking, which ends up creating near-misses and other types of care gaps," she said.
Sharma saw this firsthand when she experienced her own "near-miss" following the birth of her daughter. After returning home from the hospital following a difficult delivery, Sharma self-diagnosed her own postpartum preeclampsia.
"I ended up going back to the ER 36 hours after coming home, and it saved my life. I mean, I literally showed up on the verge of a stroke," she said.
Sharma spent more than 20 years working in healthcare, first as a management consultant doing strategy and M&A work and she was a founding executive at Burd Health, an employer health startup.
"I know the [health] system intimately from the inside. You sort of conceptually know these things can happen, but when it happens to you as a patient, it just puts all of your professional experience in sharp relief. And, I think realized, 'Oh, like are the points of failure,'" she said.
Sharma was motivated to start a maternity care model that provides "more complete, right-sized and proactive care."
Millie opened its Berkeley clinic in 2022 and has now cared for 2,000 patients and delivered hundreds of babies, Sharma said. For its Berkeley clinic, Millie partners with Alta Bates Summit Medical Center, a Sutter Health-owned hospital. Patients deliver at the hospital with Alta Bates providing OB support.
"We've solved unit economics and outcomes. We've worked through the peer contracting side, the health system partnership side of things and now we're just doubling down and expanding," she said.
Millie plans to announce two new locations later this year and is looking beyond California, she noted.
The U.S. is an outlier among peer nations in the low use of midwives in the maternity workforce.
"When you look at Canada, the U.K., France, Germany, the Nordic countries, front-line care from the community is provided by midwives and OB-GYNs really get involved when more care is needed. We've sort of done it backwards here in the U.S.," Sharma said. "For low- to moderate-risk pregnancies, and even for higher-risk pregnancies, a big portion of maternity care can be provided by midwifes and, hands down, it creates better outcomes with lower rates of C-sections. They are the right care provider—that's their training and they're very skilled at promoting natural vaginal birth."
She added, "They practice medicine very differently. They're not proceduralists, they're basically designed to care for people going through this journey, which can require a level of clinical care, but doesn't always require a level of medicalization that OB-GYNs bring to the problem."
Studies consistently show that midwives are the optimal provider for more than 80% of pregnancies that are classified as low-to-moderate risk, with lower C-section rates and higher patient satisfaction scores.
There also is a shortage of OB-GYNs, and the Health Resources and Services Administration estimates a shortfall of 5,170 of these specialist providers by 2030.
Millie employs certified nurse midwives, medical experts who are trained and licensed as both registered nurses and midwives. They are known for their intimate knowledge of pregnancy and the labor process along with their minimal-intervention approach that promotes physiological birth, according to the company. Millie patients get access to an OB-GYN for consults and additional services include home postpartum visits and 1:1 coaching with doulas.
A recent survey found that demand for midwifery care is rapidly growing, supported by a favorable regulatory landscape. In 2023, the Centers for Medicare & Medicaid Services rolled out a new payment model that aims to support state Medicaid agencies in offering whole-person maternal care. The model backs increased access to key providers, such as doulas, midwives or birth centers.
Millie says its midwife-led care model has shown better health outcomes with 30% better C-section rates among low-risk, first-time mothers and 67% better preterm birth rates.
There also are opportunities for Millie to provide more longitudinal care to patients beyond pregnancy and delivery. "We've definitely found that once patients establish care, they wanted to stay. Our patient population, the median age is in their mid-30s, and so before too long, I anticipate will be in perimenopause and menopause care, too," Sharma said.
“Millie’s inclusive approach, focus on overlooked markets, broad-based health system partnership strategy, and in-network care is purpose-built to address critical access gaps in maternity care,” said Erin Harkless Moore, managing director for investments at Pivotal Ventures, in a statement. “Its experienced team and capital efficient model offer significant potential for change at scale.”
Startup Oula also offers a maternity center that combines obstetrics with midwifery. The company, based on the opposite coast from Millie in New York City, clinched $28 million in series B funding last year to open new clinics and offer more services.