Oula’s has raised $22.3 million in seed and Series A rounds to improve outcomes for pregnant and postpartum people.
The U.S. has terrible maternity care outcomes. Compared to other developed countries, the U.S. has worse outcomes, poorer experiences, and higher costs. Women in the U.S. are 50% more likely to die in childbirth than their moms, writes Neel Shah, MD, MPP, FACOO in Harvard Health Blog.
The risk to Black women is three to four times more than to white women. More than 80% of pregnancy-related deaths are preventable, according to the CDC, and including midwives can help, according to The Lancet. Three women—Adrianne Nickerson, Elaine Purcell, and Joanne Schneider—are changing that with their collaborative care model that brings together doctors and midwives, called Oula. The startup’s patients have fewer cesareans and other preterm deliveries.
Nickerson, cofounder and CEO, and Purcel, cofounder, and COO, left their jobs in 2019. The pair were introduced to Joanne Schneider, who is a cofounder of Kindbody, which provides fertility care.
Schneider had a miscarriage at the height of hospitalizations during the Covid19 pandemic. Because D&Cs were considered elective surgery, they were postponed. She was told to let the fetus pass naturally. No one said to her that there was medication for managing miscarriages. She asked her husband, “Should I start a maternity care company?”
While Nickerson and Purcell were looking for an angel investment from Schneider, the conversation turned from her making an angel investment in Oula to joining the company. Schneider came on board as the chief experience officer in July 2020.
The three have complementary expertise.
- Nickerson spent the bulk of her career counseling large health systems and big health insurance companies on how to put patients at the center of care while improving efficiency. Later, she worked with corporations and startups on innovation.
- Purcell started her career in health policy during the passage of the Affordable Care Act. She was inspired to build holistic care models, removing some of the transactional nature of primary care.
- Schneider builds bridges among clinicians, engineers, and patients; She led value-based care and clinical decision product teams and patient-facing tools at Flatiron Health. Later, she cofounded Kindbody.
The three have a ton of experience on the business side of healthcare and knew better care models existed. They wanted to apply those models to maternity care. They are passionate about creating something that solves the poor experience, the terrible outcomes, and the insane cost that are hallmarks of maternity care in this country.
Oula offers the best of midwifery and obstetrics in a personalized and evidence-based way. Studies show that including midwives in healthcare systems could prevent more than 80% of maternal and infant deaths. Midwifery-led care leads to lower rates of preterm birth, lower cesarean birth rates, higher rates of vaginal birth after C-section, and lower childbirth costs. Oula full-service pregnancy care includes prenatal, delivery, and postpartum, including sonography and group support through the fourth trimester to offset the pressures of becoming a parent.
As bizarre as it may sound, they raised their seed round in 2020 when the U.S. was at the height of lockdowns for brick-and-mortar clinics that provided pregnancy care. In October, the startup announced the closing of its $3.2 million seed round.
In March 2021, Oula opened its doors in Brooklyn Heights. Most OB practices won’t see you until maybe week 12, but women are anxious and want to know more about their pregnancy. They want to know, “should I be taking vitamins? What should I stop doing?”
Pregnancy is an isolating experience. “Technology has this wonderful role of delivering care [early in the pregnancy and between the 14 visits made to an OB during the nine months of pregnancy] in a cohesive and modern way,” said Nickerson. It connects women early in their pregnancy, between and after doctor visits, and to others going through pregnancy at the same time they are.
Within three months, Oula reached capacity. Nickerson, Purcell, and Schneider became pregnant six months after opening the Brooklyn location. In July 2022, they opened their second location in Soho.
You don’t have to choose between a doctor and a midwife, modern medicine, and human intuition. The team gets referrals from those who have used the startup’s services and the many different types of providers, from doulas to hospitals. “We don’t have to spend much on marketing,” Purcell said.
“The existential challenge we face is the constraints of the healthcare payment system and who will pay for better care,” said Schneider. “We’re proud that we spend twice as long with patients than traditional practices do. However, the reality is we’re not getting paid twice as much even though our outcomes are much higher.”
Oula is working with payers on value-based reimbursement and building relationships with hospitals. “One payer has effectively doubled what we were originally getting paid because we were able to show that we’re delivering better outcomes at a lower cost,” said Nickerson.
“There are incredible disparities in care by socioeconomic level, race, and ethnicity,” said Nickerson. “It’s an economic and moral imperative to improve health outcomes for all.” The team is talking to people at the state and federal levels. Still, it is gaining more traction at the individual Medicaid plan level.
European countries have five to 10 times the number of midwives as the U.S. There’s much work to be done in that space, too.
In January 2023, Oula announced that it raised $19.1 million in Series A funding led by 8VC with participation from existing investors, including Chelsea Clinton’s fund, Metrodora; the Female Founders Fund; Collaborative Fund; and Alumni Ventures. Seed investors included Great Oaks, January Ventures, Rock Health, Black Jays, and individuals such as Kate Ryder of Maven Clinic, Tom Lee of One Medical, and Jonathan Bush of Athena Health. The investment brings Oula’s total funding to $22.3 million.
Oula’s announcement comes at a critical moment, with U.S. maternal mortality on the rise (particularly for Black women), reproductive rights being stripped away, and parents facing mounting challenges from a shortage of affordable childcare options to a lack of paid family leave.
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