Rebuilding Maternal Healthcare from the Ground Up: An Interview with Oula’s Co-Founders
Last week, Oula — the modern maternity center that delivers an evidence-based, personalized pregnancy experience — announced their $19.1 million Series A led by 8VC with participation from existing investors including Chelsea Clinton’s fund, Metrodora; Female Founders Fund; Collaborative Fund; and Alumni Ventures. This brings Oula’s total funding to $22.3 million and underscores the urgency of rebuilding U.S. maternity care from the ground up.
To hear more about what’s next for Oula, their future clinic expansions and hospital partnerships, what it was like fundraising in a down market, and more — we sat down with co-founders Adrianne Nickerson and Elaine Purcell to discuss. Read the full interview below.
Congratulations on closing Oula’s $19.1M Series A round! This brings Oula’s total funding to $22.3M. What was your fundraising experience like for this round? How did it differ from raising your seed round in 2020?
Thank you! The biggest difference has been that we now have the data to show that what we’re doing is working: Since opening our doors in February 2021, Oula is outperforming national, state, and city quality standards, including a lower rate of cesarean births and preterm deliveries. We’ve grown tenfold while maintaining industry-leading patient satisfaction. It’s a real affirmation of our focus on providing a great experience and great outcomes for our patients.
Both of you come from deep healthcare backgrounds. Maternal care in America has been sorely lacking for many years. What was the inspiration for Oula and where did you see the gaps in the market?
We started Oula as we were setting out on our own family planning journeys. We expected pregnancy to be an exciting, joyful time, but as we did our research and talked to people in our lives, we kept hearing the same things: For too many people, pregnancy and birth are at best impersonal and isolating, and at worst, dangerous.
From our past professional experience, we know all too well that a huge part of the problem is our broken healthcare system in the U.S., which was built to deliver individual medical services, not to provide comprehensive, patient-centered care. Add to that a whole host of other issues — like sexism, racism, implicit bias, the erosion of reproductive rights, a lack of policies to support new parents — and you have the maternity care crisis we’re living through as a country. Not only does the U.S. have some of the worst maternal mortality, NICU, and cesarean birth rates in the world, but severe maternal complications have more than doubled in the last 20 years. Infuriatingly, 84 percent of maternal deaths in our country are preventable. Study after study has found that one of the most effective steps we can take to bring down maternal mortality is to expand access to midwives — this is not some mysterious problem without a solution!
Also, as tragic as the maternal mortality numbers are in this country — especially for Black women — they are really the tip of the iceberg.
Making it through childbirth alive is simply not good enough; we need a higher standard.
Compared to women in other high-income countries, women in the U.S. have the least positive experiences in healthcare and are more likely to report emotional distress.
As we looked around, it became abundantly clear that the maternity care experience we envisioned for ourselves didn’t exist — so we decided to create it. Oula uses a model of collaborative care, which brings together doctors and midwives. Our central belief is that by improving the experience of pregnancy and childbirth, we can improve health outcomes, and bring down costs, too. In other words: It’s a win-win-win.
In 2021 Oula reached full capacity just three months after launching its first location in Brooklyn, and more than 500 births later, Oula opened its second location in Manhattan. How are you thinking about further clinic expansions, as well as virtual growth?
We’ve been thrilled by the response to our second location, which we opened with the hope of serving families from all five boroughs and New Jersey. In terms of expansion, we plan to expand to six new markets in the next three years. We’ll expand our virtual offerings along the way, and are excited to continue developing digital tools and resources like our birth plan checklist that make it easier for patients to get the information they need and communicate with their care team between appointments.
Since opening Oula’s first clinic, what have you been most surprised about? Has your vision for the clinics changed at all?
When we first opened our doors, we wondered whether people would really be willing to deliver their babies with a startup. The answer has been a resounding yes! Our biggest surprise has been realizing how little explaining we need to do — as soon as patients step into our waiting room, they get it right away. Little things, like having warm, welcoming, thoughtfully designed clinics where you actually want to spend time make a big difference. That sends a message immediately: You matter. This is a place where we care about your comfort and well-being. As we look down the road, we’re focused on growing without losing focus on the things that make Oula special and matter to our patients.
What are the major opportunities and gaps you see in the women’s and family health categories?
Maternity care costs consumers and health insurers $126 billion each year, so financially speaking, the market is huge. The biggest opportunity we see is for midwifery and collaborative care to transform the dire state of maternity care as we know it. Studies show that including midwives in healthcare systems could prevent more than 80 percent of maternal and infant deaths. The U.S. is lagging behind the rest of the world on that front — there are only four midwives per 1,000 births in our country, while a lot of European countries have five to 10 times that. We know that midwifery-led care leads to lower rates of preterm births, lower cesarean birth rates, and rates of vaginal birth after cesarean that are nearly twice as high — not to mention lower childbirth costs. And, as we see every day at Oula, it also leads to patients who are thrilled with their experience and eager to spread the word and return for future births.
In May 2021, Oula partnered with Mount Sinai so that Oula patients could receive full access to hospital resources and specialists, all while remaining under the care of Oula’s medical team for non-surgical births. How did this partnership develop and how are you approaching future hospital partnerships? Anything exciting in the pipeline?
The truth is, pregnancy and childbirth are full of false binaries — doctor or midwife, modern medicine or human intuition, medicated birth or au naturale — when most people are really looking for something in the middle. A lot of our patients are surprised to learn they can deliver in a hospital with a midwife! In fact, one of the reasons we chose Mt Sinai West as a partner is that they have a long history of working with midwives — it’s the best of both worlds. As for future hospital partnerships … stay tuned!
What are the biggest impacts the over-ruling of Roe v. Wade will have on the already broken maternity care system? How is Oula Health thinking through filling the gap that the government can not serve at this critical moment?
Choice is at the heart of everything we do at Oula — whether that means choosing what your delivery will look like or choosing whether to become a parent in the first place — so like a lot of people, we were angry and heartbroken by the overturning of Roe v. Wade. In the years to come, our country will almost certainly see an uptick in unintended pregnancy, which means this is a moment when we should be doing everything we can to improve the experience of maternity care across America. Because we believe excellent care should be accessible to everyone, we’re proud to take insurance, including Medicaid, which 1 in 5 Oula patients rely on, and we look forward to the day when this is the norm, not the exception, in midwifery. In the weeks, months, and years to come, we intend to double down on our efforts to shine a light on the problems with maternity care, and the solutions to those problems. (In a word: MIDWIVES!) We hope to continue to use our platform to help reduce abortion stigma, because abortion care is pregnancy care. And, of course, we will always stand firmly for the right of every pregnant person to make their own health decisions.
Last year Oula doubled its employee base and built a clinical team without spending any capital on recruiting. How did you think about building a company that people want to work for? With this new round of funding, which roles are you hiring for first — and where can people apply?
We’ve emphasized building a team that reflects the diversity of the communities we serve. That’s important to us, and to our patients. We are highly focused on our external product — that’s why we’re all here! — but we don’t want to lose sight of the internal product, either. We think a lot about how to retain talent, keep people happy, and make Oula a place where our employees as well as our patients actually enjoy spending time.
As a company founded and led by moms, one thing we’ve always tried to do is make this a workplace that grants parents some much-needed flexibility and support. Especially in those early days, it wasn’t uncommon to look around the table at a meeting and see more than one person pumping!
The way we see it, if we’re serious about making the world better for pregnant people and parents, we need to live those values in our own company.
What do you plan to do with this new round of financing?
We’re focused on two main priorities: opening more clinics in the New York City area and expanding the type of services we offer our patients.
We see mental health services as a big opportunity to build on something we believe is core to the patient experience. We’ve gotten overwhelmingly positive feedback from patients on our current offerings, like postpartum office hours, support groups, and dedicated monthly space for BIPOC parents and families, and we’re eager to do more in this space!
What is your advice for founders fundraising in current market conditions?
It’s discouraging to learn that women-founded startups raised a lower percentage of VC funds in 2022 than they did in 2021.
Our advice to founders is to stay focused, double down on your mission, and remember what ignited your passion in the first place — that will lead you to kindred spirits who see the value in what you’re doing.
And, of course, these are the moments when the kind of community the Female Founders Fund has built is so essential — for advice, support, and connections to capital.
What is your long-term vision for Oula?
We started Oula to have a big impact. We want to rebuild maternity from the ground up so that every person has access to the support they need to thrive before, during and after birth.