Midwifery-led startup Millie is partnering with El Camino Health to launch a joint maternity clinic in Palo Alto, California, this December, marking the first step in a planned expansion across Silicon Valley and the Bay Area.
The collaboration combines Millie’s technology-driven, midwifery-focused care model with El Camino Health’s established maternity services. The clinic aims to address longstanding gaps in U.S. maternity care, which Anu Sharma, founder and CEO of Millie, says has not evolved significantly in 75 years. Traditional models rely on fragmented visits and lack postpartum support, leaving patients to manage essential services like mental health and nutrition independently.
Reimagining Maternity Care
Sharma explains that approximately 75-80% of pregnancies in the U.S. are low-risk, yet care is often delivered by obstetricians, who are in short supply. Midwives, Sharma argues, provide better outcomes for these cases, including lower C-section rates and higher vaginal birth prevalence. The U.S. faces a critical shortage of OBs, with one-third of the country classified as a maternity care desert. By contrast, peer nations prioritize midwives in frontline care, yielding improved results. Millie’s model integrates midwives with obstetric support, using technology to streamline care coordination and risk monitoring between visits.
Addressing Disparities and Scaling
The partnership also targets racial disparities in maternal mortality, particularly in underserved Medicaid markets where access is limited. Sharma notes that Black women in the U.S. face significantly worse outcomes, often in regions with fewer OB providers. Millie has been in-network with Medicaid and private insurers since its 2022 Berkeley clinic opened, achieving actuarial savings of 12-14% for payers.
The company now seeks to scale through deeper health system integrations, having already partnered with UCSF for clinical integration. With El Camino Health, we’re building joint maternity clinics that will be co-branded and bring the best of both models to their patient population. Financial negotiations, Sharma says, are simpler than expected due to precedents in health system partnerships, focusing on aligning goals rather than complex structures.
The Palo Alto clinic represents the inaugural location in Millie and El Camino Health’s broader geographic strategy. This initial partnership serves as a model for extending their collaborative approach throughout Silicon Valley and the wider Bay Area. The co-branded facility merges Millie’s midwifery-focused technology platform with El Camino Health’s established maternity infrastructure to create a unified care continuum.
Millie’s expansion strategy emphasizes deep clinical integration rather than standalone clinic proliferation. The company’s experience with its Berkeley location, which opened in 2022, demonstrated the necessity of establishing robust infrastructure before scaling. This includes building clinical operations, developing patient acquisition capabilities, and securing network participation across major insurance plans including Medicaid. These foundational elements proved essential for demonstrating the viability of the midwifery-led model to potential partners and payers.
Payer Alignment and Financial Integration
Actuarial savings of 12 to 14 percent have consistently emerged from Millie’s integrated care approach since the Berkeley clinic’s inception. These cost efficiencies stem from the model’s focus on preventing complications through continuous, coordinated care rather than reactive treatment. The partnership with UCSF earlier established clinical integration, and that really helps us create a full continuum of care, with access to specialty care, all on a single EHR, with seamless payer contracts.
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