A new Berkeley maternity clinic opened Sept. 26 across the street from Alta Bates Summit Medical Center, promising a comprehensive approach to prenatal and postpartum care — a hybrid model that combines the “high touch” of collaborative OB-GYN-midwifery care with mental health support, one-on-one doula coaching and educational resources all under one roof.
The Millie clinic joins a new wave of hybrid prenatal health care providers that are sprouting up nationwide and include Oula in Brooklyn and Quilted in Tacoma, Washington. Millie’s efforts “to redefine maternity care” have garnered attention from Forbes magazine, and three members of the Millie team were invited to provide input on the White House’s Blueprint for Addressing the Maternal Health Crisis, which aims to combat maternal mortality.
Care at Millie begins within 48 hours after a positive pregnancy test and continues to one-year postpartum, a vulnerable time for mothers and babies.
“Clinical care is part of it, but we also aim to hold a patient’s hand through all the other ways they need support,” said Anu Sharma, the clinic’s founder and CEO. “Millie’s a model that is less reactive, more complete, more human and not as over-medicalized as standard maternity care can be.”
In a typical OB-GYN practice, for an uncomplicated pregnancy, patients visit 12 to 14 times, under guidelines established by the American Congress of Obstetrics and Gynecology, Typical appointments range from 15 to 20 minutes and usually involve a vital signs and fundal (uterus) check, listening to the fetal heartbeat and the ordering or review of a sonogram.
“There is little time for anything else,” said Talia Borgo, a midwife who worked at an OB-GYN clinic at UCSF before becoming Millie’s clinical director and co-founder.
Midwifery practices spend more time with patients, who can deliver at home, a birth center or hospital. Such practices typically handle low- to moderate-risk pregnancies. More complicated pregnancies require the patient to go outside the practice to collaborate with an OB-GYN.
“People don’t have to leave our care necessarily in the way they’d have to leave a typical midwifery practice because we’re bringing the two practices together,” Sharma said.
Millie’s model spends more time and effort around what takes place in between visits “since most of pregnancy happens outside the office,” Sharma said.
To that end, the Millie app offers round-the-clock monitoring, care team messaging, comprehensive education and mental health support, as well as access to a network of experts for specialized needs. Patients also have the option to do some of their visits via telehealth.
Sharma has spent the past 20 years as a health care consultant and created Millie after her own difficult delivery and near-fatal postpartum experience at a hospital in San Francisco. And she has the benefit of her professional experience and hails from a family of doctors. Sharma considers herself Millie’s first patient.
“It was very clear to me that the care model was broken,” she said. “That’s what Millie is trying to address.”
She said she came up with the clinic’s casual name to evoke a more approachable care experience, “like a friend or older sister who happens to be an OB-GYN or midwife.”
Like other birthing alternatives, Millie aims to soften the patient experience by having the interiors not look like a doctor’s office. The waiting room and four examination rooms in the 1,500-square-foot clinic boast a contemporary look and offer some spa-like amenities, like a range of refreshments and specially formulated tinctures created by Midwife Brews of San Francisco.
Millie’s clinical staff includes an OB-GYN, Amy Kane, Millie’s medical director, who was born at Alta Bates in Berkeley (but now lives in Albany), a team of two nurse midwives headed by Borgo, along with three lactation consultants, two doulas, two nutritionists and one therapist.
If all goes as planned, Millie will participate in a pilot program that seeks to better connect federally funded programs with the needs of patients through the White House’s Maternal Health Task Force.
The U.S. has the dubious distinction of having the highest cost of maternity care in the world and some of the highest rates of maternal mortality, study after study has shown, along with statistics from the Centers for Disease Control and Prevention. Black women suffer disproportionately from such care, resulting in mortality rates almost triple those of white women, numbers that increased during the pandemic.
Millie accepts most insurance and is working on accepting Medicaid patients. Medi-Cal plans will be accepted as of Nov. 1. Since costs vary depending on deductibles, Sharma could not provide a cost for Millie’s services, but said they are comparable to what someone would pay at an in-network OB-GYN/midwifery provider. All deliveries take place at Alta Bates.
Sharma hopes to duplicate the Millie model in other Bay Area locations.
“The future of maternal care is going to evolve into more clinics like Millie,” she said, “because that’s what patients want.”