Oula Health is reimagining modern maternity care for women, from pre-pregnancy to postpartum. Oula’s care delivery model spans from a remote care platform to their first in-person clinic located in Brooklyn, NY. Oula’s mission is to set a new standard for patients by providing personalized maternity care that bridges the gap between modern medicine and human intuition. Pulse writer Niki Bakhru connected with Co-founders Adrianne Nickerson and Elaine Purcell to learn more about their experiences creating and leading Oula Health. 

Adrianne Nickerson and Elaine Purcell, Co-Founders of Oula Health

The Pulse: Let’s start with how you got here – can you share your career path and what along the way inspired you to build Oula Health into what it is today?

Adrianne Nickerson: I feel like I’m a healthcare junkie at this point. I’ve worked on the business side of healthcare my whole career, focusing more and more on tech-enabled services. I have an MPH by background and did all of my research on sexual and reproductive health and women’s autonomy in their healthcare decision-making. So now it’s really coming full circle from how I started my career to where I am today at Oula. 

Before Oula, I co-founded a cancer care management company called Robin Care, which brought together a holistic care model of patient advocates, nurses, social workers, etc. At Robin Care, we used technology to scale the impact of our model and work through self-insured employers and health plans so that patients didn’t need to bear the cost burden. Prior to Robin Care, I was at a corporate venture arm of a huge health system and worked with a lot of early-stage digital health companies to bring innovation into how we deliver care. Today, after spending time learning the ins and outs of the business side of healthcare, I can take these lessons and use to be a force for good to create a new care model and experience for women in an area I’m really passionate about. 

Elaine Purcell: I started my career in the health policy space during the passage of the Affordable Care Act. I’ve been passionate about value-based care since I realized that much of healthcare appears to be transactional, despite being one of the most personal things we go through. Before Oula, I spent the last six years in the world of primary care, thinking through how to take mind, body, and soul and create a sustainable clinical and business model – first at a company that recently IPO’ed called Privia Health, focused on driving primary care clinics to move from fee-for-service to risk bearing models, then more recently on a senior leadership team at Caremore, now a wholly owned subsidiary of Anthem. My work at Caremore taught me how to approach a really complex patient population. There, I focused more on end-of-life care whereas today I’m happy to focusing on beginning-of-life care. Still, the same principles apply – building a care delivery approach that treats someone as whole person going through a life-changing event. 

Family planning is a unique part of healthcare because it’s not a disease, it’s a natural physiological event. Yet, many hospitals and systems still treat it as if it’s a service line like cardiovascular care, for example. When Adrianne and I were starting our own family planning processes, we came across a prolific study called the Strong Start study, which compared three different maternal care modalities and found that the midwifery and collaborative model led to better outcomes for women. That’s when a light bulb lit in our heads – we realized that maternity care should be less of an intervention and more of a comprehensive model that focuses on personalized care to drive better outcomes.  

The Pulse: Diving more into this personalized care plan, can you talk about what a typical journey looks like for an Oula patient?

Adrianne Nickerson: When we began building Oula’s care model, we thought hard about how to treat the whole person, acknowledging that this is a significant life event, not just a clinical condition. This led us to bring together a multidisciplinary care team including midwifery and OB. We also wanted to address the reality that the majority of a pregnancy happens between scheduled appointments; we wanted to use technology to build a fully-stacked care model that stitches together these moments through our automated messaging and content platform. Through it all, we’re building a two-sided relationship with our patients, helping them understand what’s happening to their bodies before it happens and helping them make the right evidence-based decisions for themselves. 

Elaine Purcell: We also think a lot about the power of peer groups in comprehensive care delivery; Oula brings together individuals who are navigating similar health experiences and we are uniquely positioned to create spaces for them to engage with one another. For example, we have an “open house,” which is an introduction to the Oula community for people trying to conceive or newly pregnant. We’re also starting to roll out postpartum drop-in hours for individuals who delivered babies within the last two to six weeks, supported by a doula. Doulas are sometimes a cost prohibitive resource in maternity care, so we offer a free doula service and drop-in hours for women breastfeeding to talk about challenges and be part of our larger community. 

The Pulse: One of the traits that distinguishes Oula from others in the space is a fully-stacked virtual and in-person hybrid care model. How do you strike the right balance between telehealth and in-person offerings? 

Elaine Purcell: When we were raising our initial round of capital, we pitched a brick-and-mortar clinic during the first week of COVID. There were investors who asked us why we couldn’t start virtually, but the simple answer is you can’t give birth over Zoom. We do have ways of remote monitoring – for instance, we’ve shipped blood pressure cuffs and we offer our patients the option of doing their visits at home when they need to. At the same time, we’re explicit about which visits it’s important they come in for, based on their health profile and care needs. We’re not just shifting site of care; we’re creating continuity that makes the end-to-end experience more personalized and drives positive outcomes.

The Pulse: Speaking of site of care, Oula recently launched its first maternity clinic in Brooklyn and established a new partnership with Mt. Sinai. Can you talk about how you’re working with other players in the healthcare ecosystem? 

Adrianne Nickerson: When we built Oula, we were very intentional about making sure that our model was a win for the system. It’s a win for health systems, seen in our partnership with Mt. Sinai, and a win for payers, seen in our care model that focuses on evidence-based outcomes with a triple aim of improving patient experience, improving outcomes, and reducing cost. Our first clinic reached full capacity months after opening, and we feel a huge sense of responsibility and urgency to build more clinics because women everywhere deserve a better care experience. Much of our focus in the next twelve to eighteen months will be growing our presence in the New York market and entering new markets. 

The Pulse: Though women make up over half of the population, the women’s health sector is a relatively new category. In recent years, we’ve seen much more traction in confronting previously unaddressed needs. How does Oula address existing inequities within maternity care today? 

Elaine Purcell: There’s a history of paternalism in maternity care underpinned by the idea that the doctor knows what is best – a challenging dynamic when the woman carrying the child likely knows her body better. We’re trying to make sure our patients feel like they’ve got an even playing field and can engage openly and directly with their care team. All Oula’s midwives and doctors go by their first names and they aren’t wearing white coats for a reason. We make sure everything is a conversation and never didactic instructions. Our team talks every day about how to reach a diverse patient population. Black women and indigenous women die three times more often in childbirth than white women – and, in New York City, it’s actually twelve times more often. It’s critical that we focus on these disparities. We’re proud of the team we’ve built – we want to make sure our patients have people they relate to; patients should have access to clinicians who look like them, who can deliver cultural, confident, competent care. In regular team meetings, we talk about our high-risk patients and how women of color face implicit biases; it’s our job to ensure there’s a trusted relationship between patient and provider that delivers the best possible outcomes. 

The Pulse: How have you seen Oula evolve since its beginning and where do you see the company heading in the years to come? 

Elaine Purcell: Adrianne and I were two of Oula’s first patients and deliveries. We raised our initial capital in June of last year. A couple months later, we figured out that we were both pregnant and just two weeks apart. Five weeks later, we found out that our third hire was also pregnant. So together, with our own experiences, we built Oula. Commiserating and asking questions ourselves inspired much of what we’ve built today. 

Adrianne Nickerson: We want to grow and expand to reach more women across the US. We also really want to expand the services we’re offering, like mental health for example, so our patients don’t need to be referred outside of the care continuum we’re building to get the additional support they need. We’re also intent on continuing to build out our tech platform to drive a better patient experience and support women in those moments outside of our clinics. 

Interviewed by Niki Bakhru, December 2021.