We know more than ever what drives healthy pregnancies in America: early engagement, continuity of care, trusted support, and attention to the social factors that shape outcomes. Yet too many women facing high-risk pregnancies, especially those on Medicaid, do not get the care they need. Instead, they are stuck in a fragmented system where outcomes suffer.
At Acumen America, we invest in visionary founders with innovative solutions to America’s toughest problems. Mika Eddy and Orlando Li founded Malama to provide Doula-led maternal care to Medicaid populations. Here’s why we invested.
Built for the mothers the system forgets
Nearly 10% of US pregnancies are affected by gestational diabetes. Eddy knows, as she was diagnosed with the often asymptomatic condition at 28 weeks. Managing the diagnosis was a part-time job, and getting it covered by her healthcare provider only added to the stress. She ultimately gave birth to a healthy baby boy, but it stirred something in her: How can we improve this experience and drive better maternal health outcomes?
She co-founded Malama in 2021 to provide low-and-moderate income (LMI) women—with a focus on Medicaid beneficiaries—the maternal care they need. And this is a pressing need, as nearly half of all births in America are covered by Medicaid. Many pregnancies for LMI women are more likely to be impacted by social determinants of health: transportation barriers, food insecurity, housing, and limited access to culturally competent care.
Malama provides doula-led, wraparound care throughout pregnancy and postpartum. Doulas offer education, emotional support, and hands-on navigation and help mothers prepare for appointments, understand their options, and recognize warning signs. In a fragmented system, that matters: The presence of a trusted guide can be the difference between an early intervention and a costly red flag. Malama’s model is already showing real-world impact, with patient-reported outcomes data from more than 2,500 women show a 6% decrease in NICU admissions, a 9% decrease in C-section rates, and a 38% decrease in preterm birth rates. A Tufts Medical Center randomized controlled trial found that women who enrolled in Malama during pregnancy were significantly less likely to develop diabetes, reporting a 40% difference in postpartum diabetes outcomes versus standard care.
Deep market expertise
Malama’s team brings a combined 40+ years of healthcare experience. The American healthcare system is complex. Medicaid even more so. We were drawn to Malama’s combination of lived experience and market expertise. They understand regulatory nuances and can navigate reimbursement structures, because they’ve done it before.
Malama is not trying to replace the existing maternal health system. It is strengthening it, and integrating doulas into formal care at a time when policy changes are finally allowing it: 31 states now reimburse doulas through Medicaid. Malama is poised to translate that policy momentum into better maternal health outcomes.
Purpose-built for Medicaid
We are the leading early-stage investor in Medicaid innovation. We back visionary women and underrepresented entrepreneurs with bold ideas to improve health equity in their communities. Malama fits squarely into our investing work in the Medicaid space.
What we found compelling about Malama’s model is that they were focused on Medicaid from day one. Many healthcare startups begin with commercially insured populations and attempt to expand into Medicaid later. The economics and operational realities often make that shift difficult. That choice drives everything: How the company contracts with health plans, how it demonstrates value, how it approaches growth, and, ultimately, how it serves its patients.
Malama is at the intersection of two huge priorities for Acumen America: Advancing health equity for Medicaid populations and supporting the evolution—and reimbursement—of the care workforce. Mothers on Medicaid should have access to meaningful and continuous support from pregnancy through postpartum. Malama is making that future real.
- Amon Anderson, Veenu Aulakh, Yichen Feng, and Steven Peralta
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