How Malama Gives Me Hope for a Broken System

I first met Mika Eddy, Founder and CEO of Malama, at a Capital F event last year. She described her business model to me. Truthfully, I didn’t understand a lot of what she was saying. But her purpose was clear, our values were aligned—and the sparks flew. 

I am not a stranger to complicated businesses. Some of our most successful brand strategy projects begin by untangling complex business hairballs before we get to the fun stuff. Malama was an especially ambitious one: Medicaid, doulas, social services, provider workflows, an app for gestational diabetes, several audiences who do not speak the same language—and so many acronyms it’s actually another language entirely.

But once we got inside the model, I understood something important. Malama is complex because the problem is complex. I’ll break it down for you so you can talk about healthcare at happy hour (acronyms not included).

The system fails where motherhood actually happens.

Medicaid financed about 40 percent of all U.S. births in 2024. This is not a niche population. It is a huge share of American motherhood.

For mothers on Medicaid managing high-risk pregnancies under the pressure of real-life circumstances, the biggest challenges don’t fit neatly into their medical charts. Because motherhood doesn’t happen in a doctor’s office, it happens everywhere else.

Medical risk rarely arrives alone. Roughly two-thirds of Medicaid beneficiaries reported at least one unmet social need. Think food, housing, transportation and utilities. It’s hard to follow your dream birth plan when you can’t get to an appointment or keep the lights on.

Access to care is getting worse. Nearly one in three U.S. counties remains a maternity care desert. Black women are still about three times more likely than white women to die from a pregnancy-related cause, according to the CDC.

Meanwhile, the pronatalist movement is enthusiastic about babies but strangely quiet about the people raising them. While it appears to put families on a pedestal, a pedestal is not childcare, housing, food or healthcare. Restricting reproductive choices while reducing access to Medicaid and food assistance has eroded an already-fractured support system, leaving parents holding the bag (along with the baby). It’s a pro-family promise that disappears before the baby is even born.

The mother of all system upgrades.

Better models are being built. Malama is one of them, with a proven model based in community-embedded enhanced care specifically for mothers on Medicaid. Here’s how it works.

Care comes before the crisis.

A missed ride, an empty refrigerator or unstable housing is a health issue. California’s Enhanced Care Management connects eligible pregnant and postpartum Medi-Cal members with coordinated care and social support.

Malama makes that support personal. A dedicated Care Manager stays with a mother from pregnancy through postpartum, helping her follow a clinical plan and navigate real life. The model does not wait for a crisis to become a claim.

She has someone in her corner.

If you know what a doula is, you may picture a premium service for highly educated, wealthy women in Marin who want a water birth. Malama rethinks who gets that kind of support by bringing doula wisdom to an underserved community.

Malama’s Care Managers are Certified Doulas trained in both maternal care and case management. They help mothers understand symptoms, coordinate with providers, access food or housing support and stay engaged between appointments. Research has associated doula support with lower rates of preterm and cesarean birth and potential Medicaid savings.

Remote monitoring closes the in-between.

Healthcare still relies heavily on the scheduled visit, as if blood sugar, blood pressure and anxiety politely wait for office hours.

Malama’s remote monitoring platform gives patients real-time feedback and providers visibility between visits. Malama reports that 80% of gestational diabetes patients achieve glycemic control within two weeks, alongside 38% fewer preterm births and 58% lower rates of macrosomia compared with national Medicaid averages.

AI stays invisible.

The best uses of AI in healthcare may be the ability to take the admin off clinicians’ plates. This is the version of AI we can get behind. Let the machine manage the data so the provider can look at the patient. The technology creates more room for care.

Postpartum becomes part of maternal care.

The baby’s birth cannot be where care ends. About half of women with gestational diabetes develop type 2 diabetes, and one in eight reports postpartum depression symptoms. Mental health conditions lead pregnancy-related deaths.

The Lindsay Clancy mistrial, following her defense’s postpartum psychosis argument, raises an overdue question: who is there when a mother needs serious postpartum care?

Malama stays through 12 months postpartum, with mental-health support, care navigation, wellness programming and diabetes prevention. Their promise: We don’t disappear.

TLDR

The idea is simple: act earlier, stay closer, make support easier to reach and use technology to reduce friction.

Malama’s proven care model connects clinical care to the human realities that determine whether care works. They make technology useful and community-based care scalable.

And they recognize that supporting a healthy pregnancy requires supporting the mother who carries everything—the baby, the family and the future of humanity.

Our branding challenge was not to make Malama’s complex business look simple (it isn’t). It was to bring clarity to the business without losing the humanity that makes it work.

Check out the Case Study to see how we did it.