This story is part of our June 2026 issue. To read the print version, click here.
Ten years ago, Melissa Hanna was celebrating her
birthday with family at Din Tai Fung in L.A. when her mother’s
phone wouldn’t stop ringing.
All Hanna wanted was an hour — just one uninterrupted hour to
celebrate. Her mother, Linda, put the phone on silent. It kept
buzzing on the table.
“Mom, really?” Hanna said.
But this was typical. Linda had spent four decades as an
obstetrician nurse and board-certified lactation consultant
before opening her own private practice. The calls came from
everywhere: physicians looking for guidance, mothers struggling
to breastfeed, parents worried something was wrong. And she was
in the middle of it all, the one who people called when they
didn’t know where else to go for help.
The phone wouldn’t stop ringing because it couldn’t.
“I got a different sense of what was really happening in her
world,” Hanna says. “She would tell these stories and be
frustrated there weren’t better ways to communicate. All these
folks were supposed to be connected, but didn’t have the
processes, systems or technology in place.”
For pregnant women and new mothers, those communication gaps can
become life-threatening. The U.S. has the highest maternal
mortality rate among high-income countries, according to data
published by The Commonwealth Fund. CDC analyses show that most
pregnancy-related deaths happen after delivery, when support
usually drops off. The maternal health crisis is especially hard
on Black and Indigenous women, who are about three times more
likely to die from pregnancy-related causes than white mothers.
More than 80 percent of pregnancy-related deaths are preventable,
the CDC reports.
Mahmee CEO and co-founder Melissa Hanna speaks at Prego Expo, a
convention for maternal health services. (Photo courtesy of
Mahmee)
The Sacramento region is feeling the pressure with birth centers
closing and fewer physicians to go around. In the past decade,
CBS Sacramento reports that more than 50 labor and delivery wards
have closed at California hospitals, and 12 counties now lack any
hospitals with labor and delivery services. But as demand strains
hospitals and resources, health systems in the region are
responding with remote tools and wraparound services to create a
safer, more integrated maternity journey.
In the company of supporters
Growing up around healthcare, Hanna realized mothers needed more
than traditional systems could provide. In 2016, she launched
Mahmee, a maternal health platform for wraparound care that
includes doulas, lactation consultants, nurses, mental health
providers and care coordinators for mothers to have support
before and long after delivery.
“The mission matters,” Hanna says. “It has such an immediate
impact on people’s lives.”
One of the biggest issues in maternal health is the delicate
window after delivery. Many patients don’t come in for a standard
check-up until six weeks postpartum. But a lot could go wrong in
that time. Mahmee aims to fill this gap by offering breastfeeding
support, postpartum monitoring and mental health services without
strict visit limits. The company also employs doulas, non-medical
workers who provide emotional and physical support during
childbirth, as salaried workers with benefits, which is unusual
in a field dominated by contract labor.
Allison Formoso holds her daughter Avery. Formoso says she found
support through Mahmee both before and after Avery’s birth.
(Photo by Melissa Strong)
Allison Formoso, who lives in Rancho
Cordova, didn’t know much about doulas. She thought they were
expensive. Late in her pregnancy, she learned her insurance
included coverage for doulas, specifically with Mahmee, and
connected with one. She says her doula, Corena, gave her
resources, discussed plans and informed her of birth choices she
didn’t know about. Along with her husband, mother and friends,
Corena made her feel supported during the birth and the
postpartum transition: They were continuously checking in, making
her food, helping around the house, helping with her newborn
daughter.
But Formoso began experiencing postpartum depression and anxiety
after the baby was born. And this made her feel guilty because
she had such a solid support system. It was her first birth
experience and she had no idea how much her life would shift.
“My entire adulthood has been focused on furthering my career and
in an instant, everything changed,” Formoso says. “This tiny
little human just shifted my mindset and goals that I have had
for decades.”
As her daughter became “increasingly more fussy for no apparent
reason,” Formoso says, she felt alone and completely lost on what
to do. After receiving her responses from a mental health
check-in, Mahmee linked her with a mental health and wellness
coach and referred her to therapists specializing in postpartum
health.
“I wish that this was discussed more, as it was extremely
isolating,” Formoso says.
It’s complicated
Postpartum complications can show up through various warning
signs, such as chest pain, trouble breathing, seizures or
thoughts of harming yourself or your baby. (Seek emergency
medical care immediately if you experience any of these symptoms.
Early treatment can be lifesaving.)
Dr. Jennifer Overbey, an OB-GYN at Dignity Health’s Mercy Medical
Group, says many postpartum mothers dismiss getting help because
they’re exhausted, overwhelmed and focused on caring for their
newborns.
“You’re tired, you’re not sure if these symptoms are severe
enough to go in,” Overbey says. “You don’t want to leave your
baby to go to the hospital.”
That hesitation can be dangerous, even deadly.
Overbey recalls one physician who had recently given birth and
had a severe headache. She thought it would go away. By the time
she came into the hospital, she had suffered a minor stroke and
lost part of her peripheral vision.
“These types of things happen all the time with mothers,” Overbey
says. “We as women are caregivers, so it’s easy for us to talk
ourselves out of going in to get care sometimes.”
Remote check-ups
To keep track of vitals before they become emergencies, hospitals
across the Sacramento region have turned to remote monitoring
programs.
Mercy Medical Group sends patients home with blood pressure cuffs
connected to an app. Nurses monitor readings and ask patients
about symptoms like headaches, blurry vision and abdominal pain.
If numbers spike too high, patients are directed to the emergency
department.
Last fall, Sutter Medical Group launched its Sutter Sync pilot
program, which also uses blood pressure cuffs and a weight
monitoring device synced to patients’ medical records. Video
visits allow mothers to get support from home, which physicians
say is especially helpful for postpartum mental healthcare.
Mahmee’s clinic in Fresno is outfitted with cozy chairs and other
accoutrements meant to make mothers comfortable. (Photo courtesy
of Mahmee)
“Patients find it’s hard to get into the office with small
children,” says Dr. Carrie Yiakis, an OB-GYN with Sutter Medical
Group and one of the physician leaders for Sutter Health’s
Women’s Service Line. “We know depression is such a significant
risk, impacting so many women. A lot of people feel comfortable
communicating from home, particularly those who just had a
procedure or had a child.”
According to Dr. Jeffrey Hastings, an OB-GYN based at Kaiser
Permanente in Folsom, maternal health problems begin before the
delivery room. Conditions like hypertension and diabetes can
increase risks during pregnancy and postpartum recovery.
“What Kaiser is famous for and does great is preventative care,”
Hastings says. “The entire system is set up to help patients be
healthy at baseline.”
Kaiser has also started using a device designed to treat
postpartum hemorrhage, one of the leading causes of maternal
complications and death. This tool uses suction to help the
uterus contract more quickly and reduce severe bleeding.
“It saves lives,” Hastings says. “Saves people from blood
transfusions.”
The doctor is out
Even as technology improves, health systems still need physicians
to deliver babies. But the shortage of OB-GYNs has been getting
worse, with projections showing nearly all states, including
California, may not have enough by 2035.
This shortage will be most severe in so-called “maternity
deserts,” rural pockets with little or no obstetric care.
Overbey, who has been with Mercy Medical for about 18 years, says
the biggest maternal health challenge is access.
“We’ve been recruiting for the same positions with much higher
pay and a really nice bonus package and it’s still very dry,” she
says.
She attributes the shortage to several overlapping factors. Many
younger physicians are opting out of traditional around-the-clock
obstetrics work to choose hospitalist positions. They want more
predictable schedules and fewer demands outside the hospital.
They want earlier retirements and a better work-life balance than
previous generations.
“We’re not working like the guys of yesteryear,” Overbey says.
“We just had two OBs that retired. One was 83 and the other was
77. And women are saying, ‘We’re not working like that.’ … I’m
not missing my son’s basketball game.”
Supporting Black mothers
On one hand, this shift is helping doctors avoid burnout, but on
the other, it also means fewer physicians available for office
visits, surgeries and long-term patient care. Absences make a big
difference in maternal healthcare, especially for Black mothers,
who already struggle to feel heard and seen.
Healthcare providers across the region agree that representation
matters for addressing such disparities. Overbey says Mercy
Medical Group has focused on building diverse care teams and
expanding remote monitoring at no cost to patients. Methodist
Hospital in Sacramento also created an OB emergency department
where every patient is evaluated by a board-certified OB-GYN
before discharge.
Hastings says Kaiser has focused on reducing anemia and
hypertension during pregnancy because both conditions contribute
to worse outcomes and have historically affected Black patients
at higher rates.
The health system has also expanded doula access and participated
in statewide maternal health collaboratives for reducing
unnecessary C-sections and improving birth equity. Hastings also
notes Kaiser is developing a “bias impact response team” in the
Sacramento and Roseville region.
“There is new tech in medicine, but the most important thing is
the people,” he says. “Having a nurse with you the entire time,
helping guide the experience, is so important and helpful.”
Different lanes
Ten years ago, while in graduate school, Hanna had moved back
home and spent many nights listening to her mother’s nursing
stories.
By then, Linda had left the traditional hospital system to
deliver home-based care out of her customized 30-foot Winnebago,
converted into a mobile maternal health office by the crew from
Pimp My Ride. Inside was a space for lactation support, nursing
bras and breast pump rentals. She used to drive from one side of
L.A. to the other delivering services, Hanna says.
The Mahmee team at work. (Photo courtesy of Mahmee)
Before launching Mahmee, Hanna received a warning from Linda
about the world she’d be stepping into: “‘There’s opportunity
here, but you’re going to need to convince a lot of people to
care about this cause.’”
But Hanna was committed, on a mission to “make the U.S. the best
place in the world to give birth,” she says.
Despite this venture-backed startup life being unfamiliar
territory, Linda came aboard as one of the co-founders, merging
decades of clinical experience with her daughter’s technical
savvy.
So what’s it like for Hanna working with her mother?
“I always ask: ‘What would it be like working with your mother?’”
She laughs. “We have very different skill sets. She specializes
in healthcare, I’m business and policy. We had to learn to
respect each other’s lanes. That’s important. You don’t want the
business of healthcare to interfere with the care of healthcare.”
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