Digital health startups brace for a post-Roe world

Per a leaked draft obtained by Politico, the Supreme Court is set to overturn the landmark Roe v. Wade decision, a precedent that protects a women’s choice to have an abortion. The move, still yet to go through, would be devastating to the women’s reproductive rights movement and a stunning jolt to healthcare in the United States.

In response to the looming potential shift, the founders of digital health startups spoke up about how the overturn will impact women. For many startups, especially those explicitly focused on women’s health, the future could directly clash with the mission they’ve raised millions and spent years trying to scale: expand access to healthcare across the board.

Nathalie Walton, the chief executive of Expectful, said that restriction “to women’s access to safe abortion services will lead to adverse health implications for countless women.” Walton took her post at the helm of Expectful after herself going through a pregnancy that almost killed her. The haunting experience made her an example of a reality she had long known: to be a pregnant Black woman is to be at risk, regardless of economic background.

While Expectful largely works with women who are on the journey to motherhood, the app dedicates an entire unpaywalled section of its content to how to navigate pregnancy loss. It is in the process of adding a section on abortions to its library, too, and that should be finalized by end of month. “As state laws evolve in the wake of the Court's forthcoming decision, we will continue to create content and programs to support all women, regardless of their unique situation,” Walton added.

Expectful is one of a growing number of venture-backed digital health startups aimed at serving women. According to data from PitchBook, investment in healthcare companies with a female founder or co-founder accounts for 43% of dollars raised by women last year. In 2011, the share was less than 25%. The growing profile of female-founded healthcare startups includes Maven, which made history last year one of the first women’s health companies to be valued at $1 billion.

Founded by Kate Ryder, Maven started as a support service for pregnancy loss and high-risk care management as the founder herself waded through the emotions and confusion of going through a miscarriage. Today, the platform works with employers to give employees a suite of services ranging from preconception to post-pregnancy to family care. A core tenant of the company is “that all people have the fundamental right to make private decisions about their bodies and their well-being, and to decide when, if and how to have a child,” Ryder wrote in a statement on LinkedIn this morning.

Ryder said that Maven has been mobilizing since last September when the Texas legislature passed a law that banned abortion after six weeks and ahead of the potential overturn of Roe v. Wade. She said that Maven Wallet, an app that helps consumers calculate the cost of reproductive procedures and facilitate reimbursement, will be leveraged to help ”American companies cover expenses for women seeking out-of-state care.” The company is also providing options counseling and a forum for people to learn about their choices.

Hey Jane is a digital abortion clinic that connects patients to licensed medical providers and delivers abortion pills to doorsteps. Co-founder Kiki Freedman said that the overturn makes abortion care via mail “now likely to be the most viable form of access for most of the country." The startup believes it will be able to operate in the six states it presently operates in: New York, California, Washington, Illinois, Colorado or New Mexico. Freedman estimates that these states account for 52% of abortion volume worldwide.

A hurdle, she expects, will be a lack of education among consumers on medication-induced abortions. The majority of abortions performed in the U.S. are via medication, except she says that only 1 in 5 people know it’s an option. “It s imperative that we continue to educate people about this safe, effective and common abortion option,” she wrote in a statement.

Hey Jane is preparing for a surge in patients and has already seen an increase after the aforementioned Texas ban. Freedman said that it’s important for California and New York to prioritize legislation that would protect providers, in-state and out of state patients and clinics.

“While we wait for the official decision to come down, Hey Jane is more dedicated than ever to putting the power back in people’s hands through telemedicine abortion care,” she said.

Lauren Berson founded digital fertility program Conceive to better support women on one of the loneliest journeys in healthcare. She tells TechCrunch that Conceive stands by its decision to help all women maintain access to good care "and will do everything in our power to live our values." The startup is donating to local abortion funds and is marching today at 5 p.m.

"And most importantly continuing to educate our community on how abortion is healthcare! The key thing is this is just a draft. Not yet final. And maybe the wake up call everyone needed," she said.

Lux Capital partner Deena Shakir has spent years investing in digital health startups that focus on women’s health and equity, including Alife, Waymark and Maven.

“Like many women and allies at the intersection of healthcare, tech and policy, my phone has been buzzing with notifications from texts, WhatsApp, Slacks, Discords, emails, calls,” she told TechCrunch. Her top priorities are mobilizing public discourse, donations and offering resources to employees and employers.

“Reproductive rights are human rights, and women’s health is population health. They are inextricable,” she tells TechCrunch. “While a tough road ahead, I’m heartened by the women founders, investors and legislators committed to addressing this. More soon.”