By dismantling the federal protections for abortion established by Roe v. Wade, the 2022 Dobbs decision has paved the way for states to impose their own restrictive laws. This has resulted in significant barriers to abortion access, especially in conservative states, with nearly 1 in 3 women of reproductive age – about 21.5 million people – now living in states that either totally ban abortion or heavily restrict it after six weeks.
Women in these areas face increased travel distances, higher costs, and logistical challenges, disproportionately affecting low-income women and women of color, exacerbating existing health disparities and leading to poorer maternal health outcomes.
Healthcare providers in states with restrictive abortion laws are encountering unprecedented challenges. Their ability to provide comprehensive reproductive care and manage pregnancy-related complications is severely limited, leading to a reluctance among providers to offer necessary care due to legal risks. For instance, cases have been documented where physicians have delayed or denied care for ectopic pregnancies or miscarriages due to fear of prosecution, endangering patients’ lives. Additionally, the mental health impact on women is significant, with increased reports of anxiety and depression in states enforcing strict abortion laws.
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The ruling has also alarmed the pharmaceutical industry, which now fears the implications of judges overturning FDA approvals of other drugs like Viagra, Humira, and Ozempic. There are also broader implications on this ruling for reproductive rights and healthcare.
Fall-out beyond the clinic
As the second anniversary of the Dobbs decision recently passed, the extensive consequences for women’s rights in the U.S. are becoming increasingly clear. On a positive note, Melinda French Gates has pledged $1 billion to support women’s health and economic empowerment, with a strong focus on safeguarding reproductive rights. She plans to fund advocacy groups and initiatives that aim to expand access to reproductive healthcare and education, counteracting recent legislative and judicial setbacks.
Republican senators in Washington, D.C., recently blocked a bill aimed at protecting access to birth control. This legislative resistance shines a spotlight on the deep political divide and the challenges in securing protections for women’s health rights.
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Meanwhile, the private sector has been proactive in addressing some of the repercussions of the Supreme Court’s decision. Numerous U.S. companies, including major players like Disney, Apple, JP Morgan Chase, Adidas, and Airbnb, have pledged to provide abortion benefits for their employees. Hundreds of other employers have shown their support for reproductive healthcare by covering the costs of out-of-state travel for abortions.
Role for innovation
If there’s any time to innovate in this space, it’s now. There is a pressing need for innovations in reproductive health, such as telemedicine and advanced contraceptive solutions. Investing in these areas is essential to provide alternative options and maintain access to care. Although women’s health has historically been underfunded, private investors and philanthropic organizations are increasingly focusing on mission-driven impact investments in reproductive care, particularly for underserved communities.
In 2023, women’s health startups saw a substantial influx of venture capital, with investments nearly tripling since 2018, reaching approximately $15.1 billion, up from $4.2 billion in 2022. Non-reproductive women’s health startups also experienced significant growth, with $435 million invested in Q3 2023 alone, indicating a broader interest in areas like menopause, pelvic health, and mental health.
For women in America, it is a tale of two cities, marked by both opportunities and setbacks. On one side, there is hope and progress driven by influential advocates and significant private sector support. On the other side, legislative resistance and political opposition pose significant obstacles, threatening to undermine efforts to secure essential healthcare services.
As impact investors with an impact lens, we understand that private capital, particularly venture capital, has a pivotal role in building the women’s health ecosystem. With the current surge in interest and investment opportunities in the market, now is the ideal moment to build on this momentum. We have identified several strategic priorities for investment and innovation that are essential to mitigating the repercussions of the Dobbs decision and advancing women’s health.
1. Revolutionizing contraceptive technologies: One of the most pressing needs in reproductive health is the development of better contraceptive options. Traditional methods, while effective, often come with significant drawbacks that limit their usability for many women. Enter the next generation of contraceptives: long-acting reversible contraceptives (LARCs), hormone-free options, and even male contraceptives, with some products already in clinical development. Companies at the forefront of these innovations offer promising solutions that can provide women with more choices and better control over their reproductive health.
One such company is Cirqle Biomedical*, which develops hormone-free contraceptive products for women. Their flagship product is a non-hormonal, on-demand contraceptive gel that empowers women with more autonomy over their reproductive choices. In 2022, Cirlqe announced a partnership with Organon to further the development of this product. As investors, backing these kinds of ventures isn’t just financially savvy, it’s a direct investment in women’s autonomy and well-being. Another company making headway in this space is Venova which is creating a new female birth control solution designed to be long acting and side effect free. While early in its development, it is showing promising results in several animal models.
2. Expanding telemedicine and remote health services: Telemedicine has become a lifeline, especially in rural and underserved areas. In the context of reproductive health, telehealth services can bridge the gap caused by restrictive laws and limited access to clinics. These services–ranging from online consultations to remote prescription services and virtual counseling sessions – ensure that women can receive the care they need, regardless of geographic barriers. By investing in telemedicine platforms specializing in reproductive health, we can help dismantle these barriers and provide crucial support to women in need.
Maven has significantly advanced the telehealth landscape, particularly in women’s health. As the largest virtual clinic dedicated to women and families, Maven aims to create a more accessible healthcare system. Its digital programs provide integrated clinical, emotional, and financial support through a single platform, addressing areas such as fertility and family planning, maternity and newborn care, parenting and pediatrics, and menopause.
3. Advancing innovative diagnostic tools: Effective reproductive healthcare hinges on early and accurate diagnosis. Companies developing diagnostic tools for conditions like endometriosis, polycystic ovary syndrome (PCOS), and sexually transmitted infections (STIs) are pivotal in this effort. These advancements enable early detection and management, improving health outcomes for countless women. One such company, Evvy*, specializes in advanced diagnostics for vaginal health. By leveraging innovative microbiome testing, Evvy provides personalized insights and treatment recommendations, addressing a critical gap in women’s health and ensuring more precise and effective care. Several companies like Hera Biotech, DotLab, and Ziwig, are at the forefront of developing diagnostic tools for conditions like endometriosis. On average, women with endometriosis wait 5-8 years to diagnose endometriosis accurately, these innovations could facilitate earlier detection and improved management of the condition.
4. Supporting underrepresented communities: Reproductive health disparities disproportionately affect marginalized communities, including low-income women, women of color, and LGBTQ+ individuals. Companies focusing on culturally competent care and addressing these disparities are essential to achieving health equity. Cayaba Care*, for instance, provides home-based maternity care designed to meet the specific needs of underserved women. Their culturally sensitive approach ensures that women receive comprehensive support throughout their pregnancy and postpartum period. Another company in this space is Health In Her Hue, Health In Her HUE is a digital platform that connects Black women and women of color to culturally competent healthcare providers, offering health information that centers on their lived experiences. By leveraging technology, media, and community, the platform aims to reduce racial health disparities and improve health outcomes. Through relevant, engaging, and accessible content, Health In Her HUE raises awareness about health and wellness issues and empowers women of color, along with their allies, to share, learn, and innovate around the health challenges that disproportionately affect them.
Moving forward
In the post-Dobbs era, investing in reproductive health is not only a strategic financial move but also a moral imperative. By channeling our investment dollars into the critical areas described above, we can support innovative solutions, expand access to essential services, and uphold the fundamental rights of women across the nation. This is our chance to make a tangible impact and champion a future where every woman has the freedom and resources to make the best choices for her health and her life.
* RH Capital portfolio companies mentioned in this article are denoted with an asterisk (*).
** We use the term “women’s health” to encompass the needs of people with uteruses and other people assigned female at birth. We acknowledge that not all people assigned female at birth identify as women and vice versa.
Photo: asnidamarwani, Getty Images
Stasia Obremskey is the Managing Partner and co-founder of Foreground Capital. She was previously the Managing Director of RH Capital. She believes the world is a better place when you educate women and give them the tools to manage their unique healthcare needs, this has inspire her work in women’s health After working professionally for over twenty-five years as a trusted advisor to non-profit organizations and start-up companies, and establishing herself as an impact investor in women's reproductive health, she joined Rhia Ventures at its inception in 2018. Stasia holds a bachelor’s degree in Business Administration with a concentration in finance from the University of Notre Dame and an MBA from the Harvard Graduate School of Business.
Meera Doshi is currently an MBA student at the Stanford University Graduate School of Business. Prior to being an investor at the Stanford GSB Impact Fund, she spent two years in healthcare investing at FFL Partners and three years in consulting at McKinsey & Company in San Francisco.
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