Why we build for pregnancy - Ruth Health

Why we build for pregnancy

It’s odd that we’re building a company in maternal healthcare.

  • Most founders and C-suite executives of healthcare companies are white men.
  • Maternal healthcare is a complex, underserved, unsexy sector in which to build a company.
  • I am not a parent (yet?).

So why would we make it our life’s work to improve the experience of pregnancy in America?

I’ll never forget a surprising tweet from a venture capitalist, highly syndicated journalist, and parent whom I respect. She said that founders who have personal stories tied to building their companies are the ones she prefers to fund.

It’s a common archetype. Look no further than our peer at Ro, Z Reitano, who told his own story of erectile dysfunction and reaped millions in venture funding. Ro is now valued at $5 billion.

Now, why is that norm? Why must we serve ourselves with our own life’s work?

I’ll concede that it’s powerful when a startup founder has a personal story tied to the business they’re building. This is why we’re awed by founders like Kimberly Seals Allers of IrthApp, Whitney Wolfe Heard of Bumble, Crystal Evuleocha of Kiira Health, Courtney Williams of Emagine, and Max Adler of Outbox NYC.

But that’s not us. Audrey and I chose a different path.

We began our adventures in “FemTech” by making a dreaded gynecological medical device more comfortable for vagina-owners. Then, we realized the speculum was the tip of the enormous iceberg.

Much of womxn’s health needed to be rethought by us, for us. So that’s what we did — moving next to maternal clinical care beyond Obstetrics.

We could have chosen a touchpoint along the journey from menstruation to menopause more relevant to our own lives, but we didn’t.

We are energized in building Ruth Health for womxn who are just like us, yet who are not us.

There’s an immense privilege in my being a woman under 30 without children. I am currently childless by choice. I have experienced pressure to have children, to plan for children with partners, and of course, the subtle, loving nag of a Greek Jewish mother who wants grandbabies.

But Lolo, my beloved four-year-old niece, has shown me that the children of others should be my priority in life right now — not the children I may or may not one day have for myself. I can only speak for myself (Audrey agrees).

This is not us patting ourselves on the back for being selfless; we see the enormous market opportunity for pregnancy care.

Our TAM is 26 million American working moms per year and, thanks to our telehealth Postpartum Pilot, 112 million working moms worldwide.

But with empathy and R&D via nearly 500 pregnant or recently pregnant birthing people, we think we can create real improvements in the lived experience of pregnant people — including those on Medicaid.

This process requires endless empathy. It is draining and infinitely worthwhile. Audrey and I cry together at times. We lead with love. We are not your average startup founders. Ruth Health is not your average startup.

YCombinator confirmed that fact by accepting us into its current Summer 2021 batch.

That’s because, as we often say, there is no such thing as an average pregnancy.

As such, we can only build with the hundreds of pregnancy stories we heard in mind. Over 100 of those stories came from “COVID moms.” These parents and their non-birthing partners survived the pandemic while pregnant. They had likely the hardest time of any generation of parents since the Great Depression.

Their work went beyond parenting; their jobs were to keep the family afloat + themselves alive in some of the darkest times in recent memory.

They lost family members to COVID. They struggled with whether/when to get vaccinated, see family, and how to go through the maternal healthcare maze alone due to COVID regulations. They had to sacrifice time, careers, and mental health to prioritize their families and babies.

That sacrifice has never been greater in our modern world than since the start of this pandemic, still very much underway.

So what are two childless womxn doing building a company that makes pregnancy care easier, more accessible, and more affordable?

Why do we fight for every dollar we raise and work 80/90-hour weeks to improve lives with a different set of life challenges than our own?

Simple: when you’re called to disrupt womxn’s health, you have the privilege to meet quite literally millions of unmet needs.

Womxn’s healthcare only receives 4% of total global R&D dollars, but we are 51+% of the global population. “Underserved” doesn’t fucking cover it.

So Audrey and I did what any serial entrepreneur would do: we picked the biggest unmet need. We muster our empathy — as female and non-binary founders like us are uniquely poised to do — to honor the stories of womxn we love, womxn we’ve never met, who build new worlds with their wombs.

All of us have been present for at least one birth.

Whether it’s our own or someone else’s, deep societal factors impact every birth. Today in America, inequity infects every layer of society—and of birth.

Birth is the foundation of life.

In a city like New York, where Black, non-Hispanic mothers are 12 times more likely to die from pregnancy-related causes than white womxn, that foundation is like the underside of Williamsburg, Brooklyn: toxic sludge.

While birth workers for the past hundred or so years have made powerful strides in improving the experience of birthing people, we’re not done.

We won’t be done until pregnancy is equitable; until womxn are not in peril as they bring life into the world; until our sisters are not pushed into avoidable C-sections, pre-eclampsia is under control, and pelvic floor prolapse is treated as the serious, painful, potentially-avoidable problem it is—not a foregone, oft-ignored conclusion.

The statistics clearly show that womxn of color are significantly more at risk during pregnancy, birth, and beyond. These womxn must be our top focus.

But Fellow White Womxn: we are not safe, either. One of many inspirations for building Ruth Health was my brilliant colleague, Jenny Eggers.

When I worked with Jenny at Siegel + Gale, I looked up to her as one of the only female leaders at the company. With a desk by her office, I heard her lead her team with love every day.

That’s why it was so painful to discover one horrific day that Jenny tragically passed away in childbirth.

Thankfully, her son and husband survived. Jenny’s legacy became larger than her huge life. At her memorial service, hundreds of us gathered in a bar in New York City and remembered her wit, grace, and determination.

The injustice of her death never settled in my mind. Jenny, an affluent white womxn, suffered the same fate as Kira Johnson (the driving force in memoriam for 4Kira4Moms).

Maternal mortality does not always discriminate.

The maternal mortality rate in New York City is higher than in any other city in the developed world. We cannot sit back and let that happen. We owe it to womxnkind to make pregnancy care easier and better.

Whether it’s womxn paying the pregnancy tax, non-birthing people lacking resources to support their birthing partners, or womxn of color suffering from institutionalized racism via ignorant birth workers… we can and MUST change these outcomes together.

Birth is life. Women’s health is human health.

And although terms like “FemTech” and “women’s health” are useful for fundraising, they are useless for families.

What families need is affordable support. For single mothers, affluent Manhattan families, queer couples, trans parents, CEOs, and underserved mothers on Medicaid — the only way out of the maternal mortality crisis in America is through it.

We promise to work with and within the existing healthcare systems to get through to patients who need us most. Yes, our first publicized patient was a celebrity; she was also publicly suffering while pregnant.

Pregnant people like Laura, Jenny, and Kira deserve joy.

It’s time to reduce suffering while pregnant. I’ve never been pregnant before, but I refuse to accept the injustices shared through stories heard over the past two years and throughout this COVID-19 pandemic.

We will not be complicit in the weaponization of birth against womxn who deserve autonomy — and even joy.

This is why we build for pregnancy.

Until feminism succeeds, we must start with birth.

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