These startups are rethinking pregnancy care


As the pandemic began in New York in April 2020, Joanne Schneider DeMeireles miscarried. She knew something was wrong when she showed up for a prenatal appointment and her obstetrician told her that her embryo was only five weeks old. “I was like, it’s not possible,” she said.

Her doctor dismissed her concern and told her to come back the following week for another ultrasound. Schneider DeMeireles had worked in a fertility clinic before and knew when she ovulated, and she had obsessively monitored her pregnancy. The small size of her embryo – the way doctors track the age of the fetus – meant there could be a problem. The following week, when she returned to the doctor, there was no heartbeat. It was a miscarriage, one that had not yet expelled.

Schneider’s doctor DeMeireles told her she had two options. She might let her body expel naturally, but miscarriages can take days and are painful. Or she could opt for dilation and curettage (D&C), a procedure that removes tissue from the uterus to prevent possible infection. It’s elective surgery, which she was unable to access due to pandemic restrictions. What her doctor didn’t tell her was that she could take a series of pills to help end the miscarriage. Schneider DeMeireles later found out that his obstetrician was affiliated with a religion and since these are the same pills used for an abortion, the doctor did not offer them. In the end, Schneider DeMeireles had to see another doctor to access the drug.

Schneider DeMeireles’ experience is not unique. But now she is one of many women inspired by their experiences of pregnancy, pregnancy loss and postpartum care who are trying to change the way women receive care. After her miscarriage, Schneider DeMeireles joined a new maternal health clinic called Oula as the experiment manager. Oula is one of a host of startups focused on improving pregnancy care that include clinics; apps that answer questions doctors might not take the time to; pregnancy trackers; and products like underwear with built-in slots for ice packs.

Adrianne nickerson (left), Joanne Schneider DeMeireles (center), and Elaine purcell (law) [Photo: courtesy of Oula]

Between 20% and 25% of pregnancies end in miscarriage. The biggest problem in pregnancy care is that the healthcare system is designed to provide individual medical services, and caring for a pregnant person requires more than just collecting billable transactions. Even when a traditional practice is good, there are problems. Meetings are abrupt 15 minutes. It’s hard to have an obstetrician on the phone when you have questions or, worse yet, major concerns. Transferring records between physicians requires a mess of phone calls, emails, and consent forms.

“Because we don’t have true data portability, you end up telling the same stories and you don’t have coordinated care across departments,” says Leslie Schrock, angel investor and author of The Pregnancy Guide. Bumpin ‘: The Modern Guide to Pregnancy: Navigating the Wild, Weird and Wonderful Journey from Conception to Birth and Beyond.

The maternity care products market is expected to exceed $ 3 billion by 2023, according to a 2018 report from Research and Markets. The cost of the birth itself is high: an average of $ 14,000 nationally. Some companies are already having success in this area. Maven Clinic, a social benefit that coordinates fertility, prenatal and postpartum services for women, has raised nearly $ 100 million in funding, according to data from Pitchbook, and has secured clients like L’Oreal, BuzzFeed and Snap. It stands to reason that pregnant women may be inclined to seek out doctors and services that can provide more for their money.

Reinventing in-person care

Oula is nestled between brown stones in a quaint Brooklyn block, with a Kiehl’s just down the street. The lobby has a warmer aesthetic than your average doctor’s office, but follows the same spatial rulebook as forward-thinking practices like One Medical or the Tend dental office. The color scheme is similar to that of the uterus, with undertones of brown, pink and red. There is feminine art on the walls and the decor is round; even the floor tiles are adorned with little red half-moons. Just beyond her sofas are children’s toys, and in the bathroom is a self-cleaning changing table from a Chicago-based startup called Rain.

The first appointment at Oula lasts an hour and can be in person or online, although the clinic encourages people to make their first visit virtually. “A lot of clinics won’t even talk to you until they can see something on the ultrasound, so we knew it was something we wanted to do differently,” said Schneider DeMeireles. “We’ll talk to you whenever you want – before you get pregnant, if you just want to talk about how to get pregnant. But what you need to know is that if you are looking for an ultrasound it will not be possible for at least 7 weeks, and if you are looking for genetic testing it will only be possible for at least 10 weeks. . “

[Photo: courtesy of Oula]

Oula is able to offer longer appointments in general because her clinic is mainly made up of midwives. The clinic has an obstetrician. “Midwives are experts in low risk pregnancies,” says Schneider DeMeireles. “They are actually the best people to manage a low risk pregnancy, while OBs are surgeons and experts in high risk pregnancies. And so at Oula, we want to be very smart about which patients need what level of care. “

Midwives are also much cheaper to employ, which allows Oula to purchase insurance, including Medicaid, like any other clinic, but offers more appointment time. The company also has a digital platform where patients can contact their caregivers for advice at home. Oula recently added the ability to message a midwife and develop a care plan highlighting key decisions that need to be made during the pregnancy journey. The platform also provides guidance on when to schedule appointments between conception and birth, and an automated check-in that asks patients to report how they are feeling. The content of the site can help answer basic questions that pregnant women may have.

So far, Oula has only one clinic in Brooklyn and will give birth in Mount Sinai West. Eventually, she hopes to open her own birth center. In the meantime, he’s exploring different aspects of how he wants to heal differently.

“We had our first missed miscarriage patient and [our team] got together and said, “Okay, we’ll give them a little care kit,” says Elaine Purcell, co-founder and COO of Oula. “Because, again, it’s not just [about medical protocol]. Let’s give them a journal, let’s start thinking about different ways for them to cope.

New layers of support

In April, medical journal The Lancet published three articles on miscarriages and called for a complete rethink of miscarriage care. This year, a group of midwives launched a miscarriage kit called Box for Loss. For $ 150, it includes Nyssa Care postpartum underwear, which has a pocket for an ice or heat pack, essential oils, vaginal vapor, CBD oil, crystals, and meditations.

Simmone taitt [Photo: courtesy of Poppy Seed Health]

Other startups are looking to prevent miscarriages. Kindbody and TMRW Life Sciences are trying to bring more care to the fertility clinic space. Meanwhile, home testing startups like Modern Fertility, Everlywell, and Oova are giving women more opportunities to understand their pregnancy and potential for miscarriage. Oova is a urine based kit that uses hormone levels to tell women when to get pregnant based on their own cycle. Some women continue to use the kit after they get pregnant to make sure they continue to make enough progesterone to keep their embryo implanted, says founder Amy Divaraniya.

Simmone Taitt, founder and CEO of Poppy Seed Health, says that when her pregnancy ended in miscarriage, her obstetrician offered no support. “She told me that my body had terminated the pregnancy. . . . She said, “But it’s okay, you can start over in a few months and I’ll see you when you get back.” “And she walked out of the room,” Taitt said. “It was a few minutes. It was devastating. It was insulating. “

It was a few minutes. It was devastating. It was insulating. “

Simmone Taitt, Poppy Seed Health

She launched Poppy Seed Health, a mobile app with on-demand access to midwives, doulas and nurses who can help people manage pregnancy and loss. The app costs $ 29 per month, but for people who have just suffered a loss, it’s free. “You give us your name and pronoun, and you are – in less than a minute – in touch with someone at Poppy Seed Health who is specifically trained to hold space for pregnancy loss, grief and loss. of an infant, ”Taitt said, adding that scholarships are available for those on Medicaid so that they can also access his platform.

Mental health care for pregnant women is sorely lacking. A 2018 report from the nonprofit California Health Care Foundation states that “Perinatal mood and anxiety disorders are the most common medical complications affecting women during pregnancy and after childbirth.” Working with the National Partnership for Women and Families, the CHCF conducted a survey that found 20% of pregnant women in California tested positive for anxiety. Another 11% tested positive for depression, more than the percentage of women testing positive for postpartum depression. Black pregnant women scored 10 percentage points more for anxiety and depression. Regardless of race, only 20% of women with mental health issues were able to get help.

Black women are also three times more likely to die from pregnancy-related causes, according to the Centers for Disease Control and Prevention. This disparity creates yet another reason why women want to reinvent pregnancy care.

“To be a black woman with great confidence, a great education. . . and I was still not receiving medical attention. . . I needed it because of my race, ”says Taitt. “We’re not reinventing, we’re building something new. “

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