Women's health dominates midterm talk

Women's health tech is poised to be in the spotlight with midterm elections looming and abortion care under attack, industry experts say.

• "A ripple effect of Dobbs is honing a light on the women’s digital health industry, even beyond abortion," Goodwin partner Delphine O'Rourke tells Axios.

Driving the news: Venture leaders, investors and entrepreneurs are responding to the Dobbs ruling and preparing for the upcoming election in a handful of ways.

• Virtual-first primary care and other in-home or remote services are gaining steam as women delay in-person care because of fear of criminal prosecution.
• There's been an explosion of venture capital interest in women's digital health, with the formation of new VC groups — such as VCs for Repro, which launched Thursday — with an exclusive focus on abortion rights, maternal health and reproductive care.
• Increased awareness around data privacy is prompting data-tracking companies — especially those that manage menstrual cycles and other fertility-related information — to reevaluate their privacy polices.

Yes, and: There has been a proliferation of women's health startups spanning the DTC and B2B realms, offering cash-based and insurance-covered reproductive health services.

• More virtual-first women's care companies targeting women earlier in life, such as mental- and reproductive health-focused Caraway, which recently debuted with $10.5 million in seed funding.

Zoom in: RH Capital managing director Elizabeth Bailey says many entrepreneurs are now focusing on "engaging women earlier."

• "When it comes to contraceptive deserts — this is where digital health is going to shine in terms of expanding access," Bailey adds.

The other side: Some stakeholders, including pharmacists and providers, are responding to legal concerns by pulling back or refusing to fill prescriptions, citing issues with potentially aiding and abetting abortion care.

• State restrictions on abortions are even seeing some airline executives mull their potential role in aiding and abetting abortion care, says O'Rourke.

What they're saying: Investors tell Axios their plan for the women's digital health sector is simple: The more restrictive laws get, the more money they'll inject into the area.

• "We’re funding solutions that’ll democratize women’s health and sexual health and I think we’re leaning into areas we might not have leaned had there not been legislation curbing these things," says Amboy Street Ventures founding partner Carli Sapir, who recently invested in telemedicine abortion care provider Hey Jane.
• "We’ll be bullish on these companies regardless of the election," she adds.
• Sapir says abortion access is one of Amboy Street's focus areas, meaning every limited partner affiliated "is comfortable with that." She says, "We are happy to be in headlines saying we support abortion access companies."

By the numbers: While interest is flowing to women's health tech, the actual percentage of female venture leaders who receive funding remains in the single digits, with just 2% of all U.S. venture capital in 2021 going to female founders.

• "The trends are super encouraging, but we’re still so small in terms of all the unmet needs," says Bailey.
• "Women are still drastically underrepresented among VCs," Sapir notes.

Meanwhile, patchwork state laws for telemedicine have placed a chilling effect on some women's health providers and companies concerned about legal ramifications.

• After the June Dobbs ruling, Sen. Lindsay Graham in September proposed a national ban on abortion care.
• A total of 17 states have moved to ban or restrict abortion following the Supreme Court's decision to overturn Roe v. Wade and end all federal protections for abortion.
• State lawmakers are cracking down on abortion medications and may seek to prosecute women who cross state lines for abortion care.
• Legal abortions nationwide have declined about 6%.

What's next: Industry observers foresee digital health tailwinds around in vitro fertilization and assisted reproductive technology.

• "As it gets harder and harder to get IVF I think we’ll see more innovation focused on what we can do before that stage," says O'Rourke.
• Employers will also be on the hook for more creative ways to offer women's health benefits, including services for menopause, that don't impinge on privacy.

The bottom line: It is the best of times, it is the worst of times for women's health, and as legislative crackdowns threaten basic rights and protections, industry experts are doubling down on filling a looming care gap.