To Be or Not to Be [Pregnant]

BY GRACE MOEN

Choice. Women haven’t always had it. And in many ways it’s still under attack. But a new wave of digital health solutions is opening doors for women to manage their unique health needs, such as family planning.

A Brief History of Birth Control.

The name says it all: Birth. Control. Control over birth. While the term is modern, the pursuit is not. Dating back to 1850 BC, Egyptian women used to rub crocodile excrement on their cervixes. Condoms were once made out of fish bladders. Victorian women had access to diaphragms made out of vulcanized rubber. It wasn’t until 1960 with the help of Margaret Sanger - a nurse who raised $150,000 for research - was the birth control pill developed. Since then women have gained access to birth control that come in a variety of form factors. And now that computers live in our pockets, a whole new suite of accompanying technology that augments and enhances family planning experiences is available for women to have more control than ever.

Convergence with Digital Health.

FemTech is a relatively new class of digital health solutions that cater to women and the health experiences unique to female anatomy. From period tracking to nursing care to sexual health, what unites the range of products is accessibility and affordability, and are thus sending barriers to reproductive autonomy into extinction. Like other digital health areas, FemTech arose from the convergence of diverse technology platforms, new formats for care delivery services, increasingly robust data sets, and, crucially, the relaxation of antiquated government regulations. The introduction of FemTech solutions focused on period tracking apps, which many women find highly useful. In a short amount of time though, and in no small part to the $200 billion in funding FemTech has garnered since 2015, the product offerings have expanded.

To Be or Not to Be [pregnant].

Period tracking now includes fertility tracking, by which temperature is often the metric of record. Temperature readings correlate to progesterone levels and when taken daily, give the algorithm important data about when a woman is most likely to conceive. Kindara is one such app / thermometer combo and their data-rich interface is beautiful. Natural Cycles is another. The Ava app is paired with a bracelet that measures temperature but adds data like resting pulse rate, sleep quality, movement and more. Some people believe that fertility trackers shouldn’t be confused as birth control though. In 2016 Natural Cycles got in trouble for dozens of unplanned pregnancies after the FDA approved the technology as “the first birth control app.” Unfortunately, tracking your natural cycle with Natural Cycle is not a foolproof method and points perhaps to marketing promises that went too far. Because of the lower efficacy rate (76% according to the CDC, relative to contraception methods such as the pill, an IUD, condoms, or an implant that come in at 91% - 99% effective) it can be more of a tool to help get pregnant than to avoid it. For women who aren’t trying to get pregnant, who are on the pill, and who find it challenging to take a daily pill, Aavia uses smart technology on its pill case to help keep users honest about adherence. The slim and sleek case syncs with an app for seamless reminders and no manual data input.

Birth Control, Delivered.

No longer restricted to provider visits, birth control has been freed from the shackles of brick and mortar offices. Through simple digital assessments and a small fee Lemonaid Health will ship birth control pills or a ring right to you. As will Nurx, who also offers the benefit of at-home screening tests for sexually transmitted infections. Simple Health doubles their birth control offering with orders for contact lenses. If wearables and tracking were the first phase of the consumerization of healthcare, then delivery services are the second. Like groceries and books and household items, the convenience factor is too great to be ignored.

Global Opportunity + Impact.

Fifty point eight percent of the American population is female, and 99% of them have used some form of birth control in their lifetime. For those of childbearing age, 62% are currently on birth control. Yet still, existing firms of birth control aren’t suitable for all women or all couples in all geographic regions. Imagine if you will, that if birth control can be delivered and Amazon is already delivering packages to remote locations via drone, there is a global health opportunity here to provide greater accessibility in developing countries. Imagine if FemTech and Digital Therapeutics had a baby, what would that technology solution look like? Imagine a birth control option for men. Imagine sensor technology that gets smaller and more nimble that could produce more accurate data for the overwhelming number of women who want to track their cycles naturally and hormone-free. Until there are options available for every woman, FemTech has massive market potential and there will remain opportunities for impact and innovation.

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