The Problem with Women’s Health
Welcome to this week’s issue of Notes to Selfe Publication where we curate insights, trends, and investment opportunities relating to The Future of Women’s Health.
While scrolling through LinkedIn last week, a post caught my eye.
It was written by Alison Greenberg, and it broke my heart.
Alison was shutting down her startup, Ruth Health. For four years, she had poured her vision, energy, and expertise into addressing gaps in maternal health, creating tools that supported moms and families in ways few others were attempting. In her note, she wrote, "even the strong often cannot survive in healthcare technology," underscoring the harsh realities that so many women’s health startups face.
Alison’s message resonated with me on a profound level.
Her journey captures the relentless challenges in building a women’s health company in an industry that often struggles to prioritize and invest in women-centered solutions. Ruth Health’s closure highlights the structural and systemic barriers that so often block progress—challenges that reflect an industry reality, not a lack of perseverance or vision. It’s a story that speaks volumes about why we need to address the fundamental issues stalling innovation in women’s health.
The Persistent Funding Gap
Women’s health startups face a critical funding gap despite the sector’s massive potential. In 2022, the U.S. women’s health market was valued at over $30 billion, growing annually at around 13%. Yet, women’s health startups received only 2% of venture capital funding in 2021—a stark reminder of the disparity. For companies like Ruth Health, which focused on maternity care, this gap is even wider. Maternal health solutions are often seen as niche, an unfortunate misconception that overlooks the fact that maternal health affects families and communities worldwide.
This limited funding hampers development, marketing, and scaling, forcing companies like Ruth Health to operate on a shoestring budget in a field that demands much more. Without sufficient capital, even the most innovative solutions struggle to reach their full potential.
The Reality of Lengthy Sales Cycles in Healthcare
Another challenge Ruth Health faced was the lengthy and unpredictable sales cycles in healthcare. According to a report by McKinsey, healthcare sales cycles can range from 12 to 18 months or longer. For women’s health startups, which frequently engage with hospitals, insurers, or public health systems, these long cycles put immense strain on cash flow and sustainability. Maternity care, in particular, often requires navigating extensive layers of approval, patient safety protocols, and integration with complex healthcare systems.
For a startup working with limited capital, waiting months—or even years—for revenue can be an insurmountable hurdle. Ruth Health’s experience highlights the critical need for financial flexibility and strategic patience, but without a secure funding foundation, it’s almost impossible for startups to endure such drawn-out sales timelines.
Relentless Bias Against Women’s Health Solutions
Bias against women’s health solutions remains a significant hurdle. In 2023, many topics in women’s health, such as pelvic floor therapy or postpartum care, still face resistance and are often misunderstood or dismissed. Alison shared that Ruth Health encountered backlash for using inclusive terms like “birthing people,” reflecting a broader cultural lag in accepting women-centered health topics with the seriousness they deserve.
Historically, only 4% of healthcare R&D funding has been directed toward women’s health, despite women comprising half of the global population. For startups like Ruth Health, this not only adds layers of complexity to product development but also requires constant advocacy to educate the market and drive social acceptance.
Resilience, Community, and the Path Forward
The closure of Ruth Health emphasizes the need for resilience in this space, but more importantly, it highlights a need for structural change. As Alison wrote, “It takes countless minds, clinicians, companies, technologies, and community-based organizations to make sustainable impact.” And that’s exactly the point: Women’s health startups cannot tackle these issues in isolation.
Investors have a crucial role to play by dedicating funds specifically to women’s health and embracing longer-term horizons. With the growth of private equity as an asset class over the past decade, many long-term investors are already familiar with illiquidity and extended investment horizons—making this commitment a natural fit.
Targeted support, such as impact investing and specialized accelerators, can help bridge the funding gap that often forces early-stage companies to close. Meanwhile, creating networks among founders, healthcare providers, and advocates can help startups navigate challenges together, building resilience through shared insights and support.
On a broader level, changing the narrative around women’s health is essential. Advocating for maternal and reproductive health as public health priorities can drive social change and garner the support these issues deserve. Public awareness, education, and visibility can empower women’s health companies to thrive in ways that funding alone cannot achieve.
Moving Forward with the Lessons from Ruth Health
Ruth Health’s closure is a loss, but it leaves behind a powerful blueprint. Alison’s message invites us to learn from both successes and setbacks, to pick up where Ruth Health left off, and to continue building a future where women’s health is not an afterthought but a priority. With every startup that steps into this space, each conversation that normalizes women’s health needs, and each investment that backs women’s health innovation, we get closer to a healthcare system that genuinely values and serves women.
Women’s health innovation demands more than just good ideas—it needs a shift in societal priorities, increased funding, and ongoing support from investors, advocates, and communities. Alison’s journey with Ruth Health reminds us that there’s no more valuable venture than empowering women through their health.
For all those in the space and those yet to come, may Ruth Health’s story be both a lesson and a legacy.
As always, I’d love to hear from you, as always, about what resonated with you, what you are thinking, and what may be inspiring you these days.
See you in the comments!
—Maryann
🔦 We’re thrilled to announce the upcoming launch of the FemmeHealth Founder Series, a new initiative spotlighting visionary founders in women’s health. In each instalment, we’ll go behind the scenes with the founders leading start-ups in areas like reproductive health, personalized medicine, mental wellness, and cutting-edge diagnostics and the investors in this space. Stay tuned for our first episode & share it with a friend—it's coming soon, and you won’t want to miss it!
P.S.
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References
Women's Health Market Size, Share & Trends Analysis Report By Type (Devices, Drugs), By Application (Postmenopausal Osteoporosis, Cancer), By End-use (Hospitals & Clinics, Home Healthcare), By Region, And Segment Forecasts, 2022 - 2030." Grand View Research, May 2022.
https://www.weforum.org/stories/2023/03/how-to-pave-the-way-towards-health-equity-for-women-and-girls/
***Disclaimer***
I agree, Maryann. Taking women's health seriously would do wonders for not just women, but for the state of the world. Thanks for posting.
I think you captured the problem with your sentence: "Bias against women’s health solutions remains a significant hurdle." Are you aware of Caroline Criado Perez, author of Invisible Women: Exposing Data Bias in a World Designed for Men, a book that highlights the gender gap in women's health. She's here on Substack.