Each year, nearly 11,500 new cases of cervical cancer are diagnosed in the U.S., resulting in approximately 4,000 deaths.1 Yet, cervical cancer is highly preventable. Regular Pap smears reduce the risk by 80%, and the HPV vaccine prevents over 90% of HPV-related cancers.2 Cutting the incidence of cervical cancer leads to lower medical spending, healthier, more engaged members, and long-term financial savings. For health plans, prevention drives more than just improved health outcomes—it delivers significant value.
A Smarter Approach to Prevention: Tailoring Care with Personalized Health Pathways
Preventing cervical cancer requires a targeted, data-driven approach. Ovia Health equips health plans with the tools to reduce risk and improve member outcomes through personalized prevention strategies.
When members sign up for Ovia, they complete our Health Assessment, which identifies key cervical cancer risk factors such as abnormal Pap results, malignancy history, and gynecological symptoms. This data forms the foundation for each member’s Personalized Health Pathway (PHP), delivering customized recommendations tailored to their specific health needs and risk profile.
PHPs guide members with actionable, evidence-based steps toward better health. By simplifying complex guidelines into easy-to-follow checklists, Ovia ensures members stay on track with provider appointments, cancer screenings, and vaccinations. Each pathway closes care gaps and provides customized education and support, aligned with members’ health histories, risk factors, and goals.
Support from Ovia’s Care Team further strengthens the experience. Comprising nurses and social workers, the team helps members understand their action items, clarifies the importance of each step, and provides ongoing support via messaging or live phone and video calls.
Join the Fight Against Cervical Cancer
Prevention requires action, and health plans have the opportunity to lead the way. Partnering with Ovia allows plans to reduce cervical cancer diagnoses, empower members, and contribute to a healthier future. From promoting screenings and vaccinations to leveraging personalized digital tools like PHPs, every step forward saves lives and reduces costs.
Let’s work together to eliminate preventable cervical cancer cases. By embracing proactive health measures and transformative technology, health plans can make prevention a cornerstone of care and improve health outcomes.
References:
A significant number of women in the United States are not receiving necessary preventive reproductive health services when they need them most. Perhaps most startling is that in 2022, one in seven infants in the U.S. were born to mothers who didn’t receive adequate prenatal care or the recommended number of prenatal visits.1 Providing women early in their pregnancies with preventative screenings, individualized care, and critical education can help lower risks of developing adverse conditions during and after pregnancy. Inadequate touchpoints with a prenatal provider can result in conditions going undiagnosed or unmanaged, leading to dangerous, expensive health issues later.
Inadequate preventative care isn’t affecting pregnant people alone–research also reveals that 15% of American women have not visited a provider for an annual exam in over three years, and 9% had never undergone a Pap test as they were unaware that they were due for screening.2 Delaying preventive care can turn manageable conditions into serious and costly health issues. Still, adherence to regular preventive care is impossible without proper knowledge of the care that is needed and when. A one-size-fits-all approach to women’s health – which doesn’t consider the unique health needs of women across their lifespan – overlooks individual risks and fails to provide the information and tools women need. Ovia does the opposite by guiding members to personalized health recommendations and providing them with preventive education and resources tailored to their unique goals and needs. Ovia’s Personalized Health Pathways (PHPs), which are comprehensively designed to help members take evidence-based action for better health, close gaps in care, and provide members with critical information to get the necessary care they need.
Available and tailored to each of Ovia apps’ audiences, PHPs are intuitive, easy-to-use checklists that outline important and relevant actions for each member based on their individual health history and goals. For example, a member in Ovia Pregnancy in the first trimester will see several action items and learning tools relevant to her personal life, health, and pregnancy. These tools deliver deeper insights and engagement with the user from prenatal through postpartum health. As the pregnancy progresses, their PHP progresses with them – making sure she knows when to attend her glucose screening or start thinking about her birth plan, ordering a breast pump, or planning for parental leave across each trimester and into the postpartum period. For parents, the PHPs in Ovia Parenting provide a holistic approach for the entire family, empowering users to track their child’s developmental milestones, monitor their child’s health and nutrition, and prompting users to talk with their providers about recommended tests and screenings.
Ovia’s PHPs are designed to be individualized for any life goal or life stage; just as no two members are the same, no two checklists are the same. An Ovia+ member who is managing menopause will receive a PHP tailored to her specific menopause journey, prompting her to confirm whether her provider has experience treating menopause or if she’s attended routine recommended preventative screenings based on her health assessment and profile. Ovia’s PHPs are integrated across the platform, working hand in hand with our in-house Care Team. Our Care Team, which is made up of professionals with backgrounds such as nurses, social workers, and midwives, reaches out to members to reinforce items on their checklist and explain what items mean for members. They can be reached by messaging or live phone or video calls. An analysis of Ovia Health members engaging with the Care Team demonstrated that those who interacted with Ovia coaches experienced a 54% reduction in preterm delivery rates.3
Aligned with our commitment to birth and health equity, we’ve also created a specific PHP designed for Black women, who are disproportionately impacted by higher maternal death rates and poorer outcomes.4 To help support Black women’s reproductive health, our PHP offers guidance on recognizing early symptoms of preeclampsia, a condition for which many women of color are at an increased risk.5 In addition to receiving preventative education, members are encouraged to log their blood pressure within the app. If measurements are high, they receive an alert urging them to contact a doctor for care, with the ability to click to call their provider right from the app for quicker action and attention.
Through each PHPs innovative, user-centric approach, Ovia is revolutionizing how women manage their health by allowing members to take charge of their own healthcare decisions. According to a member survey, users enjoy the personalized guidance Ovia provides.6 According to one user, “I love this app so much more than all the others. I like the additional information it gives throughout the day. I also like that I can log any medications I take and my weight so I can keep track of that.” Another stated, “Ovia is like a helpful big sister through my pregnancy. I trust the articles and enjoy that they are science-based and very relevant. I honestly have learned more from Ovia than my midwife.” By empowering users with resources to actively monitor various aspects of their wellbeing, from nutrition to mental health indicators, PHPs support unique healthcare journeys.
Whether it’s achieving a healthy pregnancy, successfully breastfeeding, or managing menopause transitions, PHPs offer proactive guidance. They are designed to distill complex guidelines into actionable items members can take – each PHP item is tied to an evidence-based clinical guideline in some way. By offering ways to enhance adherence to clinical guidelines and delivering a coordinated, action-oriented plan with ongoing expert support, PHPs complement our existing clinical programs by offering an additional way for members to manage their most important health goals and to make a healthy, happy family possible for everyone.
Want to know more about Ovia? We offer comprehensive women’s and family health programs that include 1:1 coaching, guideline-driven clinical programs, and personalized health and wellness education. Visit www.oviahealth.com.
- March of Dimes: https://www.marchofdimes.org/peristats/data?reg=99&top=5&stop=34&lev=1&slev=4&obj=1
- Becton, Dickinson and Company: https://news.bd.com/2023-01-05-New-Harris-Poll-Reveals-Significant-Gaps-in-Womens-Knowledge-About-Cervical-Cancer
- Ovia Health: https://images.ent.oviahealth.com/Web/OviaHealth/%7B7e8f1d16-a717-4b50-ba5a-27e18d963639%7D_How_to_Avoid_The_Million_Dollar_Baby_(Preterm_Whitepaper).pdf
- Njoku, A., Evans, M., Nimo-Sefah, L., & Bailey, J. (2023). Listen to the Whispers before They Become Screams: Addressing Black Maternal Morbidity and Mortality in the United States. Healthcare (Basel, Switzerland), 11(3), 438. https://doi.org/10.3390/healthcare11030438
- Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745#:~:text=Several%20studies%20have%20shown%20a%20greater%20risk%20of%20preeclampsia%20among%20Black%20women%20compared%20with%20other%20women.
- Ovia Health: NPS, Happiness, and Demographic Summary, 2024
Despite being a women’s health physician, I was not prepared for motherhood. I remember feeling overwhelmed, stressed, anxious, bored and just not myself. I really wondered if having a baby was a huge mistake. My postpartum care consisted of a phone call from a nurse at my OB’s office and an in-person appointment- otherwise I was on my own.
In the 17 years since the birth of my daughter, I’ve been a part of many of my patient’s postpartum health- and I know that the typical experience for American mothers is far from ideal. We don’t have the home based care common in many other countries, and many of us live far from or don’t have parents or in-laws who can provide the in-home support that most new mothers need. In effect, American women are triaging their own care. This isn’t just a nuisance, it’s a real health risk for mother’s and babies.
The fact is, women experience high levels of stress and emotional exhaustion that is overlooked and minimized because it’s not considered a “real” medical symptom like prolonged heavy bleeding or cesarean incision tenderness. Our existing model of postpartum care focuses heavily on the physical recovery from childbirth and pregnancy, which has little to do with the complicated emotions and stress that many mothers experience. Given this mismatch, it’s easy to see why as many as 40% of women miss their postpartum appointment.
For many women there is hardly any time for a woman to recover at all. Just 27% of American workers have access to paid leave, requiring many women to return to work as early as two weeks after childbirth. Given these challenges, it’s no surprise that American women have high rates of maternal suicide and substance abuse, or that 65% of maternal deaths occur after the woman leaves the hospital, of which an estimated 90% are preventable.
The good news is that there’s a growing recognition about the need to change postpartum care. Forty-seven states have expanded Medicaid coverage for postpartum care, with others on their way, and many physicians have proactively adopted ACOG recommendations to treat the postpartum period as an ongoing process, rather than a one-time visit. However, we’re also seeing the growth of a number of companies offering postpartum solutions that are largely perpetuating a failing model.
For one, they approach the postpartum period with a tabula rasa mindset, as though the postpartum period is a new, blank state stage where family health histories, gestational or preexisting conditions, and pregnancy complications are magically resolved or reset. This is dangerous. Rather than treating postpartum care as a standalone period, a clinically-sound postpartum solution must consider and incorporate each woman’s level and quality of preconception and prenatal care, as well as the health of her interpersonal and community relationships that directly affect her mental and emotional health.
More than one-third of women globally develop long-term health problems after giving birth.
Additionally, many of these companies only offer telehealth visits, ironically mimicking the exact episodic model that already exists for postpartum care but shifted to a virtual environment. For employers and health plans that are evaluating their postpartum benefits and available solutions, we need to understand how each vendor incorporates preconception health and prenatal care into their postpartum care, and how it’s personalized to each woman’s pregnancy, delivery, and recovery plan. Concurrently, ask how their solution determines when each woman’s postpartum period begins and “ends,” and if they are adding arbitrary or artificial gates around this period that may push women out of care when they still need it.
Postpartum care should create a continuity between what happens before and after pregnancy, not fracture an already fractured experience. As a clinician, I see a number of opportunities to improve the postpartum experience for women:
- Adopt ACOG recommendations to treat postpartum as a ongoing process
- Expand paid parental leave access so women have time to rest and recover
- Standardize care so that primary care better integrates with ob-gyn and midwifery care
- Take lessons from One Key Question® by asking women if they plan to get pregnant in the next year to boost preconception health and improve rates of adequate prenatal care
- Give women access to clinically guided digital tools and trusted sources to understand their bodies and their health
- Seek out providers who understand and validate your health concerns, both before and after pregnancy
- Normalize all experiences of motherhood and parenting, not just the positive ones
The last point is one that I think we can all agree needs further airtime. One of my continued joys and privileges is practicing medicine and being able to support the women and mothers across their lives, and so many times I’ve spoken to new mothers, second time mothers, third-time mothers, adoptive mothers, and all kinds of bonus parents, and assured them that all emotions and feelings are normal. And then I tell them that despite being a practicing physician, nothing prepared me for my own postpartum periods, and I share with them how hard it was for me and a few of the things that I wish I knew then.
Leslie Saltzman, DO is the Chief Medical Officer at Ovia Health, and the founder of the Rittenhouse Women’s Wellness Center, a groundbreaking private practice in Philadelphia, PA. Dr. Saltzman received her degree in Osteopathic Medicine from the Philadelphia College of Osteopathic Medicine, and her Master’s in Business Administration from New York University. She and her family reside in New York City.
There’s an increasing urgency to better support women during the postpartum period. The March of Dimes recently gave the United States a meager D+ for women’s and infant health, and the U.S. continues to be one of the only industrialized countries where the maternal mortality rate is increasing.
While most postpartum care is rightly focused on the mother’s physical recovery, there’s more to postpartum care than physical recovery. The fact is that the postpartum period is a critical time to also address the mother’s mental health and any risk factors that arose during pregnancy and childbirth. With as many as one-third of women globally experiencing health problems after giving birth that can impact the lifelong quality and trajectory of her physical and mental health, it is paramount that women have the tools, digital solutions, and trusted resources that provide early and continuous support.
Ovia Health’s new Postpartum Experience is exactly that–a comprehensive 12-month program that starts by supporting birth recovery, common postpartum conditions or complications, and providing real-time mental health support. As women progress to later postpartum stages, the Postpartum Experience progresses with them to support needs such as reproductive planning and contraception, return to work, social and financial health, and navigation to SDOH services and care where needed.
No two women’s postpartum needs are the same, and the Postpartum Experience in Ovia is designed to reflect and respond to those unique needs. One of the most exciting ways our solution innovates postpartum care is by delivering personalized postpartum insights for each member.
Each member’s recovery is personalized to delivery type and coexisting conditions, allowing them to track how they are doing each day. If a member marks a symptom that could be a potential risk based on their health history, pre-existing condition or complication, they receive a Critical Alert that explains the potential risk and the best next action: click to call their provider, and/or contact the Care Team.
Our solution also provides specific support for people who have pregnancy conditions or gestational complications that benefit from continuous management and support. For example, if a woman is diagnosed with gestational diabetes, this member’s Postpartum Experience is tailored to her health profile and educates her on the need and importance of monitoring blood sugar during her postpartum stage, the increased risk of type II diabetes, and when to take a postpartum glucose tolerance test. If she doesn’t have a physician, our Care Team can help her find one that meets her needs and preferences, or she can reach out to the Care Team to make sure she understands her specific needs.
Our postpartum programming is personalized across a number of needs, including:
- Anxiety, depression, and common postnatal mental health needs
- Episiotomy support
- Atherosclerotic cardiovascular disease (ASCVD) and cardiovascular disease
- Gestational diabetes
- Traumatic birth experiences
- Birth equity programming
As women progress into later postpartum, Ovia’s Postpartum experience evolves with them. For instance, as periods begin returning, women can begin tracking their cycle and meet with our clinical Care Team consisting of clinical and mental health specialists to help them transition back to birth control if that is their plan, while providing education and guidance for future reproductive health goals.
Unlike other women’s health solutions, our Care Team members are full-time, in-house employees, many of whom have been with our members for multiple years and many family journeys.
Finally, Ovia’s Postpartum experience supports the social and emotional aspects of the postpartum period, including returning to work, social and financial health, social determinants of health and health equity, and mental health support. If members don’t have existing physical or mental health providers, we connect them to local resources and providers for a better care experience.
Combined, the Postpartum Experience provides holistic support across all aspects of each woman’s life that are affected by becoming a parent: physical recovery, mental wellbeing and identity, social support and connectedness, and economic well being.
Key benefits include:
- Early identification and navigation to care for potential high risk symptoms, such as, shortness of breath, leg swelling, headaches, weakness
- Ensure that immediate risk factors, conditions, or complications that present before and/or after childbirth are appropriately evaluated, treated, and supported
- Encourage attendance at postpartum appointments
- Encourage mother’s return to age-appropriate screening recommendations including cervical cancer and breast cancer screenings, as well as STI testing and support
Postpartum can feel like an isolating period, but we’re here to help. Contact us to learn how we’ve partnered with employers and health plans to improve maternal physical and mental health outcomes.
Leslie Saltzman, DO is the Chief Medical Officer at Ovia Health, and the founder of the Rittenhouse Women’s Wellness Center, a groundbreaking private practice in Philadelphia, PA. Dr. Saltzman received her degree in Osteopathic Medicine from the Philadelphia College of Osteopathic Medicine, and her Master’s in Business Administration from New York University. She and her family reside in New York City.
While many people have a general understanding of menopause, fewer are aware of perimenopause, the transitional stage that precedes it. Perimenopause usually begins in a woman’s 40’s but can start earlier or later. During this time, fluctuating hormone levels can cause irregular menstrual cycles and a range of symptoms.
Perimenopause can span several years before a woman reaches menopause, which is marked by 12 consecutive months without a menstrual period, signaling the end of their reproductive years.1 As societal support and awareness of menopause grows, more women are also becoming informed about perimenopause and its potential ongoing impact on their lives.
Read the Q&A below to hear from Ovia’s Chief Medical Officer, Dr. Leslie Saltzman, as she explains what perimenopause is, what women can expect, and how to manage symptoms.
Tell us about yourself and your role at Ovia
I serve as the Chief Medical Officer at Ovia Health, where I oversee the clinical team, guiding our studies and research initiatives to ensure that Ovia’s solutions are evidence-based and inform our business and program developments.
In addition to my role at Ovia, I am a practicing physician, specializing in internal medicine with a focus on women’s health.
What is perimenopause?
Perimenopause is the time period when your body is transitioning to menopause. The level of estrogen — the main female hormone — in your body rises and falls unevenly during perimenopause. Your menstrual cycles may lengthen or shorten, and you may begin having menstrual cycles in which your ovaries don’t release an egg (ovulate). As your body progresses towards menopause, you may experience a range of physical and emotional symptoms. While this is a natural and normal process, some of the symptoms can be disruptive or uncomfortable.
What are the symptoms of perimenopause and how long does it last?
Typically, the first indication of perimenopause is irregular periods. You might notice that your once-predictable menstrual cycles become erratic, with random spotting or missed periods. Many people also experience common menopause symptoms, such as hot flashes/night sweats, and vaginal dryness. Although symptoms can vary widely, it’s common to experience mood changes like irritability, depression, or mood swings, along with low libido, urinary urgency, and sleep disturbances. Perimenopause may begin as early as your mid-30s or as late as your mid-50s. Some people are in perimenopause for only a short time, while others are in it for several years.
Can hormonal birth control mask symptoms?
Hormonal contraceptives can sometimes mask symptoms of perimenopause, and because of this, they are often used to manage the symptoms of perimenopause in patients.
What are the best treatment options for perimenopause? Are there any associated health risks?
Treatment is typically aimed at managing symptoms. Hormone therapy can help relieve the symptoms of perimenopause and menopause. Hormone therapy means taking estrogen and, if you have never had a hysterectomy and still have a uterus, a hormone called progestin. Hormone therapy can be given in different formats including pills, patches, creams, and vaginal inserts. Antidepressants can help with night sweats, mood swings, and emotional issues. It’s best to speak with your provider and track your symptoms carefully to figure out the best management plan.
Additionally, the menopausal transition is linked to a higher risk of cardiovascular disease, the leading cause of death for women in the U.S., so it’s really important to monitor women’s health during midlife.
What if a woman still intends to get pregnant?
You may be less likely to get pregnant during perimenopause, but it’s still possible. As long as you have a period, you can still get pregnant. For women over 40, we typically recommend that you consult with a reproductive endocrinologist if you are trying to get pregnant.
At what point does perimenopause end and menopause begin?
When you have no menstrual cycle for 12 months in a row, you have officially reached menopause. It is common for women to go months without a period and then randomly have one. That starts the countdown clock all over again.
What resources does Ovia provide that can help women experiencing perimenopause?
We offer a perimenopause program within the Ovia app. Members can choose “Menopause preparation” from the available programs listed under the Health tab. This provides them with access to relevant perimenopause articles and educational resources. They can use this information as a guide when tracking their health and monitoring day-to-day symptoms. Additionally, they can connect with a member of our Care Team, to assist in managing symptoms and finding the appropriate care and treatments.
Ovia also provides a menopause solution for women who have passed the transition. How does that differ?
Ovia’s menopause solution is a more expanded resource. Members begin by downloading the Ovia app and selecting “Managing menopause” as their goal at sign up. From there, they complete a health assessment that personalizes their experience by delivering content based upon where they are at on their menopause journey. At this point, Ovia customizes the user experience to explain specific symptoms and deliver relevant resources.
Members have access to comprehensive health tracking where they can monitor their symptoms, mental health, medications, and more in order to keep record and recognize patterns. This data can help identify potential triggers of symptoms and reveal health issues related to menopause such as the risk of cardiovascular disease and changes in lipids, body fat, blood sugar and blood pressure. It’s crucial that these risk factors are identified, monitored, and treated appropriately. Critical alerts are triggered in the app for symptoms such as heart palpitations with instructions to follow up with a provider.
The Ovia Care Team is also available to help with managing symptoms and finding care. For women experiencing significant symptoms, we hope they recognize the signs and seek appropriate treatment. With a personalized, proactive approach, we want to help members understand their bodies and find relief across all life stages.
Why is it important for employers and payers to invest in all aspects of women’s health including perimenopause?
Women constitute about half of the workforce, and many are grappling with health conditions like perimenopause and menopause. A recent study found that three out of five women have faced challenging symptoms while at work, with one in three actively hiding these symptoms from colleagues and managers.2 Additionally, another study revealed that nearly 20 percent of those experiencing menopause in the U.S. have either quit or considered leaving their jobs due to their symptoms.3
The burden impacts employers and payers. Women with untreated symptoms often have 121% higher healthcare utilization and experience 57% more days of lost productivity, resulting in an additional $2,100 per woman per year in healthcare and absenteeism costs.4 As budgets tighten and population health demands grow, employers and payers must seek strategies to reduce rising healthcare costs. Supporting menopause and women’s health is one of the most effective ways to accomplish this for a substantial segment of the population.
What advice would you give employers and payers considering adding a menopause program or more support for women’s health?
There are several ways to support employees going through menopause. Start by fostering an open environment where staff feel comfortable discussing their experiences without fear of discrimination. A key step in creating this culture is to train managers on menopause symptoms and how to offer support. Incorporate menopause education into your health awareness programs, covering symptoms, treatment options, and available benefits. Additionally, establish a formal company-wide menopause leave policy and work to normalize taking leave, so employees feel confident in making such requests.
Most importantly, consider investing in a solution like Ovia, which empowers members to learn about menopause, monitor their health, manage symptoms, and access expert guidance when needed. Offering these types of benefits can lead to a happier, healthier, and more productive workforce. In turn, this can help control medical costs, boost overall satisfaction, and improve productivity. Data shows that the long-standing silence around women’s health has had serious consequences. Many individuals have been forced to manage overwhelming stress due to shame or fear of discrimination, with some even leaving their jobs when the burden became too great. However, organizations have the opportunity to create a significant positive change – normalize conversations about menopause, provide accessible education so people understand what to expect and how to seek treatment, and build workplaces that support individuals through these major life transitions.
In recent years, there has been a notable increase in employers and payers investing in women’s health benefits and solutions. The fem-tech industry, as it’s been called, has already secured over $2.5 billion in funding, with this figure projected to rise further.5 Despite this encouraging trend, many organizations are still hesitant to invest in women’s health. Frequently, resources are directed toward general wellness or specific conditions rather than women’s health solutions. Some even dismiss women’s health as “niche.” However, delaying investments in this area is a missed opportunity and may prove to be shortsighted. With October being World Menopause Awareness Month, now is the perfect time to invest in the cultural shift and support that women experiencing menopause truly deserve.
For a more in-depth demonstration of the Ovia menopause program, or Ovia’s solution in general, schedule a discovery call with our team.
- National Institute of Aging: https://www.nia.nih.gov/health/menopause/what-menopause
- Vodafone: https://www.vodafone.com/sites/default/files/2021-10/menopause-global-research-report-2021.pdf
- Biote: https://biote.com/learning-center/biote-women-in-the-workplace-survey
- Sarrel, P., Portman, D., Lefebvre, P., Lafeuille, M.-H., Grittner, A. M., Fortier, J., Gravel, J., Duh, M. S., & Aupperle, P. M. (2015). Incremental direct and indirect costs of untreated vasomotor symptoms. Menopause (New York, N.Y.), 22(3), 260–266. https://doi.org/10.1097/GME.0000000000000320.
- World Economic Forum: https://www.weforum.org/agenda/2023/05/femtech-healthcare-bipoc
According to the CDC, infertility rates are rising in the United States.1 Experts believe this trend is due to a number of factors that are making infertility more common. Though research in recent years has improved our understanding of the causes of infertility, up to one-third of all cases are still attributed to unknown causes.2 Identifying risk factors for infertility as early as possible is critical for advising potential treatment options and helping individuals understand what paths to parenthood exist for them.
Digital health solutions can be a means to help people identify infertility risk factors and receive more effective treatment earlier, potentially optimizing their chances of building a family. Digital health technologies have recently grown in number and popularity to support women’s fertility goals – in the U.S., approximately 30% of women now use apps to track their reproductive health.3 Digital health solutions such as Ovia Health (a Labcorp company) work to provide customized support and education for individuals and families throughout the whole spectrum of women’s health, from cycle tracking and preconception to pregnancy, parenting, and into menopause. The broad use of reproductive mobile health solutions like Ovia present a unique opportunity to understand infertility on a larger scale.
Understanding the most common causes of infertility is critical to designing successful interventions that could reduce preventable risks and ultimately ease the financial and emotional burdens of fertility challenges. To learn more, Ovia researchers examined health assessment data from approximately 2.6 million Ovia users who self-reported the goal of “trying to conceive” upon sign up with the Ovia app. We spoke with Katie Noddin, a Senior Analytics Engineer at Ovia, to learn more about the details behind this study and what the findings mean for not only our users, but also for employers and health plans looking to support their members along their reproductive journeys.
Can you give us some background on infertility? How is it defined, and what are some well-known risk factors?
The CDC defines infertility as the inability to get pregnant after one year of unprotected sex among heterosexual couples for women under 35. Since infertility increases with age among both sexes, providers often begin evaluating women aged 35 and older who have not been able to get pregnant after six months. Common risk factors that affect men and women alike include smoking, obesity, low body weight, excessive alcohol or drug use, and physical or emotional stress. An important factor contributing to the rise in infertility to know about is age; women in the U.S. are more likely to delay motherhood now than in decades past to prioritize educational attainment, build careers, and secure financial footing. The average age of all first-time mothers in 2021 was 27.3 years, the highest in America’s history, and this trend persists across most races and ethnicities.1 This trend increases the proportion of people seeking to build a family in their 30s and 40s, when both female and male fertility declines.2 Among women aged 15-49, 13.4% had impaired fecundity, which means they are unable to get pregnant on their own or carry a pregnancy to full term, and almost 8% were infertile. Importantly, infertility and subfertility are not solely a women’s health issue; a third of infertility causes are due to male-factor infertility, and between 2015 and 2019, over 11% of men aged 15-49 reported some form of infertility.1,2 It’s important to note that though the definition of infertility uses an age cut-off for women under or over 35, the root cause of infertility is not always associated with female factors; in fact, the causes of infertility are evenly split between male factors, female factors, and unknown causes. The age cut-off is simply an indicator for a further fertility work-up.
Can you speak more about the difference between male and female infertility? Are there key differences to be aware of?
In women, infertility commonly presents itself with conditions affecting the uterus, fallopian tubes, or ovaries such as endometriosis, uterine fibroids, or polycystic ovarian syndrome (PCOS); in men, it is typically caused by testicular or ejaculatory disorders or hormonal imbalances. In many cases, the cause of infertility is undetermined.
How can digital health apps help us better understand and tackle infertility?
Digital health apps are becoming more popular among people of reproductive age–people who have grown up with technology and feel comfortable using it to inform their health journeys. Growing up, many women are taught to track their period using a pen and a calendar, which may work for folks with regular menstrual cycles; however, this approach doesn’t work for many women who experience irregular menstrual cycles and doesn’t account for other important fertility symptoms. Apps have the ability to capture data at a rate, volume, and detail that is typically unmatched in standard data reporting procedures and research practices. When these apps are designed appropriately through a clinical lens and with careful consideration of the individuals using them, the data collected are rich and robust and can provide deeper insight into risk factors affecting health conditions like infertility on a large scale. Digital health apps should be designed to fit into a user’s everyday life; at Ovia, we feel we’ve achieved that given our users log an average 15-30 sessions per month, translating to users logging in almost daily to log important fertility data. Important female fertility indicators to track include menstrual cycle information, cervical fluid, basal body temperature, ovulation predictor test results, and more. Digital health apps can make tracking these data points easier and can paint a holistic picture of a user’s fertility information while helping users feel aware of their fertility trends.
What was the motivation and background behind conducting this study? What were you hoping to find out through your work?
Our team discussed a few different health issues we wanted to investigate more deeply, and we decided the most pressing and potentially impactful topic would be infertility, given how common it is and that it’s been increasing in recent years. Our Ovia app user base is primarily female-identifying, which means that we have a unique opportunity to investigate female-related factors of fertility. We were hoping to see whether our data confirmed what national data suggests, while also uncovering other insights in the process.
How was the investigation conducted? What were the inclusion criteria?
We decided to look at infertility trends in our Ovia app longitudinally while still including key variables from the in-app Health Assessment (a series of optional questions offered throughout the app experience that captures personal and family health history variables relevant to reproductive health and socioeconomic factors). In our study, we included U.S.-based users who signed up for the Ovia app between 2017 and 2023, indicated they were trying to conceive (TTC) at sign-up, and also completed the Health Assessment. One question in the Health Assessment asks the individual to select whether they currently have or have a history of conditions such as polycystic ovarian syndrome (PCOS), uterine fibroids, endometriosis, or multiple abnormal pap smears, all of which are known risk factors for infertility. We ultimately defined infertility risk as anyone who self-reported having PCOS, uterine fibroids, or endometriosis in the Health Assessment, and we stratified these conditions by users’ race, ethnicity, and age.
What did you find out from the data collected? What were some of the key findings from your research?
Our sample included approximately 2.6 million individuals between 2017 and 2023. We found that infertility risk increased by 14% across the time period, but this varied across racial and age groups. The average age among individuals TTC rose by 8.4%, from 28.5 to 30.9 years, which is older than the average age at first pregnancy in the U.S. (27.3 years, according to the CDC). The fastest growing age group of Ovia users across the period were 45 years or older. Interestingly, the youngest age group (18-25 years) reported the highest rate increase in reported infertility risk across the time period (4.2%). Asian, Black or African American, and American Indian/Alaska Native users reported the greatest infertility risk rate increases, while white-identifying users reported the lowest. Interestingly, the overall reported rate of diagnosed infertility decreased by 42% over the seven-year time period.
What did you find to be the most common risk factors for infertility? What does this mean for Ovia members?
PCOS was the most common risk factor and also increased the most (2.9%) over the time period, followed by endometriosis (1%). Both of these conditions, as well as uterine fibroids, are common and are more prevalent among populations of color. This trend could also be attributed to an increase in awareness in provider diagnostic patterns; some studies indicate that it requires seeing more than three providers on average to receive a PCOS diagnosis and 10-11 years from symptom onset for patients to receive an endometriosis diagnosis.4,5 This temporal delay is even more pronounced for patients with limited healthcare access due to structural or socioeconomic barriers. Endometriosis, in particular, is notoriously difficult to diagnose as it requires surgical confirmation, which can be risky and inaccessible to patients depending on insurance status. Additionally, we noticed our TTC population’s age is increasing, which matches the national trends we’re observing in the U.S. It appears that users of the Ovia app are potentially older than the average person trying to conceive and may be turning to a digital health solution to give them extra support on their reproductive health journey.
Were there any limitations to this study? Are there any areas you hope to explore in future research?
One limitation of this study is that it assesses self-reported risk factors, so these aren’t confirmed by the user’s medical chart or provider. The sample may not be generalizable to all reproductive-aged women in the U.S.; though our sample size is impressive and fertility tracking apps are popular among reproductive-aged women, our users may or may not be similar to other women of reproductive age who don’t use fertility tracking apps. We’re currently pursuing a research project together with an academic research partner to assess this exact research question: How similar are Ovia app users compared to non-Ovia app users in terms of demographics and health backgrounds? More to come on those findings.
What are the impacts from the findings in your research? What does this mean for employers or health plans hoping to tackle infertility among their populations?
As women consciously delay childbearing to pursue other personal or professional goals, they are attempting to build their families and achieve pregnancy later in life than ever before. Rarely are adults taught about their fertility until it’s too late. Being properly informed about fertility health, how to optimize fertility through lifestyle behaviors such as diet, sleep, and exercise, and being aware of one’s own fertility and ovulation windows are all critical in assisting as many folks as possible in achieving pregnancy on their own without the need of expensive assisted reproductive technology such as IVF that may lead to high-risk pregnancies. Based on these findings, it’s likely that members using the Ovia app who indicate that they are “trying to conceive” at sign-up may have more pre-existing risk factors for infertility than the average woman of reproductive age. These members require more support and attention to fulfill their family-building goals. Ovia is able to provide that by helping members log the right types of fertility data, understand their data, receive personalized and evidence-based education, and communicate with the Ovia Care Team about common questions on their reproductive health journey.
1. Osterman MJK, Hamilton BE, Martin JA, Driscoll AK, Valenzuela CP. Births: Final data for 2021. National Vital Statistics Reports; vol 72, no 1. Hyattsville, MD: National Center for Health Statistics. 2023. DOI: https://dx.doi.org/10.15620/cdc:122047.
2. Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/16083-infertility
3. KKF Henry J Kaiser Family Foundation (2019.) Health Apps and Information Survey September 2019. https://files.kff.org/attachment/Topline-Health-Apps-and-Information-Survey-September-2019
4. Gibson-Helm M, Teede H, Dunaif A, Dokras A. Delayed Diagnosis and a Lack of Information Associated With Dissatisfaction in Women With Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2017;102(2):604-612. doi:10.1210/jc.2016-2963.
5. Yale Medicine: https://www.yalemedicine.org/conditions/endometriosis#:~:text=Also%2C%20a%20definitive%20diagnosis%20requires,and%20diagnosis%20(and%20treatment).
June marks the start of Pride Month, when people come together to recognize the impact that LGBTQIA+ individuals have had, as well as providing a reminder of the need to build a more inclusive culture supportive of all. Organizations have an ethical responsibility to establish workplaces where all employees can flourish and feel safe coming to work. Embracing diversity within the workforce is essential for cultivating an inclusive and innovative workplace culture, as well as to boost productivity, expand the talent pool, and ultimately drive business forward.
In the U.S., employees who identify as LGBTQIA+ comprise 5.9% of the workforce.1 Over 45% of LGBTQIA+ workers have reported experiencing unfair treatment at work, such as being fired, not hired, or harassed due to their sexual orientation or gender identity at some point in their careers.2 Other types of unfair treatment reported include losing promotions and being excluded from company events simply for being who they are. Members of the LGBTQIA+ community also often deal with insufficient support systems and a lack of inclusivity in benefits, such as health insurance that does not cover same-sex partners or provide resources for alternative paths to parenthood. With adoption costing as much as $60,000 and surrogacy ranging from $100,000 to $225,000, LGBTQIA+ employees who prioritize family-building but lack supportive benefits often face financial stress, leading to an emotional burden that can impact their job performance and overall health. This is unacceptable.
These disparities are even more pronounced for people of color. BIPOC (Black, Indigenous, and people or color) employees additionally are faced with examples of inequity in the workplace, often including incidents of harassment and discrimination, disparities in pay, underrepresentation, or unequal access to resources. Black women are three to four times more likely to die a pregnancy-related death compared to white women, and 60 percent more likely to develop life-threatening pregnancy complications.3 Employees are telling us that there is a profound lack of benefits that support women and diverse people in the workplace, such as fertility and maternity care resources, longer paid parental leave, flexible scheduling, or menopause support. This leads to a key question: How can organizations best support the well-being of diverse employees?
1. Invest in inclusive benefits
Creating a supportive workplace for all employees means fostering inclusivity in all areas of business – including your benefits. Research indicates that 63% of millennial LGBTQIA+ couples plan to expand their families in the near future.4 Many will need fertility benefits to help plan their path to parenthood, which is known to be not only expensive, but emotionally difficult. When family-building is a priority, employees face nearly impossible decisions: How will they afford the costs? How much debt can they manage? These kinds of financial stressors can lead to emotional exhaustion and negative physical health effects, which can take a toll on a person’s work life. Without fertility benefits, these individuals may seek a new employer that provides the support they need to build their family. On average, replacing an employee can cost an organization around $75,000, so it makes economic sense to invest in inclusive benefits to retain high-quality employees. Plus, these benefits are consistently in demand – each year, we conduct our annual Future of Family Friendly benefits survey where we ask more than 2,000 working parents for their thoughts on their existing benefits, and how they could improve. This year, 38% of respondents said that they are looking for their employer to provide alternative family planning support, and even more (41%) want their employer to provide fertility screenings and testing for both women and men.
Ovia Health offers a range of solutions and support for people building their families through assisted reproductive technologies (ART), adoption, and surrogacy. Through our Gay and Future Parent experience, Ovia extends our clinically driven approach to support all paths to parenthood and is available to members of all demographics and family types, including same-sex couples. In addition to addressing an important need for greater health equity and increasing support for LGBTQIA+ families, Ovia provides expanded support for maternity care and postpartum solutions, improving health outcomes and lowering costs as employees are engaged in their own personalized care pathways. Beyond this, Ovia spans the full spectrum of women’s and family health from preconception through pregnancy, parenting, menopause, and midlife – supporting employees in whatever phase of life they are in.
2. Increase access to specialized support
Data shows that 29% of LGBTQIA+ couples are raising children.5 Ovia offers content and resources tailored to the unique challenges these parents face, including navigating legal and social hurdles, managing non-traditional family dynamics, and finding LGBTQIA+-affirming healthcare providers. One such resource is our Care Team, made up of health coaches and care advocates available for 1:1 virtual coaching and support services 365 days per year. Well-versed on sensitive topics, they can guide employees through their unique challenges and answer questions about surrogacy, fostering, adoption, and general health. Additionally, our community of fellow-future-parents and current parents is always a resource to help navigate the challenges of parenting at any stage.
3. Invest in tools that support BIPOC mothers
Our data shows that Black women rank digital fertility and maternal health tools in their top five most important benefits year after year. Disparities in healthcare track with this desire as Black women are three times more likely than white women to die from pregnancy-related complications.6 Ovia is dedicated to combating these issues and addressing the need for better resources to improve birth equity. Our Black Maternal Health program provides personalized education and guidance based on social determinants of health and each person’s unique medical history and symptoms. We help members learn about their possible risk factors, catch symptoms early, navigate care, and ultimately advocate for their health. In addition, we offer guidance on building a birth team, education on care team members like midwives and doulas, and framework for a birth plan.
4. Create employee resource groups
Employee resource groups (ERGs) or other open communications forums are provide necessary opportunities for employees to build community, share information, and experiences. It’s important to encourage open dialogue and provide safe spaces for diverse employees to share and feel supported in the workplace. If your organization has these groups, it’s important to make sure they’re funded and supported as they require proper advocacy from leadership, including actively engaged executive sponsors, in order to thrive.
5. Foster an inclusive culture & equitable hiring practices
LGBTQIA+ women are twice as likely as women overall to report feeling like the “only one” in a team or meeting. This sense of “onlyness” is even more pronounced for LGBTQIA+ women of color, who are eight times more likely to experience this feeling when compared to straight white men. 7 Organizations can reduce stress and isolation with inclusive hiring and by clearly and consistently communicating and showing that inclusiveness is core to your culture. Building off of hiring practices, equally support all employees through a family-friendly culture. For example, return to work (RTW) preparation should begin long before the employee goes out on leave, and be more than just one packet of information. Center your programming on a comprehensive ecosystem of benefits, access to virtual health support, and holistic guidance for case-by-case planning between managers and new parents. Leaders should practice radical empathy, actively reinforcing company values loudly and often. Move beyond standard unconscious bias or cultural competency workshops with extensive diversity-focused training that helps employees identify their own biases and learn strategies to eliminate microaggressions in the workplace. Train managers to better support and know what working parents need, including setting expectations around hours, communication, and bringing everyone’s full selves to work.
6. Offer flexible office requirements
A flexible work schedule was the third most popular benefit parents wanted most in our Future of Family Friendly Benefits survey.8 Flexible schedules offer numerous advantages for both employees and employers. Employees enjoy greater job satisfaction, improved health, better work-life balance, and reduced stress. Employers, in turn, benefit from increased productivity, lower turnover, and less absenteeism. If a particular role doesn’t require fixed hours, recognize that the best talent is as unique as their schedules. Create part-time flexible return options for those new parents looking to gradually ease back into work, and offer remote or hybrid opportunities for all employees whose positions make that feasible, to enable them to take care of both their jobs and their families.
At Ovia, we are committed to supporting the diversity of our members as well as diversity goals across organizations through our inclusive digital health solution that supports all paths to parenthood. By working with Ovia, organizations can strategically enhance their diversity, equity, and inclusion (DEI) efforts, equip diverse employees with tools to better balance work and life, improve health outcomes across your organization, and ultimately cultivate overall workplace wellness.
1. McKinsey and Company: https://www.mckinsey.com/featured-insights/diversity-and-inclusion/how-the-lgbtq-plus-community-fares-in-the-workplace
2. Williams Institute of Law: https://williamsinstitute.law.ucla.edu/publications/lgbt-workplace-discrimination
3. Population Reference Bureau: https://www.prb.org/resources/black-women-over-three-times-more-likely-to-die-in-pregnancy-postpartum-than-white-women-new-research-finds/
4. Family Equality Council: https://familyequality.org/resources/lgbtq-family-building-survey
5. Family Equality Council: https://familyequality.org/resources/lgbtq-family-building-survey
6. Centers for Disease Control: https://www.cdc.gov/healthequity/features/maternal-mortality/index.html
7. McKinsey and Company: https://www.mckinsey.com/featured-insights/diversity-and-inclusion/how-the-lgbtq-plus-community-fares-in-the-workplace8. Future of Family Friendly Benefits survey: https://learn.oviahealth.com/benefits-that-matter
While Mental Health Awareness Month may have come to a close, it’s important to underscore how supporting mental health in the workplace is not just a monthly practice, but a critical, year-round task. This is especially true for new parents – the journey into parenthood often offers a new perspective in regards to a person’s mental health. New responsibilities, routines, stressors, emotions, and work-related accommodations, along with the physical healing and bonding process with a baby, will significantly impact a parent’s mental health needs. Statistically, women are more likely to develop depression and anxiety symptoms during the first year after childbirth than at any other time in their lives.1 As health plans and employers, it’s our collective responsibility to provide the necessary support.
Up to 80% of women who give birth report feeling postpartum “baby blues,” making perinatal (the time just prior to and following childbirth) mood and anxiety disorders (PMADs) one of the most common complications of pregnancy. PMADs have a quite significant adverse impact on the mental, physical, and emotional health of not only the women who experience them, but also their children and families. They are associated with adverse pregnancy outcomes, miscarriage, pre-eclampsia, preterm birth, and low birth weight. Dealing with PMADs can compromise parenting, impair behavior regulation, and lead to insecure attachment with the infant.2
Despite the sobering facts, there is a lack of screening or treatment for PMAD symptoms. Of particular concern is that up to 50% of mothers experiencing symptoms will not seek mental health treatment.3 Even though the risk of being diagnosed with PMADs is higher among racial and ethnic minorities, these groups are even less likely to be screened or receive the mental health support they need.4 Studies also show that Medicaid beneficiaries are less likely to be screened, creating further potential consequences for populations more likely to need support.5 These statistics demonstrate the urgent need for digital health solutions that can address perinatal and parental mental health, starting with closing the gaps in mental health screenings.
The importance of mental health screenings
The six-week postpartum visit, based on standards set by the American College of Obstetricians and Gynecologists (ACOG), is critical. This comprehensive checkup assesses a patient’s physical and emotional well-being, allowing early identification of health issues while transitioning from pregnancy care to long-term care for chronic illnesses or PMADs. It marks the shift from focusing on pregnancy care to prioritizing a parent’s overall health.6
During the six weeks after giving birth, the significant life changes of becoming a new parent can dominate parents’ daily routine. Many struggle to prioritize their own health while managing various responsibilities, such as returning to work, dealing with costly childcare, and adjusting to changes in their family dynamics. Only about 60 percent of women attend their postpartum visits, and rates are even lower for beneficiaries of Medicaid or CHIP.7 One study found that even when new parents attend the standard six-week postpartum appointments, only half of the providers asked their patients about PMAD symptoms at the visit.8
Increasing attendance rates is only part of the challenge – timing can also be a critical factor. In the U.S., the national diagnosis rate for PMADs is 11.5 percent, but Ovia’s research suggests that the true rate of PMADs is as high as 30 percent.9 In a study of over 160,000 Ovia members, we found a notable increase in PMAD mental health screener scores three to twelve months postpartum, which extends beyond the typical six-week screening window.10 It’s clear that cases of postpartum depression, anxiety, OCD, and psychosis are often being missed. People are likely to fall through the cracks when their symptoms appear later. The American Academy of Pediatrics recently amended their infant well-child visits to add in additional PMAD screening, but adherence to this guideline is inconsistent due to restricted patient interaction time and the focus of the appointment being on the child rather than the parent.
These missed and insufficient screenings provide us the opportunity to close gaps in mental health support by offering more frequent PMAD testing beyond the clinical setting. Additionally, through increasing the attendance rate at six-week postpartum visits, we can connect more people to the care they need to prevent or treat adverse health outcomes after birth.
How Ovia closes gaps in mental health care
Ovia helps remove cost barriers to reproductive education and helps parents understand the care they need in order to take control of their health journeys. We do this by giving all members evidence-based clinical content tailored to their specific needs and risks and providing them with simple, convenient tools to track their health before, during, and after pregnancy. We understand that creating a strong bridge of communication, information, guidance, and support can significantly improve the way parents prioritize their mental health.
In the case of PMADs, Ovia’s digital health solutions can act as a safety net for those whose providers or circumstances don’t offer frequent mental health screenings. While using Ovia apps, members are given the universally validated Edinburgh Postnatal Depression Scale (EPDS), the same validated tool providers use in clinical settings.
Ovia members take the screener via their smartphones, allowing them to screen more often, regardless of whether their doctors provide the screening or if they miss a healthcare visit. Prompts urge members to take the EPDS during the first and third trimesters of pregnancy and at least twice within the first six months after birth. Studies suggest that members may under-report depression symptoms in a setting where they feel uncomfortable or discriminated against — such as a doctor’s office.11 By screening at home, members may report their symptoms more accurately.
When members take the EPDS through Ovia’s solution, we offer them vital recommendations quickly. They receive an interpretation of their score right away, and when the score is high — indicative of a potential PMAD — we deliver a recommendation to contact their provider for care. Due to our approach, members participating in this program were 67% more likely to complete the screener.12
The Ovia app facilitates PMAD screenings and serves as an educational tool. Through push notifications, we remind and encourage members to attend a six-week postpartum healthcare visit, reassuring them that their postpartum health is a priority. In the third trimester, the Ovia app automatically provides information about what to expect at the appointment and what questions to ask the provider. It creates a clear line of communication and messaging that supports members as they prioritize and organize their needs while managing their family and life dynamics. Educating the member on the importance of attending the appointment, reminding the member of the upcoming appointment, and normalizing postpartum care ultimately increases the likelihood of attendance.
The results are promising: postpartum visit rates were 86% among Black Ovia members enrolled in Medicaid or CHIP and 89% for American Indian and Alaskan Native Ovia members enrolled in Medicaid or CHIP. Compared to the national average of 60%, that’s a 43% increase.13 These numbers are a testament to the potential impact of our digital health solutions. While we’ve made strides in increasing mental health screenings and access to care, we recognize the ongoing need to strive for health equity. To effect lasting change, we must confront systemic racism and connect more individuals with community resources and health programs. If your organization is committed to addressing PMADs and enhancing mental health among employees and members, a partnership with Ovia is a strategic move.
1. National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8970132/#:~:text=According%20to%20Newport%20et%20al,et%20al.%2C%202015).
2. National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8970132/#:~:text=According%20to%20Newport%20et%20al,et%20al.%2C%202015).
3. National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8970132/#:~:text=According%20to%20Newport%20et%20al,et%20al.%2C%202015).
4. National Alliance on Mental Illness: https://www.nami.org/Blogs/NAMI-Blog/July-2021/Addressing-the-Increased-Risk-of-Postpartum-Depression-for-Black-Women
5. Archives of Women’s Mental Health: https://pubmed.ncbi.nlm.nih.gov/33855652/
6. The American College of Obstetricians and Gynecologists (ACOG): https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizingpostpartum-care
7. American College of Obstetricians and Gynecologists (ACOG): https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizingpostpartum-care
8. Centers for Disease Control and Prevention (CDC): https://www.cdc.gov/mmwr/volumes/69/wr/mm6919a2.htm
9. Bradley et al., 2020. Risk of perinatal depression among women screened within a mobile application. The International Marce Society for Perinatal Mental Health Conference.
10. Bradley et al., 2020. Risk of perinatal depression among women screened within a mobile application. The International Marce Society for Perinatal Mental Health Conference.
11. Journal of Personality Assessment: https://pubmed.ncbi.nlm.nih.gov/12584064/
12. Ovia Health: https://www.oviahealth.com/blog/health-equity-sdoh/
13. Ovia Health: https://www.oviahealth.com/blog/health-equity-sdoh/
Black women in the United States face significant disparities in maternal health, and calls for additional support and changes to existing models of care could provide much needed relief. One way to help address the Black maternal health crisis is through investing in doula care. Doulas are trained professionals who can help support pregnant people during pregnancy and even throughout the postpartum period in major ways. Equipped to provide physical and emotional support before, during, and after labor, here’s why investing in doula care can increase patient access to care and improve birth equity overall.
The current state of Black maternal health
According to a recent report by the CDC, maternal mortality rates have been rising overall in the U.S. from 2018-2021. Even more disturbing are the racial disparities that persist – approximately 30% of Black, Hispanic, and multiracial mothers reported experiencing mistreatment during maternity care, and 40% of these same groups reported discrimination. Additionally, Black women are three times more likely to die from maternity related complications and experience disproportionately worse maternal and infant health outcomes than other racial/ethic groups. There are several factors that contribute to these disparities: dismissal of pain by providers, limited access to quality care, and higher rates of chronic health conditions, among others. Studies show that Black mothers are twice as likely to report being ignored by the healthcare system in regards to their concerns over pain and other symptoms. This dismissal can have devastating consequences, leading to missed opportunities for treatment and prevention. The high maternal mortality rates for Black women highlight the need for better care and support throughout the childbirth process.
The impact of doulas
For Black women and other women of color, doulas can play an especially important role in bridging gaps in care and providing essential physical and emotional support. Doulas can help the mother’s voice be heard before, during and after childbirth and provide support so that their specific needs are being met. Studies show that mothers matched with a doula have significantly better birth outcomes compared to those without doula support. Doula-assisted mothers are:
- Four times less likely to have a low-birth-weight baby
- Two times less likely to experience a birth complication
- Significantly more likely to initiate breastfeeding
Black families often are inequitably supported, included, or prioritized in decisions about their own health and wellbeing, showing the need for new solutions that are grounded in social support and center community perspectives and values. As Dr. Joia Crear-Perry, Founder and President of RH Impact (formerly the National Birth Equity Collaborative) explains, doulas are so successful because they provide social support that many pregnant women lack, particularly those underserved by the healthcare system. Doulas can also help combat issues like medical gaslighting that disproportionately impact women of color. By having an advocate present, patients are more likely to have their voices heard rather than dismissed. Additionally, through extending the provider network through doula support, patients are more likely to receive racially concordant care which improves outcomes.
This extended support from conception through postpartum facilitates a deeper relationship and understanding of the birthing parent’s needs while also promoting the health and safety of both mother and child. Their inclusion before, during, and after childbirth is a step towards more equitable care and better outcomes.
What health plans can do
Here are some steps health plans can take to improve birth equity:
1. Increase access to doulas and community care networks
Covering doula services provides wider access for marginalized groups who are at higher risk for complications. Developing care networks centered on community health workers, doulas, midwives, and lactation consultants is also a critical step towards improving health outcomes for your entire population.
If covering the cost of doulas is too large of a hurdle, providing access to peer care providers who have shared experiences with patients is an impactful first step. For example, in addition to being registered nurses, many Ovia Health coaches are mothers from diverse backgrounds who often share their personal experiences with members to create deeper connections and facilitate the best possible care.
2. Implement a Respectful Maternity Care Framework
What is a respectful maternity care framework? It’s a theoretical framework based on the birth experiences of Black mothers to inform the ways hospitals and health systems can better provide respectful, affirming care to pregnant people throughout their maternity care. This framework complements existing provider educational tools and promotes anti-racist and birth equity practices, such as shared decision making.
To learn more about this framework, check out the Respectful Maternity Care Framework guidelines
interview we did with RH Impact (formerly the National Birth Equity Collaborative).
3. Invest in preventative, personalized digital health solutions
At Ovia, we offer a platform that supports the full spectrum of women’s and family health, serving as an essential companion to help improve health outcomes and support equitable family journeys. Investing in end-to-end digital solutions that deliver 1:1 connections with care experts improves health literacy and self-advocacy, supporting individuals who might otherwise be anxious to discuss issues with their providers or feel dismissed by them. A 2023 survey of Ovia members found that those who interacted with the Care Team were more likely to report taking control of their health. For example, compared to Ovia users who did not engage with the Care team, members who did reported they were:
- 270% more likely to report that Ovia Health helped them answer a pressing health question
- 79% more likely to report that Ovia Health helped them self-identify a health
condition/symptom - 136% more likely to report that Ovia Health encouraged them to reach out to their provider
- 36% more likely to use employer/health benefits
Solutions that leverage patient-reported data can provide early identification of rising risks and alert individuals to seek care when they need it. Digital health solutions like Ovia can empower coaches with these insights to also ask critical questions of members and equip individuals to advocate for themselves when it comes to their health. Our focus on prevention, backed by human-centered guidance, isn’t just meant for one moment in a member’s life. It helps members from preconception through menopause.
With Black mothers facing disproportionately worse outcomes, action must be taken to provide better care and support. As studies show, doulas play a key role in improving birth equity and overall maternal outcomes. Health plans have an opportunity to be part of the solution by increasing access to doulas throughout the pregnancy and postpartum journey, promoting respectful maternity care practices, and investing in preventative digital health solutions. With coordinated efforts combining these actions, we can work to improve maternal health for all.
To learn more about the work Ovia does to support Black maternal health and what your organization can do, schedule a demo with a member of our health plan team.
This month, Ovia Health by Labcorp (Ovia) released its third annual Future of Family Friendly 2024: Benefits That Matter, a comprehensive report which indicates a growing desire for greater family-friendly benefits in the workplace.
The report reveals a significant shift in employee sentiment toward their benefits. More than six-in-ten employees (62%) report they do not consider their employer family-friendly, an increase from four in 10 in 2023. Additionally, 43% of employees give their existing benefits a grade of “C” or lower. Almost three-quarters (72%) of workers view family benefits as extremely important, and 73% would leave their current role for a lateral move to another company with better benefits.
Employees Want Longer Paid Parental Leave, Alternative Family Planning Support
Longer paid parental leave tops the list of benefits that are most important to employees. However, the report shows growing demand for a host of benefits rarely offered by employers. The disparity between available and desired benefits is particularly stark in areas such as pregnancy loss leave, where only 5% of those surveyed have access, despite 53% indicating it’s a benefit they highly value. Between 10% and 20% of known pregnancies, and potentially up to 30% of all pregnancies, end in miscarriage.1
Similarly, while 38% of employees seek alternative family-building support, very few have access to benefits for adoption (14%), surrogacy (5%), or foster parent support (7%). Additionally, over half of employees (53%) express a need for maternity care management support, yet only 7% report having those benefits.
Mid-Life Benefits Are in High Demand
Approximately 1.3 million women enter menopause each year. And while menopause officially marks the end of a woman’s menstrual cycles, most women begin experiencing symptoms much earlier, during perimenopause, which typically begins about eight to 10 years before menopause.
The need for better support for employees experiencing menopause or perimenopause is also a critical finding of the report. Among respondents of menopausal or perimenopausal age, 83% feel the symptoms of menopause or perimenopause impact their ability to work. Yet, a mere 1% have menopause support at work. This disparity highlights a growing need for more attention to the full continuum of women’s healthcare from employers if they wish to maintain a productive and diverse workforce that includes employees of all ages.
Supporting Women’s and Family Health Journeys
At Ovia, we offer a platform that supports the full spectrum of women’s and family health, serving as an essential companion to help improve health outcomes and support equitable family journeys.
A snapshot of our data shows when individuals use our resources to track their health data and screen themselves for perinatal mood disorders, our clients see up to a:
- 54% reduction in preterm births*
- 24% reduction in C-sections*
- 14% reduction in preeclampsia*
- 3x increase in postpartum depression screening*
- 92% infant vaccination adherence rate
What’s driving results like these?
Our focus on prevention, backed by 1:1 human-centered guidance, isn’t just meant for one moment in a member’s life. It helps members from preconception through menopause. In fact, in 2023:
- Ovia users logged more than 116 million data points and health symptoms in our apps;
- More than 216,000 Ovia users enrolled in condition management programs;
- More than 137,000 mental health screeners were completed; and,
- Ovia sent more than 400,000 critical alerts to users to help them recognize potential issues or health risks.
As we continue to navigate the complexities of women’s health and family planning benefits, it’s clear that actionable insights and forward-thinking strategies are essential for fostering healthier workplaces and communities.
Download your copy of the Future of Family Friendly 2024: Benefits That Matter and join us in shaping a better future for women’s and family health.
*Note that these outcome(s) reflect(s) the greatest improvement experienced by a single client for this/these clinical condition area(s). Other clients experienced different outcomes in this/these clinical area(s). Actual results may vary based upon initial prevalence rate and engagement rates.
** Ovia distributed its annual survey to users who are working parents. More than 2,000 working parents responded, most of whom were between the ages of 26 and 40. The respondent pool consisted of 98% women, 1% men, and 1% non-binary. The full report and its comprehensive findings can be viewed at https://learn.oviahealth.com/benefits-that-matter.
When it comes to workplace benefits, do you know what your employees value most? It can be hard for employers to know what to prioritize as employees’ needs and expectations are constantly evolving. That’s why Ovia Health conducts our annual Future of Family Friendly Benefits survey. This year, we asked more than 2,000 working parents for their thoughts on their existing benefits, and how they could improve.
Overwhelmingly, working parents are simply not getting the support they need. Sixty-two percent said their employers aren’t family-friendly enough, and over forty percent gave their employer an overall grade of C or lower.
If retention is top of mind for your organization, investing in family-friendly benefits matter more than ever. Ninety-four percent of working parents told us that these benefits are so important that they are willing to move to a new company to get them. The data is clear – a wakeup call is needed for organizations looking to improve existing benefits.
Family benefits are table stakes — and they’re more crucial than ever for retaining talent
Among the employees we surveyed, nearly all respondents (94%) told us that family benefits are a top priority. This remained steady year-over-year — a clear indicator that family health benefits weren’t just a passing, pandemic-inspired fad. These days, employees expect benefits that support them from fertility, through pregnancy, return to work, menopause, and far beyond. And that includes all paths to parenthood, such as UI, IVF, adoption, or surrogacy programs.
Improved family benefits aren’t just a nice-to-have perk. Nowadays, employees are increasingly ready to take steps to secure them – 73% of respondents told us that they would gladly leave their current role for a lateral move to a company with better benefits and a family friendly culture. Even in an uncertain economy, solid benefits can outweigh the security of a long-term job.
As more employees look to expand their families, the demand for women’s health, fertility, and maternity care management benefits will continue to grow. It is critical to increase family building benefits at any organization, especially when it comes to including fertility treatment coverage that can support all members of your workforce. With 63% of LGBTQ millenials considering expanding their families, it’s important for organizations to ensure that all employees feel supported in the benefits available to them.
Survey details: what family benefits matter most to working parents
We delved into our survey to uncover employees’ sentiments about their benefits, their actual needs, and how employers can improve.
Longer, paid parental leave and flexible scheduling continue to be the top ranked benefits when compared year over year. Tangible benefits, like childcare support, maternity care tools, and mental health support also continue to be important to employees. This year, new benefits that employees are in pursuit of include pregnancy loss leave, maternity care management benefits (like Ovia+), fertility screenings & testing, and access to midwives or doulas.
One of the most critical findings from the report showed just how many working parents don’t have a firm grasp of what benefits are offered to them, or how to navigate using them. 45% of respondents gave their employer a C average or less when it came to understanding their benefits. These trends make it clear that, despite the efforts of the last few years, there is still work to be done in order for employers to fully support their workforce.
A new finding from this year showed that there’s a strong push from employees to have better fertility benefits through their workplace. 38% of respondents said that they are looking for their employer to provide alternative family planning support, and even more (41%) want their employer to provide fertility screenings and testing for both women and men.
Despite this strong push for more inclusive family building benefits and support for the fertility journey, the current state of support is grim:
- 15% of respondents have access to family building services like IVF or IUI
- 5% have surrogacy support
- 3% of respondents have egg freezing benefits
- 14% have adoption support
- 7% have access to fertility and maternity care management tools like Ovia+
This lack of family building support impacts not only women who are waiting until their late 30s or early 40s to have a baby, but also impacts LGBTQ+ employees who often have a harder and more expensive time building their families. Without fertility benefits, more senior-level female employees who are increasingly hard to retain and whose leadership can have a huge impact on a company’s success may be eyeing the door for a more supportive workplace.
When it comes to other areas of women’s and family health, the numbers aren’t much better. 83% of respondents told us that they feel that their perimenopausal or menopausal symptoms impact their ability to work, but only 1% of respondents have any type of menopausal support at work.
Improving DEIB through inclusive benefits like fertility treatment, mental health support, return to work programming, and even menopause support is the first step in making sure all employees feel supported in their workplace.
5 steps employers can take right now to become more family-friendly
Based on the key findings from the survey, there are multiple things employers can do to boost family benefits and foster a more family-friendly culture. Here are the top five – download the full report for more.
1. Extend or enhance your parental leave program.
Four months or more of paid leave has been shown to be ideal, but make sure it does not require employees to use sick leave or PTO before taking it. Beyond just providing leave, employers can boost family-friendliness by creating a culture that accepts — and encourages — taking family leave.
2. Make DEIB a priority.
Supporting DEIB at your organization means more than just having the occasional implicit bias training. It means making sure that all employees feel supported and welcome at your organization, and it can start with inclusive benefits. This wide umbrella includes everything from fertility treatment, mental health support, to pregnancy loss leave, maternity care management, fertility screenings & testing, and access to midwives or doulas.
Another area that employers can help employees feel supported throughout their career is menopause support. The push for menopausal equity happens on many fronts, but business leaders have a central role to play in ensuring that women are supported throughout this time in their lives and it starts with inclusive, educational women’s health benefits that help build a welcoming culture for all employees.
3. Ensure your benefits are inclusive to all paths to parenthood.
Now more than ever, there’s a strong push from employees to have better fertility benefits through their workplace. It’s an important investment – over 1,000 members wrote that alternative family building support is important to them and a key factor for retention.
Here are a few ways employers can boost family building support:
- Offer better fertility benefits such as Artificial Reproductive Technology (ART) coverage that includes preferred network specialist, co-insurance, a benefits card, or reimbursement program.
- Provide access to adoption and surrogacy support. With only a fraction of respondents having support through their employer, there is a real disconnect between what employees are looking for and what they actually have access to.
4. Make sure benefits information is accessible.
Employees often don’t know enough about their benefits to make the most of them. Make sure information about benefits is easily accessible and easily understood. People can’t use what they don’t know they have. Additionally, consider a manager training program to ensure all leaders are benefits experts who help foster a family-friendly workplace culture where employees feel comfortable bringing their whole selves to work each day without fear of repercussions.
5. Partner with a digital health solution.
An effective digital health solution connects employees to a team of board-certified experts who can help them through the biggest challenges of family building, from conception through pregnancy, parenting, return to work, all the way through perimenopause and menopause. An extra layer of telehealth alone isn’t enough. For the best ROI, choose a solution that’s personalized to each member, proactive about health screenings and risk factors, and responsive to key issues such as sleep coaching, breastfeeding, mental health, and more.
Get the details from our latest Future of Family Friendly Benefits survey
Want to know more about the things working parents need to thrive — and stay? Check out the complete results of our Future of Family Friendly Benefits survey here.
If you’re looking for a digital health partner for women’s and family health, Ovia can help.We offer 1:1 coaching with certified experts in lactation, parenting, menopause, and women’s health and wellbeing; physician-developed clinical programs; personalized health and wellness education; manager training; and benefits navigators so you can provide comprehensive women’s and family health support to your employees.
For payers and providers, addressing health equity and Social Determinants of Health (SDoH) to improve maternal outcomes isn’t a new concept. It has been part of the national conversation for years. Despite the attention it has garnered, maternal mortality and morbidity rates have not improved; they have deteriorated.
Not only are these poor outcomes costing lives, data suggest the economic burden of maternal morbidity and mortality amounts to billions of dollars each year. The argument has been made that improving maternal mortality is not only the right thing to do, but also makes financial sense. That much we all agree on.
But exactly how to address SDOH has been debated. Many organizations have created stand-alone programs to improve social determinants and equity, but many of the past efforts have been too siloed. Maybe with the right players working together, the conversation can shift from why we should address social determinants, to how. And effect systemic change.
Enter: digital health. Digital health may be the missing piece to the health equity puzzle. The average person spends approximately 3 hours and 15 minutes a day on their phone and checks for notifications 58 times a day. These statistics are not limited to individuals with private insurance; studies have shown that most Medicaid beneficiaries also have access to technology and an appetite for digital health.
Given that digital platforms are ubiquitous, they provide an ideal space to test innovative programs aimed at addressing SDoH and improving maternal outcomes. Our work and outcomes strongly support this idea.
During pregnancy, the postpartum period, or when individuals are looking to expand their families, their investment in their health is at its peak, as there is more at stake. Our members’ activities reflect this, with most logging in daily. The average user logs in differently based on the stage of their lives but still does so frequently:
- Ovia’s fertility solution: 19/month on average
- Ovia’s pregnancy solution: 34/month on average
- Ovia’s postpartum & parenting solution 92/month on average
Since we have their attention, we’re in a unique position to influence their behavior, educate them and address SDoH.
Every Ovia+ member is required to complete a health assessment upon enrollment, and an impressive 95% of members complete it. This assessment includes a wide range of questions about an individual’s health, financial situation, housing, family circumstances, and medical history. Using this data, we can create a unique risk profile for each member regarding their health and social determinants. Our Care Advocate team can reach out if any risks are detected and help resolve issues, sometimes before they even occur.
This type of solution is succeeding where many other screening programs have failed. Why are people willing to share their information via digital health? Digital enables anonymity. Many in-person programs have not been widely successful in the past, often due to participants feeling uncomfortable answering sensitive questions such as “Do you feel safe at home?” or “Do you have worries about housing in the next two months?” in-person. Online, their identities can feel less exposed, and they may be more comfortable sharing this type of information, especially if they fear that their answers may lead to a visit from Child Protective Services (CPS) in a public setting.
Once risk profiles are created and assessed, our programs can begin to take action. Here are some examples of initiatives we are currently hosting and that you could replicate or join:
1. Addressing food insecurity
Accessing nutritious foods is vital during pregnancy to support infant growth as well as reduce the risk for conditions like gestational diabetes. However, an alarming 54 million people in the United States face food insecurity. While many are eligible for federal support programs like the Supplemental Nutrition Assistance Program (SNAP) or the Women, Infants and Children Nutrition Program (WIC), many do not take advantage due to social stigma, confusion over eligibility, or simply being unaware.
So, we partnered with the researchers from University of California-Davis and University of Wisconsin-Madison to educate people about WIC and improve enrollment to reduce food insecurity.
Our preliminary results, which were presented for the first time at the 2023 CityMatCH conference, suggest that participants in the treatment group were slightly more likely to have enrolled themselves (46.6% versus 42.5%, p=.14) or their child (37.5% versus 34.3%, p=.19) in WIC postpartum, and were significantly more likely to report that they were likely to enroll their child in the future (57.6% compared with 51.3%, p=0.034). You can learn more about that research and findings in this blog.
2. Improving postpartum visit rates for Medicaid or CHIP recipients
Nationally, only about 60 percent of women attend their postpartum visits, with even lower rates among Medicaid or CHIP beneficiaries. But, these visits are vital to catching a number of potential issues, especially PMADs. By increasing the rate of attendance at six-week postpartum visits, we thought we could connect more people to the care they need to prevent adverse events.
So, we created a new program to increase postpartum visit attendance, awarded by the HHS Racial Equity in Postpartum Care Challenge. Starting in the 3rd trimester of pregnancy, we use in-app education and push notifications to encourage members to attend follow-ups. This program also explains what to expect at the appointment and educates members about important questions to ask their provider.
The results are promising: postpartum visit rates were 86% among Black Ovia members enrolled in Medicaid or CHIP and 89% for American Indian and Alaskan Native Ovia members enrolled in Medicaid or CHIP. Compared to the national average of 60%, that’s a 43% increase.
3. Increasing perinatal mood and anxiety disorder (PMAD) screenings
Our solutions also serve as a safety net for those whose providers or circumstances don’t include frequent mental health screenings.
Members receive the universally validated Edinburgh Postnatal Depression Scale (EPDS) within the app. They are prompted to take the EPDS during the first and third trimesters of pregnancy and at least twice within the first six months after birth. Members participating in this program were 67% more likely to complete the screener.
4. Tackling housing insecurity
On any given day, nearly 560,000 people experience homelessness in the United States. In addition, some research shows that pregnancy can increase a woman’s risk of homelessness. Pregnant women face significantly greater health risks when their housing situation is unstable.
To address this issue, if a member expresses concern about housing in the coming months through the Ovia+ health assessment, our Care Advocates proactively reach out to hear their concerns and help connect them to local community resources that can improve their housing security. Similar efforts are made when members express concerns about financial hardships or the ability to pay for or access utilities like water, electricity, or heat. These programs, though relatively new, have already had a positive impact on dozens of families and are expected to grow.
5. Connecting members to racially concordant care
Research has established that when patients have access to racially concordant care, they have better health experiences, appointment attendance and outcomes. Our Care Advocate team understands this and works to connect members with providers who share similar backgrounds, including doulas and midwives in their area. This is crucial because studies indicate doula-assisted mothers were:
- four times less likely to have a low-birth-weight baby
- two times less likely to experience a birth complication involving themselves or their baby
- significantly more likely to initiate breastfeeding.
All members who identify as Black or African American will receive this message from their Ovia Health Coach/Expert: “Sometimes it feels most comfortable to have healthcare conversations with providers you identify with who can really understand your personal experiences. If you have health questions you’d like to discuss with a Care Team member who identifies as Black or African-American, we’re here and ready to support you! Just send us a message.”
This work complements our Black Maternal Health program, which is designed to empower and support Black members while predicting their unique risks based on experiences and conditions they are more likely to face. We partnered with Reproductive Health Impact (formerly the National Birth Equity Collaborative) on this program and their Respectful Maternity Care Framework.
6. Removing obstacles to care
Accessing proper healthcare can be challenging for many individuals due to transportation or childcare limitations. However, many people are unaware that local and federal programs are available to help them overcome these obstacles. If our screening detects that someone is hindered by either of these issues, our Care Advocate Team proactively reaches out to connect members with the available resources. Although these programs are relatively new, they have already assisted more than 60 families in accessing the care they need.
Leveraging digital health to improve health equity and SDoH programs
These are just a few of the programs we’ve built to support members and address social determinants. We’ve also piloted programs to help members who are experiencing domestic violence and need access to childcare.
While we have achieved success thus far, we recognize that there is still much work to be done to achieve health equity. To make lasting change, we must also address systemic racism in our systems and connect more people with available community resources and health programs. If your organization aims to address social determinants and improve health equity, it’s time to consider partnerships with organizations like Ovia. Our unparalleled access and engagement open new opportunities for improvement that traditional providers and payers do not possess.
I urge you to take action to ensure that the next generation does not face the same health equity challenges we are addressing today.
Food insecurity is a serious issue in the US today. Despite social programs like the Supplemental Nutrition Program for Women, Infants, and Children (WIC), more than 13.1 million children are experiencing food insecurity, and an estimated 19 million live in food deserts. That’s 6.1% of the population.
Lack of access to nourishing, and nutritious foods can have a lasting impact on longitudinal health and success. Hungry children are less likely to participate in social and physical activity and have a harder time focusing in school. Plus, undernutrition in early life is linked to many adverse outcomes, like poorer cognitive skills, reduced healing, stunted growth, lower earnings and a higher likelihood of living in poverty. This makes insufficient nutrition a major social determinant of health (SDoH), especially for pregnant people and infants.
There are programs that exist to help women and children access healthy, affordable food. The Supplemental Nutrition Assistance Program (SNAP) and the Supplemental Nutrition Program for Women, Infants, and Children (WIC) are two such programs that assist low-income families and their children in purchasing healthy foods. WIC, in particular, targets pregnant and postpartum women and, infants and children under 5 with benefits for specific foods rich in nutrients these groups are lacking.
But many people don’t leverage the benefits they’re eligible for, and many children and pregnant women aren’t getting the nutrition they need to stay healthy. Cultural taboos about federal assistance programs, fear of child welfare involvement, shame, and a lack of awareness of the program and understanding of it may play roles in this chronic underutilization. These barriers and misconceptions have such an impact that it’s estimated only half of eligible persons were participating in WIC in 2023.
To dispel myths about WIC and help connect pregnant women and children to the resources available to them, Ovia partnered with University of California-Davis and University of Wisconsin-Madison to run a first-of-its-kind study. In the following Q&A, researchers explain the findings of the first-ever randomized control trial to improve WIC enrollment, using a digital tool like Ovia, and the potential impact on SDoH, health equity, and outcomes.
Q: Tell us a bit about yourselves as researchers. Why was it important for you to study WIC, food insecurity and nutrition’s impact on maternal health?
We are an interdisciplinary group of researchers from economics, sociology, and public health. This work was led by Dr. Marianne Bitler, a nationally recognized expert in social safety programs like WIC, and Dr. Jenna Nobles, a distinguished demographer with expertise in fertility and immigration. Fiona Weeks is a PhD candidate who supported the implementation of the project.
We chose to study WIC because of the profound impact it can have — and is having — on lives. Approximately half of infants in the U.S. are eligible for WIC, and participation has multiple positive impacts on pregnancy, like improved birth outcomes, improved diet, improved infant feeding practices, improved childhood immunization, and more. However, the program is significantly under-enrolled.
We know that income inequality is growing in the U.S., and social determinants of health like food insecurity play a significant role in health outcomes, so it’s more important than ever to connect people with government-provided benefits that can help them have healthier pregnancies and families.
Q: Tell us about the study, what were you trying to learn?
Because millions of eligible people aren’t taking advantage of WIC benefits, we wanted to pursue a creative way to educate people about WIC and increase WIC program enrollment by promoting WIC through a digital health solution that millions of pregnant people in the United States already use.
To do so, we invited Ovia Pregnancy users between five and 35 weeks pregnant to complete a short prenatal survey about their eligibility for WIC. If they were deemed likely eligible for WIC based upon their self-reported household income or participation in SNAP or Medicaid in their state, we randomized them into either a treatment or control group. Treatment users were educated about the benefits of WIC and given information about their local clinic for enrollment. Control users were presented with information about nutrition during pregnancy from the American Council of Obstetricians and Gynecologists.
After the participants gave birth, we asked them to take another postpartum survey to share with us their knowledge about WIC, whether they ever enrolled in WIC, and why or why not to better understand barriers to enrollment. We also collected information about delivery and infant health outcomes for both groups.
Q: What’s unique about this study compared with other research done on the benefits of WIC? How many people participated? What’s the sample size?
This study is unique because, to our knowledge, it is the only randomized controlled trial (RCT) to experimentally test whether promoting WIC through a digital means can influence understanding of WIC and WIC enrollment.
The study is still ongoing, but to date, it has screened over 27,000 Ovia users tracking their pregnancy. Of those, over 7,000 completed the prenatal survey. We are still collecting postpartum surveys and outcomes from many participants.
Q: Why did you collaborate with a digital health solution for this project? How is this different from other research approaches?
Increasing program enrollment in WIC requires a multidisciplinary approach; some people will enroll based upon word-of-mouth, and others might see a bus or train advertisement. One thing we noted was that no one was really promoting WIC digitally.
Research suggests that smartphone apps are an increasingly popular way to track one’s health, especially before, during, and after pregnancy. More than 95% of reproductive-age women in the U.S. have smartphones, and 83% of U.S. adults with a median household income of less than $50,000 have smartphones.
Considering these data, and the common knowledge that most people are attached to their phones and the digital world more than ever, we wanted to modernize the approach to WIC awareness and enrollment. So, we created an easier, digital way for people to learn about the benefits of WIC, and tested it using an experiment.
Ovia Health’s mobile solutions are free to the end-users, so they attract a broad and diverse user base, which was attractive from a recruitment perspective for our study. Enrolling participants digitally also made it possible for us to reach many more participants than if we had enrolled participants in person.
Q: What did you find? What were the preliminary results about WIC enrollment?
Our preliminary results, which were presented for the first time at the 2023 CityMatCH conference, suggest that participants in the treatment group were slightly more likely to have enrolled themselves ( 46.6% versus 42.5%, p=.14) or their child (37.5% versus 34.3%, p=.19) in WIC postpartum, and were significantly more likely to report that they were likely to enroll their child in the future (57.6% compared with 51.3%, p=0.034).
When asked about the services that WIC provides, participants in the treatment group were more likely to know that WIC provides breastfeeding support (65.1% versus 59/0%, p=0.023).
Q: What do we know about people who did enroll? Any trends in geography, race, socioeconomic status, insurance status?
Among those who completed the first survey and received either the intervention or control condition, about 20% of participants identify as Black, 4% identify as American Indian or Alaska Native. This is important because of health disparities that disproportionately impact women and babies of color.
40% of participants were only “somewhat” or “not at all” confident that they would have enough to eat in the next month. We have participants in all fifty states, and several territories!
Q: For those who chose not to enroll, was there a reason? Why ignore benefits available?
That’s a great question. There are many reasons why someone wouldn’t enroll in WIC, but the most commonly reported reason for not enrolling in our study was that they didn’t believe they were eligible, despite meeting the income threshold for enrollment according to their intake survey. There were also respondents who said they had never heard of WIC before or they didn’t know much about it.
This finding suggests that there is still some education and promotion to do in the community about who is eligible for WIC and how to see if you are eligible.
State partners have also noted that people may not enroll because they don’t want to “take away” a spot from someone or because they are afraid it will affect their immigration status.
Q: What impact could this have on WIC enrollment, future research or outcomes? What are you looking to study next?
At the CityMatCH conference, many state WIC staff (WIC programs are directed by individual states) were excited about these preliminary results and were interested in replicating this education strategy for their communities. These results suggest that promoting WIC in a variety of modes, including digitally, may be key to reaching more eligible people and enrolling them in WIC benefits.
The next steps in addressing health equity and food insecurity
The study itself is ongoing, and researchers plan to continue surveying women about their postpartum experiences and outcomes. But early results are clear, there is an opportunity to improve SDoH in a tangible way using digital health solutions like Ovia.
These data should hopefully spark hope and interest for other population health projects. For organizations working to address health equity, trusted digital health solutions can be a viable option. Considering the maternal mortality crisis the U.S. is facing, new innovative strategies are needed to improve maternal outcomes. The methodologies of this survey, and others, could be repurposed and leveraged to tackle a number of challenges in the maternal health space. To learn more, or explore potential partnerships, reach out to the Ovia Health team.
Many of us have friends or family who have struggled to conceive, or have first-hand knowledge of the effects infertility can have on all areas of life. It’s common. So common that according to the World Health Organization (WHO), infertility affects one in every six couples trying to conceive through intercourse at some point in their lives. That’s five million couples in the United States. Though infertility is often framed through a heterosexual lens, it affects LGBTQ+ people, too, who tend to be even more marginalized by infertility.
For those who struggle, it can be a heartbreaking, lonely, expensive journey without nearly enough support. Many feel deep frustration, shame and even depression over fertility struggles. For those undergoing treatment, the financial and physical pain associated can also become a challenge. For these reasons and many more, many people don’t talk about infertility publicly.
This taboo has led to general confusion and misinformation about infertility. To help clear up questions and continue to break down cultural stigmas surrounding infertility, Ovia Health’s Chief Medical Officer, Dr. Leslie Saltzman, has put together the basics for every parent-to-be to know. Share these insights with your workforce or members.
What is infertility?
Infertility is typically defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse, or when an egg and sperm are exposed to each other for more than 12 months without achieving pregnancy. Infertility can be primary, when a pregnancy has never been achieved, or secondary, when at least one prior pregnancy was achieved.
The causes of infertility
Infertility may be caused by a number of reasons, but it’s not always possible to identify the cause. It’s also important to note that women are not solely responsible for infertility; it’s estimated that about a third of infertility is female-related, a third is male-related, and a third is unknown.
Some known causes of female infertility may include:
- Ovulation disorders, which affect the release of eggs from the ovaries. These include hormonal disorders such as polycystic ovary syndrome
- Hyperprolactinemia, a condition in which you have too much prolactin, which is the hormone that stimulates breast milk production
- Thyroid problems
- Uterine or cervical abnormalities, including abnormalities with the cervix, polyps in the uterus, or the shape of the uterus
- Noncancerous (benign) tumors in the uterine wall (uterine fibroids) may cause infertility by blocking the fallopian tubes or stopping a fertilized egg from implanting in the uterus
- Fallopian tube damage or blockage, often caused by scarring from infections or endometriosis
- Endometriosis, which occurs when endometrial tissue grows outside of the uterus, may affect the function of the ovaries, uterus, and fallopian tubes
- Early menopause (also called primary ovarian insufficiency) when the ovaries stop working normally before age 40
- Pelvic adhesions, bands of scar tissue that bind organs that can form after pelvic infection, appendicitis, endometriosis or abdominal or pelvic surgery
- Cancer and its treatment, certain cancers can impair fertility, and treatments, including radiation and chemotherapy, may affect fertility
Some known causes of male infertility may include:
- Abnormal sperm production or function due to undescended testicles, genetic defects, health problems such as diabetes, or infections such as chlamydia, gonorrhea, mumps or HIV. Enlarged veins in the testes (varicocele) also can affect the quality of sperm.
- Problems with the delivery of sperm due to sexual problems, such as premature ejaculation; certain genetic diseases, such as cystic fibrosis; structural problems, such as a blockage in the testicle; or damage or injury to the reproductive organs.
- Overexposure to certain environmental factors, such as pesticides and other chemicals, and radiation. Cigarette smoking, alcohol, marijuana, anabolic steroids, and taking medications to treat bacterial infections, high blood pressure, and depression also can affect fertility. Frequent exposure to heat, such as in saunas or hot tubs, can raise body temperature and may affect sperm production.
- Damage related to cancer and its treatment, including radiation or chemotherapy. Cancer treatment can impair sperm production, sometimes severely.
Is infertility prevention possible?
Some types of infertility are unfortunately not preventable. However, there are several lifestyle changes you can encourage your workforce and members to make that may increase their chances of getting pregnant. Couples using intercourse as their family-building method should have intercourse several times around the time of ovulation for the best chances of conception. Using a cycle-tracking app like Ovia to learn when you are most likely to be ovulating can help increase your chances.
Here are some more tips for men and women that can help increase the odds of pregnancy:
- Avoid recreational drugs and tobacco use, which may contribute to infertility.
- Avoid alcohol. It may impair your ability to conceive and have a healthy pregnancy.
- Avoid high temperatures in hot tubs and baths, as they can temporarily affect sperm production and motility.
- Limit medications that may impact fertility, including both prescription and nonprescription drugs. Talk with your doctor about any medications you take regularly, but don’t stop taking prescription medications without medical advice.
- Exercise moderately. Regular exercise may improve sperm quality and increase the chances of achieving a pregnancy. If you’re a woman, be aware that exercising so intensely that your periods are infrequent or absent can affect fertility.
- Limit caffeine. Women trying to get pregnant may want to limit caffeine intake to 1-2 cups of coffee per day
- Avoid weight extremes. Being overweight or underweight can affect your hormone production and cause infertility.
When assistance and benefits are needed
If your members have tried the above and are still struggling, the best place to direct them is an OB/GYN, midwife, or fertility specialist (reproductive endocrinologist). They can also ask their primary care doctor or provider for recommendations. Members may want to think about fertility treatment if:
- They’re younger than 35 and have been trying to get pregnant for at least a year.
- They’re 35 or older and have been trying to get pregnant for at least six months.
- They’re over 40
- They’re trying to get pregnant, and have irregular, very painful or no periods.
- They’re trying to get pregnant, and have conditions like endometriosis, pelvic inflammatory disease, or a past miscarriage.
- They think there may be a male factor (like a history of testicular trauma or past infertility with another partner).
If you want to support their decision-making and journey further, you can invest in a trusted partner like Ovia. With access to Ovia, members can lean on a certified fertility specialist or other coaching experts for support. Ovia’s Care Team helps answer member questions about infertility, listen to frustration, navigate the next steps, and offer ongoing support.
What infertility benefit options are available?
Investing in fertility solutions for members is a clear path to reduce the risk and expenditures for all parties — members, employees, payers and employers. But what options are available?
Traditional fertility coverage has included funding fertility treatments and rounds either by committing a certain dollar amount per year or lifetime use or fully covering a certain number of rounds. However, in recent years, more preventative measures have grown in popularity. Many have seen success in using cycle tracking to reduce unnecessary fertility treatment. Through Ovia’s fertility algorithm trained on millions of menstrual cycles over more than 12 years, our solution may reduce unnecessary artificial reproductive technology use, risk, costs and multiple gestations by helping people better identify their fertile window and achieve pregnancy on their own.
For example, compared to non-Ovia Health users, Ovia Health members have observed up to:
- 65% reduction in ART utilization*
- 47% reduction in multiple gestations*
- 54% reduction in preterm delivery*
- 24% reduction in c-sections.*
Fertility struggles are difficult for so many reasons, from the emotional strain to the cost and the time for treatments. But offering a benefit that helps avoid unnecessary ART treatments, supports improved outcomes post-conception, and eases cultural stigmas surrounding fertility struggles can help families grow, keep healthcare costs low, and increase retention.
Want to learn more about fertility support – from preconception health, to cycle tracking, care navigation, and emotional support – visit oviahealth.com.
*Note that these outcome(s) reflect(s) the greatest improvement experienced by a single client for this/these clinical condition area(s). Other clients experienced different outcomes in this/these clinical area(s). Actual results may vary based upon initial prevalence rate and engagement rates.
Women’s health benefits are one of the fastest growing sectors in healthcare. In the post-pandemic workplace, more and more employees are demanding benefits that support women and families—and they’re even willing to change jobs to get them. This means employers need to offer the most sought-after benefits, including fertility coverage, to compete for the best talent and maintain a diverse workforce.
But there are a few key things employers need to know when deciding how to approach fertility coverage. First, not offering fertility benefits can cost you. Second, there can be hidden costs to offering fertility benefits without a holistic women’s health program to back them up for you and your employees.
The stress of infertility may be taking a toll on your employees — and your retention goals
Fertility treatments are notoriously expensive. And it’s not a niche problem. According to the World Health Organization, infertility impacts one in six people at some point in their lives. But fertility and family-building struggles can feel like taboo subjects— which means that there’s a good chance some of your employees are dealing with these issues, and you may not even be aware.
While it’s hard to calculate the emotional stress of fertility challenges, we can put some numbers to the tremendous financial burdens people face:
- Invitro fertilization (IVF) can cost anywhere from $15,000 to $30,000 for a single round. Some people conceive during their first cycle, while others may need six cycles or more.
- Egg freezing can cost up to $8,000 for the procedure, along with $4,000 to $6,000 per cycle for medications and up to $500 or more per year for storage fees.
- Adoption can cost as much as $60,000.
- Surrogacy can cost as much as $100,000 to $225,000.
When family-building is a priority, people can face nearly impossible decisions: How will they afford the costs? How much debt can they manage? These kinds of financial stressors can lead to emotional exhaustion and negative physical health effects, which can take a toll on a person’s work life.
The financial pressures of fertility issues may be even tougher in the current economy. Inflation is up 17 percent since 2020 and according to PwC’s 2023 Employee Financial Wellness Survey, 57 percent of employees say that finances are the top cause of stress in their lives.
As financial distress ratchets up, valued employees may decide to search for higher salaries. In fact, PwC’s research also found that financially stressed employees are twice as likely to be looking for a new job. And 73 percent of financially stressed employees said they would be drawn to an employer who cares more about their financial well-being.
For all of these reasons, women’s health and fertility supporting solutions, like Ovia, are a smart investment for employers — they can improve the emotional and financial well-being of employees, boost retention and recruitment, and reduce the costs associated with hiring and training replacement employees.
Here’s why fertility benefits need to go hand-in-hand with holistic women’s health support
While a fertility benefit can help employees avoid the tremendous financial stress of family-building — and help demonstrate a company’s commitment to a family-friendly work culture — offering fertility benefits alone can come at a high cost. If you offer fertility benefits, such as IVF coverage, people will use them. (A study found, for example, that in states with mandated assisted reproductive technology (ART) coverage, use is 1.5 times higher than the national rate.) But the costs of fertility treatments don’t end when treatment is complete.
ART can increase rates of preterm births 4X and multiple births by more than 30 percent, which can both lead to expensive health complications. Consider: singleton births cost about $21,000 per delivery, twins can cost up to $105,000, and triplet births may cost 20 times as much as a singleton — up to $400,000 or more. A preterm birth can cost up to $95,000 per instance.
Employers can manage the costs of fertility by offering more holistic support. First, a fertility benefit can include education and coaching to help as many members as possible to conceive naturally, reducing the use of ART and lowering the rates of multiple births. Ovia’s fertility solution has been shown to reduce ART use by up to 65 percent and multiple gestations by up to 47 percent.*
A strong maternity care program — with a focus on prevention — can also lower costs. In the U.S., we’re already battling a broken system. Our maternal mortality rates are higher than any other high-income nation, shockingly, the vast majority of those deaths are preventable. Given the higher health risks for ART-related pregnancies, personalized preventive care is critical.
Prevention is at the heart of Ovia’s model. Using data and our experience helping millions of people through their parenting journey, we’ve built clinical pathways that take the individual health risks of each member into account. Our solution includes personalized education based on a member’s specific profile, one-to-one coaching, and reminders about critical tests and screenings. With this approach, we help members have healthier, safer pregnancies — and we’ve reduced preterm birth rates for our clients by as much as 54 percent in some cases.*
For truly family-friendly benefits, begin with family-building — and keep going
Fertility benefits can be a game changer for employee well-being and retention, and maternity care is critical for the best ROI on a fertility program.
The next step, for companies that want to provide comprehensive family-friendly benefits, is a holistic approach to women’s and family health that spans the major life milestones, including:
- Fertility and alternative paths to parenthood, including pre-conception support, and support for members to identify and navigate fertility clinics, providers, and surrogacy and adoption agencies
- Concierge services with real-time, one-on-one support and clinical guidance from Ovia’s in-house Care Team
- Maternity care management
- Postpartum health, with 12-month, personalized support for both physical and mental wellbeing
- Child health
- Advanced women’s health, including preventative care and including menopause support
If you’re ready to put all of these pieces together, Ovia can help. Our digital solution is built on more than a decade of data and experience helping people through family-building, pregnancy, children’s health, and beyond. We’re focused on prevention and personalization, and our certified health coaches bring a deep understanding of women’s and family health and well-being to every member.
Want to learn more? Ovia is here for you.
Ovia Health, by Labcorp, has served more than 22 million women’s and parenthood journeys since 2012 and is on a mission to make a happy, healthy family possible for everyone. Ovia Health is the only women’s health solution clinically proven to effectively identify and intervene with high-risk conditions. The company’s 50+ clinical programs, including predictive coaching and personalized care plans, help prevent unnecessary health care costs, improve health outcomes, and foster a family-friendly workplace that increases retention and return to work. For more information, visit OviaHealth.com.
*Note that these outcome(s) reflect(s) the greatest improvement experienced by a single client for this/these clinical condition area(s). Other clients experienced different outcomes in this/these clinical area(s). Actual results may vary based on initial prevalence rate and engagement rates.
I am a clinical psychologist by training. In the early years of my career, I had the privilege of working with families in the Latine community in the Los Angeles metropolitan area. Noting the recurrence of troubling issues that I witnessed firsthand, the impacts of health inequities and social determinants on lives were brought into sharp relief for me.
Working with adolescents who were court-mandated to receive therapy, I would bring in the family. I was trained to understand that progress often depended on addressing some of the familial dynamics. What I realized needed changing was much deeper than familial issues. It was access to education, healthcare, and making a livable wage. There were issues of safety. Individual protection, or lack thereof, hinged on participation in gangs. I saw parents working long hours at multiple jobs and young kids have no childcare. Healthy food wasn’t readily available — but processed, nutritionless food could be found readily. Yet my training was no focused, nor was my position, on addressing these systemic issues
I am also a Latine woman. My heritage, work, and experiences reinforce my connection to my community. In part, it was the stark contrast to my upbringing that provided me with a critical lens to see the systemic issues that were affecting these individuals who also identified as Latine and yet whose paths were so different than mine. I realized then that I wanted to focus my impact on addressing systemic issues. To this end, I celebrate Latine Heritage Month by advocating for urgent attention to the health inequities that affect this community.
Despite ongoing efforts to enhance clinical outcomes, health disparities persist for Latine individuals, who:
- Experience higher mortality rates from cervical and breast cancers compared to non-Latine.
- Are less likely to receive regular pap tests and mammograms.
- Exhibit a higher rate of cardiovascular disease, yet are less likely to have their blood pressure or cholesterol regularly checked.
- Are more likely to experience gestational diabetes.
As we conclude Latine Heritage Month, I take a moment as both a clinician and a member of this community to call for change. The healthcare industry must critically examine current policies and care delivery methods.
The History of Hispanic Health Disparities
The Latine community is diverse, comprised of individuals in the U.S. who identify as being of Spanish-speaking origin, descent, or background. It’s inclusive of 20 Latin American nations across Mexico, Central America, South America, Puerto Rico, Cuba, and Spain.
Despite this diversity, there are commonalities in the health disparities faced by this community. According to a recent study by Pew Research, individuals in the Latine community are less likely to have health insurance and less likely to seek preventive care compared to other segments of the American population.
In addition to historical issues related to access, the U.S. has a long history of cultural discrimination against immigrants. Language barriers, cultural obstacles, and heightened levels of poverty are all symptoms of an underlying condition: discrimination. They have contributed to poorer outcomes.
Seared into my memory is a Latine individual who was in tears while sharing with me a scary diagnosis they had just received, yet they couldn’t fully understand the discussion they had with their doctor due to a language barrier. It was further complicated by their worry that they would not be able to pay for the treatment. They also were embarrassed to talk to their family about it and felt isolated while carrying this burden. If we don’t address the many layers of challenges facing individuals in the Latine communities, the health outcomes will not improve.
This Community is Growing
Today, the Latinx community is the fastest-growing minority group in the U.S., comprising 15% of the population and estimated to expand by 115% by 2025. This growth emphasizes the need to address health inequities, not only as a moral imperative but also from a population health perspective where the cost impact could be monumental. It is in our collective interests to enact change now.
How Payers, Partners and Companies Can Usher in Change
To address health inequities for the Latine community and others. I’ve summarized five steps to address systemic issues that we can implement today. Some are simple, some will take more time, and others can be achieved through market partnerships — all are within reach.
1: Breakdown language barriers
Ensure translators are available in health care settings. Time and time again I hear stories, even from my team at Ovia, where miscommunications due to language barriers have caused adverse events or unnecessary care. These issues could have been avoided had a translator with cultural and clinical knowledge been present.
Federal and state laws mandate translators be offered in healthcare settings, however, resources are sometimes stretched too thin and services aren’t available. Health plans and organizations must hold providers accountable for providing care in the individuals’ preferred language. Through advancements in technology, however, there are digital resources that can help with translation on site. Plus, many hospitals and health systems now encourage staff to learn conversational Spanish, and offer classes and stipends to do so.
Additionally, there are personal digital health tools that are offered in many languages, like Ovia. Patients can use these digital health solutions to educate themselves and learn how to advocate for themselves. Should you partner with a digital health solution, ensure it’s available in Spanish or multiple languages.
If your organization provides care or benefits, you can play a role in making sure your content is offered in multiple languages as well.
2: Improve access to nutritious foods for pregnant women and families
Considering data suggesting higher rates of gestational diabetes among Latine women, ensuring access to nutritious foods is crucial. Today, lack of awareness about available programs, physical proximity to a grocery store with healthy options, lack of transportation, and ever-rising food costs create barriers for many to access affordable and healthy foods.
Here, once again, digital health and technology can play a role. We are educating our members about food assistance programs like WIC, working to break the stigma surrounding them, and personally navigating them to these programs. More on our work and the results of this pilot here.
There are also new solutions that can help deliver healthy food to people living in food deserts or lacking the necessary transportation. Services like Walmart+, Amazon Grocery, Stop & Shop and Instacart now accept EBT payments, SNAP and WIC benefits for online shopping and delivery.
3: Expand health care coverage
Policy and political affiliations aside, expanding access to health insurance to more Latine communities would improve preventative care adherence.
Studies indicate Latine people are less likely to have health insurance. In fact, the Latine community has the highest uninsured rate in the nation at 17.7%. The literature also suggests the Latine population is less likely to seek and receive routine care, which can prevent adverse events and conditions. There is a clear correlation between insurance status and well care. Findings illustrate that consistent access to health insurance coverage increases the use of preventative services and the health of a population.
This is especially important for pregnant women. Risk for conditions like gestational diabetes and preeclampsia can be detected early, and when identified, avoided. More on that here.
By advocating for, and expanding, coverage more people could have the access they so desperately need to seek prevention-focused care, mitigate risk, and stay healthy.
4: Encourage racially concordant care
When care is accessible, we should ensure that staff is representative of the population they serve. This enables racially concordant care, where providers innately understand the lived experiences of patients. More on racially concordant care here.
For Latine people, this is vital, and contributes to their overall understanding of and adherence to care plans.
5: Use digital health to close gaps and access in care
Health literacy and the ability to advocate for one’s health are essential. Digital health has been proven to yield improvements to quality, safety and efficiency of patient care, and help resolve barriers to access.
Digital health solutions, like Ovia, can offer health literacy and advocacy guidelines in a member’s native language. They also help members find quality providers, access benefits, and monitor their individual risk for preventative care.
Celebrate Latinx Heritage Month with Lasting Change
The Latine community is a vibrant part of our communities. If your organization wants to celebrate and honor the contributions of those in the Latine community, start by addressing the health inequities they face.
The steps outlined above provide a starting point. I urge every organization to consider what they can do to address these systemic issues. Making these investments acknowledges Latine Heritage Month, and most importantly improves population health, access to quality care, and outcomes for the Latine population. The gift of health and dignity should be afforded to every individual, and their impact cannot be understated.
Everyone has a bad meeting once in a while. Maybe you didn’t get enough sleep the night before, or a hectic personal life is stealing too much of your brain space and you can’t concentrate. Suddenly, you’re asked a question and it happens: you’re sitting there dumbfounded and slightly embarrassed, unable to put together an answer. But then you put yourself together, ask to hear the question again, and move forward.
It happens. Your co-workers get it. No big deal.
It’s certainly happened to me.
But then, it started happening more. As a senior executive, I’m supposed to be articulate, strategic, just generally on. And yet, there I was, sitting with the rest of the C-suite, having just been asked a question and I’m there with my mouth agape. It wasn’t that I couldn’t put together an answer — I couldn’t even process the question. My brain felt like it was switched off.
In hindsight, I probably could have just said, “I’m sorry, I’m menopausal and the brain fog is really hitting me today,” and I’m sure my colleagues would have been understanding. I’ve been lucky enough to spend my career at progressive companies with empathetic leadership. But talking about menopause in the workplace carries with it the exceedingly heavy weight of societal baggage and stigma.
In the U.S., 68 million women are experiencing perimenopause, menopause, or postmenopause, with symptoms often starting between the ages of 40 to 44. And although it’s something that a full half of the population will experience, it remains one of the most neglected areas of women’s health, in large part due to the attached stigma of “getting old” that comes along with it. Only half of women, in fact, ever even discuss menopause with their healthcare providers, and nearly three-quarters of them don’t ever seek treatment for symptoms.
All things considered — although my experience with menopause was, well, thorny — I still count myself very lucky. Not only did I have relatively mild symptoms, I underwent menopause in a white collar environment that, to some degree, gave me the flexibility to take a beat if I needed a moment (or more) to deal with the symptoms I was experiencing. Even still, it was an arresting experience — I felt like I was falling apart, isolated and unable to speak openly about it at work, and unsupported by the healthcare system. When I questioned my doctor about my symptoms, she shrugged it off and said, “sounds normal.”
For so many women in the workforce, their menopause experience is markedly more difficult. They not only may experience more severe physical and cognitive symptoms, they are experiencing them in workplaces that are much more rigid and unforgiving, in cultures where they have reason to fear discrimination if they speak up. Menopause is a social equity issue — its downstream effects are felt much more acutely by those lower on the income ladder.
Even for women who are fortunate to be in high-powered, high-paying positions, the challenges of working demanding jobs through menopause symptoms can be enough to push them out of the workforce altogether, leading to fewer female voices in positions of power in an already overwhelmingly male-dominated business ecosystem.
The push for menopausal equity happens on many fronts, but business leaders have a central role to play in ensuring that women are supported through perimenopause and menopause. There are a few key steps towards creating a workplaces that are equitable and welcoming to women experiencing menopause:
Business’ role in changing attitudes about menopause
Implementing the right benefits to support menopause
Time, accommodation, and flexibility are transformative. Organizations should adopt flexible PTO schedules that allow for women to take time if they need it — or, if those benefits are already in place, leaders should communicate that menopause is a perfectly valid reason for taking time off. At the same time, hybrid work environments and remote work can help employees work in a setting where they can more comfortably manage their symptoms.
Providing educational resources about menopause
Given how little menopause is talked about, so many women are taken aback by the severity and breadth of the symptoms they experience, as well as the degree to which it affects their everyday life. Digital health solutions, like Ovia, can help educate women on what to expect in perimenopause and menopause to alleviate confusion. Ovia’s Care team is staffed with Certified Menopause Practitioners who can answer questions clearly and directly with clinically-validated information, who can direct your employees to qualified healthcare providers, and most importantly, provide tools to better advocate for themselves with their healthcare provider and in the workplace.
Creating a welcoming culture
Education needs to go beyond the women experiencing menopause themselves, obviously. While it’s imperative that women have access to the resources they need to navigate menopause, organizational leaders should encourage open and honest discussion throughout their organizations to dispel misconceptions and make women feel comfortable availing themselves of the resources that are available.
The next steps to supporting menopausal women at work
Throughout our careers, many of us have had to white-knuckle our way through a workplace that expects everyone to conform. We stay quiet while we’re doubled over with menstrual pain so as to not draw attention or judgment. We keep pregnancies under wraps as long as possible to avoid being perceived differently – or less – than our male peers. Menopause is an extension of that. So we opt to white-knuckle it, just like we’ve done everything else.
But that shouldn’t be the status quo, and it doesn’t have to be. While employers are increasingly supporting family-building journeys — including paid parental leave — it’s time to take the next step to support and retain our mature workers. Let’s remove the stigma of menopause where it is felt the most profoundly — in the workplace — with policies, accommodation, healthcare, and education that support people navigating their way through this natural occurrence.
The CDC recently published a new report documenting the rise of maternal deaths and care inequities in the United States during 2018–2021 and particularly alarming racial disparities. They found:
- Approximately one in five mothers overall, and approximately 30% of Black, Hispanic, and multiracial mothers, reported mistreatment during maternity care.
- Approximately 40% of Black, Hispanic, and multiracial mothers reported discrimination during maternity care
- 45% of all mothers reported holding back from asking questions or discussing concerns with their provider.
Women deserve better. We are capable of better.
These findings are sobering, and unacceptable, although all too familiar. It’s been established that 4 out of every 5 maternal deaths are preventable, and that Black women are 3X more likely to die from maternity related complications. Yet, there’s still not sufficient urgency to solve these issues.
The industry must critically examine our current policies and care delivery methods. What we have been doing isn’t working. Despite spending an estimated $108 Billion on women’s health each year, outcomes are deteriorating. Clearly this isn’t about spending more money — this requires a holistic and intentional approach. We must move towards a more equitable and accessible system and improve the care individuals receive.
To make real change that will positively impact women’s health outcomes and experiences, let’s consider these 4 approaches:
1. Implement a Respectful Maternity Care Framework.
What is a respectful maternity care framework? It’s a theoretical framework based on the birth experiences of Black mothers to inform the ways hospitals and health systems can better provide respectful, affirming care to mothers throughout their maternity care. This framework complements existing provider educational tools and promotes anti-racist and birth equity practices, such as shared decision making.
We’ve partnered with the National Birth Equity Collaborative on these Respectful Maternity Care Framework guidelines and highly recommend it for any provider.
2. Hear what needs to be heard.
Advocacy movements have long disputed that, although individuals are raising concerns, many social inequities are rooted in a lack of true listening, willingness to learn, and listening with an intent to take action. Brené Brown coined the phrase “giving ears to the earless” to capture this idea. This concept is particularly relevant issues underpinning health inequities
Right now, millions of women are going to medical appointments, knowing and feeling with certainty that something is wrong, only to have a doctor downplay and write off their symptoms.
Known by some as medical gaslighting, this phenomenon disproportionately affects women, particularly women of color. For example, a study released nearly two decades ago showed that women are systematically prescribed lower amounts of pain medication after reporting similar levels of pain compared to their male counterparts.
Too frequently, women are telling providers their concerns, issues and symptoms, but their voices are falling on deaf ears. There is systemic deafness. It’s incumbent on providers to truly listen to and hear their patients’ concerns.
Provider organizations and health systems can tackle this issue by undergoing gender bias training, re-examining practices associated with “routine” procedures that have been highlighted as painful by patients (e.g., IUD implantation), and requiring empathy training for providers.
3. Leverage doulas, midwives and community based care to combat care inequities
Services provided by doulas and midwives are often not reimbursed by payers, despite their proven value. Studies show that expectant mothers matched with a doula had better birth outcomes than did mothers who gave birth without involvement of a doula. These data suggest doula-assisted mothers were:
- four times less likely to have a low-birth-weight baby
- two times less likely to experience a birth complication involving themselves or their baby
- significantly more likely to initiate breastfeeding.
Inclusion of doulas are even more important for Black women and other women of color. As Dr. Joia Crear-Perry, Founder and President of RH Impact (formerly known as The National Birth Equity Collaborative) noted, doulas are successful in many communities, particularly those underserved by the healthcare system, because they provide personalized social support before, during, and after delivery. By extending the provider network, individuals are more likely to receive racially concordant care, which improves outcomes.
4. Invest and integrate preventative, personalized digital health solutions
Investing in digital solutions that also deliver 1:1 connections with care experts improves health literacy and self-advocacy , supporting individuals who might otherwise be anxious to discuss issues with their providers or feel dismissed by them. This form of coaching is proven to work.
A recent survey of Ovia members found those who interacted with the Care Team are more likely to report taking control of their health. For example, compared to Ovia users who did not engage with the Care team, members who did reported they were:
- 270% more likely to report that Ovia Health helped them answer a pressing health question
- 79% more likely to report that Ovia Health helped them self-identify a health condition/symptom
- 136% more likely to report that Ovia Health encouraged them to reach out to their provider
- 36% more likely to use employer/health benefits
Personalization and prevention are key. Women don’t always recognize symptoms and other telehealth focused plans don’t help them see trends, because they’re not interactive or focused on prevention. They’re reactive. Solutions that leverage patient-reported data can provide early identification of rising risks and alert individuals to seek care when they need it and empower coaches with these insights to ask the critical questions of the members and equip individuals to advocate for themselves.
That’s why I joined Ovia Health — to be part of the solution that can really help. To address care inequities. In the last year alone, we’ve been able to deliver 198,000 critical alerts that helped women recognize potential issues and get the care they needed.*
Those interventions can help women avoid preterm delivery, reduce the risk of preeclampsia or gestational diabetes, and increase recognition of symptoms related to conditions such as PCOS or endometriosis, which can take up to 10 years to diagnose. The potential of preventative digital health — vs reactive digital solutions — is exciting. We can alter the trajectory of care. We can address care inequities.
We cannot afford to wait longer to invest and evolve women’s health care. Outcomes aren’t improving. These data suggest care is more dangerous now for women than it was 5 years ago. Though changing the system to improve women’s health is a daunting task, collectively we can. Ovia will continue to invest directly in approaches that will improve health outcomes. Let’s reverse the trends together with urgency.
*Ovia Health Quicksight data as of 8/24/23
A shocking number of pregnant people in the U.S. live in communities with no maternity care options. In fact, 35 percent of counties nationwide are maternity care deserts — they lack obstetric care providers as well as hospitals and birth centers offering obstetric care.1
Being pregnant in a community without care is already a health risk, but when we look at a map of maternity care deserts, we see that the risks run even deeper. Maternity care deserts are concentrated in the Midwest and South. Overlay this map with a map of private health insurance coverage, and a pattern emerges: A high percentage of mothers in maternity care deserts, especially in Texas, Mississippi, Alabama, Georgia, and Florida, are Medicaid beneficiaries.
Women who are most likely to be pregnant in a maternity care desert are 28.85 percent more likely than women in other parts of the country to be Medicaid beneficiaries. Here’s the breakdown of births covered by Medicaid in 2020 in each of these states:
- Texas: 50.7 percent.2
- Mississippi: 61 percent.3
- Alabama: 50.2 percent.4
- Georgia: 47.2 percent.5
- Florida: 46.8 percent.6
As we can see, in addition to a lack of local care, pregnant women in maternity care deserts are more likely to lack financial resources, which impacts health and nutrition and the ability to travel for care.
Maternity care deserts also tend to be communities with a higher percentage of BIPOC (Black, Indigenous, and people of color) mothers, who face higher health risks during pregnancy than their white counterparts. Consider this: Black women are three times more likely than white women to die from a pregnancy-related health complication.7
For payers, who spend an estimated $75.8 billion each year on maternal and postpartum health,8 and for Medicaid plans, which cover 42 percent of births in the U.S. each year,9 lowering risks and improving birth equity for women in maternity care deserts is an urgent matter. To address this challenge, payers need to understand some of the unique barriers to care in underserved communities.
Stigma and history impact how people approach medical care
Cultural and historical factors can make it harder to reach and serve the Medicaid population. Stigma around social services can keep people from accessing the care that’s available.10 And many worry because public programs can be affiliated with child protective services (CPS). One study of low-income mothers in Rhode Island, for example, found that one in six respondents had declined services because of concerns about CPS reports.11
Additionally, many BIPOC people, who are heavily represented in maternity care deserts, have a history of mistreatment by the medical establishment. They more likely to have experienced medical gaslighting,12 or to have visited doctors who dismissed their symptoms and ignored their pain.13 They may be wary of the medical system because of the history of abuse — events such as the Tuskegee Experiment and forced sterilization programs in the early and mid 1900s are still fresh in people’s minds.
To overcome these barriers, payers need to connect with members through programs that are trusted, culturally sensitive, community-focused, and tailored to each individual person’s needs and concerns.
How a digital health solution, combined with community-based health, can serve people in maternity care deserts
Digital health tools are uniquely suited to overcoming geographical barriers and meeting users where they are, in a format they can trust. Digital tools can be designed to take into account how factors, such as race-associated risks and limited resources, impact health. And they can provide an essential link to trusted community resources. For the Medicaid population, digital health can be an essential lifeline. While some initially had concerns digital health wouldn’t be accessible to this population due to smartphone affordability, recent studies have found that Medicaid users use smartphones and tablets at the same rate as the general U.S. population.14
Ovia’s digital health solution is built with all of these ideas in mind. We help pregnant people in maternity care deserts to understand their health and find the best possible care by:
- Tracking their symptoms and sending alerts when a symptom requires medical attention.
- Delivering personalized risk assessments that empower people to advocate for tests and care when needed.
- Offering personalized health pathways to help manage health
- Providing the tools to choose the closest and safest place to give birth.
- Connecting them with community-based advocates and providers, like doulas and midwives
- Helping dispel myths about government assistance programs like WIC and connect women with the support they qualify for and nutritious foods
- Improving health literacy and advocacy with proven behavioral frameworks
Ovia is also built on a deep understanding that not all experiences of pregnancy are the same, and every person deserves care that’s tailored to their own needs. We provide a pathway and module built specifically for Black women. Our members are invited to request coaching from specialists with similar racial and cultural backgrounds to their own, an approach that can help improve health outcomes.15
Another component digital health can help with is building connection to trusted community support. We help users access the resources they need for their health and wellbeing, such as WIC, which is shown to improve physical and mental health outcomes for mothers and their children. And Ovia helps pregnant people find community care advocates and community-based providers, including doulas and midwives.
To support pregnant people in maternity care deserts, payers need to think beyond traditional engagement models. A thoughtful digital solution, tied closely to trusted, community-based resources, can help improve health outcomes and birth equity while lowering costs — and it can make a huge difference for pregnant people who urgently need safer, better care.
Want to learn more? Ovia is here for you.
Ovia Health, a Labcorp subsidiary, has served more than 18 million family and parenthood journeys since 2012 and is on a mission to make a happy, healthy family possible for everyone. Ovia Health is the only family health solution clinically proven to effectively identify and intervene with high-risk conditions. The company’s 50+ clinical programs, including predictive coaching and personalized care plans, help prevent unnecessary health care costs, improve health outcomes, and foster a family-friendly workplace that increases retention and return to work. For more information, visit OviaHealth.com.
1: March of Dimes: https://www.marchofdimes.org/maternity-care-deserts-report
2: March of Dimes: https://www.marchofdimes.org/peristats/data?reg=99&top=11&stop=154&lev=1&slev=4&obj=1&sreg=48&creg
3: Center for Mississippi Health Policy: https://mshealthpolicy.com/wp-content/uploads/2021/02/Post-Partum-Medicaid-Feb-2021.pdf
4: March of Dimes: https://www.marchofdimes.org/peristats/data?reg=99&top=11&stop=154&lev=1&slev=4&obj=1&sreg=01
5: March of Dimes: https://www.marchofdimes.org/peristats/data?reg=13&top=11&stop=154&lev=1&slev=4&obj=1&sreg=13
6: March of Dimes: https://www.marchofdimes.org/peristats/data?reg=12&top=11&stop=154&lev=1&slev=4&obj=1&sreg=12
7: Centers for Disease Control: https://www.cdc.gov/healthequity/features/maternal-mortality/index.html
8: Maternal and Child Health Journal: https://pubmed.ncbi.nlm.nih.gov/21318294/
9: Medicaid.gov: https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/maternal-infant-health-care-quality/index.html
10: SSM – Population Health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9127679/
11: Casey Family Programs: https://www.casey.org/media/20.07-QFF-RFF-Concealment-and-constraint-in-institutional-engagement.pdf
12: Canadian Medical Journal Association: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9828884/
13: Proceedings of the National Academy of Sciences: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843483/
14: Deloitte: https://www2.deloitte.com/us/en/insights/industry/public-sector/mobile-health-care-app-features-for-patients.html
15: Journal of Racial and Ethnic Health Disparities: https://pubmed.ncbi.nlm.nih.gov/33403653/.
World Heart Day is September 29th. As employers, payers, and providers look for ways to bring awareness or celebrate the occasion, I urge you also to acknowledge the greater risk heart disease poses for women and the contributing factors.
Heart disease is the leading cause of death among women in the United States, and one of the most preventable. This may be shocking to some, as it’s not something you hear on the news every night. It’s often a silent killer. According to a 2021 study published by The Lancet, “cardiovascular disease (CVD) in women remains understudied, under-recognised, under-diagnosed, and under-treated, with women under-represented in clinical trials.”
Why are women at higher risk for heart disease?
Traditional risk factors for coronary artery disease — such as high cholesterol, high blood pressure and obesity — affect both women and men. However, a host of factors specific to women may play a bigger role in the development of heart disease. Factors that are specific to women include:
- Preeclampsia and pregnancy-associated hypertension: Preeclampsia greatly raises the risk of developing hypertension and/or diabetes later in life. It also increases the risk of a stroke. A preeclampsia diagnosis makes a person 75% more likely to die of cardiovascular disease down the road.
- Gestational diabetes: A gestational diabetes diagnosis raises the lifetime risk of developing diabetes. About 50% of women with gestational diabetes develop type 2 diabetes.
- Polycystic ovary syndrome (PCOS): PCOS raises the cardiovascular disease risk. People with PCOS often develop individual risk factors such as diabetes, high blood pressure, high cholesterol and sleep apnea. Estimates show that up to 5 million people of reproductive age in the U.S. have PCOS.
- Menopause. Data suggests that women with the most severe night sweats and hot flashes that go untreated have higher risks of heart disease.
Factors that impact women differently:
- Diabetes. Women with diabetes are two to four times more likely to develop cardiovascular disease compared to men with diabetes. Also, because diabetes can change how women experience pain, women have an increased risk of having a silent heart attack — which increases their risk of dying from heart disease.
- Emotional stress and depression. Women have double the rates of stress-related psychiatric disorders, including PTSD and depression, compared to men. These disorders are linked with an increased risk of heart disease. Studies show that the risk is greater for women than men.
- Smoking. Women who smoke are more likely to develop cardiovascular disease than men who smoke. They’re also three times more likely to have a heart attack.
- Inflammatory diseases. Women make up about 80% of people diagnosed with autoimmune diseases (such as rheumatoid arthritis and lupus) in the U.S. Autoimmune diseases greatly increase a person’s risk for heart attack, heart failure and other cardiovascular problems.
How you can address heart disease risk factors
The good news is there is a significant opportunity to decrease the risks of CVD by addressing these risk factors. And these are things every company can consider offering or doing for their populations. We’re partnering with payers and employers across the nation to do so.
To make a real dent in CVD for women, you should address the issues that fuel it. We recommend focusing on mitigating risk for people with the following conditions or risk factors:
- Preeclampsia
- PCOS
- Mood Disorders and Stress
- Gestational Diabetes
- Menopause
Where do you start? Let me share what we’re doing. First, let me introduce Ovia Health. Ovia is a comprehensive digital family-building solution helping people navigate their reproductive health and parenting journeys from preconception through fertility, pregnancy, postpartum, parenthood, and menopause. We’re there to support women through every stage of their lives and the unique risks they face.
We’re built using +10 years of claims data and clinical expertise. Our clinical programming includes educational content and personalized health pathways, which serve as a customized guide for preventative health topics. Some examples include healthy eating, exercise, and substance use, which support the heart health of our members. In addition, Ovia has comprehensive, personalized clinical programs designed to mitigate adverse maternal and child health outcomes, which are assigned based on a member’s unique risk profile.
Here’s how we’re partnering with employers and payers to improve outcomes and reduce the risks associated with these conditions.
Preeclampsia
Ovia provides general education about high blood pressure before, during, and after pregnancy to all members. It also has clinical programs like Hypertension Management and Preeclampsia Prevention, which are automatically assigned to members based on their health history and unique risk factors for hypertensive disorders. These programs contain educational articles about hypertension/preeclampsia during pregnancy, how to take your blood pressure using a cuff, the importance of blood pressure monitoring, and how to prevent and spot early signs/symptoms of preeclampsia.
Members with preeclampsia risk factors are also provided information about aspirin and those prescribed aspirin and enrolled in our Aspirin Adherence Program. So far, these programs are helping reduce preeclampsia rates up to 14% for members.*
PCOS
The Ovia app can help identify members who may have PCOS by assessing their risk factors at sign-up through the Health Assessment prompts, and clinical education. We also deliver critical alerts if a member logs symptoms associated with PCOS, such as irregular menses, facial hair, or acne.
By assisting members identifying potential signs or risk factors of PCOS, Ovia Health can guide members to treatment. Suppose a member already knows they have an endometriosis or PCOS diagnosis. In that case, the Ovia app actively supports members with these conditions through clinical education about how to manage symptoms, treatment options, how to talk to their provider, and related conditions.
Mood Disorders and Stress
Believe it or not, stress enormously affects heart health, overall health, and productivity. Ovia is one of the world’s leading mental health screening providers for depression throughout the reproductive healthcare continuum, especially during and after pregnancy.
Ovia delivers two externally validated mental health screeners: the PHQ-9 depression screener, which screens for general depression, and the Edinburgh Perinatal Depression Screener (EPDS), which screens for perinatal depression.
Members are proactively screened throughout their Ovia journey, including at least once every trimester and several times throughout the first year postpartum. Members can also take the mental health screeners at any time, and their historical scores are stored for review with a mental health provider. This method is proven to work, as we’ve seen up to a 3% increase in postpartum depression diagnosis rate* for members and reports that indicate members are up to 3X more likely to take a postpartum depression screening compared to the national average.*
When a member reports a high score on a mental health screener OR reports any thoughts of self-harm, regardless of score, they are immediately brought to a screen that explains what the score means and when to talk to a provider. They also receive a critical alert with a click-to-call message encouraging them to contact their provider. A perinatal mental health specialist on the Ovia Care Team also immediately proactively reaches out to help the member understand their results and identify the next best steps to support them. More on how the screening and postpartum care programs work here.
All Ovia Care Advocates are Certified in Perinatal Mental Health. The Care Team utilizes an extensively curated referral network within the client’s network. It utilizes call lines and online resources to ensure members get access to the mental health services they need in the context and time that they need them.
In addition, Ovia supports the mental well-being of all members with resources, guides and navigation to local resources to help members experience stress.
Gestational Diabetes
Ovia aims to prevent gestational diabetes for those at risk and also to support members diagnosed with gestational diabetes. The programs support the health needs by providing information about dietary choices and exercise, which help members lower their risk. In addition, Ovia members can also have additional personalized support from our registered dietitian. These programs and support are helping some clients cut gestational diabetes risk by up to 35% or 50%, respectively.
Menopause
Though every woman experiences menopause eventually, many aren’t prepared for “the great change,” as it’s been dubbed. In fact, in a recent study, 70% of Ovia users surveyed said they didn’t know enough about Menopause and wanted to learn more.
Ovia supports members who are perimenopausal/menopausal with a dedicated, customized mode. This experience explains their symptoms, delivers relevant resources, and allows them to connect to one of Ovia’s Certified Menopause Providers who provide personal support to manage their symptoms and find care and treatment based on their unique needs. Our program also allows them to track their symptoms so they can easily evaluate if treatments are working. In addition, members are supported through menopause-specific personalized health pathways, which empower them to be screened for other cardiac risk factors such as high cholesterol or triglycerides and diabetes.
The bottom line on heart disease for women
Tackling heart disease is a big job, and no organization can tackle it alone. But, to decrease risk for women, there are steps every company can take today, and partners are willing and able to assist.
Ovia’s comprehensive approach to improving the health of women and families addresses their unique needs at every life stage. By empowering and supporting women with risk factors for or conditions that increase their risk of CVD, Ovia is able to help improve the long-term cardiovascular health of our members.
*Note that these outcome(s) reflect(s) the greatest improvement experienced by a single client for this/these clinical condition area(s). Other clients experienced different outcomes in this/these clinical area(s). Actual results may vary based upon initial prevalence rate and engagement rates.
Fertility benefits aren’t just a nice-to-have anymore — they’re critical for attracting and retaining the talent companies need to succeed. Time and again, studies show that diverse teams, especially those with diverse leadership teams, are more creative and more profitable. In fact, according to a recent study by McKinsey & Company, organizations whose leadership teams are in the top quartile for gender diversity are 25 percent more likely to see above-average profits compared to those in the bottom quartile. And the more diverse a company becomes, the more likely it is to outperform.
But achieving gender diversity is getting harder. Women in leadership are leaving their jobs at the highest rate since McKinsey and LeanIn.org started tracking back in 2015. Much of this has to do with fallout from the pandemic, when schools and daycares closed, and women bore a disproportionate childcare burden while also trying to balance work.
Many people have come out of this pandemic experience with fundamentally changed priorities. The McKinsey-LeanIn.org study shows that senior-level women are now willing to switch jobs to find flexibility; support for diversity, equity, and inclusion; and a workplace that values women’s well-being. And younger women are following their lead, making career decisions with similar priorities in mind.
Ovia’s research reveals some of the ways this shift is shaping employee expectations. When we surveyed nearly 1,500 working parents and child-bearing-age employees, 77.8 percent said family-friendly benefits were extremely important—and nearly 50 percent said they’d be very likely to take a job at another company with better family benefits.
So, which family benefits make a difference? You may be thinking about things like maternity support, childcare, and flexible work schedules — and these are huge. But to win the battle for the best, most diverse teams, companies need to differentiate themselves by thinking bigger. Fertility support is a critical piece of a larger, holistic wellness plan.
Why do fertility benefits matter?
Impaired fecundity (difficulty becoming pregnant and carrying to term) and infertility are more common than most of us realize — according to the World Health Organization (WHO), infertility impacts one in six people at some point in their lives. But prevention, diagnosis, and treatment of fertility issues can be extraordinarily difficult to access. The costs are high, and the availability of qualified care is limited. On top of that, the topic can be hard to talk about, so people don’t address issues with their doctors early or may not even know where to start when they need support.
Fertility issues can have an outsized impact on women who delay family building to focus on their careers. In addition to the increased health risks of pregnancy later in life, these women may discover that they’re trying to conceive right as their fertility is declining. The rate of impaired fecundity (difficulty or inability to become pregnant or carry a pregnancy to term) among those who’ve never given birth is 22.2 percent for women ages 30-39. It jumps to 33.4 percent for women between 40-49. That’s a 50 percent increase in 10 years or less.
The challenges can be even greater for BIPOC (Black, Indigenous, people of color) women. Non-Hispanic Black women are 44 percent more likely to struggle with infertility compared to women of other races. But studies suggest that African American women, along with Chinese and Hispanic women, are significantly less likely to seek care for fertility issues and are underrepresented in the infertility clinic population.
But when barriers to access are removed, women choose fertility care services. For example, in one study, Black women with at least partial insurance coverage for fertility care through their benefits were found to be four times as likely to use assisted reproductive technologies (ART) compared to the general US ART population.
Taken together, these details give us a clearer picture of an issue people rarely talk about: fertility is a widespread health issue, and most companies don’t offer sufficient (or any) coverage for care. This may be taking the biggest toll on non-white women and women who are further along in their careers — those who are increasingly hard to retain, and whose leadership can have a huge impact on a company’s success.
It’s clear that fertility is a benefit companies need to cover. Here’s a closer look at the types of fertility benefits, how they work, and which ones have the biggest impact.
Fertility benefits 101
There are two main types of fertility coverage: network-based and reimbursement. Network-based coverage is typically offered through a third-party administrator. Employees are given access to a pre-vetted network of providers which they can access through their benefits. The upside of this type of coverage is that employees can access quality care, and they don’t have to take on the extra task of searching out a provider. This type of program also relieves the administrative burden for HR departments. The downside is some networks leave gaps, or even care deserts, in some locations.
Reimbursement coverage, on the other hand, is a fund or pre-determined amount of money set aside for fertility benefits. For employees, this allows an unlimited network to choose from. Companies can set a cap on fertility-related spending, and the work for HR teams is minimal. But this system can add extra burdens for employees who have to do more administrative work and may need to cover costs up front, and then wait for reimbursement.
There are also two common ways to arrange payment for fertility benefits: cycle-based coverage and reimbursement coverage. With cycle-based coverage, employees are allotted a set number of rounds or cycles of treatment at a provider organization. This payment system offers clarity, since treatments are typically billed per cycle. However costs can vary considerably between providers.
Some organizations offer reimbursement coverage, which provides employees with a lifetime maximum for coverage. Within parameters set by the organization, employees can choose to spend the funds as they see fit. Reimbursement can be structured as a full fund where employees access benefits, a reimbursement model, or a co-insurance model in which the organization covers a percentage of the cost of treatments.
Employers may also choose to create a plan that combines elements of the different coverage structures.
Looking beyond fertility to support every type of family
For a holistic approach to fertility benefits, we can think bigger than treatments for fertility, and embrace all types of family-building.
Alternative paths to parenthood include adoption, surrogacy, and egg freezing. Support for these life events can be just as impactful as fertility support, especially for those in the LGBTQIA+ community, single parents, people who are not able to conceive or carry a pregnancy, and those who want to preserve fertility into the future.
With a reimbursement coverage model, a company can easily wrap resources for alternative paths to parenthood into their fertility coverage.
Fertility benefits need to go hand-in-hand with maternity care
Fertility benefits are a powerful way to show that your company supports women and families — which can translate to better retention for some of your most critical employees. But on its own, a fertility benefit can lead to a spike in healthcare spending. That’s because ART and advanced maternal age can increase the rates of preterm births and multiple births — both of which are expensive. In fact, births of multiples can cost up to 20 times more than singleton births.
The key to a cost-effective fertility benefit is to pair it with a comprehensive maternity care management program. Or even better, offer employees a broader women’s health solution that focuses on helping as many people as possible conceive naturally (to reduce multiple births). This type of holistic support can provide personalized prevention programs to help reduce preterm labor and other adverse, expensive, health outcomes.
This is the focus of Ovia Health’s programs — helping our members navigate their health and wellbeing through all the stages of family building. Ovia clients have seen the need for ART reduced up to 65 percent, multiple gestations reduced by as much as 47 percent, and preterm birth rates reduced by as much as 54 percent.*
Getting the most value from your women’s and family benefits
To attract and retain a diverse workforce, companies need to pay attention to employees’ shifting priorities and offer the benefits to match — including a culture that supports families and work-life balance, as well as resources for women’s health.
Adding fertility benefits is a huge step in the right direction. For even more value, companies can cover a full spectrum of women’s and family health needs, including:
- Alternative paths to parenthood
- Maternity care management
- Postpartum health
- Child health
- Advanced women’s health, including menopause support
If you’re ready to boost your benefits, you don’t have to make sense of this new landscape alone — the right digital health partner can help. Ovia has supported millions of people through fertility, pregnancy, early parenthood, and beyond. Our digital health solution is built on over a decade of data and experience, and our app-based support is backed by a certified care team with a deep understanding of women’s and family health and wellbeing.
Want to learn more? Ovia is here for you.
Ovia Health, a Labcorp subsidiary, has served more than 18 million family and parenthood journeys since 2012 and is on a mission to make a happy, healthy family possible for everyone. Ovia Health is the only family health solution clinically proven to effectively identify and intervene with high-risk conditions. The company’s 50+ clinical programs, including predictive coaching and personalized care plans, help prevent unnecessary health care costs, improve health outcomes, and foster a family-friendly workplace that increases retention and return to work. For more information, visit OviaHealth.com.
* Note that these outcomes reflect the greatest improvement experienced by a single client for these clinical condition areas. Other clients experienced different outcomes in these clinical areas. Actual results may vary based upon initial prevalence rate and engagement rates.
In the US, we’re in the midst of a maternal health crisis. Pregnancy-related health conditions are on the rise1 and, even though we spend more money on maternity care than any other industrialized nation,2 our maternal death rates are still — alarmingly — the highest.3
It’s clear that our current model of care isn’t working. As we focus our energy and healthcare dollars on reacting to health emergencies, we miss a myriad of opportunities to prevent maternal health issues before they become expensive and dangerous. In fact, according to the CDC, 80 percent of pregnancy-related deaths are preventable.4
So how can health plans and employers flip the model, and put effective prevention at the heart of their maternal care strategies? One key is connecting people with a comprehensive, easy-to-access digital solution personalized to a user’s unique risk factors and constantly updated with the latest clinical guidelines for prevention, which begins before they become pregnant and accompanies them through pregnancy and parenthood.
Personalization powers prevention
The best preventative care can’t be one-size-fits-all. It needs to consider each person’s unique health risks and deliver exactly the information and tools they need.
Here’s an example: we know that eclampsia and preeclampsia are 60 percent more common among Black women than white women.5 Patients with hypertensive disorders during pregnancy have, on average, a twofold higher risk of developing hypertension later in life6; so it’s important to try to prevent these conditions wherever possible.
Ovia’s clinical pathway for Black members calls out this risk. It provides information about how to recognize early preeclampsia symptoms (which can be easy to miss) and encourages positive health behaviors like taking low-dose aspirin as an effective preventative measure against developing preeclampsia. In addition to the preventative education, members are encouraged to then log their blood pressure within the app to visualize measurements longitudinally and will alert members when measurements are concerningly high. If measurements are high, it will push members to contact a doctor for care if necessary, with click to dial functionality.
Ovia can deliver this and over 50 other personalized pathways by ingesting information about members from an intake health history assessment and ongoing health screeners, along with our own data and experiences from more than a decade of working with millions of Ovia members.
The platform supports users through their reproductive journey — preconception, pregnancy, postpartum, or menopause — using intuitive, personalized health pathways that take the guesswork out of making positive health decisions. Ovia Health’s new personalized health pathways create an intuitive and easy-to-use guide of what members need to do, monitor, and ask based on their unique health risks. Coaching support from a team of licensed clinicians is also proactively integrated into this journey and automatically added when the need is detected based on someone’s symptoms and risk.
This personalized approach has a powerful impact on reproductive and maternal/fetal health and our clients’ bottom line. Consider Ovia’s focus on cervical length screenings. All Ovia members managing their pregnancy receive education about the importance of this screening to help prevent preterm delivery. Coaches proactively remind members to request the screening at their appointments and track results in the app. These members are, in turn, more likely to take other steps to prevent preterm delivery, including participating in a preterm delivery prevention program when necessary and enrolling in a progesterone adherence program if needed.7 With these interventions, we’ve reduced the preterm birth rates for Ovia Health members by up to 54 percent compared to non-members. *
Keeping up with health guidelines empowers patients
Beyond personalization, a preventative digital health solution needs to evolve quickly, in step with the most up-to-date clinical guidelines.
With this in mind, Ovia Health is constantly evolving our clinical programs. For example, we updated our preeclampsia prevention program to include new US Preventive Services Task Force (USPSTF) recommendations on aspirin for pregnant people with one or more moderate preeclampsia risk factors (such as pregnancy through IVF, Black or African-American ancestry, financial insecurity, and maternal age above 35). When Ovia members know about their risks, and ways to prevent adverse outcomes, they are empowered to discuss appropriate options with their healthcare providers. In doing so, Ovia members observe up to 14% decrease in preeclampsia rates compared to non-Ovia Health members.
We also added details about clinically-validated preeclampsia prevention protocols — such as the optimal time of day for aspirin administration, and the impact of exercise and specific dietary recommendations for reducing preeclampsia risk. Providers may not have time to share this level of detail with patients during brief office visits that can be as short as 10 or 15 minutes, but Ovia can fill these important educational gaps with clear, actionable guidance that helps members make the best health decisions to optimize their health.
Ready to prioritize prevention? Find the right digital solution
Not all digital health solutions have deep personalization capabilities or the ability to iterate and update quickly. But these are exactly the features that build trust with users, improve health outcomes through prevention, and lower costs.
If you’re ready to embrace more prevention for maternal health programs, you don’t have to figure this out alone. You just need a digital health partner devoted to comprehensive, personalized care and constant evolution.
Want to know more? Ovia can help.
Ovia Health, a Labcorp subsidiary, has served more than 18 million family and parenthood journeys since 2012 and is on a mission to make a happy, healthy family possible for everyone. Ovia Health is the only family health solution clinically proven to effectively identify and intervene with high-risk conditions. The company’s 50+ clinical programs, including predictive coaching and personalized care plans, help prevent unnecessary healthcare costs, improve health outcomes, and foster a family-friendly workplace that increases retention and return to work. For more information, visit www.oviahealth.com.
1: The Commonwealth Fund: https://www.commonwealthfund.org/publications/issue-briefs/2021/nov/high-costs-maternal-morbidity-need-investment-maternal-health
2: The Commonwealth Fund: https://www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-reflecting-poorly
3: The Commonwealth Fund: https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries
4: Centers for Disease Control: https://www.cdc.gov/media/releases/2022/p0919-pregnancy-related-deaths.html
5: Harvard Public Health: https://www.hsph.harvard.edu/magazine/magazine_article/america-is-failing-its-black-mothers/
6: Boston Medical Journal: https://heart.bmj.com/content/105/16/1273
7: Ovia Health: https://images.ent.oviahealth.com/Web/OviaHealth/%7Bc81c4ef7-21c5-4d9a-b11d-e97db367bf6f%7D_All_AllENT_OnePager_ACOG-Coaching-Study_MC_V1_12May21.pdf
*Note that these outcome(s) reflect(s) the greatest improvement experienced by a single client for this/these clinical condition area(s). Other clients experienced different outcomes in this/these clinical area(s). Actual results may vary based upon initial prevalence rate and engagement rates.
Women’s health needs aren’t the same as men’s — and employers are taking notice. More and more organizations are ready to invest in robust women’s health benefits packages. But with so many new and changing options, it can be hard to know which benefits provide the best support to employees and the best value to employers.
This guide will help you make sense of the main types of offerings, understand how they support women, and see how to put the pieces together into a meaningful benefits package.
Women’s health fundamentals
The six pillars of women’s health benefits are rooted in the main areas of women’s health. With each priority, benefits can play an integral part in establishing and maintaining optimal care.
To start, let’s consider the main areas of women’s health, and the benefits that address each key area.
1. Reproductive health
This pillar encompasses everything from general health tracking to help with period pain. It also includes support for painful conditions, such as PCOS and endometriosis, which can impact daily life and fertility.
As a category, reproductive health is notoriously neglected — partly because it can be hard to talk about. The stigma around women’s bodies, and even issues as common as menstruation, means that many women avoid asking questions at the doctor’s office. And when they do ask, they may find that their concerns are minimized or dismissed as ‘all in their heads.’
When patients’ pain is dismissed, their medical diagnoses are impacted, too. For example, it takes an average of 8 to 12 years for a woman to receive an official diagnosis of endometriosis — a condition that presents with severe pain and heavy periods. In a survey of women diagnosed with endometriosis, 60 percent said they’d been told by at least one doctor along the way that nothing was wrong.1
Employers can help women navigate reproductive health with benefits that offer education and support. For example, a digital health solution can help women track their health, research symptoms and conditions, access experts when they have questions, and find a community of support for managing conditions and advocating for care.
2. Fertility health
Among the benefits for women’s health, fertility is probably the most well-known. Fertility benefits often cover assisted reproductive technologies (ART) and other family-building paths, including:
- In vitro fertilization (IVF)
- Intrauterine insemination (IUI)
- Surrogacy
- Adoption
Coverage may also include fertility testing and diagnosis of fertility issues.
The best fertility health benefits also include coaching to help people conceive without ART treatments, if possible. This can lower costs and help avoid the health risks that come with ART, including a higher rate of multiple gestations. (Births of multiples have a higher risk for health complications and can be up to 20 times more expensive than singleton births.2)
Fertility benefits may be offered in partnership with a full network, or as a separate benefit through a third-party administrator. Some organizations choose to reimburse employees up to a specific dollar amount, or to cover a set number of treatments.
3. Maternity health
Maternity care management benefits include digital or in-person services to help pregnant people manage health concerns during pregnancy and address issues early. Programs can include access to telehealth services or digital coaches.
Overall, this type of women’s health benefit is increasingly vital for employers to offer. Maternity care is some of the most expensive, and risky, in the US today. Some reports estimate in the US, payers and families spend a whopping $75.8 billion on maternal and postpartum health each year.3 Plus, new reports from the CDC have also indicated that 4 out of every 5 pregnancy-related deaths in the US were preventable.4
Digital solutions can help educate users about healthy pregnancies and their personal risks, allow them to track their health, and help them prevent or catch health issues by advocating for the care they need.
4. Postpartum mental health
Perinatal mood and anxiety disorders (PMADs) are probably more common than you think: one in seven women experience a PMAD during pregnancy and the year following birth. But it’s a pillar many benefits plans overlook, and many women go undiagnosed and untreated.5
The cost of PMADs is high — an estimated $14 billion for the 2017 birth cohort from conception to five years postpartum, with an average cost of $31,800 for each affected mother-child dyad.6 And when mothers are impacted by mental health challenges, their performance at work may suffer, impacting employers as well.
The best postpartum benefits can make a difference by helping to catch and treat PMADs early. Important elements include regular digital screenings for mood disorders and access to experts who can help people find support as soon as it’s needed.
5. Breast health
Every 14 seconds, someone is diagnosed with breast cancer.7 Preventative screenings can help women catch and treat issues early, which can and save lives.
Breast health benefits educate women about their risk factors and encourage timely screenings.
6. Advanced women’s health
Even though it’s a natural process, perimenopause and menopause can come with symptoms, such as hot flashes and sleep disturbances, that make it hard to manage work and everyday life. But much like women’s reproductive health in general, secrecy and stigma around menopause (and around aging in general) make it difficult for women to seek the support they need.
According to studies of Ovia Health users, women suffering from menopause symptoms have 57 percent more days of lost work productivity and $2,100 in additional costs per year for healthcare and absenteeism. Menopause support can have a positive effect in helping women manage their care.
A good digital solution can educate people about menopause, allow them to track their health, help them know when to seek help for symptoms, and provide access to experts for guidance.
Building a better benefits package for women
The best women’s health benefits package is one that covers all of the key pillars of women’s health, or as many as possible.
It’s also important to know that, if you’re choosing among benefits, some offer far more value together. For example, fertility benefits are best coupled with maternity support. That’s because the use of ART can increase the risk of expensive complications, including preterm and multiple births. When you couple fertility and maternity care, women in these higher-risk categories can learn about their unique risks and discover which screenings they need to stay healthy and catch potential problems earlier — when they are easier, and less expensive, to treat.
Here are a few more things to consider as you put together a meaningful and cost-effective women’s benefits package:
- Choose a digital health solution so it’s convenient, accessible to everyone, and easy to use whenever it’s needed.
- Opt for a preventative approach that uses data and personalization to educate women about their unique risk factors to help prevent health issues or catch them early.Look for a personalized program that can adapt to each individual and evolve to meet their needs. Each user should get timely, relevant support — such as a reminder to get a health screening on time, a mental-health check-in postpartum, or access to a human coach when a question might feel hard to raise at the doctor’s office.
- Ensure a connection back to a user’s OB GYN or primary care provider. Telehealth solutions can offer medical guidance quickly, but they can also create gaps in care. A user may get quick advice to resolve a symptom, but never reconnect with their provider to determine if the symptom is part of a larger health issue. A personalized system, with data at the center, can put symptoms in context and refer members to their provider for needed follow-up.
Want to know more? Ovia can help.
Ovia Health, a Labcorp subsidiary, has served more than 17 million family and parenthood journeys since 2012 and is on a mission to make a happy, healthy family possible for everyone. Ovia Health is the only family health solution clinically proven to effectively identify and intervene with high-risk conditions. The company’s 50+ clinical programs, including predictive coaching and personalized care plans, help prevent unnecessary health care costs, improve health outcomes, and foster a family-friendly workplace that increases retention and return to work. For more information, visit OviaHealth.com.
1: The Alliance for Endometriosis: https://www.allianceforendo.com/
2: American Journal of Obstetrics and Gynecology: https://www.ajog.org/article/S0002-9378(13)01043-0/fulltext
3: Dyck, Kenney, Oogan, Toomer, 2012
4: https://www.cdc.gov/media/releases/2022/p0919-pregnancy-related-deaths.html
5: American Journal of Public Health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204436/
6: American Journal of Public Health: https://pubmed.ncbi.nlm.nih.gov/32298167/
7: Breast Cancer Research Foundation: https://www.bcrf.org/breast-cancer-statistics-and-resources/
For many of us, it’s easier to communicate with a healthcare provider who has a similar background to our own — especially a shared racial identity. And better communication can lead to better care. In fact, studies show that racial concordance increases patient satisfaction and visit attendance.1 Researchers who looked at emergency department use, hospitalizations, and healthcare expenses even found that racial concordance leads to improved healthcare in general.2
That’s why Ovia has launched a simple, powerful, new initiative. All members who identify as Black or African American will receive this message from their Ovia Health Coach/Expert: “Sometimes it feels most comfortable to have healthcare conversations with providers you identify with who can really understand your personal experiences. If you have health questions you’d like to discuss with a Care Team member who identifies as Black or African-American, we’re here and ready to support you! Just send us a message.”
The message is part of Ovia’s larger commitment to BIPOC (Black, Indigenous, and people of color) members’ care and improving birth equity. As Ovia Health Expert Edwina Zant, a Black-identifying nurse midwife, explains, “This small step offers proactive support to members by acknowledging their unique cultural backgrounds and health concerns, and connecting them with an empathetic and knowledgeable Care Team member with a shared lived experience.”
We talked with Zant about Ovia’s new messages to members, and why proactively offering racially concordant care is a priority.
You helped launch Ovia’s new outreach messages about racially concordant care. Why is this an important step?
Black women and birthing people commonly struggle because their health concerns are ignored, downplayed, or dismissed altogether. In fact, 45% of Black Ovia users told us that they’ve had a healthcare provider who didn’t take their health concerns seriously.
This is part of why Black women may distrust healthcare providers and resist seeking out timely care — which can have potentially devastating results with life-threatening consequences.
So offering racial concordance is one way Ovia can support partnership building and participatory decision-making between individuals and their providers. And this can lead to better care and healthier outcomes.
How are Ovia members responding so far?
Members who identify as Black or African American across Ovia apps will receive this message from their Ovia Health Coach/Expert.
Before these messages, we were already working to support the unique needs of Black and African American-identifying members through the Black health equity clinical programs, but many users didn’t know they had the option to request racially concordant care. That’s why we wanted to offer it proactively.
So far, members have been enthusiastically responsive. They’ve welcomed this additional support, which has been wonderful to see.
What change do you hope to see with this new program?
As we know, healthcare is a partnership between an individual and their healthcare provider. A strong partnership educates both the patient and their provider and empowers an individual to advocate for their health needs and concerns. My hope is that Ovia helps build our members’ confidence as experts on their health and living in their own bodies, and that we can help instill an expectation of respectful exchange in every healthcare setting.
Your personal and professional experiences have influenced your thoughts on racially concordant care. Why is this issue important to you?
I was diagnosed with a chronic illness in my teens and have been managing a complicated medication regimen since then. I’ve also been a healthcare provider for 20 years, so I’m very knowledgeable about my health and a vocal self-advocate — but I’m still left scrambling at times to make sure my providers are all communicating and to avoid treatments or medications that would harm my health.
Being a healthcare provider and still struggling to be heard by my own providers motivates me to advocate for our members and work toward a more equitable healthcare system.
Want to know more about Ovia? We offer comprehensive women’s and family health programs that include 1:1 coaching, physician-developed clinical programs, and personalized health and wellness education. Visit www.oviahealth.com to discover more.
1. Journal of General Internal Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9186269/.
2. Journal of Racial and ethnic health disparities: https://pubmed.ncbi.nlm.nih.gov/33403653/.
The Food and Drug Administration has approved a once-a-day pill for dealing with hot flashes brought on by menopause. The new drug, Veozah (fezolinetant), blocks a chemical in the brain called neurokinin B (NKB), which regulates body temperature.
Approximately 80% of women experience hot flashes during perimenopause or after menopause and on average they last about 7 years. Hot flashes cause sensations of heat, sweating, flushing, anxiety, and chills and can cause considerable distress especially when severe and frequent. For many women these are much more than a nuisance- and negatively impact all aspects of their life.
Menopausal hormone therapy (MHT) is currently used for treating vasomotor symptoms (hot flashes and night sweats) but it can increase the risk of breast cancer and blood clots.1 As a result, it is not an option for many women, particularly those with a history of breast cancer, heart disease, blood clots, and those at high risk of cardiovascular disease.
The approval for Veozah, which is a non-hormonal treatment, was based on a late-stage study that showed it helped reduce the frequency and severity of hot flashes and night sweats and improved patients’ quality of life over the treatment period. Use of antidepressant paroxetine was the only FDA approved non-hormonal option available to patients until Veozah’s approval.
“The approval of a new treatment and the first in a new class of medications is really important to address the unmet need of millions of women whose lives are impacted by menopausal symptoms,” says Dr. Leslie Saltzman, CMO of Ovia Health. “Prior to this approval, if a patient wasn’t a candidate for MHT and couldn’t tolerate paroxetine, I really didn’t have much to offer.”
- U.S. Food and Drug Administration: https://www.fda.gov/consumers/womens-health-topics/menopause
Maternity care management programs are ready to evolve. Most programs rely on telephone-based coaching, which can have genuine benefits for members. But these programs don’t get enough engagement, and don’t reach pregnant members early enough to significantly improve maternal outcomes and lower maternity costs.
Maternal health and the associated costs have reached a crisis point: right now, the U.S. has the highest rate of maternal deaths among developed nations1, and studies show that four out of five of these deaths are preventable.2 Our maternal outcomes have fallen behind our peers, even though we spend more on healthcare than any other high-income nation.3
In the midst of this crisis, payers have the opportunity to improve maternal health outcomes and lower costs by modernizing their nurse care management (NCM) programs.
Three steps for payers to evolve their NCM programs
If you’re ready to modernize your NCM program, here are three steps to get started:
1. Audit your existing NCM programs.
Consider your NCM program’s functionality. The most impactful programs reach members early in pregnancy, when risk prevention matters most. And they connect with members in multiple ways, including by phone and app. Here are the questions to ask about your NCM:
- Is your program only available by telephone?
- When do members first interact with your program? Is it early in pregnancy?
- Which modes do you use to reach members?
2. Integrate a digital health program with a proven track record.
Digital health programs, like Ovia, can increase member engagement and help catch health risks early to improve health outcomes. To find the right digital partner, look for an established track record of engaging early and often with members.
Ovia has supported over 18 million journeys over the last 10 years. Our members tend to log health data and interact with Ovia tools daily — the average user interacts with Ovia 34 times per month.
Eighty-three percent of our members enroll in Ovia during their first trimester or earlier (through our Ovia app), sooner than members tend to engage with standard NCM programs. Once members are enrolled, they take in-depth health assessments and log their health with Ovia tools (95 percent of Ovia members who begin our initial health assessment complete it). Through this early and frequent engagement, Ovia is able to identify high-risk pregnancies earlier, and refer them for needed care.
3. Choose a digital health partner that integrates with your existing NCM efforts.
Improving your NCM program doesn’t mean starting from scratch. Instead, look for a partner that can work with your existing systems to improve engagement, outreach, health support, and referrals.
Ovia offers NCM portal integration. We support members by answering day-to-day questions and providing digital health screenings — and we work directly with NCM teams to facilitate referrals to Care Management and high-risk maternity programs. Ovia also offers a live member-level data feed option to give payers deep insight into pregnancy and population health.
Looking for a partner to help evolve your NCM program so you can improve maternal outcomes, lower costs, and provide the support women need? Ovia can help. We offer 1:1 coaching with certified experts in lactation, parenting, menopause, and women’s health and wellbeing; physician-developed clinical programs; personalized health and wellness education; manager training; and benefits navigators. Find out more at www.oviahealth.com.
1. The Commonwealth Fund: https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries
2. Centers for Disease Control (CDC): https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/data-mmrc.html
3. Kaiser Family Foundation (KFF): https://www.kff.org/slideshow/health-spending-in-the-u-s-as-compared-to-other-countries-slideshow/
Mothers are not getting the support they need. We can see it in the numbers: the U.S. has the highest rate of maternal deaths among developed nations,1 and studies show that four out of five of these deaths are preventable.2 Our maternal outcomes have fallen behind our peers, even though we spend more on healthcare than any other high-income nation.3
In the workplace, we can see how having children and parenting without enough support impacts women. During the pandemic, when mothers bore the heaviest burdens from lack of childcare and family-friendly work policies, 3.5 million women left the workforce.4 And women are still leaving at record rates — the most recent annual study from McKinsey and LeanIn.org found that women leaders are leaving their jobs at the highest rate ever recorded.5
If we want to make a difference — for maternal health outcomes and retention — the first step is to listen to women. What do women really need to care for their health and balance parenting and work? We asked 1,500 Ovia members in our annual Future of Family Friendly Benefits survey, and they were loud and clear about the benefits that matter most for their health and wellbeing.
Here’s what we learned.
Most women need more information about the benefits they already have, and health education is critical right now
Before we dug into the specific benefits women need, we asked our survey respondents if the benefits they already have are easy to understand — and a shocking 77 percent said no. This means that many people may not even realize they have programs like nurse care managers (NCM) for support.
In addition, we learned that 68 percent of our respondents were first-time parents — this is a significant increase since the height of the pandemic when many people were holding off on building families. This large cohort of new parents is likely to need fertility, pregnancy, and parenting education in addition to NCM support.
Parental leave is one of women’s top priorities, and many companies fall short
When we asked women which benefits matter most, the top two answers were about parental leave. Respondents wanted parental leave that’s long enough and paid.
We discovered that most — but not all — of the people we surveyed had parental leave benefits:
- 84 percent of respondents were eligible for leave, which is good, but still leaves room for improvement.
- Of those who had leave, about 50 percent had at least three months.
But we found notable variations in paid-leave policies:
- 43.5 percent had their leave funded at 100 percent of their salary.
- 37 percent had leave funded somewhere between 50-75 percent of their salary.
- 21 percent had to take unpaid leave.
Parents want more support when they return to work
At the other end of leave is return-to-work (RTW), another critical time for new parents. To manage this transition, new parents need a solid plan, flexibility, and support for their basic needs, including breastfeeding. Among our respondents:
- Only 5 percent have a mother’s room at work that they can reserve for pumping.
- Fewer than 15 percent said their employer encourages them to block time on their calendar for pumping.
Based on these responses, there’s a huge opportunity to improve lactation support, which is especially important given the significant health benefits for babies and mothers. Benefits such as breastfeeding classes, access to certified lactation specialists, and education about the benefits of breastfeeding can ease the transition back to work and improve retention.
Mental health is another critical issue for RTW. Perinatal mood and anxiety disorders (PMADs), which include mood disorders during pregnancy and the year following birth, affect at least one in seven women. But PMADs are often undiagnosed and untreated.6 Among our respondents, nearly 47 percent wished their benefits included better perinatal mental health support.
Women need benefits for family-building
Nearly 40 percent of respondents told us that they wanted fertility tools as part of their maternity care programs. To truly serve a diverse organization, these programs need to include options for all kinds of families, including LGBTQIA+ individuals, and those looking to adopt and pursue surrogacy.
While many respondents asked for these benefits, it’s possible that some already have them and don’t even know it — when we asked members about their existing fertility support, 26 percent weren’t sure. This points to an opportunity for employers to communicate more clearly about the benefits they offer.
Women are asking for more health support in general
Maternity care isn’t the only area where benefits fall short. Twenty-six percent of respondents told us that their current benefits don’t do enough to support women’s health overall.
For example, nearly 70 percent told us that they don’t know enough about menopause, and nearly half were eager to learn more about it. For many respondents, menopause support would be a timely intervention — more than 10 percent were already experiencing perimenopause symptoms.
When we asked women about other benefits they’d like to see, we found that:
- 25 percent wanted coverage for contraceptives/birth control.
- 23 percent wanted menstrual leave.
- 21 percent wanted access to free menstrual products at the office.
- 20 percent wanted travel funds to receive out-of-state reproductive healthcare.
Other top priorities included access to doulas, coverage for in vitro fertilization (IVF), intrauterine insemination (IUI), and egg freezing, and access to personalized digital health tools so they can track their health and message directly with health coaches.
We’re overdue for a culture shift at work
Beyond specific benefits, women told us that simply being a woman and mother at work can be challenging:
- 26 percent of our respondents felt that being pregnant or a parent impacted their ability to receive eligible promotions.
- Nearly 30 percent reported experiencing discrimination or microaggressions because they were women.
- 25 percent said they didn’t think their employer was supportive of women in general.
All of these survey responses point in the same direction: we need a culture shift in the ways we support women at work. This shift needs to include comprehensive health benefits with women’s unique needs in mind, better infrastructure for RTW, and training to help managers understand and support working parents.
Looking for a partner to help improve maternal outcomes, lower costs, and provide the support your employees need? Ovia can help. We offer 1:1 coaching with certified experts in lactation, parenting, menopause, and women’s health and wellbeing; physician-developed clinical programs; personalized health and wellness education; manager training; and benefits navigators. Find out more at www.oviahealth.com.
1. The Commonwealth Fund: https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries
2. Centers for Disease Control (CDC): https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/data-mmrc.html
3. Kaiser Family Foundation (KFF): https://www.kff.org/slideshow/health-spending-in-the-u-s-as-compared-to-other-countries-slideshow/
4. The Associated Press: https://apnews.com/article/coronavirus-pandemic-business-lifestyle-health-careers-075d3b0ab89baffc5e2b9a80e11dcf34
5. LeanIn.org: https://leanin.org/women-in-the-workplace/2022
6. American Journal of Public Health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204436/
New reports indicate that women leaders are exiting the workforce or changing roles at a higher rate than their male counterparts. And while across industries the percentage of women in leadership roles is slowly ticking up, still only a quarter of C-suite executives are women. The truth is that employers can’t afford to lose this talent.
Let’s consider why gender diversity matters so much, what’s causing the outflux of women leaders, and how employers can retain and attract talent.
The background
Women disproportionately carry the mental load of parenting and caregiving — wearing more hats at home, and in many cases swimming upstream at organizations that are not designed for working parents. The precarity of this work/life “balancing act” has been obvious for a while, but the pandemic shone a harsh light on just how unsustainable the situation has become.
I worked from home while pregnant with two kids under four throughout the pandemic. I was living in constant fear of their emotional wellbeing, my elderly parents’ physical safety, and my pregnancy health. And now nearly three years later, I see the impact it continues to have on family wellbeing. The masks are off, but parents like me haven’t come up for air. Childcare and teacher shortages persist, our infrastructure has changed, and racial and gender divides are widening.
The role of the pandemic
When the pandemic hit, overnight families became responsible for more than many could reasonably handle — navigating school and daycare closures, teaching from their kitchen tables, caring for their elderly parents. We were scared for our children’s safety. And we burnt out fast. Many working mothers were forced to leave their jobs.
Since March of 2020, the U.S. workforce has lost more than 5.4 million women,1 putting the country at a 33-year low for women’s labor force participation. 2
While some of the acute pains of the pandemic have waned, it has reframed priorities for many of us. Working women and moms have been taking notes and they’re clear on what they want (more on this soon).
Why retaining working parents matters for employers
A diverse workforce is a more productive, innovative, successful one. In fact, organizations that rank in the top quarter for gender diversity are 15% more likely to outperform their competitors. Add in racial diversity and the number jumps to 25%. Once in leadership positions, women serve as mentors and motivators to younger generations — inspiring those early in their careers to envision themselves in leadership roles. Retaining diverse women in leadership roles isn’t just the right thing to do, it’s the smart thing to do.
6 things employers can do to retain women in leadership
There are many actions organizations can take to retain and attract top talent. Based on recent studies and our own research, we recommend the following tactics as a good starting place.
1. Broaden your organization’s understanding of the postpartum period and return to work
Only 65% of moms end up returning to work postpartum. Some reports indicate that only 80% of those who do go back are still there one year after their child’s birth.
Returning from parental leave is challenging. New parents struggle with a number of issues that can affect their work: PMADs (like postpartum depression and postpartum anxiety), sleep deprivation, breastfeeding challenges, and the list goes on. They’re still figuring out how to care for themselves and navigate new personal responsibilities when they return to work and they need support.
This is why Ovia’s return to work program provides new and expecting parents with unlimited, on-demand access to a dedicated Ovia Care Team that includes parenting coaches, licensed lactation consultants, baby sleep experts, Certified Nurse Midwives, and pediatric specialists to help them navigate every new stage.
If working parents continue to feel forced to choose between their children, their mental health, and their careers, organizations will continue to see a loss of productivity and a rise in attrition.
2. Invest in family benefits
In Ovia’s latest Future of Family Friendly Benefits 2023 Report, we surveyed 1,500 working parents and childbearing aged employees. They provided their thoughts on their existing benefits, and what could be improved.
Almost all the respondents we surveyed (96%), say family friendly benefits are important to them, but 55% don’t consider their employer family friendly. And respondents are ready to make moves — 80% would gladly leave their current role for a lateral move to a company with better benefits. If retention is important to a company, providing a strong parental benefits package is crucial.
When asked to rank benefits in order of importance, working parents made it clear they want more support for leave, caregiving, and work flexibility. Here’s their list:
- More and longer paid parental leave
- Flexible scheduling, remote, or gradual return to work options
- Childcare and caregiver support
- Family-friendly culture
- Easy-to-understand benefits
- Fertility and maternity care management tools
- Mental health support for PMADs
- Pumping-friendly work environment
- Lactation room quality and bookability
- Alternative family planning support (adoption, surrogacy, etc.)
3. Embed equity into benefits packages
No two paths to parenthood are the same, and benefits packages need to consider various family building avenues, from adoption and surrogacy to Assisted Reproductive Technologies. 1 in 8 couples experience fertility challenges and 63% of LGBTQ+ individuals are expanding their families, yet access to diverse family building options are limited, costly, and emotionally taxing. More and more employers are recognizing the urgency to invest in family building resources.
Benefits packages should also consider health disparities and social determinants of health. For example, we know that when Black women have access to doulas and midwives, they have better outcomes and so do their babies.
Employers need to expand their offerings to include resources like digital health and doula support to help employees break down barriers to equitable care and self advocacy. Ovia’s birth equity programming, for example, gives Black mothers and birthing people access to a diverse care team, personalized educational content, and uplifting stories of the Black birth experience.
4. Nurture a culture of belonging
Women who are early in their careers look to senior leaders for mentorship and to set the standard for work/life balance.
As Ovia’s Co-Founder, I’m extremely aware of the norms I set as a working parent — and so I celebrate when my kids barge in the room during Zoom calls (rather than excusing their presence) and I mark my calendar when I’m taking time for my children.
Family friendly policies help more people feel comfortable taking these kinds of small actions. And when more of us feel comfortable bringing our full selves to work, that’s when company culture begins to shift.
5. Normalize partner support for parenthood
There isn’t always recognition of the ways all parents’ identities shift when they become parents. When non-birthing parents and partners return from work after having a baby, they deserve paid leave, support, and flexibility too.
Research shows that inadequate parental leave increases the risk of PMADs in women, but new studies are coming to the same conclusion for men. And we already know that 1 in 4 fathers experience some sort of postpartum depression.
When one partner doesn’t get adequate support, the burden often trickles down to the other to carry the domestic and mental load. Employers have an important role to play here. They should celebrate partners and fathers for taking time off for their sick children, offer parental leave, and encourage all parents to utilize their family benefits.
6. Activate managers to make mental health a team priority
Maternal mental health is the number one complication of pregnancy, and yet less than 10% of cases get treated due to stigma, gaps in care, or limited mental health training. And if people are afraid to tell their own healthcare providers and partners how they feel, imagine the barriers to these types of conversations at work.
We need to train managers to make mental health a company-wide concern rather than an individual’s problem. This is why Ovia Health provides dedicated, specialized training for managers to support people on their paths through parenthood — from managing the announcement of pregnancy, to supporting those undergoing fertility treatments, to bringing a child home through adoption.
What does this mean for the future: Building better family benefits in 2023
I’m seeing the trend of organizations offering inclusive benefits that reflect their employees’ values. It’s because of this push to provide better, more intersectional benefits packages that Ovia is serving 2,000 employers and health plans today.
More and more organizations are recognizing that to retain women leaders, they need to see employee wellbeing as family wellbeing. There is no greater impact on the health and happiness of an employee than access to the resources to care for what matters most, their family.
1: National Women’s Law Center: https://nwlc.org/wp-content/uploads/2021/01/December-Jobs-Day.pdf
2: CNBC: https://www.cnbc.com/2021/02/08/womens-labor-force-participation-rate-hit-33-year-low-in-january-2021.html
During Black History Month, we’re reminded that there’s so much more we can do to strengthen diversity, equity, and inclusion (DEI) and improve birth equity. But the task can feel overwhelming — it’s hard to know where to begin, or what will really make an impact.
That’s one reason we checked in with nearly 1,500 Ovia members in our Future of Family Friendly Benefits survey to get an insider’s view on the state of DEI for working parents.
What employees say about DEI
When we asked Ovia members who were working parents to grade how well their employers’ benefits support DEI, we quickly learned that people are not impressed. On average, our respondents gave their employers a C on DEI.
When we broke the data down, we found that Black respondents were 6 percent more likely to give their employers a failing grade (a D or an F) on being diverse, equitable, and inclusive in their benefits programs. Clearly, something needs to change.
The benefits that matter most for DEI and birth equity
To better understand what companies can do to improve their DEI efforts and support Black women at work, we asked employees to rank their most important benefits. Then we compared the priorities between groups and found a lot of similarities, and one key difference.
Among Black women, the five most important benefits were:
- Childcare
- Flexible scheduling
- Leave quality
- Digital fertility and maternal health tools
- Family-friendly culture
Their white counterparts ranked their most important benefits this way:
- Leave quality
- Flexible Scheduling
- Childcare
- Family-friendly culture
- Easy-to-understand benefits
One difference especially stands out — Black women ranked digital fertility and maternal health tools in their top-five most important benefits. To make sense of the difference, we need to consider the deep disparities in birth outcomes. In the U.S., Black women are three to four times more likely to die a pregnancy-related death compared to white women. They’re 60 percent more likely to develop life-threatening pregnancy complications, such as preeclampsia. Black mothers are seeking access to tools to support their health.
Black women underscored the point when we asked if adding a personalized health program to improve birth equity and Black maternal health was an important addition for 2023 — they were 104% more likely to say yes compared to white respondents.
Our respondents also told us that they need more support for their mental wellbeing, with Black women emphasizing the importance of mental health for focus and performance at work. We found that:
- 62 percent of Black women had experienced mental health issues that sometimes or often interfered with their ability to be present at work, compared to 60 percent of white women.
- Black respondents were 13 percent more likely to feel at least somewhat comfortable talking about their mental health at work.
When it comes to improving benefits for DEI, one big way companies can step up is by investing in tools that support Black mothers’ mental and physical health.
How a digital solution for maternal and family health can make a huge difference for DEI and birth equity
In a recent analysis of Ovia’s 2022 self-reported member data from a subset of clients, we found that Ovia’s digital health tools, including proactive clinical education, daily health tracking, and 1:1 coaching from Ovia’s Care Team, have a clear impact on how Black women access and advocate for their maternal healthcare.
Compared with their white counterparts, Black-identifying Ovia members were:
- 74 percent more likely to report that Ovia encouraged them reach out to their provider.
- 50 percent more likely to report that Ovia helped them self-identify a potential health condition or symptom.
- 47 percent more likely to report that Ovia encouraged them take action related to their health.
- 9 percent more likely to report that Ovia answered a pressing health question.
These findings suggest that, through personalized education and proactive coaching, Ovia helps members recognize health issues early and then empowers them to seek medical help when it’s needed. These are critical steps toward improving birth outcomes for Black mothers.
Ovia’s approach to supporting Black mothers and families
Ovia’s data shows that employees simply aren’t satisfied with their company’s DEI efforts. And one key way that employers and payers can improve is by listening to Black mothers and supporting their unique health needs. This means investing in solutions that improve birth outcomes, including mental and physical wellbeing.
Ovia has begun this work with our Black Maternal Health program. The program offers personalized education and coaching based on social determinants of health and each individual’s unique medical history and symptoms. Ovia helps members learn about their risk factors, catch physical and mental health symptoms early, navigate their care, and advocate for their health.
If you’re looking for a digital health partner that can help strengthen your DEI efforts and improve birth equity, Ovia can help. We offer 1:1 coaching with certified experts in lactation, parenting, menopause, and women’s health and wellbeing; physician-developed clinical programs; personalized health and wellness education; manager training; and benefits navigators so you can provide comprehensive women’s and family health support to your employees.
Do you know what your employees really think about their benefits? Employees’ needs and expectations are constantly changing, so it can be hard for their employers to keep up. That’s why Ovia Health conducts an annual Future of Family Friendly Benefits survey. This year, we asked more than 1,500 working parents which benefits matter most, and where their employers are falling short.
Overwhelmingly, working parents told us that they are not getting the support they need. Fifty five percent said their employers aren’t family-friendly enough. In fact, more than half gave their employer an overall grade of C or lower.
For employers, this is a wakeup call — not just because there’s lots of room for improvement, but because family-friendly benefits matter more than ever for employee retention.
Family benefits are here to stay — and they’re more important than ever for retention
Among the employees we surveyed, nearly everyone (96.5 percent) told us that family benefits are a top priority. That’s a 24 percent year-over-year increase — a clear indicator that family health benefits weren’t just a passing, pandemic-inspired fad. These days, employees expect benefits that support them from fertility through their return to work and far beyond.
And better family benefits aren’t an optional perk. More than ever, employees are willing to take action to get them. Ninety-one percent of respondents said they would at least consider a lateral move to another company with better family benefits and a family-friendly culture. That’s up 2 percent year-over-year, suggesting that even in an uncertain economy, solid benefits can outweigh the security of a long-term job.
Our survey also suggests that family benefits will become more important in coming years. At the height of the pandemic, many people held off on expanding their families. But this year, 68 percent of our respondents were new, first-time parents. These numbers show that people are turning their attention back to family-building. As more employees expand their families, the demand for women’s health, fertility, and maternity care management benefits will continue to grow.
Survey details: the family benefits that matter most to working parents
Our survey dug deep to find out how employees feel about their benefits, what they really need, and how employers can do better.
One finding was particularly surprising. Employees often don’t know enough about their benefits to make the most of them:
- Only 22 percent of respondents said their benefits were easy to understand.
- Most (63 percent) didn’t even know if they had family benefits such as miscarriage leave and adoption, surrogacy, and maternity care management resources.
But even the benefits employees did understand fell short. For example, nearly a quarter of respondents (24 percent) reported that they don’t have one of the most basic family-friendly benefits: paid parental leave through their employers.
For those who had leave, 55 percent said their company’s return-to-work policies needed a major overhaul, including the overall company culture for working parents, and details like breastfeeding policies, flexibility, digital health support, childcare support, and support from managers.
- 31 percent said their team managers weren’t understanding about their parenting needs.
- 26 percent thought being a parent impacted their ability to get a promotion.
- 42 percent felt their employers didn’t offer enough flexibility for working parents.
Employees also told us that their benefits don’t do enough to support diversity, equity, and inclusion — on average, respondents gave their employers a C grade for DEI.
Top 5 actions employers can take right now to become more family-friendly
Based on our survey results, there are many impactful things employers can do to begin improving family benefits and building a more family-friendly culture. Here are the top five, download the full report for more.
1. Provide enough paid family leave.
While some leave is better than none at all, four months or more of paid leave is ideal. Beyond providing leave, employers can boost family-friendliness by creating a culture that accepts — and encourages — taking family leave.
2. Revamp return-to-work.
Employees told us that their organizations’ return-to-work (RTW) programs aren’t cutting it. This is an especially critical issue for retention — in those first few months after parental leave, employees face the stress of a major life change. It’s one of the key junctures when they decide whether they can balance their new family responsibilities with their job.
Here are a few ways employers can improve RTW:
- Create a clear and concise process for how to take leave and return to work. This includes teaching managers to prep an employee and their team for leave and provide a flexible transition back to work.
- Establish lactation policies to ensure employees have time to manage pumping with their work schedules. It’s also important to ensure that parents have a clean, private space for expressing milk. Keep in mind that more than one employee may need access to the space, and that they will need time to travel to the lactation room, set up equipment, pump for 15 to 20 minutes, clean equipment, store milk, and return to their work area.
- Support employees through perinatal mood and anxiety disorders (PMADs). PMADs are common in the early months of parenthood, and often untreated. A good RTW program should include tools that help employees screen for PMADs, and managers should be trained to help employees find appropriate support.
- For more ideas and tips, download our whitepaper on the cost of RTW
3. Increase flexibility.
While a solid RTW plan goes a long way toward supporting parents, flexibility is the other key. As employees transition back after leave, employers can offer a temporarily lighter workload, a flexible work schedule, or a gradual return process. These are invaluable benefits for employees who are managing sleep deprivation, adjusting to a major life change, and figuring out a new work-life balance.
4. Invest in manager training.
Managers set the tone for a family-friendly culture, but figuring out how to be family-friendly isn’t intuitive. Managers need training to recognize and address unconscious biases that impact working parents, and to understand the needs of employees managing PMADs. With training, managers can offer the support employees need to balance work and their major life transitions.
5. Partner with a digital health solution.
An effective digital health solution connects employees to a team of board-certified experts who can help them through the biggest challenges of family building, from conception through pregnancy and parenting. An extra layer of telehealth alone isn’t enough. For the best ROI, choose a solution that’s personalized to each member, proactive about health screenings and risk factors, and responsive to key issues such as sleep coaching, PMADs, and breastfeeding.
Get the details from our latest Future of Family Friendly Benefits survey
Want to know more about the things working parents need to thrive — and stay? Check out the complete results of our Future of Family Friendly Benefits survey here.
If you’re looking for a digital health partner for women’s and family health, Ovia can help. We offer 1:1 coaching with certified experts in lactation, parenting, menopause, and women’s health and wellbeing; physician-developed clinical programs; personalized health and wellness education; manager training; and benefits navigators so you can provide comprehensive women’s and family health support to your employees.
Maternity costs in the U.S. are shockingly high — higher than in any other industrialized nation. But, even with all of this spending, U.S. women face the highest maternal death rate among high-income countries. Much of this is because we fail to identify risks and institute preventative care in time.
And maternity care may continue to become more expensive. Women in the U.S. have some of the highest rates of multiple chronic conditions in the world and the highest rate of mental health needs. For many, adding the cost of prenatal care is just too much, so they skip or delay routine health visits. This can lead to more dangerous, expensive health issues later.
This broken system also impacts the bottom line for health plans and employers: the annual total healthcare expenditures for people with female-specific health conditions is estimated to be more than $108 billion.
Preventable pregnancy-related health issues make up a notable percentage of these costs. For example, in the U.S.:
- Preterm births cost more than $25 billion per year.
- Gestational diabetes costs $636 million per year.
- Preeclampsia costs $1.03 billion per year.
The good news is that there are lots of things payers can do to lower costs and improve pregnancy outcomes. One of the most important is to reach people early in their pregnancies with care, screenings, and education to help them lower their risks and stay healthy.
There are three important steps healthcare plans and employers can take to make this change:
- Identify pregnant members earlier.
- Use data to understand risks for pregnant members as early as possible.
- Personalize care for each member based on their specific risks. This includes targeted education, symptom tracking, and tools for behavior change.
The trick to discovering pregnancy — and risks — early so you can improve health outcomes
Catching risks early is especially difficult when it comes to pregnancy because most health plans don’t know a member is pregnant early enough. Oftentimes, they aren’t aware until they receive a claim for a member’s 12-week ultrasound, the second-trimester anatomy scan, or even later. But data shows that addressing risks earlier is the key to improving pregnancy outcomes. The first trimester is critical for fetal development, and it’s the time when people make decisions about their prenatal care.
First-trimester interventions can help members:
- Understand their risks and how to lower them.
- Advocate for the care they need, such as cervical measurement, to help catch health issues early.
- Begin taking prenatal vitamins and other preventatives if needed (such as low-dose aspirin to reduce the risk of preeclampsia, or progesterone to lower the risk of preterm birth).
- Adopt an exercise plan and understand healthy weight gain during pregnancy.
- Choose a high-quality hospital to help reduce the risk of unnecessary C-section.
Lots of health plans include these steps in their maternity care programs, but if you don’t know a member is pregnant, you can’t reach them in time to lower risks and help them adopt the behaviors that lead to healthier outcomes.
That’s where a good digital health partner comes in — one that can engage members at the very beginning of a pregnancy (or even before conception) and see them through the whole process with personalized risk assessments, education, and support.
Want a digital health partner to help your members have safer birth outcomes? Look for these 5 things
If you’re looking for a digital health partner who can help you reach members early and guide them toward healthy behaviors and preventive care, here are the five most important qualities to look for:
1. A program with a large user base and a proven track record of early adoption and regular use.
Over the last 10 years, Ovia has served more than 18 million family journeys. 83 percent of them enrolled during their first trimester or earlier (Ovia also offers fertility support). On average, Ovia members engage with our program daily.
2. A history of motivating members toward healthy behavior change, and an ROI to prove it.
On average, Ovia clients see a 4:1 ROI. Our solution is backed by more than a decade of claims data that shows reductions in costly health outcomes from conception through birth, along with greater adoption of risk-reducing behaviors. For example:
- 33 percent of members identified as subfertile went on to conceive on their own, without ART (assisted reproductive technology). This helped reduce dangerous multiple births, increasing singleton pregnancies by 30 percent.
- 28 percent reduction in preterm delivery and NICU stays.
- 34 percent reduction in C-section rates.
- 18 percent reduction in preeclampsia.
- 91 percent breastfeeding initiation rate.
- 31 percent increase in perinatal mental health treatment.
3. Products and programs built on clinical evidence.
Ovia’s algorithms continuously evaluate more than 70 risk factors based on the latest obstetric and gynecological guidelines. This helps identify risks well before claims data is available. Using what we’ve learned about risks and outcomes over the past decade, we’ve developed more than 50 clinical pathways so that we can address each member’s specific risks and needs.
Ovia is also the only women’s and family health solution with its own dedicated research branch. Our team has partnered with more than 40 academic institutions (including University of Arizona, University of Wisconsin, and Harvard’s TH Chan School of Public Health) to study women’s health. And we’ve published more than 50 peer-reviewed clinical papers in leading journals.
4. A proactive, personalized approach.
Ovia personalizes each member’s experience based on a comprehensive assessment (95 percent of members who begin our assessment complete it) and daily data inputs by members. We monitor data to provide predictive interventions, reaching out directly to members when a sign or symptom requires action. We recommend visits to a primary care doctor or obstetrician when needed.
5. Data-sharing capabilities so you can integrate with your existing nurse care management system.
Ovia is designed to integrate a member-level data feed with health plan partners. We can also integrate and augment existing maternity care management programs to create a seamless experience for your members.
Want to know more about Ovia? We offer comprehensive women’s and family health programs that include 1:1 coaching, physician-developed clinical programs, and personalized health and wellness education. Visit www.oviahealth.com to discover more.
1. Kaiser Family Foundation (KFF): https://www.kff.org/slideshow/health-spending-in-the-u-s-as-compared-to-other-countries-slideshow/
2. The Commonwealth Fund: https://www.commonwealthfund.org/publications/issue-briefs/2022/apr/health-and-health-care-women-reproductive-age
3. The Commonwealth Fund: https://www.commonwealthfund.org/publications/issue-briefs/2022/apr/health-and-health-care-women-reproductive-age
4. The Commonwealth Fund: https://www.commonwealthfund.org/publications/issue-briefs/2022/apr/health-and-health-care-women-reproductive-age
5. Women’s Health Issues: https://pubmed.ncbi.nlm.nih.gov/17321943/
6. March of Dimes: https://www.marchofdimes.org/peristats/data?reg=99&top=3&stop=362&lev=1&slev=1&obj=1
7. Population Health Management: https://www.liebertpub.com/doi/pdf/10.1089/pop.2009.12303#:~:text=Our%20national%20estimate%20of%20%24636,by%20an%20average%20of%20%243%2C305
8. American Journal of Obstetrics and Gynecology: https://pubmed.ncbi.nlm.nih.gov/28708975/#:~:text=Overall%2C%20the%20total%20cost%20burden,at%2036%20weeks%20gestational%20age
9. Maternal and Child Health Journal: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5269518/
At first glance, one digital health solution might look a lot like another. In the case of maternal health, many solutions are based solely on telehealth access. They give members another layer of healthcare providers in addition to their regular primary care and OBGYN visits, but that doesn’t always equal better care or better health outcomes. It may be missing personalization.
In fact, bringing more providers into the mix can cause problems for two big reasons:
- First, members can end up with disparate moments in care — there’s no one to put together the big picture of their health and risks.
- Second, a disconnected layer of telehealth is almost always reactive, not preventive.
How reactive, disparate care happens — and why the gaps are a problem for maternal and fetal health outcomes
Patients usually use a digital health platform to connect with a telehealth provider for quick questions about specific issues. But the telehealth provider doesn’t have access to the patient’s background, risk factors, or earlier symptoms, so there’s no opportunity to understand whether one small symptom might be part of an underlying or developing health issue. Plus, a member only calls when they notice an issue. The care can only be reactive, not preventive.
And since a patient’s primary care provider or OBGYN may not know about a telehealth interaction, they can’t put the self-reported symptoms from the telehealth visit into context either. With this gap in care, it’s easy to miss small warning signs, meaning that patients may not get the screenings and care they need.
Here’s an example of how this kind of gap in care can turn into something much bigger: imagine a member meeting with a telehealth provider between prenatal checkups to ask about headaches. The member gets advice on how to safely treat a headache during pregnancy.
But headaches can also be an early sign of preeclampsia (high blood pressure during pregnancy). And the telehealth provider doesn’t know that the patient has other preeclampsia risk factors (such as preeclampsia in an earlier pregnancy, kidney disease, or an autoimmune disease). Without this knowledge, the provider doesn’t see a problem developing. And the patient, having already consulted with a telehealth doctor, doesn’t mention headaches to her regular doctor.
In this case, the care team misses the opportunity to reduce the risk of preeclampsia with a simple preventive: low-dose aspirin. Or to provide other life-saving measures, from monitoring and medication to early delivery if necessary. Untreated, preeclampsia can lead to preterm birth, placental abruption, and, if the condition develops into eclampsia, seizures and coma.1
The secret to a digital health solution with better health outcomes and a tangible ROI? Personalization
An extra layer of telehealth alone just isn’t enough. For better birth outcomes and a meaningful ROI, a digital health solution needs to include personalization and proactive care. Members need to be able to track and record their health, and someone needs to be looking for trends so health issues are caught and addressed early.
Ovia Health is built with personalization at its core — members begin the Ovia program by taking a comprehensive health assessment. Then, they’re given the tools and prompts to track their health daily, from weight and nutrition to sleep and physical and mental health symptoms.
Ovia uses its repository of health data from research, along with claims and experiences from more than 18 million Ovia member journeys, to assess risks for each person. From there, we use personalization to provide members with the specific education they need, help them understand their risks, and guide them toward clinically-proven steps to help reduce adverse health events.
Let’s consider another example — the risks associated with a short cervix. For some women, the cervix begins to shorten too soon during pregnancy. This raises the risk of preterm labor, in turn increasing the health risks for newborns. But few women know about the importance of cervix length, or that their cervix length should be checked regularly.
To help members discover any cervical issues and prevent preterm births, Ovia uses personalized pathways. First, we educate members about the importance of having the cervix measured. Then, our coaches proactively message members with a reminder to have their providers check cervical length (we also provide support if members need help advocating for care). Finally, our app offers members the ability to track and understand their cervical measurements.
A recent study proved members who work with Ovia coaches in this personalized way are more likely to take steps to help prevent preterm delivery. Members are:
- Two times more likely to receive cervical length screenings during pregnancy.
- Two times more likely to take part in our preterm delivery prevention program.
- Three times more likely to be enrolled in our progesterone adherence program to help prevent preterm birth.2
With this type of personalized approach, which combines data with human health experts who can stitch everything together, we’ve reduced the preterm birth rates for Ovia members by 54 percent.
Ovia’s approach also improves birth equity and maternal outcomes for Black mothers. This is critical because Black women are three to four times more likely to die from pregnancy-related causes than white women.3 And they’re 60 percent more likely to develop preeclampsia.4
To address these disparities, Ovia built an entire program and clinical pathway tailored to the unique needs and risks of BIPOC members. For example, when a member identifies as BIPOC (or has a history of high blood pressure), Ovia personalizes their experience to ensure they know about the risks and signs of preeclampsia, and helps them track relevant symptoms. The Ovia Care Team also monitors health inputs. If a member records symptoms that could be early warning signs (high blood pressure, dizziness, blurry vision, headaches, etc.), an Ovia Health Coach will proactively reach out to refer them to their provider for testing.
Ovia also helps at-risk members with low-dose aspirin use — a simple, effective step to help prevent preeclampsia. And members can opt into a monitoring program that includes a Wi-Fi-enabled blood pressure cuff.
To date, Ovia members have reduced their preeclampsia rates by 18 percent.
With Ovia’s personalized, proactive model, a member’s provider remains at the center of care, so members get the guidance they need, and they don’t fall into a care gap. The results are safer births, and a significant ROI for employers and health plans.
What to look for in a digital health partner
If you want a digital health partner that can help you save costs and improve birth outcomes, these are the most important things to look for:
- Personalization for every member.
- Health tracking and proactive outreach to help members understand and address their unique risks.
- A plan to keep members in-network and prevent disparate moments of care.
- A track record of improving birth equity.
- A proven ROI.
Your next steps to integrate personalization in digital health
Ready for a new partner for women’s and family health? Learn more about Ovia. We offer comprehensive women’s and family health programs that include 1:1 coaching, physician-developed clinical programs, and personalized health and wellness education. Visit www.oviahealth.com for more.
1: The Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745
2: Ovia Health: https://images.ent.oviahealth.com/Web/OviaHealth/%7Bc81c4ef7-21c5-4d9a-b11d-e97db367bf6f%7D_All_AllENT_OnePager_ACOG-Coaching-Study_MC_V1_12May21.pdf
3: Clinical Obstetrics and Gynecology: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5915910/
4: Harvard Public Health: https://www.hsph.harvard.edu/magazine/magazine_article/america-is-failing-its-black-mothers/
Ovia is launching a new menopause program, here’s what it means for you.
Menopause symptoms can make it hard to manage work and everyday life. Plus, the secrecy and stigma associated with this stage often prevents people from finding the support they need, even if a menopause program exists.
While standard benefits packages don’t offer much help, there is a lot that employers and payers can do to help their menopause populations better understand, anticipate, and manage symptoms — enabling them to be healthier and more productive.
That’s where Ovia Health’s new offering comes in. Ovia has always been about breaking stigma when it comes to women’s and family health — from periods and fertility to pregnancy and postpartum. As we close out the year, we’re excited to announce our new menopause support program!
Read the Q&A below to hear from Ovia’s Chief Medical Officer, Dr. Leslie Saltzman, as she explains how Ovia’s expansion can help those experiencing menopause symptoms today, and why investing in a holistic women’s health solution is a must in 2023.
Interview with Dr. Leslie Saltzman, Ovia Health CMO
Tell us about you and your role at Ovia
I am the Chief Medical Officer at Ovia Health. I also oversee Ovia’s clinical team, including their studies and research initiatives, to inform our business and program developments and to ensure Ovia’s solutions are evidence-based.
In addition to my role here at Ovia, I am also a practicing physician. I’m an internist and I focus on women’s health.
Why is it so important to support advanced women’s health areas like perimenopause and menopause?
Well, perimenopause and menopause impact 50% of the population. Most women experience symptoms related to the menopause transition and these symptoms often last for years.
The average life expectancy for women is 81 years, meaning that on average 40% of a woman’s life is spent in post-menopause. From a risk perspective, we know that the menopausal transition is when cardiovascular disease risk for women increases, so it’s really important to monitor women’s health during midlife.
What does Ovia’s new solution look like?
Our new menopause tool is exciting because it’s an entirely new experience for the Ovia audience. It’s a new “mode” in our namesake app, the Ovia app. This means it’s a completely personalized experience based on an individual’s needs.
Members can download the Ovia app and select “Mangaging menopause” as their goal at sign up. At this point, Ovia customizes their experience to explain their symptoms, deliver relevant resources, and connect them with a member of our Care Team. All the members of the Ovia Care Team are board-certified clinicians who can help members manage their symptoms and find care and treatments based on their needs.
It’s this beautiful mix of personalized technology and human care. The hope is that people can find the education and relief they need from a tool that is specifically designed for them.
There are a lot of digital health solutions available today — how is Ovia’s menopause program different and why is that important?
Well, there are a few things. First, our longevity and market share in terms of audience makes us stand out. We’ve supported 18 million journeys and this year we celebrated Ovia’s 10th birthday. We’ve built our solution based on our experience over the last decade.
Also, as I mentioned before, the new menopause tool is an entirely new experience for the Ovia member, and a completely personalized, and interactive one at that. Most solutions in the market are just an expanded physician network with static content, meaning it looks nice but it isn’t personalized to an individual’s risk factors, experiences, and symptoms. In short, our competitors’ solutions don’t grow with members as their experiences change — Ovia does.
One of the things that I love about Ovia (and what is so different about our menopause experience) is the way that members are able to track their symptoms. We anticipate that this tracking feature will allow members to get the treatment they need and easily evaluate if it’s working.
This tool is so powerful because it’s personalized, which enables us to be proactive vs reactive. If symptoms start to indicate early warning signs of issues, our Care Team is there to help members see the risk and take action. Any tool that can impact ROI needs to be personalized, proactive, and backed up with a human touch.
You mentioned personalized and proactive as two important factors to look for in any digital health tool. Why is that vital to success?
There’s so much stigma around menopause and many people do not feel comfortable talking about it. There’s also a lot of misinformation, so it’s really important that we take a proactive approach to help destigmatize and normalize this stage of life.
In terms of our solution, as I mentioned previously, members can interact with the tool and actually track their symptoms. They can start to see trends and understand triggers or treatment options. As they are proactively tracking their health, Ovia Health Coaches will reach out about concerning symptoms to offer support and connect members to resources. When tools are generalized — and not personalized based on an individual’s experience or risk factors — they’re generally less effective.
Also, Ovia’s tech serves up info in a personalized feed — so members can easily ingest what they have time for at the moment. And Ovia grows with the member, so every time they open their app they’ll find new information. Ovia’s solution is learning and helping guide members on an educational journey vs acting as a static list of documents and resources.
When can we expect to see the new menopause program?
We’ve had some menopause content for a while, but this new expansion really provides more breadth and depth. It includes deep educational content, comprehensive clinical modules, more specific health tracking, and an entirely new experience.
It’s live now! So when members download or log into the Ovia app, they can select “Managing menopause” as their goal.
What outcomes are you hoping to see among those using the tool?
For those that are highly symptomatic — we hope that they are able to recognize their symptoms and seek out treatment, rather than suffering in silence or getting evaluated/treated by the wrong specialists.
We also hope that by supporting women through menopause transition — we can positively impact their careers — decreasing absenteeism and presenteeism.
Why is preventative health or longitudinal, whole-person health, so important?
The menopause transition is where risks really accelerate for women. Cardiovascular disease starts about 7-10 years later in women, with menopause we see changes in lipids, body fat, blood sugar and blood pressure.
It’s really important that these risk factors are identified, monitored, and treated appropriately. Cardiovascular disease is the leading cause of death in American women.
In addition, women need regular screening for cervical cancer, breast cancer, and colon cancer.
As a provider, what’s one piece of advice you’d give people experiencing menopause today?
Don’t be ashamed. What you’re going through is natural. If you’re experiencing symptoms that are uncomfortable, don’t be afraid to take action. Talk to your doctor about your symptoms, you don’t have to suffer. Get a second opinion if needed.
Also take a look at your employer-sponsored benefits, and check to see if you’re offered help through a menopause program. If so, ensure you’re taking advantage of every opportunity to get treatment and manage your symptoms. You’re in charge of your health and there are things you can do.
Similarly, what advice would you give employers and payers considering adding a menopause program or more support for women’s health?
Firstly, if you haven’t already, start talking about menopause when you talk about health and wellness, and include men in the discussions. Being open and talking about it will help reduce the stigma.
Additionally, you can show your workforce or members that you care by investing in holistic women’s health tools, like Ovia, that help them manage symptoms and improve outcomes — not just for menopause, but for any range of women’s health issues and conditions. This way they’re covered at every stage of life and across all areas of women’s health, from conditions like PCOS and endometrosis all the way to advanced women’s health conditions, like menopause.
Plus, if you’re offering these types of benefits, your populations won’t just be happier, they’ll be healthier and more productive. This can help you contain medical costs, improve overall experience and satisfaction, and drive productivity.
Why employers and payers can’t afford to wait on women’s health
In past years, payers and employers have started to invest more deeply in women’s health benefits and solutions. The fem-tech industry, as it’s been coined, has already garnered more than $2.5 billion in funding and that number is only expected to grow.
However, despite this growth, too many organizations are delaying women’s health investments. Time and time again, investments have been made in favor of more generalized wellness or conditionary-specific areas (like mental health or musculoskeletal benefits) over a women’s health solution. Some have even called women’s health “niche.”
But, it may be unwise to push investments much longer. Women make up approximately half the workforce, and many are suffering from women’s health conditions, like severe menopause symptoms.
In a recent study, three out of five said they’d had to deal with difficult symptoms while on the job — and one in three actively worked to hide symptoms from their colleagues and managers. Almost half said they were afraid they’d be stigmatized if people knew they were going through menopause. What’s more, another study concluded that nearly 20 percent of people with menopause in the U.S. have quit or considered leaving a job due to their symptoms.
The burden isn’t just on women suffering from menopause symptoms, it’s also a pain that can be felt by employers and payers. Those suffering from untreated symptoms typically see
- 121% higher utilization of healthcare resources to manage and treat symptoms
- 57% more work productivity loss days
This can cost $2100 per woman/per year in additional healthcare and absenteeism costs.
As budgets decrease in today’s uncertain economic climate and population health demands become more serious, employers and payers will need to find ways to help reduce rising healthcare costs. Supporting menopause and women’s health is one of the easiest ways to do so for a huge percentage of populations.
With this new expansion and personalized, proactive approach, Ovia Health is poised to help members understand their symptoms and find relief across all life stages.
For a more in-depth demonstration of the Ovia menopause program, or Ovia’s solution in general, schedule a discovery call with our team.
Aristotle mentioned it, a French physician named it in 1821, and in the 1930s doctors thought it was a disease. But even after all these years, we’re still not talking enough about menopause — and that’s a costly problem for employers.
Even though it’s a natural process (and definitely not a disease), menopause can come with symptoms that make it hard to manage work and everyday life. But the secrecy and stigma around menopause can make it difficult for people to find the support they need. And standard benefits packages don’t offer much help, either.
For women, the result can be shame and frustration. For employers, ignoring menopause means lost productivity and employee turnover. For payers, it can mean higher medical spending.
If this is so important, why aren’t more people talking about it?
At work, women face sexism (we still make 84 percent of what our male colleagues earn).1 Then, as we reach the peaks of our careers, ageism kicks in. There are countless stories about women who hit 50-ish only to lose hard-earned standing at their jobs, or suddenly discover that it’s much more difficult to find a new position.2
And then there’s menopause. It’s associated with both sex and age, along with the taboo topic of women’s reproductive health. On top of that, the rare pop culture reference to menopause is almost always a character who’s overly emotional and out of control.
Put all of these pieces together and it’s no wonder people are reluctant to speak up about their experiences and needs.
What it’s like to go through menopause without support
Since it’s tough to even bring up menopause — and women have legitimate concerns about discrimination — many people manage this major life change in silence.
Experts estimate that 85 percent of women who go through menopause have at least one related symptom.3 Among the most common are:
- Hot flashes and night sweats
- Sleep disturbances
- Mood changes
- Weight gain
In a 2021 survey of more than 5,000 women in various stages of menopause, three out of five said they’d had to deal with difficult symptoms while on the job — and one in three actively worked to hide symptoms from their colleagues and managers. Almost half said they were afraid they’d be stigmatized if people knew they were going through menopause.4
The business costs of ignoring menopause
When people aren’t supported through menopause, it impacts their employers and payers, too. According to research, women suffering from menopause symptoms have:
- 121 percent higher use of healthcare resources to manage and treat symptoms
- 57 percent more days of lost work productivity
- $2,100 in additional costs per year spent on healthcare and attributed to absenteeism5
Another study that included 17,322 women with diagnosed menopause found even higher costs, including increased medical expenses ($4,315 versus $2,972), pharmacy expenses ($1,366 versus $908), sick leave costs ($647 versus $599), and sick leave days (3.57 versus 3.3). 6 These costs translate to payers.
Struggling through menopause can also take a toll on productivity and engagement. The same study found that employees with diagnosed symptoms had 10.9% lower annual productivity than people without symptoms.7 On a global scale, experts estimate that those productivity losses cost upwards of $150 billion each year.8
Menopause matters for keeping some of your most valuable employees
Nearly 20 percent of U.S. workers with menopause symptoms have either quit or considered leaving a job because of their symptoms.9 That’s already more people than employers can afford to lose. But consider this: on average, symptoms start in a person’s late 40s, when they are well into their careers. That means that without support, employers risk losing senior leaders with indispensable experience and knowledge.
How to truly support employees
If you’re ready to support employees through menopause, there are a few changes that can make all the difference:
- Create an environment where employees can talk comfortably without fear of discrimination. A good first step toward this culture shift is training managers to understand menopause symptoms and know how to be supportive.
- Highlight menopause information in your health awareness initiatives, including symptoms and available treatments, as well as available benefits.
- Develop an official, company-wide menopause leave policy, and normalize taking leave so employees aren’t afraid to request it.
- Most importantly, invest in a solution, like Ovia Health, to help employees learn about menopause, track their health, manage symptoms, and get expert guidance when they need it.
Building the future of menopause at work
The years of silence around women’s health have taken a toll. Employees have been asked to manage a tremendous amount of stress out of shame or risk of discrimination — and some have had to leave their jobs when the burden became too much.
But we can make a huge, positive change for a large and important segment of our population. We can make it okay to talk about menopause. We can make education accessible, so people know what to expect and how to get treatment if they need it. And we can create workplaces that support employees through their major life changes.
October is World Menopause Awareness Month. What better time to invest in the culture shift and menopause care people need? It’s a huge benefit to employees, and it’s a smart way to save costs and attract and retain some of the very best talent.
About Ovia
Ovia Health, a Labcorp subsidiary, has served more than 17 million family and parenthood journeys since 2012. Ovia’s dedication to women’s and family health is founded in evidence-based data. As a result, Ovia is the only digital health solution clinically proven to effectively identify and intervene with high-risk conditions. The company’s 50+ clinical programs, including predictive coaching and personalized care plans, help prevent unnecessary healthcare costs, improve health outcomes, and foster a family-friendly workplace that increases retention and return to work. For more information, visit www.oviahealth.com.
1: Pew Research Center: https://www.pewresearch.org/fact-tank/2021/05/25/gender-pay-gap-facts/
2: Harvard Business Review: https://hbr.org/2016/03/older-women-are-being-forced-out-of-the-workforce
3: BMC Women’s Health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4542113/
4: The Society for Human Resource Management (SHRM): https://www.shrm.org/resourcesandtools/hr-topics/behavioral-competencies/global-and-cultural-effectiveness/pages/menopause-what-employers-need-to-know.aspx
5: Sarrel, P., Portman, D., Lefebvre, P., Lafeuille, M.-H., Grittner, A. M., Fortier, J., Gravel, J., Duh, M. S., & Aupperle, P. M. (2015). Incremental direct and indirect costs of untreated vasomotor symptoms. Menopause (New York, N.Y.), 22(3), 260–266. https://doi.org/10.1097/GME.0000000000000320
6: Journal of Occupational and Environmental Medicine: https://journals.lww.com/joem/Abstract/2013/04000/Direct_and_Indirect_Costs_of_Women_Diagnosed_With.14.aspx
7: Journal of Occupational and Environmental Medicine: https://journals.lww.com/joem/Abstract/2013/04000/Direct_and_Indirect_Costs_of_Women_Diagnosed_With.14.aspx
8: Bloomberg: https://www.bloomberg.com/news/articles/2021-06-18/women-are-leaving-the-workforce-for-a-little-talked-about-reason
9: The Society for Human Resource Management: https://www.shrm.org/resourcesandtools/hr-topics/behavioral-competencies/global-and-cultural-effectiveness/pages/menopause-what-employers-need-to-know.aspx
The history of return to work programs
In the U.S., on average, only 65% of moms end up returning to work postpartum. Some reports indicate that only 80% of those who do go back are still there one year after their child’s birth. There are many reasons new parents leave the workforce, including lack of comprehensive return to work programs.
Returning from parental leave is challenging. New parents may be struggling with a litany of issues — sleep deprivation, breastfeeding, parental guilt, postpartum depression, the list goes on. Without the proper support at work, employers often see a rise in attrition and presenteeism and a loss of productivity. While working parents feel forced to choose between their children and their careers.
But there are ways employers can step up to make the transition easier, and it may even be more profitable for them to do so.
So, where are the return-to-work gaps? What can employers do to better support and retain new parents? And why should they invest in these programs? Our own Care Advocate Lead, Tamika Simpson, PsyD, MPH, IBCLC, PMH-C, CHES, wanted to know. So she dedicated her doctoral project to finding out.
The following is an interview with Tamika about her study, and why it’s vital for employers to invest in return-to-work programs.
An Interview with Tamika Simpson
Before we begin, tell us a bit about yourself, your role, and your background. What makes you so passionate about women’s health?
I worked at Ovia as a health expert providing both lactation and mental health support. I now also lead the Care Advocate team, a team of wonderful people who are assisting with benefits navigation as well as offering mental health support. They come from various public health backgrounds and are all certified in perinatal mental health (PMH-C).
I joined Ovia because I loved the idea of leveraging all of my experience to support women’s health. My background is in Public Health and I worked in reproductive health for a long time before I decided to expand my education into mental health. Working at Ovia gives me the opportunity to use all of the experience. It’s wonderful to work with an organization that is so committed to supporting physical health while also placing focus on mental health and overall wellbeing.
You recently finished your PsyD. What were you studying?
I wanted to explore what it was like for people to return to work after having a baby. So, return to work programs.
I was curious about their perception of employer support and what was helpful or not so helpful during this transition. I wanted to know whether employer support had an impact on their mental health and how it affected their productivity at work. I did a qualitative phenomenological study and interviewed Ovia participants about their specific situations.
What was your hypothesis?
I hypothesized that a lack of employer support, and a lack of comprehensive return to work programs, led to an increase in presentation or severity of perinatal mood and anxiety disorders. By doing this style of research I was able to gain unique insight into the participants’ lived experiences.
How did you conduct your research?
I partnered with Ovia to launch a survey. In order to participate in the study, participants needed to be using the Ovia apps within the United States, be under one year postpartum, and have returned to work within the last year. They also had to indicate symptoms of a perinatal mood or anxiety disorder (diagnosed or undiagnosed).
The survey link screened for this eligibility. We invited eligible participants to schedule an interview. The interview consisted of semi-structured questions allowing for a conversational approach.
The research questions used in this study were:
- How do perinatal mood and anxiety disorders impact productivity in the workplace?
- In what ways can employers support employees who are returning to work to increase positive health outcomes?
- What are the participants’ experiences with early screening, diagnosis, and treatment for perinatal mood and anxiety disorders?
What were the findings of the study?
When examining how perinatal mood and anxiety disorder (PMAD) impact productivity in the workplace, this study showed that PMADs can cause employees to struggle to pay attention to details, be present in the moment, and remember all the steps required in their daily work.
The participants also provided several ways that employers can be more supportive:
- Allowing for a paid leave
- Providing support and resources that can assist with the parental leave process
- Offering flexible schedules upon returning
- Reducing the workload as they adjust to the transition
- Providing adequate time and a clean and private place to express milk
Lastly, employees expressed that their organizations need to recognize that screening for perinatal mood and anxiety disorders can be inconsistent, meaning that employees can return to work while still experiencing a perinatal mood or anxiety disorder.
What are gaps or adjustments employers can make?
Rather than assuming that employees are adjusting well to this major life transition, it may be beneficial to check in empathetically and see if there is anything that employees need that they may not necessarily be asking for due to fear of being perceived differently.
Upon returning from leave, it would be helpful if the employee is eased back into their work. Someone should cover the position as an interim while the employee is on leave so that work does not accumulate. Allowing a period of transition with a lighter workload may assist the employee with learning to balance parenthood and their career.
Employees in this study frequently discussed not telling their employer about their symptoms due to fear of losing respect or their position in the company. It might be helpful if employers created an environment where employees can discuss their needs without fear of judgment (Shann et al., 2019).
Employers who check in on their employees using a judgment-free tone and allow for honesty without negative consequences may be better able to determine the needs of their employees.
Why is this something employers should focus on?
Employers are often focused on meeting the needs of the company; however, by meeting the needs of the employees, the needs of the company will be met as well.
When employers are not supportive, it can lead to a loss of revenue through absenteeism and presenteeism, or even turnover. But when employers create an environment that allows people to feel like they can bring their whole selves to work this fosters an environment of support.
The participants in this study were looking for parental leave, paid leave, and access to a streamlined system to access information related to leave. What they often received was confusion from management or HR departments or numbers to call to figure it out on their own.
Employers should keep in mind that this is a stressful time, and employees will appreciate having information easily attainable. This can also make the situation easier for employers to navigate as well and clears up expectations for all parties before leave.
Mental health seems to be a recurring theme here. How can returning to work impact mental health for women?
Returning to work before seven months is associated with an increased risk for perinatal mood and anxiety disorders (PMADs). After nine months postpartum, returning to work becomes a protective factor against depression (Lewis et al., 2017).
Employers who rush their employees back to work after delivery increase the risk of PMADs among employees who give birth.
Experiencing a perinatal mood or anxiety disorder is common (1 in 7) and when we add in other variables — sleep deprivation, additional pressure from an employer, trying to transition into being a parent of a newborn and an employee again — it can exacerbate existing symptoms or even make the chance of developing a PMAD higher.
This will be different for everyone as their situations are unique. But the participants in this study indicated wanting to return to work as a means of keeping their identity, they just needed some time to recover and prepare for transition before returning.
You talked about presenteeism and absenteeism — what is that?
Absenteeism is related to not being at work consistently. Presenteeism is more about being at work — physically showing up, but not being mentally focused or prepared to be working. For example, showing up for work when struggling with your mental health can lead to reduction in productivity, mistakes, and other negative consequences.
People will often show up because it is expected by their employer, or they feel pressured to return sooner than they are ready. But employers may want to consider this before setting expectations.
Breastfeeding and ensuring there is time to pump at work seemed to be a big trend with surveyed moms. Why is this so important? Why are women uncomfortable pumping at work? What can employers do?
Lactation accommodation is a federal law. Employees who are breastfeeding need to be allowed adequate time for expressing their breast milk as well as a private place that is free from intrusion that is not a bathroom. While this law has some exceptions, it’s clear that providing this space is still the right thing to do.
Aside from the minimum requirements mandated by law, employers can exceed expectations and work to create a supportive environment. They can create great return to work programs. Employees have found it useful for employers to allow them to take pump breaks that are not micromanaged in a clean facility that locks and has an outlet for a breast pump to be plugged in, along with a space to refrigerate milk.
If employers are only letting employees pump during their scheduled 10- or 15-minute breaks and lunch, they have not met the adequate pumping time requirement as it takes longer for most people to travel to the pumping space, set up, pump, clean up, and travel back to their workstation.
Employers should also consider schedule flexibility (Maxwell et al., 2018). Offering the ability to work remotely, use flex time, paid time off, intermittent leave, and other creative approaches to scheduling may help employees as they adjust to returning to work with a newborn. Additionally, during pregnancy and afterwards, employees will have to attend medical appointments. Having flexible arrangements can help with this, too (Maxwell et al., 2018).
What financial impact does extending leave and making return to work more comprehensive have for employers?
During a six-year study, it was estimated that the societal cost of PMADs is over $14 billion covering the period from fertilization to five years postpartum (Ko & Haight, 2020). The average cost for each parent baby dyad was approximately $31,800. Society has often placed focus on treatment approaches, however, recently, there has been a shift toward preventative efforts and improved wellbeing (Moloney & Newham, 2015).
What advice would you give employers on how to improve and close these gaps?
Through this study, I discovered that employers could be more supportive by:
- Adjusting workloads and types of work during pregnancy to ensure safety
- Providing a paid leave and encouraging employees to take their leave
- Providing a clear and concise process for taking the leave and returning to work
- Offering flexible work arrangements upon return
- Providing a private (and clean) place to express milk that is free from intrusion, has an electrical outlet, and considers the possibility of multiple employees needing to use the space
- Allowing for adequate break time to express milk (15-20 minutes of active pumping time and additional consideration of the time necessary to travel to a lactation room, set up, pump, clean equipment, store, and return to workstation) a temporarily lighter load to allow the participant to ease back into working while also being sleep deprived
- Establishing an understanding between an employee and their employer and coworkers that this is a tough time
Remember, these new parents are going through a major transition as human beings. But, they are still valuable to the workplace and their production will improve with time.
Based on the results of this study, employers who are more supportive of their employees can help to improve mental health outcomes, leading to enhanced productivity in the workplace and a reduction in turnover, absenteeism, and presenteeism.
When employers are supportive of their employees’ mental health, it serves a dual purpose by being more cost effective to the employer, while the employee benefits from better mental health.
What employers can do today to improve return to work programs
Since the modern workplace existed, working parents have always struggled to find balance between work and their family.
The findings from this research make the financial and empathic cases for strengthening return to work clear. It confirms that working parent guilt is real, and it’s not as simple as “letting it go.” And although uncomfortable and painful at times, working parent guilt can be very useful — it can force parents to reflect on why they are feeling this way, and realize what’s truly important. A parent awakening.
This awakening of the working parent is probably one of the most obvious, and impactful to HR leaders. And it holds untapped potential. Employers now have the chance to amend and evolve policies to close the gaps that this study uncovered, driving increases in retention, productivity, and profitability.
And it couldn’t have happened at a more impactful time. Today, in 2022, we’re witnessing a 33 year low in women’s participation in the labor force — many having left because they simply didn’t have the resources or infrastructure to balance work and parenting in this “new normal.”
We can’t afford to lose an entire generation of women. Not only can the labor market not stand the talent drought, studies have shown that when companies have strong gender diversity, they’re more profitable.
Employers can meet the needs of parents with new, innovative benefits. Those who strengthen return to work and embrace the notion of family friendly will be well positioned for success.
Ovia is here to help. We offer deep training and guides for employees, and managers to strengthen return to work programming. Our solution also provides 1:1 coaching with certified experts in lactation, parenting, and women’s health and wellbeing; physician-developed clinical programs; personalized health and wellness education; manager training; and benefits navigators so you can provide comprehensive women’s and family health support to your employees. Contact our enterprise team to learn more about these services.
In our society, breastfeeding often gets the same treatment as other women’s health issues — it’s downplayed or dodged, making women feel confused when it doesn’t go smoothly, overwhelmed about their options, and even embarrassed to pump in the workplace or breastfeed in public.
This year for Breastfeeding Awareness Month, we want to help turn the status quo upside down by talking about what it takes to really support mothers at work and why breastfeeding is so incredibly valuable for infants, mothers, and even employers.
Breastfeeding matters — for everyone
You’ve probably heard that breastfeeding has benefits for babies and mothers, but you might not realize how extensive — and impressive — that list of benefits really is or how those benefits ripple out to all of us.
To start, breastfed infants have:1
- Lower rates of infant mortality, including sudden infant death syndrome (SIDS)
- Stronger immune systems, which results in fewer illnesses and hospitalizations
- Fewer cases of diarrhea, constipation, gastroenteritis, gastroesophageal reflux (GERD), and preterm necrotizing enterocolitis (NEC)
- Less respiratory illness, including colds, pneumonia, respiratory syncytial virus (RSV), and whooping cough
- Fewer ear infections
- Fewer cases of bacterial meningitis
- Better eyesight and fewer cases of retinopathy of prematurity
Beyond babies, breastfeeding has significant physical and mental health benefits for mothers. It’s been shown to:2
- Reduce postpartum bleeding and stimulate the uterus to contract and return to size
- Help with weight loss after birth
- Reduce rates of urinary tract infections and anemia
- Lower the risk for postpartum depression
- Improve mood and reduce stress by producing the hormones oxytocin and prolactin
These benefits don’t stop with the mother and child either. Breastfed babies tend to cry less, which eases stress for everyone. And the strong physical and emotional bond that comes from close contact during early life may help reduce social and behavioral problems later.
Employers benefit, too. Working parents of breastfed babies miss less work than their counterparts with non-breastfed babies. According to one study, mothers of breastfed babies had one-third the number of one-day absences compared to mothers of formula-fed babies. In the same study, 86 percent of the babies who had no illnesses at all were breastfed.3 Based on all the benefits, it’s no surprise that breastfeeding mothers have higher morale at work, too.4
For employers, the benefits of breastfeeding translate to healthcare cost savings, lower absenteeism, and happier employees — which, in the long term, can save the costs associated with replacing workers.
While it’s important to remember that breastfeeding is a challenge for some mothers and infants – and the best option is always the one that works for a woman and her family – there are lots of reasons for employers to embrace breastfeeding for any mother who chooses it. But Ovia’s recent survey shows that breastfeeding support in the workplace still has a long way to go.
Women aren’t getting the health support they need at work or the doctor’s office
We recently surveyed Ovia moms about breastfeeding and their health in general, and several findings stood out.
First, when we asked moms with a workplace whether they feel comfortable breastfeeding or pumping there, nearly half (49.8 percent) said no. One big reason? Thirty-eight percent said their workplace did not offer a clean, safe, private space to breastfeed or pump; another 23.7 percent weren’t sure if their employers offered a lactation room at all.
Discrimination isn’t just happening at work. We asked our respondents how their doctors address their health needs, including whether they’ve experienced “medical gaslighting” — defined as having feelings or symptoms dismissed by a provider in such a way that the patient doubts her own experience. The numbers were striking:
- 84.7 percent said they’d experienced medical gaslighting.
- 63 percent said medical gaslighting had significantly delayed their ability to receive an accurate diagnosis.
- 42 percent of those who’d experienced medical gaslighting said it happened with their primary care provider (PCP). This is significant because PCPs are often the gatekeepers to specialized care.
Together, these findings tell us that in key areas of their lives, including work and the doctor’s office, women’s health is still overlooked. Even when employers offer meaningful benefits, such as well-appointed private spaces to pump, women may not know because no one is talking about it. Employers may have the best intentions, but they aren’t loud and clear about how they support mothers.
The good news is that there is a lot employers can do right now to make positive changes for working moms.
4 ways to support breastfeeding mothers in the workplace
A few steps can go a long way toward showing how much you value working mothers:
1. Start with lactation rooms. While basic mother’s rooms are legally required through the Fair Labor Standards Act and the Break Time for Nursing Mothers law, you can create a respectful space by making sure it’s private, comfortable and reservable.
Even better: add a refrigerator to store milk, a comfortable chair, water, and a few nutritious snacks. (Check here and here for more lactation-room best practices.)
Creating a great space for breastfeeding or pumping isn’t just about logistics for mothers. It signals a bigger cultural shift toward acceptance.
2. Boost your pro-breastfeeding culture. Train managers and teams to understand the value of breastfeeding, and to treat pumping time as sacred time (many women say they cut pumping short because they feel judged).
3. Add breastfeeding-specific benefits. Additional perks, from lactation coaching to breastmilk shipping for employees who travel for work, can make a big difference for moms.
4. Go beyond breastfeeding. You can help bring attention to women’s health needs and provide support with programs and coaching for common health concerns, such as PCOS, and through major milestones, from fertility to menopause and beyond.
Ovia can help you change the game for working mothers
Taking women’s health seriously isn’t just the right thing to do. It’s also critical for lowering healthcare costs and building a corporate culture that lifts employee morale and increases retention.
Ovia is here to help. We offer 1:1 coaching with certified experts in lactation, parenting, and women’s health and wellbeing; physician-developed clinical programs; personalized health and wellness education; manager training; and benefits navigators so you can provide comprehensive women’s and family health support to your employees. Contact our enterprise team to learn more about these services.
1: Cleveland Clinic. The Benefits of Breastfeeding for Baby & for Mom: https://my.clevelandclinic.org/health/articles/15274-the-benefits-of-breastfeeding-for-baby–for-mom
2: Cleveland Clinic. The Benefits of Breastfeeding for Baby & for Mom: https://my.clevelandclinic.org/health/articles/15274-the-benefits-of-breastfeeding-for-baby–for-mom
3: Cohen, R. American Journal of Health Promotion. Comparison of maternal absenteeism and infant illness rates among breast-feeding and formula-feeding women in two corporations. https://pubmed.ncbi.nlm.nih.gov/10160049/
4: The Cochrane Database of Systematic Reviews. Interventions in the workplace to support breastfeeding for women in employment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7388861/#CD006177-bbs2-0009
The Supreme Court has voted to overturn Roe v. Wade, removing federal constitutional protections to abortion, and leaving the decision up to each state. Though the federal ruling has changed, the need for women to have safe access to care has not. New restrictions could impact decisions related to a woman’s health and lifelong decisions related to family planning.
Accessing quality care is a family issue
As cofounder of Ovia Health, which serves millions of people navigating their reproductive health and parenting journeys, and as a mom of three myself, I empathize that the parenting decision is deeply personal and must be one of the most challenging moments of a person’s life. It’s a decision that some make for themselves, and some make for their existing families.
Building and caring for a family is challenging, especially for families who already face barriers to care including low income and access to quality care. 60% of abortion patients are already mothers (CDC 2019), and close to half are living below the poverty level. Many parents simply don’t have access to equitable maternal care, affordable childcare, paid parental leave, quality lactation rooms, flexible work options, and family-friendly work environments.
Moms deserve better
Safe access and quality care are important to addressing maternal death and mental health disorders, impacting the wellbeing of the entire family. There are many challenges and barriers to quality, accessible healthcare on the path to and through parenthood, including:
- Health knowledge and coverage deficits, which negatively impact equitable access and adherence to contraceptive care
- Inadequate maternity care: 7 million women in the U.S. live in areas without access to quality maternity care
- The maternal mortality rate: The U.S. leads the developed world in maternal mortality
- Women of color are 3x as likely to die from pregnancy-related causes
- Inadequate family leave: Less than one in four workers in the U.S. have access to paid family leave to recover from childbirth, breastfeed, and bond with their child without the fear of financial insecurity
- Lack of access to childcare: 83% of parents struggle to find quality, affordable childcare, limiting their earning potential and careers
Families and children deserve more — they deserve to not only survive, but to thrive.
Filling the gaps in your care
Ovia Health’s digital solution for reproductive health, pregnancy and parental wellbeing is designed to fill gaps in care and empower members to make proactive, informed decisions about their health. We’ll continue to provide evidence-based programs to navigate these critical health and life stages to millions of people, available as a covered benefit at over 2,000 employers nationwide, and at no cost to individuals.
As a women’s health ambassador, I’ve dedicated my career to building technologies that break down barriers to self-advocacy and care. During this pivotal moment in history, I am proud to be part of a purpose and community that believes every person deserves equitable care, and a healthy happy family.
Over the last two years, the world of work has changed in profound ways. This year’s annual meeting of the Society of Human Resource Management (SHRM) was an opportunity for thousands of HR leaders to assess these changes and chart a path forward. They examined new retention challenges, discussed the power of flexibility and the need to update approaches to physical and mental wellness, and explored the difference between DEI and DEI&B.
Here are the top five big takeaways for HR professionals.
1. Retention is hard — but not impossible
In a post-Covid world, employee retention is all about understanding what employees value most and creating a culture that supports work-life balance.
One of the top pro tips from this year’s SHRM is to embrace the entry (or stay) interview. Speak with employees early to find out what they value outside of work and make sure that their role fits within their priorities. For example, an employee whose priorities revolve around their role as a parent may say that being able to pick the kids up and be home for dinner is everything to them. For this person, flexibility is key and should be built into their role. Knowing and protecting employees’ priorities helps to ensure their long term happiness at work.
The experts also stressed investing in a culture and policies that truly match the values of your workforce. For example, if you’re spending money on free dinner at 6:30 each night, but your employees are family-focused — or just need time to rejuvenate away from the office in the evening — you might be doing more harm than good. Most employees, especially your high achievers, are likely to feel guilty or anxious when they can’t stay for dinner. That perk quickly becomes a stressor that drives people away.
As Arianna Huffington explained in her keynote, supporting employees’ priorities — like being home in time for dinner — matters because today’s workforce values work-life balance even more than increases in pay. And employees want you to value what they value. That’s why best-selling author and multi-generational workforce expert, Lindsey Pollack, Yale University’s Raina Sorgenti, and Ovia’s Shauna Murphy Cour dedicated their session to innovative benefits that support families and help retain more working parents and women.
A recent study by Ovia found that 90% of members would consider moving to a new company (in the same role) if it had better family benefits. It’s clear that family-friendly policies are a key to retention. The top three most-requested benefits are fertility, maternity, and parenting support; longer and more flexible parental leave with gradual return-to-work options; and better return-to-work planning. Other popular requests are caregiving benefits, coaching for pregnancy, postpartum, parenting, and mental health support.
2. Physical and mental wellness programs need a makeover
The pandemic has helped us come to an important collective realization: physical and mental health are workplace issues. And there’s a lot more we can be doing to support employees’ wellness. This year’s SHRM speakers shared plenty of ideas for reinventing health and wellness at work.
One of the top actions employers can take is to provide comprehensive wellness benefits for everyone, including extra safety nets for major life events (think: fertility, pregnancy, postpartum, early parenting, menopause, and times of grief and loss). These are moments when people are vulnerable to burnout and serious illness.
While we all know that physical health is key to maintaining a functioning workforce, many companies are realizing that they haven’t done nearly enough to support employees’ mental health. As Huffington explained in her keynote, “We’ve shared a collective delusion that burnout is the price of success.” But science tells us the opposite: when people care for themselves, set boundaries, and find balance, they’re able to be more productive and successful.
To really take advantage of this insight, leaders must buy into the idea that self-care and work-life balance are key to business success. Managers must share this message with employees and everyone must feel encouraged to find a healthy balance. Employees need time and permission to reset, and access to mental healthcare for issues such as depression and anxiety if they need it.
Improving mental and physical health resources isn’t just a nice benefit, it’s a business strategy. When organizations care for their employees, those employees bring their best selves to work, and they’re more likely to stay. When it comes to attracting and retaining employees, every business is a healthcare business.
According to a study published in the journal of Population Health Management, overall well-being is predictive of future employer outcomes related to health care, productivity, and retention. The estimated cost to employers of absence and performance loss from physical health issues alone is $225.8 billion per year, 71% of which stems from on-the-job productivity impairments. When employers were able to provide and impact wellness, they realized substantial health care savings, productivity gains, and turnover reduction by improving the well-being of their employees.
3. Flexibility is king
Employees (especially parents) need flexibility to maintain work-life balance. Flexible hours, remote and hybrid work options, and personalized return-from-leave programs are key for engagement, retention, and talent acquisition. In fact, according to Ovia’s recent survey, having a flexible work arrangement ranks as the third most important benefit for working parents today.
As so many of us have seen through the pandemic, embracing remote and hybrid work also means finding new ways to engage and support employees. In her SHRM session, Sonia Aranza, CEO of Aranza Communications covered some do’s and don’ts for building an inclusive hybrid workplace culture. She and other speakers offered tips including creating digital spaces for remote workers to build a shared culture and making sure teams have the collaboration tools they need to work together smoothly.
In another session, HR leaders talked about policies that give employees more flexibility. For example, Raina Sorgenti of Yale University described their generous leave policy that covers up to 18 weeks of paid leave and 36 position-protected weeks total. She also noted updated LOA policies that allow employees to take family leave without using up their sick leave first. This small change is a huge benefit for new parents who often need sick days to care for themselves or their children after their parental leave is over. It’s tweaks like these that give employees the flexibility they need to thrive.
4. Diversity and inclusion are the future
If you’re up on the research, you know that diversity can boost a company’s success and profitability. So you might be thinking about how to strengthen your own DEI initiatives. Speakers at SHRM had plenty of useful insights. To start: check your existing benefits to make sure they don’t exclude anyone. Are policies written in a way that’s accessible to everyone? Do they embrace all different kinds of families?
Once your policies are in good shape, add belonging to DEI. DEI&B means making sure employees feel they can bring their whole selves to work. That way, employees can focus their whole attention on work and don’t spend energy, or anxiety, keeping parts of their lives secret. That vital sense of belonging tells employees they don’t have to compartmentalize their lives. It’s the warmth that keeps employees cozy in their positions and with your organization.
To nurture DEI&B, develop your talent pipeline early and put your money where your values are: fund your ERGs and invest in benefits that close gaps in coverage for your workforce and ensure all employees feel welcome and supported.
5. Emotional intelligence is the heart of any HR strategy
While we can’t always anticipate the next HR challenges, the experts were clear on one thing — we’ll need to keep leading with emotional intelligence. While people tend to be their most reserved at work, we still need to recognize and address emotional wellbeing in the workplace so we can resolve conflict, lift people up, and get the job done. When everyone’s emotional needs are cared for, teams are set up to be cohesive and collaborative.
SHRM 2022’s point: it’s time for human-centered HR
Together, these five takeaways can be boiled down to one big idea: we’re all human, and we have the opportunity to care for our employees accordingly. Putting humans at the center of our HR strategies — through careful listening, wellness programs, DEI&B, and benefits based on our employees’ values — takes us a long way toward solving the biggest HR challenges, from attrition, to engagement and productivity.
Over the last few years, the workforce has changed in profound ways. Remote work and increased flexibility have become commonplace in many industries. But for some industries, the type of remote work many people ask for is just impossible. Universities and schools are among these.
The education industry, from a human resources perspective, has also been in turmoil over the past few years. Teachers and professors are increasingly burned out. Lack of pay and resources are leaving many school districts with a serious teaching shortage. HR leaders are left scrambling to find ways to retain staff, with the same or less resources.
There’s no silver bullet to retention, or the teaching shortage. But, some are turning to benefits as a creative way to improve retention packages for their staff. But what benefits can entice staff to stay? Let’s consider who your staff is and look at successful benefits packages from other schools.
Customizing benefits to meet the needs of staff
A review of today’s education industry reveals a clear picture of staff. In the US, women make up 76% of K-12 teachers and 54% of principals. In higher education 49.8% of all college professors are women,
According to the National Center for Education Statistics, the average age for a teacher spans between 30 and 49 years of age.
- Under 30 years: 15%
- 30 – 49: 56.9%
- 50 – 54: 11.6%
- 55+: 16.5%
This full breakdown shows some interesting trends. Ages suggest they’re in key childbearing years or approaching perimenopause and menopause. Given these demographics, investing in a women’s health benefit solution is only rational.
The sentiment was echoed in a recent survey of Ovia members, where 96% of women of this age considered family friendly benefits to be important. Many were asking for things like extended maternity leave, digital health tools to help them track and manage their health during pregnancy, fertility and family-building benefits, access to specialists who can help them manage postpartum health, mental health and baby care such as sleep or lactation coaching.
Maternity care isn’t the only area where members called for more help. Twenty-six percent of respondents told us that their current benefits don’t do enough to support women’s health overall.
For example, nearly 70% told us that they don’t know enough about menopause, and nearly half were eager to learn more about it. For many respondents, menopause support would be a timely intervention — more than 10% were already experiencing perimenopause symptoms.
While women’s health isn’t the only benefit that helps build a strong and attractive retention package for those in education, it is clearly extremely important to women in the workforce today.
Lessons learned from one university
That was the lesson that one university learned recently. In a post-Covid world, employee retention is all about understanding what employees value most and creating a culture that supports work-life balance. Where you may not be able to offer flex scheduling or remote options in education, there are things you can do.
In a recent panel discussion, Yale University’s Raina Sorgenti, was joined by Ovia Health’s Shauna Murphy Cour and multi-generational workforce expert, Lindsey Pollack to discuss what has worked for Yale thus far.
One of the top pro tips they learned was to embrace the entry (or stay) interview. Speak with employees early to find out what they value outside of work and ensure their role fits their priorities. For example, an employee whose priorities revolve around their role as a parent may say that being able to pick the kids up and be home for dinner is everything to them. For this person, flexibility is key and should be built into their role. Knowing and protecting employees’ priorities helps to ensure their long-term happiness at work.
The experts also stressed investing in a culture and policies that truly match the values of your workforce. For example, if you’re spending money on free dinner at 6:30 each night, but your employees are family-focused — or just need time to rejuvenate away from the office in the evening — you might be doing more harm than good. Most employees, especially your high achievers, are likely to feel guilty or anxious when they can’t stay for dinner. That perk quickly becomes a stressor that drives people away.
And employees want you to value what they value. That same Future of Family Friendly study quoted earlier found that 80% of members would consider moving to a new company (in the same role) if it had better family benefits. It’s clear that family-friendly policies are a key to retention.
These leaders explained how family-friendly policies that give employees more flexibility don’t always mean WFH. For example, Sorgenti described their generous leave policy that covers up to 18 weeks of paid leave and 36 position-protected weeks total. She also noted updated LOA policies that allow employees to take family leave without using up their sick leave first. This small change is a huge benefit for new parents who often need sick days to care for themselves or their children after their parental leave is over. It’s tweaks like these that give employees the flexibility they need to thrive.
What education leaders can do today
Together, these takeaways can be boiled down to one big idea: We’re all human, and we have the opportunity to care for our employees accordingly. And when your employees are mostly women, investing in an end-to-end women’s health benefit may be in your best interest. Putting humans at the center of our HR strategies — through careful listening, wellness programs, DEI&B, and benefits based on our employees’ values — takes us a long way toward solving the biggest HR challenges, from attrition, to engagement and productivity.
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Want to learn how you can invest in similar women’s health benefits? Let’s chat.
Ovia Health, a Labcorp subsidiary, has served more than 18 million family and parenthood journeys since 2012. Ovia’s dedication to women’s and family health is founded in evidence-based data. As a result, Ovia is the only digital health solution clinically proven to effectively identify and intervene with high-risk conditions. The company’s 50+ clinical programs, including predictive coaching and personalized care plans, help prevent unnecessary healthcare costs, improve health outcomes, and foster a family-friendly workplace that increases retention and return to work. For more information, visit www.oviahealth.com.
Becoming a parent changes everything, especially for working moms. Of the 44 million mothers in the US, more than 75% work full-time1 — and many of them also do the majority of the housework and childcare. In fact, women in the US spend an average of two hours more each day on housework and childcare than men.2
And that’s just the day-to-day tasks. Women are also eight times more likely to stay home when a child is sick, and they’re the ones who most often manage complicated schedules of activities and appointments.3 This double-duty of work and parenting — the Mother Load — can lead to burnout, parental guilt and mental and physical health issues, even for people who’ve never experienced them before.
That’s why it’s so important for employers to help ease the burden on working mothers, especially when they’re transitioning back to work as new parents.
How heavy is the Mother Load?
In May, we celebrate Mother’s Day and Mental Health Awareness Month, so it’s the perfect moment to pause and consider how much we’re asking working mothers to carry, and the toll it takes on their wellbeing.
Let’s start with burnout at work. The pandemic has been a struggle for all of us, and reports of burnout at work are higher than ever. Nearly 60 percent of millennials (those in their childbearing years), reported symptoms of burnout in the last year.4 But it’s not just that burnout is skyrocketing — in a study across all ages, researchers found that the gender gap for burnout has nearly doubled. In 2021, 42% of women reported burnout compared to 32% in 2020. For men, 35% experienced burnout in 2021, compared with 28% in 2020.5 Burnout is a problem everywhere, but women are being hit the hardest.
This aligns with the changes we’ve seen in the workforce since the start of the pandemic. During the Great Reassessment, women faced impossible childcare situations and work policies that made it too hard to balance career and family. In the last two years, 3.5 million women decided their best option was to leave the workforce.6
Even without a pandemic, the Mother Load can be overwhelming. The challenges start early — postpartum depression (PPD), is one of the most common mental health conditions for new parents (though it’s significantly more common among women, men can experience PPD, too). The reported rate of PPD in the US is about 13.2%,7 but many women are never screened. Ovia’s research — including 13 million mental health screeners we’ve delivered to our community — suggests that the true rate is closer to 30%. During the pandemic rates of distress rose higher, especially for BIPOC (Black, Indigenous, people of color) mothers, first-time mothers, and mothers between 35-39.
If you’re an employer, the Mother Load matters
All companies want to attract and retain the best employees — and we all know that losing talent is disruptive and costly. So, if you are considering how to update your policies and benefits, easing the Mother Load for new parents is one of the most impactful things you can do. Here’s why:
- As we’ve seen over the past two years, when the burden of balancing a job and family is too much, employees leave. In fact, according to a recent Ovia survey, 90% of employees said they would likely take another job if it offered better family benefits.8
- New mothers between the ages of 35-39 are among those who’ve suffered the biggest increase in mental health challenges during the pandemic. These are your mid-career managers — employees you can’t afford to lose.
- Postpartum depression usually presents three-to-six months after a baby is born — which is just about the time mothers are returning to work. This means that employers have a unique opportunity to provide help when it matters most.
- Mental health challenges are the tip of the iceberg. Even if employees can muddle through, mental health issues can contribute to costly physical health problems, too.
How to build a better return-to-work program with mental health support
A comprehensive return-to-work program needs to begin before maternity leave and continue well after parents are back on the job. Here’s what’s important at each step of the process.
1: Get ready before it’s time for leave.
Most women decide whether they’re coming back to work before they go on maternity leave. So to retain employees, you need to offer support early. This begins with the very first interaction a parent-to-be has with her manager. Managers need training about how to respond well to a pregnancy announcement, use supportive language throughout the process, and notify the rest of the team in a positive way.
After the initial announcement, employers should connect employees to the benefits they’ll need, create a pre-leave plan that helps ease stress and ensures continuity for teams while someone is on leave, and plan for a stop date (along with a backup plan if the date comes early).
Since benefits can be hard to understand, it’s also useful to create a simple, easy-to-read summary that explains FMLA, STD, and other policies. Getting pre-leave right takes a lot of knowledge and planning. That’s why Ovia’s training programs help managers every step of the way.
2. Protect a calm and peaceful leave.
Once an employee is on maternity leave, support them by making sure they don’t receive work messages or feel pressure to keep working. Ask in advance if they’d like to share updates or photos with their team — and respect their wishes.
During leave, check in to be sure employees are receiving all of their benefits. And even though it’s not necessary, a new baby gift is always welcome.
3. Make return-to-work as smooth — and flexible — as possible.
Returning to work after maternity leave is a huge adjustment. To ease the transition, consider offering a gradual return, with part-time or shorter hours for the first month or two. In addition to reduced hours, understand that new parents need flexibility to take children to doctor’s appointments or pick them up from daycare. You’ll take a huge step towards building a family-friendly culture if you make this kind of flexibility the standard, not a perk.
You can also ease the transition back by creating a project update and plans to help your employee catch up without feeling overwhelmed.
Mother’s rooms are another important part of return-to-work. Make sure the space you offer is private, comfortable, and reservable. Include a milk fridge, a comfy chair, and breastfeeding essentials, such as nutritious snacks and drinks. You can find more tips on mother’s room best practices here and here.
Since new parents are at risk for postpartum depression, consider how you can help destigmatize mental healthcare. Include mental health resources in your benefits conversations and let employees know how to access them. Beyond mental health support, ask managers and HR teams to check in regularly to find out if employees have all the resources they need. For more tips on supporting mental health for your employees, check out this expert panel.
While these best practices focus on new mothers who’ve just given birth, it’s also important to ensure that your policies are inclusive of new fathers and parents who adopt or use a surrogate.
Why now’s the time to address the Mother Load through mental health support and return-to-work — and where to start
Working mothers are a huge percentage of the workforce, and we can’t afford to keep losing them — which is what happens when we ask them to choose between their careers and their children. It’s time to establish better return-to-work policies, along with mental health support, so moms can manage the Mother Load. When employers support mothers at those moments when they need it most, employees remember — even when other offers come their way.
Do you need help with your return-to-work program? Ovia Health offers guidance, manager training, workshops, and worksheets for a supportive, inclusive return-to-work process. We are also one of the nation’s largest perinatal mental health screeners, having delivered more than 3.6 million digital risk screeners in 2021 alone. Ovia also offers 1:1 benefits navigators and certified coaches who can help ease the Mother Load every step of the way, from conception through birth and parenting.
1: Forbes: https://www.forbes.com/sites/lizelting/2019/08/21/why-women-quit/?sh=bc2874016fa7
2: Institute for Women’s Policy Research: https://iwpr.org/media/press-hits/women-do-2-more-hours-of-housework-daily-than-men/
5: Associated Press: https://apnews.com/article/coronavirus-pandemic-business-lifestyle-health-careers-075d3b0ab89baffc5e2b9a80e11dcf34
6: Associated Press: https://apnews.com/article/coronavirus-pandemic-business-lifestyle-health-careers-075d3b0ab89baffc5e2b9a80e11dcf34
7: Centers for Disease Control: https://www.cdc.gov/mmwr/volumes/69/wr/mm6919a2.htm?s_cid=mm6919a2_w
8: The Future of Family Friendly Report, Ovia Health: https://user.oviahealth.com/future-of-family-friendly/index.html?page=4
Working mom guilt is real, and it’s not as simple as “letting it go”
Sometimes the source of my parental guilt is easy to identify — like when I miss out on an evening with my kids to attend a work event, or when my baby cries as I leave for the office. Other times it’s more difficult to pinpoint, like when I’m just not “emotionally present” or when I rush the bedtime routine so I can find 20 minutes for myself at the end of the day. In these moments, while I may be physically present with my kids, I’m not truly engaged with them, which causes guilt. I know I’m not alone in this feeling.
In the workplace, HR leaders measure “presenteeism” — the state of workers being physically present but mentally unengaged or distracted. In the last few years, as work-life boundaries have blurred, are we now facing “parent presenteeism” in the home?
Working mom guilt is real, and it’s a sign that our support systems need a reboot.
What is parental guilt?
“Parental guilt can occur for a variety of reasons. Parents may feel that they’re working too much or that they aren’t devoting enough time to their children, offering the most nutritious meals, or providing their children with enough love,” says Tamika Simpson, perinatal mental health specialist and Ovia Care Advocate. “There is often some doubt as people try to be perfect parents. Parents compare themselves to those around them or to what they see others post about on social media.”
Why we can’t (and shouldn’t) just “let go” of our guilt
According to Dr. Komal Gupta, Psy.D. in Clinical Psychology specializing in maternal mental health and parental wellbeing, “The goal is not to do away with parental guilt completely. Parental guilt can be functional and informative at times. It can help us to evaluate whether changes need to be made if we did do something wrong or if there are ongoing challenges that require additional support. Parental guilt often occurs in the context of beliefs that we hold, unconsciously or consciously, about what parenting should look like. These beliefs are often rooted in internalized messaging that we have received from family, friends, culture, and society. The guilt that we experience in relation to unrealistic beliefs about parenting is less helpful in our day-to-day lives.”
Mom guilt is a symptom of a bigger, systematic problem
When I take inventory of all the things we feel guilty for as parents, the guilt looks less like a self-inflicted, universal emotion, and more like a symptom of a much bigger problem in parent infrastructure:
- Moms feel guilty if they don’t breastfeed for long enough when they don’t have access to paid parental leave, supportive work cultures, and functional lactation rooms.
- Moms feel guilty if they don’t spend enough time with their kids when their jobs aren’t designed to be flexible.
- Moms feel guilty when they don’t work outside the home to contribute financially to their households when the pandemic made it impossible for them to participate in the workforce due to school and daycare closures.
- Moms feel guilty when they return to work after having a baby when their parental leave period isn’t long enough or paid to enable them to do so in appropriate time.
- Moms feel guilty if they don’t have their “body back” when they’re required to return to work before their bodies have physically recovered from birth, and remain at risk for perinatal mood disorders.
- Moms feel guilty when they don’t prepare home-cooked, healthy meals for their children, when they don’t have the time or financial resources to provide them.
- Moms feel guilty when they don’t have the energy to be emotionally present with their kids when they’re exhausted by their workplace’s burnout culture.
Why this matters more than ever
Every parent is a working parent — whether their work is paid or unpaid, in or outside the home, part or full time, seen or unseen. In the United States, women perform an average of four hours of unpaid work per day compared to men’s two and a half hours. This might sound alarming, but as a mom of three myself, this average feels low when I consider the amount of headspace and energy I spend parenting beyond the hours of cooking and cleaning. This looks like: fostering healthy relationships between my daughters, ensuring each of them gets 1-1 mommy-me time, modeling healthy physical and emotional behaviors, searching for and shuttling them to enrichment activities, among many others.
Working parents have carried the mental load of the pandemic. Juggling work and home was a challenge before COVID-19 hit, but the pandemic made things worse. Parents are working overtime to support their families — navigating work from home or continuing to work in person while much of the country isn’t, dealing with a lack of childcare, school closures, constantly changing guidelines, and sick family members.
Since February 2020, when the pandemic began, more than 3.5 million moms have left the workforce — many due to childcare issues. Those who remain are struggling.
As parents, we have an expanding set of jobs to perform without an expanding amount of time to complete them. We need to reverse course in order to be present at home, productive at work, and — perhaps most importantly — mentally healthy. We need an intentional redesign of the concept of career and workplace productivity that is informed by parenthood and caregiving.
How employers can help
It starts with cultural expectations. When parents feel uncomfortable or penalized for calling attention to their values in setting boundaries in order to be a present parent — or to fully recover from and adjust to becoming a new parent — it not only creates lack of belonging, it causes psychosocial stress, which is a risk factor for mental health concerns. Parent mental health coach and Ovia care advocate Tamika Simpson shares, “There are plenty of things that people could feel parental guilt about, but there is no such thing as a perfect parent. Being a parent is hard enough without the added expectations we place on ourselves to be ‘perfect.’ You can be a great parent without being perfect.”
It’s essential that organizations have a framework for parents and caregivers to take the time needed to take care of their wellbeing — and that they feel encouraged to do so as part of their ability to thrive at work. Offering flexible leave and family-friendly benefits and making sure that these benefits are clearly communicated and easily accessible, contributes to a culture of inclusion that sets employees up for success. We know that in today’s world, family friendly benefits are no longer a nice-to-have. Employees are actively seeking employers that set them up to be the parent they want to be and have the career success they envision.
As the cofounder of Ovia Health, the leading family health solution serving over 17 million families and 2,000 employers and health plans, I have the honor and privilege to meet and speak with working parents day in and day out. I hear loud and clear that parents want:
- Paid parental leave, and more of it. In Ovia Health’s 2021 Future of Family Friendly Survey, we surveyed thousands of full-time working moms who had benefits prior to leave and recently had a child. They spanned age groups, job cohort levels, and industries across the nation from the c-suite in New York City to the front lines in Arkansas. Across these groups, better parental leave policies (including length and pay options) was the #1 consideration in selecting an employer. The science supports this takeaway, too — employers who offer longer paid leave help to reduce adverse outcomes after delivery, increase breastfeeding rates, and lower rates of perinatal mood disorders.
- Equal parenting at home and at work. A cultural shift is happening when it comes to the role of dads and partners. According to a 2020 Better Life Lab report on ‘the Opportunities for and Barriers to Equal Parenting in the United States, 31% of fathers shared that there were barriers preventing them from being the dads they want to be. Top responses included their paid jobs and a general lack of resources like money and time. We know it takes a village, and workplace cultures must shift to enable dads and partners to take on more responsibilities at home.
- Flexible schedules and remote options. Also in Ovia Health’s 2021 Future of Family Friendly Survey, moms shared that being thrown back into the deep end after having a baby was overwhelming, and can even exacerbate underlying conditions like postpartum depression. Parents need the ability to wade back into work at their own pace so they can execute strongly at work and adjust family demands as needed.
Easy-to-understand benefits, quality lactation rooms, child care assistance (like on-site childcare or financial support), mental health support, and equitable pay all enable employees to have quality time with their families without the fear of financial instability and are urgently needed.
It’s only when employers make systematic improvements and take action to care for parents’ wellbeing that we can be expected to “let go” of parental guilt.
Most of the time, we think of fertility as a very personal issue. For those who struggle, it can be a heartbreaking, lonely, expensive journey without nearly enough support. So this year for National Fertility Week, we’d like to bring that journey into the light–and talk about how fertility impacts people’s lives and work.
Even if you don’t realize it, there’s a good chance fertility issues are affecting your employees’ productivity and wellbeing right now, not to mention your healthcare costs and ability to attract and retain talent. But you can make a difference by offering fertility support with your benefits and helping break down the stigma around fertility at work.
Fertility issues are more widespread than you think—here’s why you’re not hearing about them
Infertility, the inability to conceive after trying for one year, impacts one in every six people of reproductive age worldwide —that’s about 1.34 billion people each year.1 In fact, fertility issues are as common as breast cancer, and even more common than type 2 diabetes.2 But, even though fertility issues touch so many people, you probably don’t hear a lot about them from your colleagues and employees. And there are lots of reasons why.
For one thing, there’s a taboo around reproductive health—especially women’s reproductive health—which makes it incredibly hard to talk about. On top of that, many people who struggle to conceive internalize feelings of guilt or shame. They may be afraid they’ll be judged, and often they don’t feel safe or comfortable talking about the problem. Many also worry that sharing their plans for building a family could put them at a disadvantage at work.3
Even if they aren’t talking about it, the struggle to conceive can have a deep impact on every part of a person’s life, from personal relationships to focus at work. The journey is exhausting, emotionally and financially, with painful disappointments made even harder by the challenges of finding good care. To put the impact of fertility issues into perspective, consider this: depression levels among people struggling with fertility are comparable to those of patients diagnosed with cancer.4
As workplace demographics change, women’s health is becoming a bigger issue at the office
Two major demographic shifts are making infertility a more important workplace issue than ever before. First, women make up more and more of the workforce. Second, as they focus on their careers, people are having children later, which increases the chances of fertility issues.5
Here’s a look at the numbers: By 2025 millennials will make up 75% of the global workforce. And the millennial workforce has a higher percentage of working women than any generation before—72% of millennial women are employed, compared to just 40% of the silent generation and 66% of baby boomers at the same age.6 Along with this increase in workforce participation, the average age for first-time motherhood has gone up 24% in the past ten years7—from 21 to 26. Men are having children later too, with the average up from 27 to 31 over the last decade.8
Though the numbers aren’t clear yet, COVID-19 may have an impact as well. US births declined during the pandemic9 and, according to a recent study from NYU, nearly half of the women in New York who’d been trying to become pregnant before COVID-19 stopped trying within the first few months of quarantine.10 As we begin to emerge from the pandemic, people may decide the time is finally right to build their families. But, now that they are two years older, they are more likely to face fertility challenges.
Why fertility benefits, coupled with maternity and family health support, are good business
Since more of your employees may be dealing with fertility issues, it’s worth considering how fertility support can save costs and help attract and retain employees.
When it comes to cost, the risk of adverse, and expensive, birth events (such as c-sections, preterm birth, and other complications) increases with maternal age.11 Since personalized, proven fertility support can help people conceive sooner, it can lower those risks.
Personalized fertility support can also help reduce the need for expensive fertility procedures such as in vitro fertilization (IVF). And even if you don’t cover IVF, the process can still raise healthcare costs because IVF increases the likelihood of multiple births—while a single birth costs an average of $21,000, births of multiples can cost up to $105,000 or more.12
And, while fertility support can save costs, it’s also important to realize that there can be some additional costs and risks. So how can you increase your benefit offerings and remain competitive without breaking the bank? Pair your fertility support with maternity and family health solutions that are proven to address and reduce avoidable adverse health events. When you combine the two, people may be able to conceive naturally sooner–or become more educated about reproductive technologies if they need them–and they’ll be more likely to get the care they need and understand their unique risks, both of which can lower adverse health outcomes. For example, when people know that advanced maternal age raises the risk of preeclampsia or preterm birth, they’re more likely to get the tests and treatments they need, watch for warning signs, and catch problems early, when they are easier (and less expensive) to treat.
An example of this in action, recently, a client discovered how important it is to pair fertility support with maternal and family health solutions. At first, the company decided to simply add fertility support to their benefits. But after one year–and millions of dollars in additional healthcare costs for multiple births and other health issues–they realized that they needed digital maternity and family support, too. Since implementing both (with Ovia Health as their digital and maternity support) costs have normalized, saving the company millions of dollars.
While it may seem like a lot to take on at once, adding fertility and maternity support can save you the cost of replacing employees and help you attract the best talent. That’s because, in our post-pandemic world, family-friendly benefits are more important than ever. According to a recent Ovia survey, 77% of working parents consider family-friendliness their number-one priority, and 90% would consider leaving for another job if it offered better family benefits.13
How to make a culture shift, and offer the benefits that matter most
Fertility struggles are difficult for so many reasons, from the emotional strain to the cost and the time for treatments, just to name a few. But we can talk about fertility until it’s not so stigmatized anymore, and offer benefits that help ease the burden.
The first step is culture change–we can create work cultures that are open, supportive, and understanding about the ways fertility issues impact peoples’ personal and work lives. We can talk often about benefits, and make it clear that women’s health—including fertility and maternity care—is a priority. We can train managers about the unique needs of employees who are struggling with fertility, and help them create environments that are supportive of the process.
We can also invest in fertility benefits that help families conceive earlier and with fewer complications. Programs that offer personalized fertility support are critical. So are programs like Ovia, which can partner with these fertility companies to provide maternal health care management, education, and one-on-one coaching to help families all the way from conception, through birth, and returning to work as new parents.
This year, for National Infertility Week, let’s make it okay to talk about fertility issues, and let’s offer meaningful support to those who are struggling.
1: World Health Organization: https://www.who.int/news-room/fact-sheets/detail/infertility
2: Sohrab, Serena and Nada Basir. Navigating Work While Undergoing Fertility Treatments. Harvard Business Review: https://hbr.org/2021/11/navigating-work-while-undergoing-fertility-treatments.
3: Sohrab, Serena and Nada Basir. Employers, It’s Time to Talk About Infertility. Harvard Business Review: https://hbr.org/2020/11/employers-its-time-to-talk-about-infertility.
4: Rooney, Kristin L., et. al. The Relationship Between Stress and Infertility. Dialogues in Clinical Neuroscience. 2018 Mar; 20(1): 41–47: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016043/
5: American College of Obstetricians and Gynecologists: https://www.acog.org/womens-health/faqs/having-a-baby-after-age-35-how-aging-affects-fertility-and-pregnancy
6: Teamstage: https://teamstage.io/millennials-in-the-workplace-statistics/
7: Centers for Disease Control: https://www.cdc.gov/nchs/products/databriefs/db232.htm#:~:text=Data%20from%20the%20National%20Vital,pronounced%20from%202009%20to%202014
9: United States Census Bureau: https://www.census.gov/library/stories/2021/09/united-states-births-declined-during-the-pandemic.html
10: NYU Langone Health: https://nyulangone.org/news/many-mothers-may-have-delayed-or-abandoned-plans-additional-children-because-covid-19-pandemic
11: American College of Obstetricians and Gynecologists: https://www.acog.org/womens-health/faqs/having-a-baby-after-age-35-how-aging-affects-fertility-and-pregnancy
12: CBS News: https://www.cbsnews.com/news/cost-of-having-baby-21k-for-single-birth-105k-for-twins/
13: Ovia Health: https://user.oviahealth.com/future-of-family-friendly/index.html
An interview with the National Birth Equity Collaborative (NBEC) about Respectful Maternity Care
Our system of birth care is broken. Black women are three-to-four times more likely to die from pregnancy than their white peers1—and most of those deaths are preventable.2 During labor, Black mothers are less likely to receive pain medication, and more likely to report that their providers didn’t address their pain adequately during delivery.3 The crisis impacts infants, too—Black and AIAN (American Indian/Alaskan Native) babies are twice as likely to die during their first year of life compared to white babies.4
Even though the numbers tell a clear story of racial disparity, we haven’t done nearly enough to improve experiences and outcomes for BIPOC (Black, Indigenous, and people of color) mothers and their children. Of course there are well-meaning providers who work hard every day for their patients, but the problem runs deeper. To reach birth equity, we need systemic change.
That’s where the National Birth Equity Collaborative (NBEC) comes in. In collaboration with Johns Hopkins University and Ovia Health, NBEC has developed a comprehensive framework that guides hospitals and health systems toward anti-racist healthcare practices, and provides practical tools to measure and track progress.
We talked with leaders at NBEC about why racial disparities run so deep in maternal and infant care, their practical on-the-ground work to improve birth equity, and what employers and payers can do to help.
Q: Tell us about the National Birth Equity Collaborative (NBEC). What’s your goal and mission?
NBEC creates transnational solutions that optimize Black maternal, infant, sexual, and reproductive wellbeing. We shift systems and culture through training, research, technical assistance, policy, advocacy, and community-centered collaboration with a vision that all Black mamas, babies, and their villages thrive.
The Research & Strategy Team works with all teams on funded and independent research, builds professional networks for birth equity, and eliminates silos in pursuit of NBEC’s strategic vision. We intentionally incorporate reproductive justice and decolonized methodologies in all of our research. We support NBEC’s programmatic teams and their research opportunities. We manage a large number of relationships and assist other NBEC teams with their activities towards our collective Strategic Plan. We create opportunities to publish original content and disseminate research.
Q: You use the term Respectful Maternity Care. Can you tell us what that means?
Respectful Maternity Care is a global movement. We have learned from partners at White Ribbon Alliance, with branches all over the world, that women and birthing people are asking for specific things and one is to not be disrespected at a time like childbirth. The problem is that the maternal health crisis in the U.S. is worsening, and we need a culture of Respectful Maternity Care to change it.
Maternal health inequities weigh on Black and Indigenous communities globally and every country is different with its cultural, social, and structural systems. The data in the U.S. shows that our inequity is due to structural and interpersonal racism. We need to be honest about how Black women are treated during maternity care.
Q: Why was it important to take a stand and create this framework?
Despite the prevalence of racist microaggressions and bias fueling disrespect in labor and delivery care in the U.S., there are limited tools that can measure disrespect or that encourage provider behavior change. Our systems acknowledge racism in maternity care and are exploring innovative anti-racist models for quality improvement.
NBEC has launched the Respectful Maternity Care Initiative, shifting the culture for all mamas!
Q: What challenges do diverse women face today in their healthcare?
All childbirth is a complex psychological and physical shift in a person’s life. It is undeniably natural and specifically medicalized, putting birthing people in precarious positions. The medical challenges that Black mamas experience can be due to chronic conditions or some pathologized illness. The challenges that we are trying to measure are specific to the intersectional experience of Black mamas in spaces that also dehumanize all birthing people.
Racial microaggressions are lumped into the familiar experience of disrespect felt by Black mamas. Unmeasured racism can impact Black maternal health, from the quality of prenatal care and the intake process, to being overstepped in consent procedures or pain crises being ignored.
Q: What impact do those challenges have on outcomes?
Institutional racism in health care systems prevents equitable funding, positive community collaborations, and even individual processes like patient complaint reporting. Equitable systems would be delighted to lead community collaborations that would increase the scale and impact of patient experience. The lack of energy towards these system-quality improvements highlights the lack of equity.
Providers have reported being overwhelmed and under-resourced in these inequitable systems. The most well meaning providers cannot appropriately care for birthing people when they do not have adequate time to listen, communicate, treat, and evaluate their patients. Crisis situations, overcrowded hospitals, and provider shortages exacerbate the harm that comes from unresponsive providers in a culture of overmedicalized birth. Provider burnout is apparent and dangerous to patients. Providers can take care of Black women respectfully when they are also fully present and well.
Every mama is an expert on their own body. If providers believed that, mamas would not have pain crises ignored, signs of hemorrhage questioned, and preventable deaths. Mamas would not have to get into squabbles with nurses about unnecessary restraints or have their requests to walk in labor or drink water denied. Applying this knowledge in labor and delivery is the beginning of shared decision making.
Patients are not trusted by their healthcare providers to be honest, to care for themselves, to follow directions, or to be autonomous over their bodies. The core of this challenge is that the medical system has created an environment of authority, fear, and dehumanization for Black mamas over time. These mamas are exhibiting a natural distancing between the agent of healthcare service, which is a response to not feeling safe. Mamas don’t need to be more trusting of health care systems, health care systems need to be more trustworthy.
Q: What does your Respectful Maternity Care framework look like? How does it work and who can use it?
The Cycle to Respectful Care is a theoretical framework based on the birth experiences of Black mothers, created to inform the ways hospitals and health systems achieve respectful care. This framework complements existing provider educational tools and promotes anti-racist and birth equity practices. The Respectful Maternity Care initiative bridges community assets to hospital care by centering the cultural, biopsychosocial, and holistic needs of Black mothers in order to reduce disparities in clinical and patient reported experience and measure outcomes for all birthing people.
A culture of respectful care would prioritize sexual and reproductive wellness for all people, whether or not they want to have a baby. Raising the bar for anti-racist care means we should expect our healthcare providers to prioritize tools created for, by, and with Black mamas.
Q: How can patient self-reporting and patient-driven care influence outcomes?
The data we need can only come from people with lived experience, because clinical data alone is not providing feasible solutions. Hospitals and health systems are aware of their inequitable outcomes. They engage in learning collaboratives, quality improvement initiatives, PDSA cycles, and short cycle solutions for poor health outcomes. Though some systems reap overall clinical benefits, they fail to correct the racial inequity. NBEC is trying something different by creating quality improvement tools that are rooted in the experiences of Black mamas in their own local contexts.
The most effective health improvement models, to date, are created by health science research scholars and health care providers in the Black Mamas Matter Alliance network. They use research methodologies and implementation science to legitimize community knowledge. Dr. Karen Scott’s SACRED Birth Initiative, Aza Nedhari’s Mamatoto Village, Jennie Joseph’s The JJ Way, and Black Women Birthing Justice are all examples of systems solutions with Black families at the helm.
Q: How can payers and organizations help make systemic change toward birth equity?
Those aforementioned solutions that lead to respectful maternity care are fighting towards validation and scalability. Quality improvement tools created by, for, and with Black communities are on the long trail to being considered evidence-based, which includes a history of tests, evaluations, and manuscripts. The other path to advancement is the strategic plan of payment systems. Employers and insurance companies hold significant power and can choose to invest.
The Affordable Care Act of 2010 was an excellent example of a culture shift of payment systems towards quality of care. One of the policy suggestions, in addition to expanding Medicaid, was extending the postpartum health coverage to one year for all birthing people. There are only five states that have made that policy shift, today. Medicaid is the number-one payer of childbirth medical services, covering over 42% of birthing people. This sets an undeniable precedent for what is considered standard, and other payers follow.
One way to leverage this power is to challenge hospitals and healthcare facilities to change behavior in order to change outcomes. Having them partner on and invest in pilot phases of new anti-racist measures, like NBEC’s Respectful Maternity Care Patient Reported Experience Measure, is a specific action for this goal.
Have questions about how your organization can improve birth equity? Reach out to NBEC, a team of advocates for change in the Black maternal health and infant mortality crises. And get in touch with Ovia to learn about data-driven solutions for reproductive health, family building, pregnancy, and parenting.
1: Howell, Elizabeth A. Reducing Disparities in Severe Maternal Morbidity and Mortality. Clin Obstet Gynecol. 2018 Jun; 61(2): 387–399. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5915910/
2: Centers for Disease Control (CDC): https://www.cdc.gov/mmwr/volumes/68/wr/mm6818e1.htm?s_cid=mm6818e1_w
4: March of Dimes: https://www.marchofdimes.org/materials/March_of_Dimes_2021_Full_Report_Card_11152021_v1.pdf
I’ve worked in healthcare leadership for 20 years, and I specialize in diversity, equity, and inclusion (DEI). But even with all of that experience, some things still shock me—like when I see the numbers and hear the stories about how our healthcare system continues to fail Black mothers and their children.
The good news is that we already know what health plans and healthcare organizations can do to change the system and improve healthcare and birth equity for people of color. Now what we need is action.
True stories of a real-life Black mother
Before we dive into solutions, let’s consider what it really means to say that the healthcare system is failing Black mothers. First, the numbers: it’s estimated that non-Hispanic Black women are almost four times more likely to die while pregnant, or within a year after childbirth.1 Black mothers are also less likely to receive pain medication during birth, and are more likely to report that their pain wasn’t adequately addressed by their providers during labor and delivery.2
The stress of the lived experiences of racism in our daily lives, and in medical care, add to this burden, especially when it comes to our mental wellbeing. Up to 28% of non-Hispanic Black women experience perinatal depression.3 This problem has grown during the pandemic, with a 10% increase in severe symptoms of depression and a 26% increase in reports of suicidal ideation among BIPOC (Black, Indigenous, people of color) mothers.4
During my first pregnancy, I thought that my academic and professional background would make my experience different, but I was wrong. Early on in the pregnancy, I had some health concerns, so I requested an extra ultrasound. This is how my doctor discovered that I had a short cervix, a condition that can lead to preterm labor and pregnancy loss. To lower my risk, I needed a cervical cerclage, a routine procedure that includes a spinal tap, made even more stressful because I was in the middle of a cross-country move. Now I needed to find a new provider, in a new city, who could manage my condition.
Finding a new doctor can be difficult anytime, and I was fortunate that I knew how to proceed—I needed an in-network provider with a low c-section rate and cervical cerclage experience. I managed to track down the one doctor who fit the bill in my new city. But just imagine trying to find that needle in a haystack—so you can get safe care—without a healthcare background to guide you. The complexities of benefits and navigating the healthcare system are serious barriers to care that we need to address for everyone.
But I was lucky, and I got all of that figured out. Still, my labor was so much more difficult than it should have been. I knew that I’d need my cerclage removed before labor, which is fairly normal and was planned when my doctor scheduled my induction. I arrived on a Tuesday, and didn’t have my baby until 4:00 a.m. on Thursday. During 30 hours of labor, I saw many different care teams—some that were wonderful, and some that treated me with very little respect or compassion. I felt that my care teams weren’t addressing my pain even half as much as I needed, and I kept wondering, ‘Is it me, or is it something else? Is it because I’m Black?’ Even having that thought is traumatic.
When the team switched and my doctor returned for my delivery, I was grateful. I gave birth to a beautiful, healthy daughter. But I also knew that I needed to report the hospital for discrimination. To my surprise, no one at the hospital was surprised—in fact, one particular nurse seemed to have a reputation for poor bedside manner. I wondered how this could be. Why hadn’t the hospital already made moves to address the problem?
The more I thought, the more questions I had. If I, as a well-educated, financially secure woman with a master’s degree in healthcare administration, had such a hard time getting through the system and advocating for myself, how can we expect people without those advantages to make their way? How can we educate women about their health needs and make sure they are able to find the care they deserve? And how can we advocate for safe, respectful care for everyone, especially women of color?
These questions brought me to Ovia Health, where we’re working every day to improve birth equity and help employers and payers support people all along their parenting journeys.
How healthcare organizations can do right by Black moms
The roots of inequity, especially when it comes to maternity care for people of color, run deep in healthcare. That’s why change has to run deep too. Healthcare systems need to take an honest look at their practices and find the places where bias creeps in. From there, they need to train providers on equitable care,set goals for change, and hold themselves accountable to realize that change.
However, healthcare systems need accessible, evidenced-based tools to build this new, intersectional future of maternal care. Ovia partnered with the National Birth Equity Collaborative (NBEC) to create practical tools and supporting infrastructure for better birth outcomes. The core of our project is to elevate Respectful Maternity Care (RMC), a framework built by Black moms, for Black moms, and how healthcare systems can begin to deliver respectful maternity care to their patients. RMC tools help healthcare organizations:
- Critically evaluate their health systems to identify where they are failing women of color, and where changes are needed.
- Recognize implicit bias at all levels of healthcare administration, especially providers, and deliver training to address bias in patient interactions
- Train providers on how to incorporate patients as equal decision makers in their care, restoring power to historically disempowered groups.
- Adopt an equitable, intersectional, and measurable standard of respectful maternity care, create goals for improvement, and track progress through patient feedback loops.
How Ovia is empowering Black mothers
Though top-down, systemic change within healthcare is essential to achieve equitable care, patients too can drive change by demanding the quality care they deserve from their providers.
That’s another way Ovia is helping to make change–we’re empowering our members, particularly Black women, with the information they need to understand what respectful maternity care looks like and how to advocate for it throughout the reproductive health journey.
Ovia’s diverse team of one-on-one health experts and care advocates are the strong support system walking with mothers day in and day out through the entire parenting journey. Our new Empowered Beginnings clinical module magnifies the unique experiences of Black women navigating motherhood. It includes guidance for building a birth team, education on types of care team members like midwives and doulas, and frameworks for building a birth plan. The module also:
- educates members on the importance of a strong support system to advocate for you before, during, and after their pregnancy
- provides information on what to expect during pregnancy and postpartum
- offers detailed physical and mental health screeners tailored to the unique health risks of Black mothers.
Now’s the time to make care equitable for Black mothers
From my personal experiences, and my professional vantage point, I can tell you that the time for change is now. We need to define reproductive justice and respectful maternity care, and begin the work toward deep and lasting change. This means training providers and setting clear goals so we can keep our progress on track. We also need to support Black mothers every step of the way.
Every day, I’m alarmed by disparities in maternity care. But I’m also optimistic. We know how to make change, we know how urgently it’s needed, and together, we have the power to achieve birth equity.
Kami Wigginton is Ovia Health’s Director of Payer Solutions. For 20 years, Kami has been a leader in sales, solutions, and client services in healthcare, wellbeing, and health information technology for some of the industry’s most innovative organizations. Kami holds a bachelor’s degree from the University of Alabama, a master of health administration from Belhaven University, and a certification in Diversity, Equity, and Inclusion from Northwestern University. And she’s the mother of two amazing daughters, 10-year-old Simone and 4-year-old Sutton.
1: Juanita J. Chinn, Iman K. Martin, and Nicole Redmond. Health Equity Among Black Women in the United States. Journal of Women’s Health. Feb 2021: 212-219: http://doi.org/10.1089/jwh.2020.8868.
3: Juanita J. Chinn, Iman K. Martin, and Nicole Redmond. Health Equity Among Black Women in the United States. Journal of Women’s Health. Feb 2021: 212-219: http://doi.org/10.1089/jwh.2020.8868.
4: Ovia Health: https://www.oviahealth.com/blog/digital-depression-screener-data/
Why working moms are leaving their jobs–and what employers can do to retain and attract female leaders
It’s not our mothers’ workplace anymore. Today, nearly half of the US workforce is women,1 and nearly one-third of us are moms.2 But even as our numbers have grown, and even as we’ve watched glass ceilings shatter to the ground, the workplace hasn’t kept up.
In so many cases, women are still punished for having children. It happens through subtle biases, and it’s written into policies and benefits that don’t support the needs of mothers. But the fact is, companies need women to succeed, and replacing working moms who are nudged out or burned out is too expensive to be sustainable. To solve the problem, companies need to embrace family-friendly policies that allow mothers to balance their lives and thrive at work.
About the time I got pregnant–and fired–and other mothering-at-work stories
Before we can talk about how to make things right, we need a good sense of what women face each day at work. I’ll start with my story.
As a Black woman, I was taught that I should go to college, launch a career, and then prioritize starting a family. For a lot of us, this means that we’re suddenly in our thirties and facing huge hurdles. We have to balance work while navigating an often-biased healthcare system, potentially sort out fertility challenges, and then battle the stigma of taking time off for maternity leave.
This is where I found myself not all that long ago (in 2011). I was thriving in my sales job when I became pregnant with my first child. Delighted, and nervous, I waited through the first trimester and then went to my manager to share my news and create a plan for my maternity leave and return to work. It was Friday. By Tuesday I was fired. On Wednesday, still not sure why I’d been let go, I asked for the termination cause in writing. By Thursday the company had clearly realized they’d violated the law and their own policies, so he re-hired me. Thus began one of the most stressful chapters of my professional life—figuring out my maternity plans with three men in charge of my job security.
Remember, this was only 11 years ago—and this kind of thing STILL happens. Women are still stigmatized and punished for growing their families. And while a flat-out firing might be relatively rare, so many women can tell you about losing out on a big project or promotion, or just feeling the disapproval of their colleagues and the exhausting lack of support.
Right now, we’re seeing significant fallout from poor treatment of women in the workplace. Since February of 2020 we’ve been in the Great Reassessment—more than 3.5 million mothers of school-age children have left their jobs.3 And it makes sense. The pressures of a workplace that wasn’t designed for us to succeed were always there, and then the lack of childcare during the pandemic broke us.
While the unfair treatment of working moms is clearly wrong, it’s also bad business. If companies want to keep the best talent, and attract tomorrow’s leaders, they need women, and they need working mothers. It’s time for companies to invest in culture, benefits, and training that make it possible for women to stay and grow in their careers.
Here’s what employers can do to change the game for working moms
If you’re an employer, these are steps you can take to help working moms now:
- Create a family-friendly culture. There are lots of big and small ways to let your employees know that you value families, from making it okay to pick up kids from school in the afternoon, to being flexible about doctor’s appointments. You can also improve lactation rooms, train managers to support parents, create parent resource groups, and help with parental leave planning. One of the most concrete ways to make a culture shift, and improve employee retention, is to invest in tools and programs (like Ovia), that help educate and support parents on their journey.
- Help your employees know about—and understand—their benefits. Since most people aren’t benefits experts, you can help them discover and take advantage of key programs. Train managers to talk about benefits, create a benefits checklist to circulate several times each year, and review your benefits materials to make sure they are clear, simple, and inclusive of all employees.
- Create return-to-work programs for parents. Coming back to work can be physically and emotionally overwhelming. To help, consider gradual return-to-work programs that let parents build back to their regular schedules slowly. Create pre- and post-leave checklists and training to help employees feel prepared (Ovia offers training, checklists, and workshops). And train your managers about parental leave.
- Make sure your family policies are inclusive and equitable. Re-read your policies to make sure they support all kinds of families, including LGBTQIA+ families, single parents, families that are adopting or using a surrogate, people who don’t have experience navigating the healthcare system, and non-English speakers.
- Stay flexible and understanding. If possible, help employees create a routine that meets their parenting needs, from hybrid remote work to flexible working hours, gradual return from leave, and leave for parents experiencing pregnancy loss.
- Extend leave time. This is a pro-active investment that can save costs in the long term. Research shows that every extra week of parental leave reduces the risk of adverse maternal and child health outcomes, including infant mortality.4 So, adding a bit more leave may change your employees’ lives and lower your healthcare costs. Additional leave may also help save costs by retaining employees—in a recent survey by Ovia, 90% of respondents said they’d leave their employer for better benefits, and more paid parental leave was their number-one request.
- Invest in comprehensive family benefits. Benefits like fertility support, virtual-first health support, coaching, and milk shipping help build a foundation for a family-friendly culture.
What’s ahead for working moms
If there’s a silver lining to all we’ve been through with the pandemic, it may be that we finally have a clear view of the ways work isn’t working for women. And that gives us a once-in-a-lifetime opportunity to rebuild. We know how to create supportive, family-friendly workplaces, and we can work together to make it happen. It will be a game-changer for women now, and a profound gift to our daughters.
Kami Wigginton is Ovia Health’s Director of Payer Solutions. For 20 years, Kami has been a leader in sales, solutions, and client services in healthcare, wellbeing, and health information technology for some of the industry’s most innovative organizations. Kami holds a bachelor’s degree from the University of Alabama, a master of health administration from Belhaven University, and a certification in Diversity, Equity, and Inclusion from Northwestern University. And she’s the mother of two amazing daughters, 10-year-old Simone and 4-year-old Sutton.
1: Institute for Women’s Policy Research: https://statusofwomendata.org/earnings-and-the-gender-wage-gap/womens-labor-force-participation/#:~:text=Women’s%20increased%20labor%20force%20participation,in%201970%20(Fullerton%201999)
2: United States Census Bureau: https://www.census.gov/library/stories/2020/05/the-choices-working-mothers-make.html#:~:text=Working%20mothers%20make%20up%20a,%25)%20of%20all%20employed%20women
3: Associated Press: https://apnews.com/article/coronavirus-pandemic-business-lifestyle-health-careers-075d3b0ab89baffc5e2b9a80e11dcf34
4: Ruhm C.J. Parental leave and child health. J. Health Econ. 2000; 19:931–960: https://pubmed.ncbi.nlm.nih.gov/11186852/.
The last two years have been a difficult chapter in women’s history. The pandemic made it clear that the world of work was never set up to support women, especially when times get tough. And we were reminded that women’s health—both physical and mental—is still so taboo that women often don’t get the care they need.
What’s more, women in the work are underrepresented and sometimes still discriminated, even though companies who have gender diversity on their executive teams were 15% more likely to experience above-average profits.
So, we have a proposal for how to truly honor International Women’s Day, Women’s History Month and women’s health all year round. Let’s come together to make practical, long-overdue changes for working women.
How the pandemic hit working mothers hardest
From the beginning, the pandemic upended childcare options, and women bore most of the burden. They found themselves with the herculean task of managing work and childcare at home. Many struggled to patch together scarce childcare resources so they could go out to work.
For some, the balancing act wasn’t sustainable—3.5 million women have left the workforce since the start of the pandemic.1 Among them, 32% say they left because of childcare.2
For those who didn’t leave, pandemic parenting took a toll on mental health. Nearly 60% of employees of childbearing age say they’ve experienced burnout recently.3 And Ovia’s depression screener data reveals how deep those problems run for working mothers, especially first-time and BIPOC mothers. Comparing data before and during the pandemic, we found that:
- Women aged 30-34, reported an 11% increase in moderate-to-severe depression symptoms. For women 35-39 it was a 22% increase and a 24% increase in reports of suicidal ideation.
- Among BIPOC (Black, Indigenous, and people of color) mothers, we saw a 10% increase in reports of severe depression symptoms and a 26% increase in reports of suicidal ideation.
- Among first-time mothers, there was an 11% increase in reports of moderate depression symptoms and a 7% increase in reports of suicidal ideation.
These numbers reveal a pre-existing condition. In the US, mothers have always faced unequal burdens at work. Often, women who go on maternity leave or take time to pick up their children from school or take them to doctor appointments report losing out on big projects and promotions. In extreme cases, they may get fired after announcing a pregnancy. But even when things go relatively smoothly, the culture of work can wear women down. They’re exhausted from the many daily reminders that parenting is considered a nuisance in the workplace.
The biggest day-to-day challenges for working mothers are the return-to-work process, a stigma surrounding women’s health issues and bodies, and lack of leave. Here’s how the pandemic made these things even harder—and what we can do to help.
Return-to-work is broken
In the best of times, returning to work after maternity leave is stressful, especially when managers aren’t supportive, and when women don’t have options for gradual re-entry. But over the last two years, new mothers heading back to work felt even more alone. According to Ovia’s analysis of almost 3000 parents on how COVID-19 has impacted return to work, 68.8% of working parents reported feeling like they had less support from friends, family, and work as a result of the pandemic.
Without support networks, many parents had to change their RTW plans. 80% had planned to return as soon as their leave was up, but only 44% were able to do so.
As you’d imagine, mothers were usually the ones to delay—56% of women weren’t able to return as planned compared to only 12.8% of men. Among those who changed their RTW plans, 26.8% delayed their return to work or quit entirely, while 14.5% returned remotely.
Among parents who delayed their return, COVID-19 was a one of the biggest factors:
- 63.2% said they didn’t feel safe with their childcare options, or simply couldn’t find childcare at all.
- 39.7% said they didn’t want to return because they were concerned about how COVID-19 could impact their family’s health.
- 27.8% reported that they were too stressed and needed more time before returning to work.
- 18.4% were struggling with postpartum depression.
Respondents were clear that they needed more flexibility to make return-to-work possible: nearly 60% said they would be more likely to return, and return faster, if they had remote or flexible hybrid options.
We still stigmatize and ignore women’s health
At nearly every stage of life, our culture stigmatizes women’s bodies. So it’s no wonder that so many women are uncomfortable talking about the health concerns that impact their happiness and professional productivity—things like pregnancy loss, PCOS, endometriosis, period pain, pregnancy health issues, and menopause. And since few people are talking about them, it’s easy for companies to believe that these issues are simply too niche; that they don’t need attention or support.
But that fact is, supporting women’s health isn’t niche at all—it’s about addressing the needs of 52% of the population.
And amidst the Great Reassessment—as many women have realized that they need better benefits to balance work and family—employers can no longer afford to ignore women’s health. In fact, in Ovia’s recent family-friendly benefits survey of 2,919 parents, 90% said they would likely leave their employer for a position with better benefits.
So what can employers do to help keep and attract talent? They can offer benefits that meet women’s needs, including quality support for fertility and physical and mental health. This includes programs that offer accessible health knowledge, discreet expert consultation, and screening and symptom tracking based on each woman’s specific risk factors.
We’re way behind on equal pay and parental leave
It’s 2022 and women still make 18% less than men in the same jobs—that’s just 82 cents for every dollar.4 And when it comes to paid leave to care for a new baby? We’re the only wealthy country in the world that doesn’t have it.
Paid leave may sound like an expensive benefit, but it’s key to retaining employees (according to Ovia’s family-friendly benefits survey, paid leave is the most-requested improvement for working families) and it actually saves employers money.
Consider this: on average, it costs one-and-a-half to two times an employee’s salary to find a replacement. So if you have an employee who makes $75,000 annually, it can cost up to $150,000 to replace them. But three months of paid parental leave and three months of unpaid FMLA leave cost $56,250 (this includes paid leave, lost productivity, and a temporary replacement).
On top of these savings, research shows that every extra week of parental leave reduces the risk of adverse maternal and child health outcomes, including infant mortality.5 So, adding leave may have a profound impact on your employees’ lives and lower your healthcare costs.
10 ways we can fix work and change women’s history
These simple, important changes can take us a long way toward creating a woman- and family-friendly workplace:
- Offer adequate paid leave.
- Provide flexible remote or hybrid schedules when possible.
- Choose comprehensive, inclusive benefits that address women’s health concerns and offer support at any stage in their life – from cycle tracking to fertility and pregnancy to parenting and into menopause.
- Create return-to-work training and programs that help parents build a transition plan and return gradually.
- Train managers to cultivate a family-friendly culture and support return-to-work programs.
- Provide private, comfortable, bookable mother’s rooms. (Learn how to improve your lactation rooms from the CEO of Milk Stork and the CEO of Pumpspotting.)
- Establish employee resource groups for parents to build community and provide a sounding board for employers.
- Offer childcare options, including paid emergency childcare and childcare stipends.
- Make your benefits easy to understand.
- Provide resilience training and mental health services to support the wellbeing of employees and prevent burnout.
If you’re a working parent, you know how much these benefits would have helped you to be there for your family and bring your best to work.
Now, as we rebuild from the pandemic, and with women’s workforce participation at a 33-year low,6 better benefits and a more family-friendly culture are more pressing than ever. Without them, companies won’t be able to maintain the workforces they need to succeed.
So let’s celebrate Women’s History Month by building a workplace that not only supports and respects working mothers, but celebrates their stories, values and contributions. Together, let’s change the course of women’s history.
1: Associated Press: https://apnews.com/article/coronavirus-pandemic-business-lifestyle-health-careers-075d3b0ab89baffc5e2b9a80e11dcf34
2: New York Times: https://www.nytimes.com/interactive/2021/02/04/parenting/working-moms-coronavirus.html
5: Ruhm C.J. Parental leave and child health. J. Health Econ. 2000; 19:931–960: https://pubmed.ncbi.nlm.nih.gov/11186852/.
6: Payscale: https://www.payscale.com/research-and-insights/gender-pay-gap/
Understanding Black Women’s Birth Experiences So We Can Improve Outcomes and Equity
If anything, the last few years proved that when the need is urgent, organizations can move mountains to improve health and safety with unprecedented speed. Now that we’ve discovered what payers and employers are capable of, it’s time to pool our collective power, as communities, health experts, and corporations, to make birth safe, respectful, equitable, and inclusive for everyone.
That’s why we recently joined forces with the National Birth Equity Collaborative (NBEC) for their Justice & Joy Holiday Event, an event that raised, celebrated, and supported the voices and experiences of Black mothers and birthing families in response to the Black maternal health crisis and blatant lack of birth equity. At the event, speakers and attendees discussed birth experiences, deep and persistent barriers to respectful and quality care, and tools to help improve birth equity. Events such as this are important because they help to identify some of the most important steps employers and payers can take right now to address birth inequities, and provide a safe space for Black mothers to examine and explore shared experiences.
“It’s important that birthing people are armed with tools and information that supports their health and wellbeing,” says Joia Crear-Perry, MD, FACOG and the founder and president of NBEC. “With Justice & Joy, we wanted to create space for our audience to share their experiences and hear from others. The liberating nature of these events is essential if we want the community to truly absorb the information and share it with others.”
Confronting health disparities for mothers of color and their babies
There is a crisis in maternal and infant health in the U.S. Black and AIAN (American Indian/Alaskan Native) women are two to three times more likely to die from pregnancy-related complications compared to their white counterparts1, and most of those deaths are preventable.2 The crisis impacts children, too—Black and AIAN babies are twice as likely to die during their first year of life compared to white babies.3
These disparities persist, regardless of income or education. In fact, a college-educated Black mother is at 60 percent higher risk for maternal death compared to a white or Latina woman with less than a high school education.4
Beyond birth outcomes, women of color often receive a different quality of maternity care. For example, recent research found that Black and Hispanic women are given less pain medication after labor compared to white women, even though they rate their pain higher. Women of color are also less likely to receive a prescription for pain medication when they leave the hospital.5
So what’s at the root of these disparities?
Many researchers and healthcare providers agree that high maternal mortality and morbidity rates among women of color are a result of structural racism within the healthcare system.6 Hearing from and addressing the disparities for those with the worst health and birth outcomes will ultimately help improve access to birth equity for all mother and birthing families.
But what are the experiences and access issues women face today? And how can organizations identify where they can help? The experiences shared at the event made some of the most pressing issues, and opportunities for improvement, more than evident.
The Black birthing experience: A tale of two deliveries
To move toward birth equity, we need to understand the numbers and listen to the lived experiences—positive and negative—of real people. That was one of the goals of Justice & Joy.
“As a result of the trauma Black birthing folks and families endured in 2020 and 2021—the pandemic, social unrest and police brutality, and numerous viral Black maternal mortality incidents—we wanted to create an event to celebrate, inform, and educate Black birthing families across the country. We wanted a space where folks could breathe and feel free to release the heaviness of it all,” explains Kiley Mayfield, Director of Community Power Building and State/Local Policy for NBEC. “Justice & Joy truly sums up one of our main goals—to achieve justice in Black maternal and infant health while simultaneously cultivating the spirit of joy.”
During the event, speakers shared stories of respectful, well-supported births as well as traumatic ones.
A mother of four described her planned home birth, where she was surrounded by family (including her older children) and her care team: a Black midwife, doula, and obstetrician. She spoke of the love, empowerment, and genuine care she felt with the support of people who understood the cultural nuances and needs of her family. She was proud of her decisions, and grateful for the opportunity to trust her body and her team throughout the birth and recovery process.
Our second community member shared a story of loss. At 28 weeks pregnant, she woke up with sharp stomach pains. She had to visit multiple hospitals before she received care, only to learn that she had pre-eclampsia (a condition she’d never heard of) and that her baby boy’s heart had stopped beating. With her own body in distress, she endured the vaginal birth of her stillborn son. She described chaos at the hospital, and feeling deeply violated as she was strapped to a bed during delivery. While she plans on a future pregnancy, she plans to find a Black care team that will give her compassionate care, as a direct result of the unfortunate and traumatic experience she had during her previous pregnancy.
Though the outcomes of these stories are dramatically different, one theme unites them—Respectful Maternity Care is essential for positive maternal outcomes.
What health plans and employers can do to promote birth equity
These numbers and personal stories show us that improving birth equity is the right thing to do. If you’re a payer, whether you have a commercial or Medicaid plan, working toward birth equity should be central to your population health strategy. And if you’re an employer, you know that diversity, equity, and inclusion (DEI) are increasingly important for employee retention and success, so it makes sense to create benefits—including those for birth and parenting—that are inclusive and equitable for diverse employees.
The good news is that there are clear, concrete steps you can take to make birth more inclusive, equitable, and safe for all mothers and babies.
Here’s how payers can improve birth equity and take important steps toward improving outcomes, which may also help with various equity program accreditations:
- Cover doula services. Doulas are non-clinical professionals who provide physical, emotional, and informational support to mothers before, during, and after childbirth. The mothers who may benefit most from doula care are often the least able to access it, both financially and culturally. But increasing doula access in under-resourced communities, or communities of color, can improve birth experiences and outcomes, and lower costs by reducing unnecessary medical interventions. One study found that doula-assisted mothers were four times less likely to have babies with low birth weight, two times less likely to have birth complications, and more likely to breastfeed their babies. Working with a doula also increased mothers’ feelings of self-efficacy around pregnancy.7
- Make sure your preferred healthcare partners follow a framework for respectful maternity care, such as NBEC’s Cycle to Respectful Care, an actionable tool designed to support healthcare quality with an anti-racist lens.
- Invest in partnerships and digital health tools (like Ovia) that focus on improving health for BIPOC (Black, Indigenous, People of Color) mothers and their families through clinical programming and intervention services. These resources allow members and employees to:
- Track their health.
- Learn what to expect, and how to stay healthy, during each stage of family building.
- Understand how to self-advocate with healthcare providers.
- Catch health issues early through predictive, data-driven clinical intervention programs developed specifically for BIPOC women based on their experiences and risks.
- Take classes on important skills, such as infant care, breastfeeding, or postpartum depression.
- Monitor mental health and get treatment if needed.
- Talk to a benefits and health coach 24/7.
- Easily understand benefits—and use them.
And here are simple steps employers can take to improve birth equity:
- Review your existing benefits and plans to ensure that language, policies, and programs are inclusive of all families.
- Provide adequate parental leave benefits. Research shows that every extra week of parental leave reduces the risk of adverse maternal and child health outcomes, including infant mortality.8
- Create employee resource groups (ERGs) or other open communications forums for mothers to build community, share information and experiences, and know that they are heard.
Toward a healthier, more equitable future
There’s so much we can do to help babies and their mothers begin their lives together in a more just and joyful way. By working toward birth equity, we strengthen DEI initiatives, lower healthcare costs, and build healthier families and communities for a brighter future.
Have questions about how your organization can improve birth equity? Reach out to NBEC, a team of advocates for change in the Black maternal health and infant mortality crises. And get in touch with Ovia to learn about data-driven solutions for reproductive health, family building, pregnancy, and parenting
2: Centers for Disease Control (CDC): https://www.cdc.gov/mmwr/volumes/68/wr/mm6818e1.htm
3: March of Dimes: https://www.marchofdimes.org/materials/March_of_Dimes_2021_Full_Report_Card_11152021_v1.pdf
4: The Commonwealth Fund: https://www.commonwealthfund.org/publications/issue-brief-report/2020/dec/maternal-mortality-united-states-primer
6: Center on Budget and Policy Priorities (CBPP): https://www.cbpp.org/research/health/closing-the-coverage-gap-would-improve-black-maternal-health
7: Gruber, Kenneth J., et al. The impact of doulas on healthy birth outcomes. The Journal of Perinatal Education. 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647727/.
8: Ruhm C.J. Parental leave and child health. J. Health Econ. 2000; 19:931–960: https://pubmed.ncbi.nlm.nih.gov/11186852/.
How has the pandemic impacted birthing trends and anxiety for parents-to-be during pregnancy?
Download this study to find out. Results showed that the worry, isolation, loss of support, anxiety, and grief reported by pregnant persons during the COVID-19 pandemic may impact maternal pre- and postnatal mental health and are not borne equally. Birthing persons of color appear disproportionately impacted. This demonstrates the need for maternity care providers to assess worry prenatally and provide individualized education and resources to pregnant patients, centering individuals and communities made most vulnerable by structural inequality.
Employees are over burnout culture—here are 7 ways to prioritize the things working families need
Millions of people have left their jobs since the start of the pandemic, and many of you in the HR community are feeling the impact. Pundits and business leaders are calling it The Great Resignation, but I think they may be missing the most important point. It’s a reassessment. Instead of focusing on how many people are leaving, we need to look at why it’s so hard for people to stay.
It started when the global pandemic changed everything. Employees were forced to reconsider their careers, their priorities, and what they can manage. This past spring, Heather Long at The Washington Post was trying to make sense of the newest numbers—millions were out of work, but employers couldn’t find candidates to fill their jobs. Instead of accepting it as an economic “anomaly,” Long realized we were in the middle of a great reassessment—people were reconsidering their jobs, and re-thinking what they wanted to do with their lives.
At Ovia, we’ve seen this Great Reassessment up close. We’re a research-driven, family-building solution, and we’ve helped over 17 million families navigate fertility, pregnancy, birth, and parenthood. Over the last two years, we’ve supported families through COVID-19, and we’ve shared in their struggles.
We’ve also surveyed parents, and our findings are clear—in a post-pandemic world, organizations need strong family benefits to retain (and attract) employees, help working parents develop into leaders, and meet growing DEI needs.
I’d like to share what we’ve learned—especially why family benefits matter more now, which benefits employees need most, and how to assess your organization so you can make the most cost-effective, impactful changes.
How the pandemic hit families—especially moms—so hard
Since February 2020, more than 3.5 million mothers of school-age children have left their jobs1. This number is so huge that women’s workforce participation levels are now lower than we’ve seen since the 1980s2.
This seismic shift didn’t come out of nowhere. Mothers have always done a disproportionate amount of the labor when it comes to childcare, and many women struggle to balance families and their work lives on a daily basis. During COVID-19, it just became immeasurably harder.
This struggle is evident everywhere. In a recent study of childbearing-age employees, 60% of respondents said they’ve experienced burnout—or are experiencing it right now3. We’ve seen the signs of distress among our members, too. Ovia offers a digital screener for perinatal mood disorders, and since the pandemic we’ve found a drastic increase in conditions such as postpartum depression. We also offer, through our enterprise solution, one-to-one coaching to support parents, and there we’ve seen a 200% increase in demand for services. It’s clear that parents are desperate for support and guidance.
Among parents who decided to leave their jobs, a few main factors seemed to tip the scales:
- Childcare. Without affordable, accessible, and dependable childcare, many parents found that they couldn’t care for their children while they work, or that they couldn’t be as productive as they needed to be.
- Health and balance. The remote office blurred the lines between work and home. Without any sense of separation or balance, parents’ mental health suffered.
- Culture. COVID-19 reminded parents that family matters most, so they re-prioritized, and left for jobs that allow them to focus more on their families.
- Inclusion. While many companies are putting more resources toward DEI, parents often feel that their companies don’t have policies and benefits that understand and fit their needs.
- Competition. Companies are fighting for in-demand employees, so those who are already re-thinking their priorities—and hoping for more family-friendly benefits—are being poached.
It’s clear that mothers aren’t resigning because they’re sick of working. They’re just sick of working jobs that don’t fit their needs and the needs of their families. They’ve reached the breaking point, so they’re reassessing what matters most and taking action to align their work life and their family priorities.
What matters most for a family-friendly workplace amidst The Great Reassessment
If you’re an organization that wants to retain and attract the best employees during The Great Reassessment, here’s what you need to ask: How can we build a culture—and provide benefits—that allow parents to balance their lives, stay engaged, and be productive?
We surveyed 2,919 parents to find the answers. In our soon-to-be published Future of Family Friendly Report, we asked many of our 2 million active daily members—a diverse group of mostly female-identifying professionals—how happy they are with their current benefits, which benefits are most meaningful to them, and what they’re hoping for in the future.
One of our most definitive findings was that family-friendly benefits matter—a lot—when it comes to retaining employees. 90% of our respondents said they’d leave their employer for one with better benefits. They’re no longer content to stay put for traditional, unimpressive packages.
So what do better benefits look like? We asked parents to rank more than 40 options. You can see from the top five responses that employees want a workplace that truly supports the unique needs of working parents:
- Better leave policies
- A family-friendly culture
- Flexible schedules and remote or hybrid work options
- Return-to-work prep and flexibility
- Easy-to-understand benefits
Here’s something that might surprise you about the top five: most of them don’t have a hefty price tag. While better leave policies top the list, the rest are about building a flexible workplace where employees are accepted, and comfortable bringing their whole selves to work. This is the fundamental message of The Great Reassessment —employees are leaving because the human aspects matter. They want to work in a place where their relationships, inside and outside of work, are valued.
The top ten also included the types of benefits that can really make a company stand out as family-friendly: child care assistance, better lactation rooms, mental health support, pregnancy care management, and coaching for new parents.
Our findings don’t just show what parents are looking for, they show that parents still don’t have the basic benefits and cultural support they need to stay at their jobs. In their reassessment, they’re choosing work that allows them to live in a different, more sustainable, way.
How to assess your benefits and build a more family-friendly workplace
If you’re ready to make family-friendly benefits a priority, I’ve got good news. Most of the high-demand, employee-retaining benefits are absolutely do-able. Let’s take them one-by-one.
1. Create a family-friendly culture.
Culture can feel vague and hard to measure, but there are lots of big and small ways to let your employees know that your organization values families. At Ovia, family-friendly means that it’s okay to block your calendar to pick up your kids in the afternoon, take a morning off for a pediatrician appointment, and leave early a day or two to get the kids to soccer practice. There’s no stigma to these basic accommodations.
Being family-friendly can also mean improving lactation rooms, training managers to understand the needs of parents, creating resource groups to support parents, offering parental leave planning, and just making it okay for employees to talk about their children. In fact, in my own career, I always ensure that my manager knows my kids’ names—if they don’t, I know they’re not invested in me and what matters most in my life.
There’s also a more concrete side to building a family-friendly culture. To show that parents are a top concern, you can invest in benefits that meet parents where they are. Tools and programs (like Ovia) that support parents on their journey make a huge difference for employee retention.
2. Help your employees know and understand their benefits.
Most of us aren’t benefits experts, so there’s a lot organizations can do to help people understand—and take advantage of—key programs:
- Talk about benefits often. Train managers to talk about benefits in employee one-on-ones and block time for teams to talk about benefits together.
- Create a benefits checklist. Benefits can be confusing, and they can get lost in the shuffle. You can make sure employees know about all the benefits you offer by circulating a simple checklist several times a year. (The Ovia solutions include a benefits checklist tailored to each employer.)
- Make benefits accessible and easy to understand. Review invitations, enrollment guides, and plan comparisons to make sure they are clear, simple, and inclusive of all employees.
- Tap into community groups. Work with existing groups of employees who are going through similar life experiences to help explain and enroll benefits.
3. Create return-to-work programs for parents.
Returning from parental leave can be physically and emotionally overwhelming for parents, even when they have a generous leave program. I was fortunate enough when I had my children—many years ago—to have 20 weeks of paid leave. But once I came back, my company’s corporate culture was far from family-friendly. I had to pump in a storage closet, sneak out to get my baby from daycare before they closed, and then jump back into work after my baby went to sleep. It was stressful and exhausting.
There are a few key return-to-work initiatives that can make this transition so much easier:
- Offer a gradual return-to-work program. Allow parents to start part-time and build back slowly to their usual schedule.
- Create pre- and post-leave checklists and training. Help parents feel prepared before they go on leave, so they’ll feel less overwhelmed when they return. (Ovia offers training, checklists, and workshops for organizations that want to deepen their return-to-work programs.)
- Train your managers. Having a manager who’s understanding and knowledgeable about parental leave can make the difference between a stressful transition back to work and an easy one. (Ovia provides manager training.)
Create a mothers’ room that truly welcomes mothers back to work. Of course, a mothers’ room is required by law, but you can show your family-friendly values by making your mothers’ room private, comfortable, and reservable. Learn more about building the best mother’s rooms here.
4. Make sure your family-friendly policies are inclusive and equitable.
Not all families look the same. Take the time to review how your family-friendly policies are written, and who they’re written for. Update them if they don’t work for every employee and all kinds of families. To start, ask yourself:
- Do our policies support LGBTQIA+ families?
- Do our policies work for parents who are adopting or using a surrogate?
- Do our policies support single parents?
- Are our policies clear and manageable, even for people who don’t have experience navigating the healthcare system?
- Are our policies accessible to non-native English speakers?
- Are we using inclusive pronouns?
5. Stay flexible and understanding.
Whether it’s scheduling or work location, you can help parents create a routine that meets their parenting needs—without any stigma or strings attached. I can attest first-hand that flexible work is a game-changer. About two years after I had my first child, we were in the middle of the dot-com boom, so the software company where I worked launched a flexible work program to try to retain more women. I was a guinea pig for the program, and it changed my world instantly. I finally felt that I had the balance I needed to have a life—which meant I became more invested in my work than ever before.
There are lots of ways to build parent-friendly flexibility into your programs, including:
- Hybrid remote options.
- Flexible working hours.
- Gradual return from leave.
- Leave for parents who’ve experienced the wrenching pain of a lost pregnancy.
6. Extend leave time.
Extending leave time may seem like an expensive benefit, but it’s a proactive investment that can save you costs in the long term. Here’s why:
- Research shows that every extra week of parental leave reduces the risk of adverse maternal and child health outcomes, including infant mortality4. So, even if you’re on a limited budget, adding just an additional week or two of leave may change your employees’ lives in profound ways and lower your healthcare costs.
- Longer leave is so important to employees (it was at the very top of our survey) that it may be the thing that keeps them. When you do the math, investing in longer paid leave can save an average of 50% compared to losing an employee.
The Great Reassessment is all about prioritizing what matters, and it’s clear time with family matters.
7. Invest in comprehensive family benefits.
As you look at your family benefits, make sure they are inclusive of all kinds of parenting journeys, from single parents to stepparents and those struggling with fertility. Offering things like fertility support, return-to-work planning, virtual-first health support, coaching, and milk shipping can make a big difference when it comes to helping parents feel seen, so they want to stay.
For reassessment and investments with the most impact, make sure they are:
- Engaging (which often means virtual-first).
- Clinically validated.
- Tangible and available when and where they matter most.
- Cost-effective.
- Used—the only benefits that matter are the ones your employees know about and use.
Surviving The Great Reassessment
It’s true that millions of parents have left their jobs during the pandemic, and more probably will during The Great Reassessment. But our research, including data from our Future of Family Friendly Report (check the report later this month for a full report of our findings), shows how to get ahead of the trend and come out on top. When organizations listen to families, and structure their culture and benefits to help people balance the work they love and the people they love, employees stay and thrive.
This isn’t just a pandemic solution. The Great Reassessment only intensified the problems working parents have managed for far too long. That’s why the future of benefits is family-friendly. In fact, this shift may be one of the few truly good things to come out of so much upheaval—at this moment, we get to reimagine the world of work. We can make it more sustainable, equitable, supportive, and inspiring for all employees—and their families.
1 Associated Press: https://apnews.com/article/coronavirus-pandemic-business-lifestyle-health-careers-075d3b0ab89baffc5e2b9a80e11dcf34
2 National Women’s Law Center: https://nwlc.org/wp-content/uploads/2021/03/Final_NWLC_Press_CovidStats.pdf
4 Ruhm C.J. Parental leave and child health. J. Health Econ. 2000; 19:931–960: https://pubmed.ncbi.nlm.nih.gov/11186852/
Can a smartphone-based health coaching and behavior change for pregnant patients?
This research suggests so. Download the study to learn how digital coaching services can act as vehicles for positive behavioral change in pregnant people by intervening in-between provider appointments to reinforce obstetric guidelines and proactively discuss high risk conditions. These services empower patients and may reduce the risk of adverse maternal and fetal outcomes.
It’s almost Thanksgiving, and as I look back on a rocky, exhausting, sometimes trying, rollercoaster of a year, I’m so filled with gratitude.
Like most women, I have a few jobs. I’m the director of client success for Ovia Health, so I spend my days making sure families have the support and resources they need to grow and thrive.
I’m also a mom of three amazing children. My first two hit pretty much every milestone by the book. But my youngest is on another journey. He learns and processes information differently. Just as we were working to find answers, the pandemic hit, the world shut down, and appointments were delayed. It was only this year, at the age of four, that we finally got his diagnosis. My son has autism.
In many ways, the diagnosis was a relief—we had a name and an explanation for what we’d been going through. But it was also the beginning of a new, complex, and incredibly difficult phase.
Through the diagnosis and into the maze
You’d think, since I’m an expert in healthcare benefits, that I’d know right away what to do with this new diagnosis.
The truth is, even those of us in the healthcare system can get lost in the maze. At first, you don’t know what kinds of care are available or what your child needs, and from there, you’re tackling mountains of paperwork, from completion of milestone forms for speech, occupational, and behavioral therapy to diagnostic forms, observations, and assessments, on top of individual education plans (IEPs) and more. You’re hoping for approvals and adding your child to waiting lists that can take up to a year or longer, all while working with your insurance company to understand coverage, copays, and deductibles. As you’re doing all of this, you’re also managing multiple new care teams—at school, at home, at church, and with healthcare providers. Keeping everything organized feels like a herculean task.
Here’s another truth: You shouldn’t have to become an expert, advocate, and administrator of healthcare and education overnight. A true care system wouldn’t ask that of you when you’re dealing with a difficult condition and the emotions that come with a new diagnosis.
But that’s where I found myself earlier this year. My new world felt like its own full time-job, so I had no space to tend to my own needs, and I was struggling to be productive at work. Even when I wasn’t with my children, my heart and head were with them.
What I learned about asking for help
Overwhelmed with red tape, a confusing healthcare system, and a million questions, and having survived three full-family COVID quarantines, I found myself alone on my back deck in tears. I was at my breaking point. I pride myself on being able to handle anything that comes my way, but at that moment, I realized I had to give myself a little grace. I decided it’s okay not to be okay, and that accepting help doesn’t mean I’m failing.
Once I got out of my own way, I realized how lucky I am. Ovia offers autism support to our clients and to our employees—parents like me. Ovia’s autism support includes a module that helps you learn on your own, discover tips and tricks, and cope with the stress of managing your child’s needs.
Ovia also offers coaching, which I like to call my “magic support system.” Our coaches are healthcare experts, and many have experience working with children with autism, so they can help you navigate the health system, your health benefits, paperwork, and everyday challenges with your kids and your own mental wellbeing. You can reach out to them directly, from 9 a.m to 9 p.m., 365 days a year. For me, it’s an unbelievable relief.
So what’s it like to have an Ovia coach in my corner? I’ll share a quick vignette from a few days ago. If you have a child with autism, you already know how important it is to have a predictable daily routine. I’m up every morning at 5:00 a.m. to set my son up for a good day. But in the real world, things don’t always go as planned. The other day we had one of those mornings. My son wouldn’t settle down and get on the bus, so I had to cancel my morning meetings to help. Stressful as it was, I knew I didn’t have to figure it all out alone. I started messaging the coaches right there in the school drop-off line and they came back with support and guidance to help get me through.
What I wish employers and payers knew about autism
I’ve been telling you a very personal story, but it’s not mine alone. One out of every 54 children is born with autism. If you’re an employer or a health plan, there’s a good chance many of your people are trying to make their way through healthcare mazes and significant distress right now.
Support, especially experienced coaches, can save your employees and members precious time and emotional energy by helping them:
- Get through mountains of paperwork.
- Find services their children need.
- Learn how to calm and care for their children.
- Understand how to advocate for their children and coordinate care.
- Manage stress and their own mental health.
- Know they have a safety net—even if it’s just someone to talk to—when it’s desperately needed.
You have a huge stake in the wellbeing of your employees, and something as life-changing and common as a child with autism is too big to ignore. Without backup, you’re likely to lose valuable employees who are just too overwhelmed by navigating the system and caring for their children.
Even if employees are able to tough it out with work and caring for their children, a lack of support can harm parental outcomes, and lead to costly, avoidable medical expenses. From my own experience, it’s easy to see how a parent who’s stretched too thin could neglect their own mental and physical wellbeing. In fact, studies show that parents of children with developmental disabilities have higher rates of depression1 and poorer physical health2.
For all of these reasons, support for parents should be universal—it’s in your people’s best interest, and yours, too.
Advice—and hope—for employers and parents with autistic children
I’ve told you a lot about my struggles, and at this point in my journey, my overwhelming feeling is gratitude for my support network, which lets me balance caring for my family with a job that helps other parents do the same.
If you’re where I was—trying to understand a diagnosis and figure out how to care for your child—please reach out for help early, when the journey is hardest. Give yourself grace, be flexible, and find support.
If you’re an employer, please don’t ask your employees to go through this on their own. Connect them to the resources they need to adjust, cope, understand, and move forward. It will help them, and it will help you keep them.
I wish you all a Thanksgiving filled with gratitude, and all the support you need.
1 Journal of Autism and Developmental Disorders: https://link.springer.com/article/10.1007/s10803-017-3063-y
2 Maternal and Child Health Journal: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7170980/
Today is a new day for Ovia Health. We just announced our acquisition by Labcorp, a leading global life sciences company. As Ovia’s co-founder and chief technology officer, this moment truly takes my breath away. Not only does it recognize our tireless efforts to get here, it also opens up so many new and exciting opportunities for us to continue to help shape the definition and development of family health in the years to come.
Reflecting on the past 10 years, I can’t help but feel a sense of pride for everything our dedicated engineers, designers, writers, marketers, nurses, researchers, managers, salespeople, and many other passionate team members have accomplished.
We had a big idea back in 2011. We wanted to build a new type of women’s health company—a “Health 2.0” company, we called it—where technology and machine learning would meaningfully improve people’s health outcomes. It was a bold vision at the very beginning of the mobile, cloud and data science revolutions, which have become the drivers of innovation across industries today. To start, we focused on applying predictive science to conception. But we had bigger goals in mind. Our collective desire was to help millions of women and families through every stage of their journey, from pregnancies and parenting to lifelong health.
Fast forward to 2021. Not only have we stayed true to our original idea, but we have also gone above and beyond our early ambitions in more ways than one. While working to achieve our mission, we have helped tens of millions of families overcome significant challenges by providing education, support and coaching. And our vision has captured the minds of some of the largest organizations in the world. Most importantly, our technology has helped save lives, and it continues to improve health outcomes across a broad spectrum of care.
Today, we can proudly claim that the company we built has made—and will continue to make—a positive difference in the world. It gives us great joy knowing that our employees are passionate about the company’s culture and about their work, and that our business model is both tested and proven.
We have done well by doing good.
There’s a lot to be proud of about Ovia’s technology. Ovia’s platform is now a dynamic, real-time health engagement engine that processes billions of transactions each day, provides interactive, AI-powered guidance, and connects to hundreds of employers’ and health care organizations’ systems. The scalability and extensibility of the platform has enabled us to continuously add new products and services that benefit users and customers.
Starting today, we have an amazing opportunity to make an impact beyond our original ambition. Joining Labcorp means we can extend our reach to a much larger audience of members, providers, doctors, and health care organizations. We will also be able to apply our technology to new domains, bring our state-of-the-art engagement engine to new areas, deliver more value and support to our members, and help Labcorp expand and grow its connections with these audiences.
Our relationship with Labcorp isn’t new. They previously invested in us and have worked with our team for the better part of a year, proving to be an exceptional partner that’s aligned with our mission and supports our values. They highly regard and trust our technology and expertise, and we are humbled to have had the backing—and to now be part of—a global life sciences leader. The Labcorp team is truly eager to support Ovia in its quest to make a happy, healthy family possible for everyone.
This is the start of a new chapter at Ovia, and I’m both proud of and excited about the past, the present and our path forward.
Sincerely,
Alex Baron, CTO
When myself, Chief Technology Officer Alex Baron, Chief Product Officer Gina Nebesar, and VP of Engineering Rory O’Connor started Ovia Health nearly a decade ago, we did so with twin aims: To make the reality of a happy, healthy family a possibility for everyone, and to build a welcoming, diverse and inclusive tech company. We wanted to establish a culture that embraces the very principles we work with our clients to advance.
With that ambition top of mind, I’m incredibly excited to share the news that Ovia Health has been acquired by Labcorp, a leading global life science company. This new arrangement allows us to accelerate and expand our work in ways we never thought possible, all while remaining an independent subsidiary and continuing our passion of helping families grow.
Labcorp’s interest in us should be seen as incredible recognition for the work done at Ovia since our humble beginnings. We launched the femtech space and spurred billions of dollars in investment, as well as the growth of an entire industry. Ovia was the first to identify and meaningfully address the gaps in family planning and care through data-driven, consumer applications and family benefits, which allow employers, health plans and consultants to empower family journeys of all types. We led the way in helping consumers, moms and families take greater control of their own health and the health of their loved ones. We’ve also changed the practice of medicine through groundbreaking clinical research, having published over 35 peer-reviewed papers.
Importantly, we’ve demonstrated why family benefits such as ours—clinically backed and proven to improve outcomes across the family care journey—are so important.
That’s why the announcement of our new ownership is so exciting to all of us at Ovia Health. By joining Labcorp, we’re able to accomplish so much more and bring both our mission and our important work to millions of additional patients and Labcorp customers across the country. We also have the opportunity to extend our reach to every health care provider and doctor in the U.S., as well as the millions of patients served by Labcorp.
21st Century leadership means giving all parents equal opportunities and driving diversity, equity, inclusion and belonging in every workplace, for every family. Ovia Health has been, and will continue to be, at the forefront of this fight by helping employers and health plans reimagine benefits for the modern workplace. Because after all, family-friendly benefits should not just be a priority, they should be universal.
Ovia Health’s mission, values, independence, culture and its people remain the same and align perfectly with Labcorp’s mission to improve health and improve lives. Now we will have the backing of an international life sciences leader that believes in us and our shared ability to close gaps in family care and deliver better outcomes for everyone.
Sincerely,
Paris Wallace, CEO
As a seasoned Nurse-Midwife and digital health coach, I’ve spoken to many people who are working to expand their families. Maternity and early parenthood are incredibly magical times in someone’s life, but can also be riddled with uncertainties and anxiety. Which is why I feel so called to help. My goal as a health professional, and Ovia Health’s goal as a company, is to help women and families at this pivotal point make informed decisions about their health. Today, this means ensuring families have the information they need from trusted sources like the American College of Obstetricians and Gynecologists (ACOG).
In my recent conversations with women who are trying to conceive, women who are pregnant, and women who are breastfeeding, many have asked questions about the COVID-19 vaccine, and whether or not it is safe for them. This uncertainty is understandable as there’s so much information out there about the COVID vaccines and so little time to sort out what’s true and what isn’t.
As of today, ACOG’s recommendation is that the vaccine should not be withheld from this population due to the heightened risks that we have seen in pregnant people who have been infected with COVID.
To help provide education around the vaccine, our clinical team has created a COVID vaccine guide to help people understand how the COVID vaccine could impact their reproductive health. Available today, My COVID-19 Vaccine Guide can help you get answers to questions about the COVID vaccine, whether you’re trying to get pregnant, are pregnant, or are deciding for your child. You can download the apps to access the guide.
In addition to this new tool, I’ve also put together a list of the most common questions I’ve heard while talking to patients and provided some answers you can share with your employees.
What’s driving this specific misinformation?
In this country, we all have the right to informed consent. Vaccines are no exception! So some questioning of whether or not a new treatment is safe is very reasonable and responsible. Some of the questions have come out of how quickly these vaccines were developed. The general public knows that this type of coronavirus was new in late 2019 because we’ve all lived through the pandemic. However, vaccine science is not widespread knowledge. Vaccine developers are a very small portion of the population and how vaccines and our immune systems work are not common knowledge in general. So the lay-person sees this highly technical intervention come out very quickly and it is natural to question if corners were cut or steps were skipped.
In addition, the internet has put a lot of information at our fingertips, but with no guarantee of accuracy. It is so important to choose your information sources wisely, but not everyone knows how to do that. Even some reputable sites will misinterpret scientific studies unintentionally. The scientific process is a very dependable source of information, but data can be misinterpreted by really smart people who are not trained to see the flaws in study designs or the further need for studies to rule out alternative reasons for the associations brought up by a single study.
For example, there could be a study done that shows more balding men have heart attacks than those with a full head of hair. One might say losing your hair increases your risk of heart attack.
However, if you look at the population of men, those who have heart attacks are typically older. Those who are older are also more likely to be balding. Thus, you have a correlation without causation. This is a very simplistic example. But it illustrates how misinterpretation of data can suggest that something false is supported by evidence.
Why is it such a persistent myth?
Social media continues to be an enormous, influential source of misinformation. In this age where everyone has a platform to share their opinions, it’s really difficult to discern what is truth and what is opinion. And in the case of COVID-19 where we are learning something new every day, it is really hard to keep up with the most current accurate information. This is directly contributing to the persistence of misinformation.
Fear is powerful and can certainly cloud one’s judgement. One specific fear (with no evidence to support it) is the relationship between COVID-19 vaccines and fertility. The idea that protecting myself from this potentially deadly virus could cause me to not be able to have a child is a very emotionally-loaded concept. Even without information behind why those two things could possibly be linked, the fear is real. What if that was true? I might never forgive myself for getting the vaccine. And once even the possibility of that outcome takes hold, it can be hard to eliminate, even when information about the lack of data on that topic is presented.
How did it come about?
Early on, there was a misinformation social media frenzy around the COVID-19 vaccine causing infertility. To understand how the (false) idea of getting a vaccine could be linked to problems conceiving, it’s important to understand how the vaccine works.
Two of the vaccines currently available in the US are mRNA vaccines (Moderna and Pfizer). They do not contain the virus itself (dead or alive) and therefore, cannot cause infection. What they do contain is the mRNA (think blueprint or recipe) that codes for the spike protein found on the surface of the COVID-19 virus. Our bodies respond to the presence of the mRNA by reading the “recipe” or “blueprint” and then creating copies of the spike protein. The protein on its own is harmless in our bodies. However, it is a foreign protein that is not otherwise found in the human body. Because it is foreign, our immune system (specifically our B-lymphocytes and T-lymphocytes) learns how to fight the virus by recognizing the spike protein, creating antibodies to it, and deactivating it. Thus, if the COVID-19 virus were to enter a vaccinated person’s body, the spike proteins on its surface would be familiar and our immune cells would remember how to quickly create antibodies that bind to the virus and stop it from invading the cells of the body.
While the protein coded for by the mRNA in the COVID-19 vaccines is commonly called a “spike protein,” this does not mean it is identical to all so-called “spike proteins.” For example, there is a spike protein involved in the placenta’s attachment to the uterus during conception and development of a pregnancy called Syncytin-1. The Syncytin-1 protein is an essential part of the type of cells that create the connection and exchange of blood between the mother and the fetus. Without it, a healthy pregnancy would not be possible.
However, the theory that once we develop antibodies to the COVID-19 spike protein, those same antibodies can disable all spike proteins is absolutely false. As an analogy, if the syncytin-1 protein’s recipe is 1 page long, the COVID-19 protein’s recipe is 18 pages long. They are totally different in size and makeup. The antibodies we form are very specific to the antigen they disable. So getting the COVID-19 vaccine absolutely does not cause infertility.
How are doctors combating it? Is there evidence that vaccines impact fertility?
By sharing this information. Patient education is so powerful. This goes back to informed consent. We have a right to know the risks and benefits to the treatments we are getting. It is the healthcare provider’s responsibility to educate their patients on these things. Your provider is trained to understand how vaccinations work and how scientific studies need to be interpreted by experts. Part of their training is to sift through misinformation and spread the information that is evidence-based and trustworthy.
Can you explain how the body expels genetic material after vaccinations?
mRNA specifically uses a part of the cell called the ribosome (like a 3-d printer) to make the spike protein. Our ribosomes are within our cells, but are outside of the nucleus (where our human DNA is stored). Thus, mRNA vaccines do not have the ability to alter our DNA. They never come into contact with one another. Additionally, mRNA doesn’t live in the cell very long at all. Our body has chemicals called enzymes that break down the mRNA and dispose of it. The fragile nature of the mRNA is actually what makes distribution of this vaccine difficult because it has to be encased in a shell that requires it to be stored at very low temperatures.
What advice do you have for teens/parents who are concerned the vaccine could impact fertility/menstruation.
There is zero animal or human evidence that the COVID-19 vaccine causes infertility or changes our DNA. In fact, many people who were vaccinated have since become pregnant, and many people who were pregnant while vaccinated have since delivered healthy babies. The choice to be vaccinated is personal and should be made alongside your healthcare provider so you have the opportunity to ask questions and get solid, trustworthy information. For each individual, there will always be risks and benefits to be considered. This is the perfect opportunity to help your teenager make an informed decision using the resources available to them (with your help, of course).
What can we do to support employees as they return to in-person work settings?
Allowing for open dialogue with concerned employees is essential to demonstrate empathy for these challenging decisions. Empowering them with tools that provide decision-support and an avenue for clinical questions is key to help individuals make informed decisions. As you consider return to office policies, or vaccine mandates for your organization, ensure upfront conversations for those trying to conceive or pregnant are addressed to avoid alienating these team members . Expressing the intent for health and safety of all employees speaks volumes to demonstrate a culture of inclusion during this challenging time
To support employers and managers, we’re actively updating resources like this interview with the science lead for the COVID Project, Jessica Malaty Rivera, the Ovia My COVID-19 Vaccine Guide, and referring to this CDC resource hub to support teams with up-to-date, easy to understand guidance, delivered in a way that is relatable for women and families.
With access to verified information, each employee can make an informed decision about their health, and proactively engage their healthcare providers to share in decision making with full consideration of their risk factors.
- https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/how-they-work.html?s_cid=10491:how%20the%20covid%20vaccine%20works:sem.ga:p:RG:GM:gen:PTN:FY21
- https://www.idsociety.org/covid-19-real-time-learning-network/vaccines/vaccines-information–faq/
- https://www.chop.edu/centers-programs/vaccine-education-center
Illustrated in-app guides provide guidance for every stage of the family-building journey
BOSTON (PRWEB) JUNE 11, 2021
Ovia Health, the only clinically-backed family health digital platform, has rolled out a dynamic new set of interactive guides to help families make critical decisions about the COVID-19 vaccines. The COVID Vaccine Informational Guides, appearing natively for users of Ovia’s Fertility, Pregnancy, and Parenting apps, are available today in both English and Spanish.
The guides come at a key moment. Employers are charting paths back to safe in-person workplaces and tackling how to address vaccination policy, but vaccination progress and pace is waning. Although the United States has reached the milestone of 50% of people receiving at least one dose, rates of vaccination have slowed dramatically in the last two months, as supply of the vaccine has finally outpaced demand. Hesitancy to receive the COVID-19 vaccine is strongest among populations that are often at higher risk, such as people of color, those of lower socioeconomic status, and those with comorbidities.
Another subpopulation expressing strikingly high vaccine hesitation rates are women trying to get pregnant, are already pregnant, or are newly postpartum–the same population that makes up much of the Ovia Health community. The adverse effects caused by COVID-19 on pregnant people and babies are well-known: increased risk of preterm birth, respiratory distress, and hospitalization. Data from Ovia users in December 2020 showed that almost half of users said they wouldn’t take the vaccine. Despite more research and guidance released in the new year, an additional poll by Ovia Health in March 2021 suggested that 1 in 3 women are still hesitant to receive the vaccine. This anxiety is fueled by confusing guidance for pregnant or postpartum parents, misinformation about the vaccine’s safety, and community stigma surrounding the COVID-19 vaccine.
Through a 5-10 minute module, the guides provide awareness and latest vaccine guidance for decision support in a relatable conversational format between a fictional Ovia member and her certified nurse midwife. They discuss frequently asked questions surrounding the COVID-19 vaccine’s impact on reproductive health, such as:
- The initial clinical trials didn’t include pregnant or breastfeeding women. How do I know the vaccine is safe for me?
- I’m unsure of the vaccine development process. How do I really know if they work?
- Is it safe to get the vaccine if I have allergies?
- Will the vaccine negatively impact my fertility or my baby’s development?
- What are the current recommendations for women trying to conceive regarding the COVID-19 vaccine?
- What are the current recommendations for pregnant women regarding the COVID-19 vaccine?
- What are the current recommendations for my children regarding the COVID-19 vaccine?
The COVID Vaccine Informational Guides, like all of Ovia’s content, are rooted in clinical evidence from governing bodies like ACOG (American College of Obstetricians and Gynecologists), ACNM (American College of Certified-Nurse Midwives), and ASRM (American Society for Reproductive Medicine). The guide is updated on a weekly basis to ensure Ovia is sharing the most up-to-date vaccine-related evidence with its community, especially as clinical trials with pregnant women and children are ongoing.
Most importantly, the guide brings the recommendations to life by breaking down daunting questions into clear explanations, and provides a talk track for members to ask these same questions to their own doctors, midwives, pediatricians, and other providers.
“Ovia, as a trusted, evidenced-based thought leader in reproductive health, has a unique opportunity to lead the field by providing clear, empathetic direction on COVID-19 vaccine guidelines in our community. Our members turn to us to help them navigate some of the most complex decisions about fertility, pregnancy, and parenting,” said Paris Wallace, Ovia Health Chief Executive Officer. “Now, we’re ready to help our members sift through misinformation and provide clear and concise educational resources to help make important decisions for them and their families. ”
The guide presents evidenced-based information about the COVID-19 vaccine through empathetic storytelling, and does not encourage or endorse vaccination. To download the Ovia apps for free and see the guides in action, click here. For more clinical perspectives on vaccine decisions for women and families, click here: https://info.oviahealth.com/ent-covid-vaccine.
About Ovia Health
Since 2012, Ovia Health has helped more than 15 million people successfully navigate their parenthood journeys and is on a mission to make a happy, healthy family possible for everyone. Ovia is the only family health solution clinically proven to effectively identify and intervene with high-risk conditions. The company’s 50+ clinical programs, including predictive coaching and personalized care plans, help prevent unnecessary healthcare costs, improve health outcomes, and foster a family-friendly workplace that increases retention and return-to-work. For more information, visit OviaHealth.com.
Media Contact:
Shannon Mullins
Scratch Marketing + Media for Ovia Health
shannon@scratchmm.com
From a rise in c-sections to shorter hospital stays and more emotional distress, COVID-19 is changing pregnancy, delivery, and early parenthood. Here’s what we can do.
Over the last year, COVID-19 changed everything, including the experience of pregnancy, birth, and early parenthood. New mothers faced unprecedented challenges, from restrictions on visitors and support staff during hospital births, to the isolation of caring for an infant during quarantine, and the struggle of managing childcare and work in a world turned upside down. In order to better understand the scope of COVID-19’s impact on delivery trends and maternal outcomes, and to illuminate these impacts for our community and the scientific community, we took a look at Ovia Health’s data.
Ovia is a digital family health platform that helps people navigate reproductive health, pregnancy, and parenting from the palms of their hands. Our diverse members are representative of the US population, and thousands of them complete birth reports and health assessments each month. These data give us a unique view into pregnancy, birth, and maternal wellbeing trends.
What the numbers tell us about pregnancy, birth and delivery trends during the pandemic
Using anonymous data from 415,125 births in 2019 and 2020, we created two cohorts for comparison: pre-COVID (for births between October 2019 and March 2020) and during-COVID (for births between April 2020 and September 2020).
Our research study, Changes in Delivery Outcomes During the COVID-19 Pandemic as Reported in a Pregnancy Mobile App, was peer-reviewed and presented at the American College of Obstetricians and Gynecologists (ACOG) annual conference in April 2021. Most importantly, it uncovered trends in birth outcomes that everyone in the healthcare community and beyond had been wondering throughout the pandemic.
Most notably, compared to mothers who delivered pre-COVID, mothers who delivered during COVID:
- Were significantly more likely to deliver by Cesarean section
- Had hospital stays that were, on average, 8.2% shorter
- Were significantly more likely to choose a home birth
- Were significantly less likely to deliver preterm
“Our study offers insight into the stresses and strains the pandemic has put on pregnant mothers, new parents, and babies—as well as our healthcare system,” said Danielle Bradley, MS, MPH, Ovia’s Director of Clinical Evidence and Services. “We found a significant rise in c-sections, which can raise health risks for mothers, as well as healthcare costs. And, at the same time that mothers experienced more medical interventions, their hospital stays grew shorter. It’ll be important to track whether hospital length of stay bounces back to pre-COVID lengths, and if there are any lasting impacts on women who didn’t receive the typical length of post-birth care in the hospital.”
The rise in women choosing home births is another of these delivery trends worth following. Mothers may have felt that staying home was safer during COVID-19, but the risks of home birth are substantial—including a two-fold increase in the perinatal death rate.1 Ovia will continue to track this trend as well, and provide guidance to our community about how to decide where to deliver, keeping health risk and safety top of mind.
“We were also interested to see a decrease in preterm births during COVID-19, which is a good thing,” adds Bradley. “We’ll look more deeply into why preterm numbers went down—with the hopes that we can learn how to add strategies to Ovia’s existing preterm prevention programs once the pandemic is behind us.”
New data reveals the emotional toll of COVID-19 on mothers
In a separate study, Ovia looked at the mental health impacts of COVID-19 on new mothers. Even before the pandemic, we were in the midst of a maternal mental health crisis—more than 60% of perinatal mental health issues go undiagnosed and untreated.
Our new study showed that COVID-19 has deepened the distress—and first-time mothers, BIPOC (Black, Indigenous, and people of color) mothers, and mothers between 35-39 have been hit the hardest.
The study compared nearly 18,000 pre-pandemic and during-pandemic responses to the Edinburgh Postnatal Depression Scale (EPDS). We tracked an 8% increase in mild-to-moderate postnatal distress or depression, and a 7.5% increase in moderate-to-severe depression overall.
Among first-time mothers, the numbers were higher—we found a 12% rise in mild-to-moderate symptoms and an 11% rise in moderate-to-severe symptoms.
BIPOC mothers also showed higher distress levels than the overall average, with a 10% jump in moderate-to-severe depression, and an alarming 26% increase in reports of suicidal ideation. The most significant increases occurred among Black mothers.
“As we know, there are deep racial disparities in maternal outcomes. In this study, we see that COVID-19 has widened the gap even more, with BIPOC mothers bearing some of the heaviest burdens of parenting during the pandemic,” explains Bradley. “It’s an urgent wake-up call. We must do more to bring support and resources to the parents and communities that are suffering right now.”
Ovia’s findings on delivery trends, maternal outcomes, and postnatal depression during COVID-19 are early indicators of how deeply the pandemic has changed parenthood. Each of these changes is likely to have long-term impacts on parents, children, and the workforce.
Standing by employees in a COVID — and post-COVID — world
The strains of pregnancy, birth, and motherhood during COVID-19 have contributed to another trend—the re-shaping of the American workforce. More than 2.3 million women have left their jobs since February 2020, sending us back to workforce participation levels we haven’t seen since 1986.2 As of last September, one in four women were still considering leaving the workforce or downshifting their careers because of COVID-19.3
“For companies looking to support and retain parents, and to ease the burnout that’s set in with COVID-19, employers need to step up,” says Bradley. “From immediate relief, like flexible work schedules, to longer-view plans, including more support across the parenting journey—there’s so much we can do to even a playing field that’s become even more unfair during this pandemic.”
How Ovia Health supports every parenting journey and new delivery trends
Ovia’s digital family health platform helps support and retain employees during their parenting journeys, while delivering a clear ROI for employers. Ovia offers 1:1 coaching and personalized care to reduce costly adverse outcomes, including unnecessary fertility treatments, preterm deliveries and NICU stays, and c-section rates. Ovia also increases employee retention, breastfeeding initiation, and vaccine adherence for infants.
Ovia is also here to see parents through the uncertainties of COVID-19, whether we’re helping with everyday concerns about prenatal care, mental health, and childcare, or addressing urgent issues, such as delivery trends or the safety of the COVID-19 vaccine during pregnancy (see our recent interview with Jessica Malaty Rivera, Science Communication Lead for the COVID Tracking Project, for the latest).
To discover more about Ovia Health, please visit www.oviahealth.com.
1 The American College of Obstetricians and Gynecologists: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/04/planned-home-birth (accessed April 2021).
2 National Women’s Law Center: https://nwlc.org/resources/january-jobs-day-2021/ (accessed April 2021).
3 McKinsey & Company and LeanIn.org: https://wiw-report.s3.amazonaws.com/Women_in_the_Workplace_2020.pdf (accessed April 2021).
May is Asian American & Pacific Islander (AAPI) Heritage Month, a national celebration of the AAPI community. It’s critically important for organizations to recognize and celebrate not only AAPI Heritage Month, but any and all events honoring their diverse workforce. Diversity is the backbone of any truly successful organization. It’s been proven time and time again and credited with nearly a 20% increase in revenue by Forbes and other highly esteemed organizations. But to truly celebrate diverse employees, especially AAPI employees, is to hear our stories and our truths — even the ugly ones.
Amid the rise of anti-Asian hate crimes and violence, Asian American women have been grappling with their physical and emotional safety at home and at work. Rampant stereotypes of being “dragon ladies” or submissive still permeate how many see us, cheapening our value and breeding contemptuous indifference at best, fatal violence at worst.
History is rife with anti-Asian discrimination
There’s a long history of anti-Asian sentiment in the United States. Whether it was anti-Asian immigration policy (the Paige Act in 1875, which barred Chinese, Japanese, or “Oriental” women, and the Chinese Exclusion Act of 1882), systematic oppression (the Japanese internment camps of World War II), or racial injustice (the targeted murder of Vincent Chin), the system has made our community feel “othered” and silenced. It bubbled to the surface during a global pandemic that was blamed on us, with terms like “kung flu” and “China virus” deemed acceptable by national leaders.
A recent survey shows that while Asian Americans are significantly underrepresented as leaders in business, politics, and media, nearly 50% of non-Asians believe that Asian Americans are fairly or even overrepresented. The same survey also shows that 15% of respondents are not comfortable with an Asian American as their boss. These studies are in stark contrast with the common perception that Asian Americans are all successful and that we don’t experience race-based discriminations, especially in the workplace.
What can employers do to create a more inclusive workplace?
Business leaders need to be aware of this disparity between perspective and reality, and do what they can to close the gap. “Make a concerted effort to recruit us and give us leadership opportunities (responsibilities, speaking assignments, etc.) early in our careers,” recommends Pamela Abbott, General Manager of Consumer at Ovia Health. “Outreach, coaching and mentorship, especially in more creative fields, are key to developing a pipeline of senior leadership.” Abbott is Korean-born and was adopted by a predominantly white American family.
Abbott’s career history prior to joining Ovia includes major TV network news and digital media, where she built a firm foundation for her leadership skills. Abbott asserts that in this environment, it’s easy to lose your identity as a woman of color, and recommends that business leaders recognize the individuality of each person.
“We are not a monolith,” said Abbott. “At the most basic level, [we should be] seen, heard and supported as individuals while understanding AAPI leaders do share culture and community as POC.”
The ugly truth
I am an American-born Chinese woman who has worked in enterprise tech and the entertainment industry, both of which have earned reputations of hostility towards women. I have personally seen and experienced the fetishizing of Asian women at work and behind the scenes. “Happy ending” jokes, “me love you long time” imitations, blunt questions about my sexual experience – I’ve heard it all, and yes, while at work.
The sinister view that Asian women are nothing more than sex objects is more pervasive than most realize. We fear repercussions if we report harassment. We fear not being believed. We fear the violence that stems from years of victimization, brought to light by the Atlanta murder spree that claimed the lives of eight people, six of whom were Asian American women. It’s nothing new to us, and it stymies our ability to be the parents and leaders that we strive to be.
Finding an equitable path forward
But there is hope. Business leaders who embrace diversity will find that not only will their workforce stay engaged and productive, but also bring fresh perspectives and experience that keeps the business innovative and nimble. Making diversity an asset instead of a requirement makes your company more attractive to top talent and all of their networks.
Pamela Abbott and I work at a company where diversity is appreciated and encouraged. Empowering women of color is more than something we value in our products; the leadership walks the walk as well. It’s one of the many things that drew me to the company, and it keeps me passionate about my work.
Where to start, and how to evolve
For companies who aren’t sure where to start, creating forums for representation and celebration of the unique voices that make up the fabric of your talent community is where it begins. Establishing employee resource groups, putting inclusivity on the agenda for leadership messaging and manager training, and creating a path for mentoring relationships are a few ways companies achieve a safe space for people of color to collaborate toward solutions. Looking forward, we can together redefine what “leadership material” looks like, and allow employees to feel valued, engaged and ultimately bring their best, full selves to achieve company goals. Also, consider hiring strategies to attract AAPI people in a variety of ranks and functions so that nobody feels like the lone Asian.
Elaine Hom is a former journalist, sometimes-actor, and the Sr. Manager of Member Marketing at Ovia Health. She is the first-generation daughter of two Chinese immigrants and proud to be phenomenally Asian.
Authors: Katie Noddin, MPH (Ovia Health), Paige Beauchemin, RN (Ovia Health), Adam Wolfberg, MD, MPH (Ovia Health & Cambridge Hospital), Dani Bradley, MS, MPH (Ovia Health)
Validating the impact of a digital health coaching service on uptake of cervical measurement during pregnancy
According to a new study from Ovia Health, presented at the The American College of Obstetricians and Gynecologists Annual Meeting on April 30th, 2021, women who engaged with health coaches in digital preterm delivery prevention programs were more likely to receive cervical length screening at their mid-trimester appointment, a demonstrably effective way of identifying risk and avoiding preterm delivery.
The study is the first of its kind to demonstrate the impact, efficacy and degree to which digital health coaching can have on maternity outcomes.
Women with short cervixes have a 50% chance of preterm delivery, according to March of Dimes, a leading organization fighting for the health of all moms and babies. Women who have their cervical length measured and received progesterone therapy, if indicated, are shown to have significantly lower rates of preterm delivery.
“These findings underscore how critical it is for employers and health plans to be working with maternity care management and digital health partners that help women understand the issues affecting their pregnancy, advocate for themselves, and ensure the highest quality of care across the continuum,” said Rachel Boyd, VP of Enterprise Marketing, Ovia Health. Download the full study for additional details on findings.
About Ovia Health
Ovia Health has helped over 14 million women and families. We offer a comprehensive maternity and family benefits solution from preconception and pregnancy through return-to-work and parenthood.
Ovia Health:
- Engages women early, and sustains long term daily participation
- Actively encourages partners to participate in the process
- Includes predictive coaching and mobile alerts for identified health issues
- Supports return-to-work with a proven approach
- Boosts utilization across an employer’s benefit ecosystem
- Drives behavior change and reduces maternity costs
Authors: Katie Noddin, MPH (Ovia Health), Adam Wolfberg, MD, MPH (Ovia Health & Cambridge Hospital), Dani Bradley, MS, MPH (Ovia Health)
New study presented at the The American College of Obstetricians and Gynecologists Annual Meeting: Changes in Delivery Outcomes During the COVID-19 Pandemic as Reported in a Pregnancy Mobile Application
As the pandemic transformed healthcare delivery across the board, childbirth, maternal and delivery outcomes were also significantly impacted, according to a new study Ovia Health presented at The American College of Obstetricians and Gynecologists Annual Meeting on April 30th, 2021.
The study, which analyzed births from the months immediately preceding and after the start of the pandemic, found that women who delivered during the pandemic were less likely to deliver preterm, but more likely to deliver by Cesarean section; more likely to choose a home birth; and had hospital stays that were, on average, 8.2% shorter.
While the preliminary findings don’t unearth the specific factors driving the changes in birth and delivery, they underscore how significantly the pandemic has affected outcomes and point to the need for additional research.
“These findings – especially the dramatic increase in home births, which carry more risk than hospital births – point to the sheer scale of the impacts the pandemic will have for years to come,” said Dani Bradley, MS, MPH, director of Clinical Services and Evidence, Ovia Health. “We will continue to track these trends and to provide guidance to our community about how to decide where to deliver, keeping health risk and safety top of mind.” Download the full study to learn more.
About Ovia Health
Ovia Health has helped over 14 million women and families. We offer a comprehensive maternity and family benefits solution from preconception and pregnancy through return-to-work and parenthood.
Ovia Health:
- Engages women early, and sustains long term daily participation
- Actively encourages partners to participate in the process
- Includes predictive coaching and mobile alerts for identified health issues
- Supports return-to-work with a proven approach
- Boosts utilization across an employer’s benefit ecosystem
- Drives behavior change and reduces maternity costs
It’s time to celebrate, highlight and honor organizations who are truly committed to supporting, uplifting and improving the health & lives of their employees. Tune in to our new podcast series to hear stories from organizations that are setting the example of best-in-class benefits, creating innovative solutions to improve the health, wellness, and livelihood of their workforce, and driving the industry forward.
What is the OviaAsks Podcast?
In this new podcast series, we interview HR leaders and dive deep into programs that are improving access to care, enhancing employee and family health, increasing retention rates, and closing gaps in diversity, equity and inclusion. Tune into these and future podcast episodes to learn best practices to make your organization the employer-of-choice for working parents and families.
Pair of new studies from Ovia Health show significant new trends in preterm births, cesarean sections, hospital stays, and impact of digital health coaching
BOSTON (PRWEB) MAY 06, 2021
Ovia Health, the only clinically backed family health digital platform, today published a set of new studies that show the dramatic effects the pandemic has had on delivery and birthing options, as well as the benefits digital coaching has on maternity care.
As the pandemic transformed healthcare delivery across the board, childbirth and maternal outcomes were also significantly impacted, according to one of the two studies, both of which were presented at The American College of Obstetricians and Gynecologists Annual Meeting on April 30th, 2021.
The study, which analyzed births from the months immediately preceding and after the start of the pandemic, found that women who delivered during the pandemic were less likely to deliver preterm, but more likely to deliver by Cesarean section; more likely to choose a home birth; and had hospital stays that were, on average, 8.2% shorter.
While the preliminary findings don’t unearth the specific factors driving the changes in birth and delivery, they underscore how significantly the pandemic has affected outcomes and point to the need for additional research.
“These findings – especially the dramatic increase in home births, which carry more risk than hospital births – point to the sheer scale of the impacts the pandemic will have for years to come,” said Dani Bradley, MS, MPH, director of Clinical Services and Evidence, Ovia Health. “We will continue to track these trends and to provide guidance to our community about how to decide where to deliver, keeping health risk and safety top of mind.”
A second study by Ovia, also presented at the American College of Obstetricians and Gynecologists Annual Meeting, found that women who engaged with health coaches in digital preterm delivery prevention programs were more likely to receive cervical length screening at their mid-trimester appointment, a demonstrably effective way of identifying risk and avoiding preterm delivery.
The study is the first of its kind to demonstrate the impact, efficacy and degree to which digital health coaching can have on maternity outcomes.
Women with short cervixes have a 50% chance of preterm delivery, according to March of Dimes, a leading organization fighting for the health of all moms and babies. Women who have their cervical length measured and received progesterone therapy, if indicated, are shown to have significantly lower rates of preterm delivery.
“These findings underscore how critical it is for employers and health plans to be working with maternity care management and digital health partners that help women understand the issues affecting their pregnancy, advocate for themselves, and ensure the highest quality of care across the continuum,” said Rachel Boyd, VP of Enterprise Marketing, Ovia Health. “Through studies like these, we are continuing our commitment to clinical excellence and evidence-based care, and advocating for clinical guideline changes at the highest levels of policy to improve standards of care and outcomes.”
About Ovia Health
Since 2012, Ovia Health has helped more than 15 million people successfully navigate their parenthood journeys and is on a mission to make a happy, healthy family possible for everyone. Ovia is the only family health solution clinically proven to effectively identify and intervene with high-risk conditions. The company’s 50+ clinical programs, including predictive coaching and personalized care plans, help prevent unnecessary healthcare costs, improve health outcomes, and foster a family-friendly workplace that increases retention and return-to-work. For more information, visit OviaHealth.com.
Media Contact:
Shannon Mullins
Scratch Marketing + Media for Ovia Health
shannon@scratchmm.com
We’re all reeling from the pandemic and living with mixed messages about the future. Although a significant percentage of the U.S. population will soon be vaccinated, infection rates have increased among young adults. There are new strains. There is still a lot we don’t know. Living with this uncertainty, and the abrupt changes the pandemic has triggered, is taking a toll on people’s mental health, especially expectant parents and parents with newborns and young children. Ovia Health’s new research, featuring digital depression screener data, highlights how difficult mental health challenges have been for parents over the past year.
Recent results from our digital depression screeners tell us that the percent of parents reporting mild, moderate, and severe anxiety and depression symptoms has increased during the pandemic. The most significant increases in anxiety, depression, and suicidal ideation are among women aged 35-39, in the BIPOC community (especially Black mothers), and first-time mothers.
The entire community has a responsibility to help face this crisis. Employers, health insurance providers, and their strategic partners can take leadership roles in combating this alarming mental health crisis. Preserving employees’ health and well-being and holding onto top workers is not only pragmatic; it’s the right thing to do. Working mothers and their families deserve a higher standard of care. The U.S. is now in the middle of a mental health crisis from which it will be difficult to recover if we rely solely on conventional approaches to care.
Choosing between children or paychecks
While we are all unsteady because of the pandemic, why are families, and especially working mothers, in crisis?
According to the Bureau of Labor Statistics, nearly 2.4 million women have left or lost their jobs since February 2020, compared to less than 1.8 million men. The pandemic has forced many working mothers to make impossible choices between childcare and their income. Daycare was either not an option during a pandemic, or the risks associated with it were not something families were willing to take on. Many parents are also responsible for simultaneously taking care of their own aging parents. Because of the pandemic, many women have given up their hard-won careers to care for their families.
Mothers who continue to work are often under pressure to maintain the same level of productivity they delivered before the pandemic, or risk losing their jobs. Others have been under the additional stress of being on the ‘front lines’ exposed regularly to people who may or may not be masked or adhering to social distancing. Many working mothers have risked their lives and their families’ health and safety just by going to work.
Disruption of family life
Intimate partner violence (IPV) has increased by 8.1 percent over the past year, according to a report from the National Commission on Covid 19 and Criminal Justice. Many incidents of IPV go unreported, so it’s likely that the number of incidents is even higher than those cited in the study.
The disruption of family life – giving up a job and losing household income, overseeing Zoom schooling or being expected to help teach themselves, losing contact with friends and family, living under tight restrictions – has fueled the mental health crisis. The strain of living through this pandemic continues to threaten parents’ mental health, increasing families’ risks of stress, depression, anxiety, and suicidal ideation.
What the digital depression screener data are telling us
Lack of childcare, financial stress, IPV, remote work and schooling, are taking a toll on parents.
We’ve been screening expectant mothers and postpartum mothers using digital depression screener surveys like the EPDS and PHQ-9 for the last several years. The Edinburgh Postnatal Depression Scale (EPDS) is a validated instrument made up of 10 screening questions used to determine whether a patient has symptoms of depression during pregnancy and in the year following the birth of a child. Scores on the EPDS can range from 0 to 30. The Patient Health Questionnaire Module 9 (PHQ-9) is another validated tool, comprising nine questions, which clinicians use to screen for depression and monitor the severity of depression and response to treatment using the DSM-IV criteria, with scores ranging from 0 to 27. While many providers use these screening tools, not all women are screened and that has become increasingly true as access to care has worsened during the pandemic.
We analyzed data from a sample of nearly 18,000 postpartum women who took the EPDS in Ovia’s apps either pre-pandemic (January 1, 2019 – February 29, 2020) or during the pandemic (March 1, 2020 – March 1, 2021). The results were alarming, but not unexpected.
Findings indicate that EPDS scores, in general, are higher during the pandemic than before. We are seeing the greatest increases in scores and suicidal ideation among women aged 35-39, in the BIPOC community (especially Black mothers), and in first-time mothers. Since the start of the pandemic, digital depression screener data have reported:
- Many women are having a harder time with anxiety and depression.
- 8% increase in women (overall) reporting mild to moderate symptoms of anxiety and depression and 7.5% increase in those reporting moderate to severe symptoms.
- The mental toll is greater for women in their 30s.
- Compared to women aged 25-29 who reported an average reduction in severe symptoms compared to before the pandemic, women aged 30-34 had an 11% increase in reported moderate to severe symptoms
- Women aged 35-39 had a 22% increase in reported moderate to severe symptoms and the greatest increase in reports of suicidal ideation (24%)
- Changes in screening results are even more significant for BIPOC women, especially Black mothers
- White women had a 10% increase in the proportion of moderate symptoms reported, but generally stable proportions in all other categories, including suicidal ideation.
- In contrast, BIPOC mothers had a 10% increase in severe symptoms reported and a 26% increase in reports of suicidal ideation.
- These changes so far appear to be primarily driven by increasing scores in Black women, more so than Hispanic or multiracial women.
- The pandemic has also disproportionately affected first-time mothers
- First-time mothers had a 12% increase in reports of mild depression and anxiety, an 11% increase in moderate symptoms, and a 2% increase of reported severe symptoms.
- First-time mothers also had a 7% increase in reports of suicidal ideation, compared to a 13% decrease in non-first-time mothers.
It’s clear mothers are struggling. Their employers and health plans should be focusing on new programs and benefits that can help alleviate the pressures of parenting during a pandemic, and invest in long-term benefits that will ensure their workforce is adequately supported in the future.
Raising the standard of care. How employers and health plans can support working parents
For nearly ten years, Ovia Health has been the leader in using digital health to proactively identify, stratify, and escalate health risk factors among new and expectant parents. Our clinical team has delivered more than 10 million digital depression screeners. The screeners we use help us understand how mental health uniquely impacts women on their parenthood journey.
We can identify factors that affect a woman’s risk of developing perinatal depression and continue to expand the role digital depression screener tools can play to fill in mental health screening gaps. Throughout the pandemic, we’ve been working with many organizations, like the March of Dimes, to continuously publish new research on how the pandemic impacts care delivery for parents, pediatrics, prenatal care, racial disparities in family care, and the parent mental health crisis.
We’ve partnered with large employers and health insurance providers to address these findings, and provide long-term benefits coverage and support for families. Our clinical intervention programming not only helps improve early identification for depression, it’s helping families and women connect to care in their networks, and avoiding healthcare spend associated with undiagnosed mental health conditions, and other adverse maternity events.
Return to work programming, parenting support, and manager training is also helping women juggle their careers and parenting duties. Equipped with stronger, more inclusive and comprehensive parental support programs, employers who work with Ovia are seeing a return to work rate of 92% after parental leave, and a one-year retention rate of 88% vs the industry standard of 80%.
With so many parents, especially women, struggling with mental health, employers and health plans need to act to address this crisis and prevent long-term leadership draughts. They owe it not just to their employees and members, but to parents everywhere, to invest in benefits beyond the traditional. Benefits and programs that count where it matters most — close to home.
Delivery Outcomes During the COVID-19 Pandemic as Reported in a Pregnancy Mobile App: Retrospective Cohort Study. JMIR Pediatr Parent 2021;4(4):e27769
Given obstetric care rapidly changed during the COVID-19 pandemic, Ovia set out to better understand how delivery outcomes were changing. We analyzed over 300,000 births (half reported pre-pandemic, half reported post-pandemic) and found that the post-pandemic cohort reported a 5% decrease in preterm birth rates, a 30% increase in home birth rates, and 7% decrease in average length of stay at the hospital post-delivery. There were no differences in C-section rates between groups.
Offering equitable, preventative, and attractive health benefits for employees is one of the most challenging obstacles HR leaders face every year as premium costs increase and consumer preferences shift. Many financial institutions, including some of the largest banks in the country, have embraced this challenge by expanding the definition of traditional health and wellbeing benefits to include maternity benefits and family solutions like Ovia Health.
Among the diverse set of companies Ovia Health proudly supports, US banks have been some of the most proactive employers to not only offer their populations the most loved and trusted digital health solution utilized by more than 15 million women and families, but actively work to drive engagement utilizing their existing programs, to ensure happier employees and better health outcomes.
Financial industry demographics, maternity benefits, and maternity care by the numbers
- Approximately 50% of babies are born on employer-sponsored health plans
- 43% of highly qualified women with children leave their careers after giving birth
- Replacing an employee who leaves after giving birth can cost up to 213% of annual salary
- 89% of millennial parents prioritize benefits over pay raises and 83% would change jobs for better benefits
- 88% of Ovia Health parents are still with the same company a year after giving birth
- 7 of the country’s leading banks are utilizing Ovia Health to better support their families
Targeted impact on population health and organizational wellbeing
With over two million women dropping out of the workforce in 2020, we’ve effectively rolled back decades of progress on gender equality, an impact that has profound implications on businesses for many years to come. The pandemic has intensified challenges that women, particularly women of color, already face. This is an emergency for corporate America, as companies are losing women in leadership roles as well as future female leaders, in alarming numbers.
The crisis can present an opportunity, however. If companies invest in building more flexible and empathetic workplaces, they can retain the employees most affected by today’s emergencies and foster a culture in which women have equal opportunity to achieve their potential over the long term. Employers are quickly adopting proven strategies and solutions to combat this devastating trend and ensure that their employees feel supported and guided through some of the most trying periods of their careers.
By working closely with HR leaders at the country’s top banks and financial institutions, we find that salaries and increased time off can only go so far in attracting and retaining top talent. Working mothers need better support and clinical attention before, during, and after their leave as well as better social support and more flexibility throughout the family-planning process, starting pre-conception.
A truly equitable benefits solution for every path to parenthood
Traditional family-building benefits are built for heterosexual couples, and often don’t take into account the unique experiences and challenges of family-building for LGBTQ+ families or single parents. Whether or not an employee identifies as LGBTQ+, more and more workers want to know that their employer is considering the needs of all employees and offering benefits that are fair and equitable to their coworkers.
Going above and beyond to offer truly inclusive and equitable benefits, especially maternity benefits, shows that employers are committed to fostering a diverse workforce, and employers with more diverse workforces are 35% more likely to outperform their industry counterparts in revenue and earnings growth alone. Ovia Health supports all paths of parenthood, including social cryopreservation (egg freezing), adoption, surrogacy, infertility, and planned conception without the need of assisted reproductive technology (ART), making it truly equitable across the organization.
For employees considering fertility treatment, our coaching team is able to provide compassionate, customized education about when it’s time to consider treatments and how to discuss the topic with their provider. Ovia coaches include those who have received infertility treatment, been a surrogate, served as an egg donor, conceived as a single-mother-by-choice using donor sperm, had twin pregnancies, and more. These diverse experiences enable them to guide members through the risks and benefits of different treatment options, such as side effects and success rates. They also work with employees to navigate their available employer- or health plan-provided benefits, including infertility services.
The only evidence-based, clinically-proven maternity benefits solution that drives measurable results
With 83% of participants engaging daily and during pre-conception or by the end of the first trimester, Ovia Health is able to clinically-prove a 30% decrease in ART-utilization and 28% reduction in preterm births. Advanced health assessments and symptom tracking alert members when a potential medical or mental health issue is detected, and navigate them to the right support, proactively detecting and preventing high-risk complications. Predictive analytics, risk stratification, and tailored intervention drive significant results, ensuring that the program quickly pays for itself in the first year of partnership.
Employers experience massive losses when employees leave mid-career or after giving birth. While many mothers wish to come back to work after their children are born, they struggle to find the right support. Research shows that good health outcomes for mothers strongly depend on two main factors during their first year: social support and perceived control. When companies are able to promote these two factors, and have top-of-class maternity benefits, everyone wins.
Ovia Health is empowering women and families to make the best choices for their health and helping companies make the most of their health programs. To learn more, please visit oviahealth.com, schedule a demo, or reach out to me personally at amy.page@oviahealth.com.
New partnership seeks to reduce perinatal mood disorders, focus on the use of breastmilk, and provide essential guidance for families with newborns in the NICU
BOSTON (GLOBE NEWSWIRE) MARCH 03, 2021
Ovia Health, the most trusted family health digital platform, today announced a new strategic partnership with March of Dimes, the nation’s leader in the fight for the health of all moms and babies, to provide evidence-based education and support for families with babies in the neonatal intensive care unit (NICU) and promote healthier outcomes for parents and babies.
Parents with children in the NICU are under immeasurable stress, often alone and without peer support. Through new resources, coaching, and support in the Ovia Parenting solution, Ovia and March of Dimes are seeking to provide NICU parents with guidance to reduce perinatal mood disorders and improve outcomes.
Nearly 9% of newborns spend time in the NICU after birth, and the experience can be traumatic for parents. Activities like feeding and bonding are more emotionally and logistically challenging as parents worry about the health of their babies, make difficult care decisions, and navigate a complex healthcare system. NICU parents experience depression and PTSD at higher rates than average, with 20-30% having a mental health diagnosis in the first year of their baby’s life (compared to a national postpartum depression rate of 11.5%).
Preterm birth, meanwhile, presents challenges to breastfeeding, including lower maternal milk supply, the inability of some babies to directly breastfeed, and challenges with keeping a supply of expressed milk while mothers are separated from infants in the NICU. Human donor milk, increasingly seen as a superior alternative to formula, is available, but awareness and access are often limited.
Ovia’s enhanced support for families in the NICU, in partnership with March of Dimes, offers March of Dimes’ educational resources specifically tailored to the NICU parenting journey, support for pumping and providing mother’s own milk, and help finding and accessing donor milk – all through Ovia’s existing Parenting solution.
“Having an infant in the NICU is an incredibly challenging experience for parents,” said March of Dimes Sr. Director of NICU Family Support, Heather Reimer. “It’s a crossroads – a time of risk not only for infants, but for parents as well. As we celebrate the 20 year anniversary of our NICU Family Support® program, we’re so happy to be working with Ovia, already a proven support platform for NICU parents, now with March of Dimes’ educational content to provide parents with guidance and improve outcomes for entire families.”
The March of Dimes partnership and increased support for NICU families builds upon Ovia’s already robust foundation of materials and assistance for parents, both in the NICU and outside. Ovia’s programming is instrumental in providing guidance and support that not only improves healthcare outcomes for families, but results in concrete cost savings for self-insured employers and health plans. For example:
- An increase in breastfeeding rates is estimated to save about $500 per breastfed infant. This cost avoidance is specifically derived from breastfeeding reducing the likelihood of common infantile illnesses in the first three months of life, as compared to formula-fed infants.
- Ovia members are 31% more likely to be treated for a perinatal mental health condition and Ovia identifies 60% more women at risk than the CDC estimates. This is done with improved and expanded screening tools and personalized navigation to care, resulting in a cost avoidance of $2,500 per case identified.
“We are so incredibly pleased to be working with March of Dimes, the nation’s leading nonprofit helping families of infants born too soon or too sick, on this important issue,” said Ovia Health Co-founder and Chief Product Officer Gina Nebesar. “We are working together to put the most vulnerable parents and children in the best hands possible, with the support they need at every stage of their journey – including the most challenging ones.”
About Ovia Health
Since 2012, Ovia Health has helped more than 15 million people successfully navigate their parenthood journeys and is on a mission to make a happy, healthy family possible for everyone. Ovia is the only family health solution clinically proven to effectively identify and intervene with high-risk conditions. The company’s 50+ clinical programs, including predictive coaching and personalized care plans, help prevent unnecessary healthcare costs, improve health outcomes, and foster a family-friendly workplace that increases retention and return-to-work. For more information, visit OviaHealth.com.
About March of Dimes
March of Dimes leads the fight for the health of all moms and babies. We support research, lead programs and provide education and advocacy so that every baby can have the best possible start. Building on a successful 80-year legacy of impact and innovation, we empower every mom and every family. For more information, visit MarchofDimes.org.
Media Contact
Anya Nelson
Scratch Marketing + Media for Ovia Health
anyan@scratchmm.com
Ever since Ovia Health launched in 2012, our mission to improve the world for women and families has been central to everything we do. As a company built on empirical evidence and committed to the rigor of the scientific process, we’ve built partnerships with leading research institutions in order to tackle some of healthcare’s most complex challenges. Our work has allowed us to build programs with demonstrated clinical efficacy and also contribute to research that informs healthcare policy and elevates the standard of care for millions of families. A scientific approach is the key to creating effective and impactful products, programs, and services.
Ovia Health’s Reach & Research
It has always been our intention to do our part to advance the fields of women’s and family health. By earning the trust of over 15 million families and demonstrating unparalleled levels of engagement, Ovia Health has become a premiere research partner with one of the largest anonymized datasets on women’s health in the world — several billion data points available to answer the most pressing questions. Recognizing the limitations of traditional research methods, including cite-based studies, sample size limitations, and exorbitant cost, we knew our scale could meaningfully contribute to scientific research.*
Working with members to improve care
We are incredibly honored to have a highly engaged and diverse member base of families who trust us to guide them on their journeys. In turn, we trust and depend on our community to inform what we do, including product development, clinical research, and institutional partnerships, because we recognize that in order for healthcare to improve, the patient must be at the center.
When we created our program to reduce the incidence of preeclampsia, a dangerous and sometimes deadly condition characterized by high blood pressure in pregnancy, we knew we needed to focus on barriers to treatment identified by patients themselves. In order to increase the utilization of low-dose aspirin, a medication that has been shown to significantly reduce the likelihood of developing preeclampsia among those at risk, we leaned on our community, and we learned a lot. We published and presented our findings at the American College of Obstetricians and Gynecologists annual conference and used the results to design our Preeclampsia Prevention and Management programming. The program focuses on improving education and trust in the medication, enhancing patient-provider communication, and overall accessibility and adherence — resulting in an 18% reduction in cases of preeclampsia. This is just one example of the ways our community and our commitment to science have allowed us to create a solution that is fundamentally changing the way high-risk conditions are managed.
Together with our nearly 40 academic research partners, we have been able to address the most pressing issues facing women’s and family health today.
Together, we explore questions like:
- What is the true incidence of miscarriage? And why do they occur more often in some communities than others?
- Are there symptoms that can be identified during pregnancy to alert patients and providers to behavioral health conditions?
- What is the best way to navigate eligible people to resources shown to improve outcomes, particularly among underserved communities?
- How can we help highlight the differential experiences in the US healthcare system between Black and White women, in order to address the disturbing 3-4x higher maternal mortality rate among Black women?
We are working with researchers around the world to answer these pressing questions — from our relationship with Dr. Michael O’Hara and his team at the University of Iowa, to our partnership with Dr. Jenna Nobles at the University of Wisconsin-Madison, to Dr. Joia Crear-Perry at the National Birth Equity Collaborative (NBEC), and our many colleagues at the Harvard Schools of Public Health and Medicine, including Dr. Neel Shah and Dr. Ateev Mehrotra.
Ovia Health & COVID-19
Most recently, Ovia Health has assumed our role in helping families navigate the COVID-19 pandemic. The current health emergency has brought on an immeasurable number of stressors including illness, childcare limitations, financial strain, social isolation, and more. We have been monitoring these experiences and rapidly developing strategies and tools to support our community in real-time. For instance, in March 2020 Ovia Health was the first to release a COVID-19 symptom tool, specifically geared towards pregnant women. Since then, we’ve maintained clinical guideline-driven information regarding COVID-19 symptoms, risks, and now, vaccines. We’ve curated decision-making support to help parents navigate the unique challenges of working without childcare, and our coaches — a team of licensed healthcare professionals — increased messaging and telephonic services by 240% in 2020. We’ve also contributed to broader understanding of the patient and parent experience during the pandemic, with publications in the Journal of Patient Experience and Journal of Maternal Child Nursing, and an upcoming presentation at the American Psychiatric Association’s annual meeting in May 2021.
As a digital healthcare company serving millions of members in a world profoundly impacted by the pandemic, Ovia Health is pioneering a future where the patient is at the center of healthcare. With the strain on the healthcare system caused by the pandemic, there is an even greater need for a reliable and scalable approach to preventative care. We are honored to be trusted by millions of women and families, who we thoughtfully and empathetically guide through their healthcare journeys, and we remain committed to contributing to the advancement of women’s and family health science.
Ovia Health is empowering women and families to make the best choices for their health and helping companies make the most of their health programs. To learn more, please visit oviahealth.com, schedule a demo, or reach out to our enterprise team at enterprise@oviahealth.com.
*Author’s note:
The privacy and security of personal health data — particularly data related to fertility, pregnancy, and postpartum health — is an issue that’s incredibly important to us. Ovia Health adheres to all applicable privacy and security laws and regulations, including HIPAA and GDPR. In addition, we are HITRUST-certified, fulfill our annual SOC 2 attestation report, and follow the same rigorous privacy and security regulations required by medical institutions. All of our research is supervised by Institutional Review Boards.
BOSTON (PRWEB) FEBRUARY 22, 2021
Ovia Health, the most trusted digital family health solution, is pleased to announce it has been accepted to the Digital Therapeutics Alliance (DTA), a global non-profit organization with the mission of advancing digital therapeutics into healthcare. Ovia is the first maternal and family health company to join the Alliance and the first of its kind to announce a pipeline of digital therapeutics products.
By entering the digital therapeutics category, Ovia is seeking to enable earlier and improved health management across the reproductive and family health continuum. Ovia is investing in a pipeline of digital therapeutics designed to fill the unmet needs of people experiencing reproductive health conditions. This investment in cutting-edge technologies further supports Ovia’s mission to elevate the standard of care for women and families across a range of conditions and life stages.
As an Alliance member, claims from Ovia’s digital therapeutics products will undergo rigorous evaluation by independent, peer-reviewed publications in accordance with the Digital Therapeutics Alliance’s key principles, including demonstrating adherence to strict clinical criteria and ROI calculation methodologies.
“At Ovia, we combine evidence, advanced analytics, and empathy to build daily digital health programs that help families achieve better outcomes and their dreams of having a healthy, happy family,” said Paris Wallace, Ovia CEO and co-founder. “This entrance into digital therapeutics represents our commitment to accelerating the digital transformation of healthcare and expanding the landscape into family and maternal health, which includes some of the most costly and complex condition areas for the healthcare ecosystem.”
“Digital therapeutics are transforming the global healthcare ecosystem, improving clinical outcomes, and building stronger care processes that are designed around patient needs,” shared Megan Coder, DTA Executive Director. “We are therefore proud to welcome Ovia Health into this incredible industry, especially as they build on their innovative work to deliver maternal and family health-focused digital therapeutics.”
Ovia Health is at the forefront of digital health transformation for families. Joining the Digital Therapeutics Alliance marks Ovia’s entry into digital therapeutics and is reflective of its longstanding commitment to clinical efficacy and research-based innovation.
About Ovia Health
Since 2012, Ovia Health has helped more than 15 million people successfully navigate their parenthood journeys and is on a mission to make a happy, healthy family possible for everyone. Ovia is the only data-driven solution to effectively identify and intervene throughout the family health journey. The company’s 50+ clinical programs, including predictive coaching and personalized plans, help prevent unnecessary healthcare costs, improve outcomes, and foster a family-friendly workplace that increases retention and return-to-work. For more information, visit OviaHealth.com. For more information on how Ovia Health is supporting employers during this time, request a consultation.
About DTA
The Digital Therapeutics Alliance (DTA) is a global non-profit trade association of industry leaders and stakeholders with the mission of broadening the understanding and adoption of digital therapeutics into healthcare. DTA works to enable expanded access to high quality, evidence-based digital therapeutics for patients, clinicians, and payors in order to improve clinical and health economic outcomes. To learn more please visit: http://www.dtxalliance.org.
Media Contact:
Anya Nelson
Scratch Marketing + Media for Ovia Health
anyan@scratchmm.com
617-817-6559
Remote monitoring enables at-risk populations to mitigate impact of social determinants of health
BOSTON (GLOBE NEWSWIRE) JAN 27, 2021
Ovia Health, the most trusted family health virtual platform, and MGM Resorts International (NYSE: MGM), a global hospitality and entertainment company, have partnered to create a new virtual program aimed at decreasing adverse maternal and child health outcomes among high-risk employee populations.
Eligible pregnant MGM Resorts Health Plan members who enroll in Ovia Health’s preeclampsia or hypertension programming will receive free, WiFi-enabled blood pressure cuffs. These cuffs allow members to measure their daily blood pressure levels proactively and input their data into the Ovia Pregnancy app-based program, which then alerts them of any concerning data trends.
“Self-monitoring during pregnancy is more crucial than ever before. In our peer-reviewed study with March of Dimes, we discovered that 20% of prenatal appointments during the pandemic were modified, moved online or canceled,” said Ovia Health Co-founder Gina Nebesar. “This is when biometrics are typically monitored and evaluated, so by delivering devices to people at risk for hypertension and preeclampsia, expecting parents can have more frequent and deeper insights into their pregnancy health in between episodic visits.”
The program is not intended to replace external monitoring according to a healthcare provider’s recommendations, but rather to supplement it by offering members feedback in real time, as well as rich visualizations to analyze and flag potential concerns. Members are also encouraged to share their data with their healthcare providers to better monitor their hypertension or preeclampsia risks over time.
“We are proud to partner with Ovia Health to provide best-in-class preeclampsia and hypertension resources to our pregnant plan members, especially during the COVID-19 pandemic,” said Tamra Lynn, Director of Clinical Programs and Case Management at MGM Resorts International. “We saw a need and worked with Ovia to develop a process that they were able to use with other companies as well; this is a time for our communities to come together, and in a way, we’re doing just that.”
“The ability for Ovia to help members monitor their health at home during the pandemic – and on an ongoing basis – is critical. Our collaboration with MGM Resorts is the first of many programs of its kind, all aimed at making members active participants in their own healthcare and helping healthcare providers transition from reactive to anticipatory healthcare. The challenge in diagnosing preeclampsia is that the clinical signs can be nonspecific, so early-detection and a preventative approach is crucial,” said Nebesar.
Ovia Health is starting this program with a focus on preeclampsia prevention among vulnerable populations. Throughout 2021, Ovia will be rolling out additional clinical programming that goes beyond the digital health space, utilizing remote monitoring devices and other means to empower members with proactive measures and increase their chances of preventing adverse and costly health outcomes.
ABOUT OVIA HEALTH
Ovia Health has supported over 15 million women and families through clinically proven health programs, coaching, and personalized educational content since 2012. Ovia is dedicated to supporting families across their diverse health journeys, including fertility, pregnancy, and parenting. For more information about Ovia Health, visit www.oviahealth.com. For more information on how Ovia Health is supporting employers during this time, request a consultation here.
ABOUT MGM RESORTS INTERNATIONAL
MGM Resorts International (NYSE: MGM) is an S&P 500® global entertainment company with national and international locations featuring best-in-class hotels and casinos, state-of-the-art meetings and conference spaces, incredible live and theatrical entertainment experiences, and an extensive array of restaurant, nightlife and retail offerings. MGM Resorts creates immersive, iconic experiences through its suite of Las Vegas-inspired brands. The MGM Resorts portfolio encompasses 29 unique hotel and destination gaming offerings in the United States and Macau, including some of the most recognizable resort brands in the industry such as Bellagio, MGM Grand, ARIA and Park MGM. The Company’s 50/50 venture, BetMGM, LLC, offers U.S. sports betting and online gaming through market-leading brands, including BetMGM and partypoker. The Company is currently pursuing targeted expansion in Asia through the integrated resort opportunity in Japan. Through its “Focused on What Matters: Embracing Humanity and Protecting the Planet” initiative, MGM Resorts commits to creating a more sustainable future, while striving to make a bigger difference in the lives of its employees, guests, and in the communities where it operates. The global employees of MGM Resorts are proud of their company for being recognized as one of FORTUNE® Magazine’s World’s Most Admired Companies®. For more information, please visit us at www.mgmresorts.com. Please also connect with us @MGMResortsIntl on Twitter as well as Facebook and Instagram.
Media Contact:
Anya Nelson
Scratch Marketing + Media for Ovia Health
anyan@scratchmm.com
617-817-6559
Seven million women of childbearing age in the US, 35% of whom are women of color, live in “maternity care deserts,” or areas where health care systems do not offer obstetric care, birthing services or specialized providers. This is according to a new report from March of Dimes, a non-profit organization leading the fight for the improved health of all moms and babies.
Maternity care deserts in the U.S.
About 35 percent of all U.S. counties (1,095 counties) were identified as maternity care deserts by the report, which make up approximately 500,000 annual births. Without access to routine and quality health care, these moms and babies have an increased risk of serious health complications, including maternal and infant mortality and morbidity, as well as low birthweight and preterm birth.
COVID-19 Impact
We were recently able to survey 14,000 pregnant women in the US to evaluate the effects that the current health pandemic is having on the way women are receiving care. Our findings, which were featured in the March of Dimes September Report, emphasized how effective digital health solutions and telehealth can be utilized to support prenatal and postpartum care.
Following the sobering findings of the March of Dimes report, we hosted a webinar with March of Dimes Chief Medical and Health Officer, Dr. Rahul Gupta, to discuss maternity care deserts and why our healthcare system is failing 7 million women every year. Dr. Gupta expanded on vital aspects of the report and emphasized how employers, health plans and policymakers must work together to increase access to services that are designed to fill gaps in maternity care.
4 key takeaways from our conversation with Dr. Gupta
- One-third of maternity care deserts are based in metropolitan areas, while two-thirds are in rural areas. This means that regardless of geographic location, women in America aren’t getting the care they need and with hospitals currently closing or overwhelmed, maternity care deserts can be found all across the nation.
- Addressing the health inequities faced throughout our nation is just as fundamental as addressing maternity care deserts. This is why expanding awareness and access to birth centers, doulas, and midwives is critical as they are uniquely positioned to provide critical support that women in under-resourced areas need.
- Early-identification is extremely important but traditional risk identification methods are failing women. Someone dies from childbirth or complications every 9 hours in the U.S. and, according to the CDC, 6/10 deaths are preventable. Identification doesn’t need to happen in-person and evidence-based digital solutions have proven to effectively identify and intervene with high-risk conditions virtually.
- The current pandemic has exacerbated the lack of access to quality care but has also presented key opportunities for health plans, employers, providers and policy makers to collaborate and establish a new approach that centers the patient, and not the healthcare system.
As Dr. Gupta stressed during the webinar, “we are able to do something to address this despicable mortality and morbidity crisis and early diagnosis is extremely important.” This applies to us all: health plans, employers, providers, policy makers, and health technologies like Ovia.
Our nation is experiencing a national maternal and infant health crisis, which is disproportionately impacting moms and babies of color. We urgently need to increase access to care, eliminate health disparities, and address preventable conditions to drive health and social equity.
We must also work to address the systemic health disparities that exist in our nation and find real solutions for the seven million women living in maternal care deserts. We can start by accelerating and mobilizing virtual services, like telehealth and peer-to-peer support services, to provide vital aid to women living in these deserts.
You can view the full report here or download our conversation with Dr. Gupta here. We also urge everyone to visit BlanketChange.org to learn more about March of Dimes’ latest campaign demanding nationwide changes in support of these issues.
In early November, Ovia Health and I joined forces to deliver a webinar titled “Why Women Are Leaving The Workforce: From Mental Health To Social Determinants Of Health.” Together we provided the audience with an understanding of what moms are going through right now, what exactly is a social determinant of health, and how employers can take action to slow down the unfortunate secession occurring in America right now.
During the webinar, I discussed the social determinants of health most impacting employers’ working parent workforce. According to the Center for Disease Control, social determinants of health are conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes. Ovia Health has found social determinants of health determine 50% of a persons’ health outcomes.
We took a deeper dive into how work conditions impact social determinants of health and found three drivers:
- disconnection and lack of ambient belonging,
- racial and financial inequalities (e.g. the housework and wage gap), and
- health issues on the rise (e.g. maternal mental health and physical challenges).
Disconnection and Lack of Ambient Belonging
Ambient belonging is feeling comfortable in a space — like you are accepted, valued, and included there. Even prior to COVID-19, many women in the workplace didn’t have a sense of ambient belonging, especially mothers. These women also have a disproportionate ability to connect at work. For the women who’ve managed to connect and thrive in the workplace, being forced into quarantine and a stay at home mom role is challenging as well. According to Motherly’s State of Motherhood survey, 41% of full-time working mothers say that they are most strongly defined by other non-motherhood aspects of their life and self.
Racial and Financial Inequalities Fuel Social Determinants of Health and poor outcomes
Black women tend to be caregivers for not only their children but more than likely elderly family members. According to LeanIn.Org, Black women spend nearly three times more hours per week caring for elderly or sick relatives during the pandemic, compared to just the 12 hours white women spend. Also, Black women spend half a day more (12 hours) on child care per week than white women. Ovia Health is reporting disproportionate effects on Black women as well. 61% of black women themselves are receiving less frequent, lower quality care due to the COVID-19 pandemic. 44% of Black women report not receiving any communication about COVID from their provider compared to 38% of White women.
Financially, women are considering leaving the workforce because it ultimately costs them more to remain in it. We cannot forget about the housework and wage gap, issues for women long before COVID-19 reared its ugly head. According to USA Today, last year women earned 80 cents for every man working. But working moms earn even less at 69 cents. As it affects their hiring and promotion, motherhood costs women $16,000 per year in lost wages.
Childcare is a tremendous financial stress, with families going into debt trying to scramble together solutions. According to the National Association of Child Care Resource and Referral Agencies, the cost of center-based daycare in the United States can run up to $18,773 a year ($361 a week). On average, child care costs can take up to 40 percent of a dual-income household in America. Without question, childcare is often the second largest monthly expense for families after their mortgage or rent payment.
Social Determinants of Health Issues on the rise
It’s no secret women are taking on more of the work at home in addition to the professional jobs, and it’s taking a toll on their physical health. According to NordVPN the average employee is logging three more hours of work a day, and long work hours and shift work, combined with stressful or physically demanding work, can lead to poor sleep and extreme fatigue. The World Health Organization estimates that about half of the population is experiencing “pandemic fatigue”, but fatigue for mothers is also increasing the risk for injury and deteriorating health, including infections, illnesses, and mental health disorders. During the webinar we also discussed the breakdown in maternal and infant health and family wellbeing.
As a working mom, I’d like to more forward to what can be done to improve work conditions for women. Ovia Health and I uncovered the three things working moms need most from their employers: empathy, decisions, and care from their employers. We also discussed the steps employers need to take now that drive immediate impact and long-term transformational change, and an effective strategy to support and retain working parents.
I encourage you to listen to the webinar and assess your organization against our recommendations. Women are gauging right now whether their managers and their employers are treating them with respect and care. They’re also making decisions now about whether they want to stay with that organization. They’re turning to their leaders and their organizations for stability in our uncertain world of divisiveness and environmental unrest.
Some leaders will emerge more successfully than others, if they’ve found a solution to keep their female talent within the organization.
Parent Perspective on Childhood Development after Assisted Reproductive Technology: A National Survey.
J Hum Reprod Sci. 2020 Jul-Sep; 13(3): 221–234.
This publication demonstrated that there is no difference in the way parents who conceive spontaneously vs. with medical assistance view their children’s development. This was one of the first times this topic has ever been researched.
BOSTON – October 14, 2020 – Ovia Health, the most loved and trusted digital health companion utilized by more than 15 million women and families, has been recognized as a “Top Women’s Health Program” in 2020 by Shortlister.
Shortlister, the number one marketplace for finding and selecting vendors in the wellness, HR technology, and benefits space, evaluated women’s health programs on three criteria: Company Background & Stability, Business Performance & Rating Data, and Market Presence/Buzz Factor.
Ovia Health helps employers, health plans, and consultants provide standout benefits to their populations as the only maternal health solution clinically proven to effectively identify and intervene with high-risk conditions. The company’s mobile-first platform combines evidence-based clinical tools, guidance, predictive coaching, and proactive interventions to deliver daily customized support throughout the family journey — from pre-conception to pregnancy, postpartum, and infant development.
Joe Miller, President and Co-Founder of Shortlister, said, “We are excited to announce that Ovia Health has been named a Q4 2020 Top Vendor for Women’s Health Program by Shortlister, the number one marketplace for employers and consultants to find and select providers in the human capital, wellness and benefits space. Ovia Health’s inclusion makes it part of an elite list, just three of 46 companies earned Top Vendor status in Shortlister’s Women’s Health Program category. Shortlister evaluates providers based on a number of data points, including number of clients, number of lives covered, bid inclusion, and wins vs. losses.”
“Enterprise clients — from employers to health plans alike — are looking to deliver inclusive family benefits that support all parents and expectant families at home and at work. Ovia is proud to offer evidence-based solutions that are proven to improve clinical outcomes, reduce medical spend, and engage populations in a meaningful way. We would like to thank the entire Shortlister team for their hard work delving into this innovative space that has made an impact in the lives of millions of families,” said Paris Wallace, CEO at Ovia Health.
Ovia Health was founded in 2012 and is headquartered in Boston, MA. For more information about Ovia Health, visit www.oviahealth.com.
Nearly 10% of babies born in the United States are born premature — which results in not only adverse health outcomes for mom and baby, but also significant healthcare costs. According to the March of Dimes, a premature baby spends an average of 25.4 days in a speciality care nursery at an average cost of $144,692. The cost associated with preterm birth adds $26.2 billion to U.S healthcare costs each year.
Ovia Health is reducing incidences of preterm births
Ovia Health is actively reducing preterm births, helping moms have healthy, full-term deliveries. We do this by identifying risk factors — such as history of preterm bith, short or insufficient cervix, and multiple gestation — and providing women with personalized guidance and information to help them make choices that reduce the risk of preterm delivery.
For example, if a woman has a history of preterm birth, we deliver content prompting her to ask her provider about progesterone, an effective treatment in reducing the risk of preterm delivery. If she indicates that she has been prescribed progesterone, she will then be delivered prompts to aid with medication adherence.
This engagement, coupled with the Ovia Health Behavior Change Framework, is essential in reducing preterm delivery rates and helping more babies stay out of the NICU. Ovia Health has been able to reduce rates of preterm births by 25%.
Preterm Birth Delivery Interventions
Ovia Health is also conducting groundbreaking research about preterm delivery interventions. Our latest research has been published by and presented with the Society for Maternal and Fetal Medicine and the American College of Obstetrics and Gynecology, two of the most prominent authorities in the women’s health medical landscape.
When Ovia Health identifies risk factors for preterm delivery early in a woman’s pregnancy, we can prevent preterm births, improve health outcomes for moms and babies, and significantly reduce healthcare costs for employers and health plans.
Download our new whitepaper to learn more about how Ovia Health leverages engagement, behavior change theories, and physician-developed health programs to reduce the risk of preterm birth.
Adding Ovia Health for healthier outcomes, reduced costs, and a safe, productive workforce during the pandemic and beyond.
Learn the facts surrounding COVID-19, your workforce, and things you can do to have an immediate impact for your employees in the next month.
the facts
COVID-19 has impacted many employers and employees. From remote work and home schooling situations, to essential employee burnout, there is a lot of stress on the workforce today. Here’s what we know:
- Women make up 49% of your workforce — many of them are homeschooling and caring for their children or facilitating childcare, while working from home since the outset of COVID-19
- Women make 89% of healthcare decisions for their families and as access to fundamental health services continues to shift, they are facing new challenges
- Adherence to routine and preventive care has dropped significantly during the COVID-19 pandemic, increasing healthcare costs and negatively impacting health outcomes for the foreseeable future
- 30% of prenatal care has been modified (March of Dimes, Ovia Health)
- 70% drop in pediatric vaccines (CDC).
- Families are facing increased levels of stress and anxiety, impacting family dynamics and child well-being during COVID-19.
- $31,800 is the cost of an untreated perinatal mood & anxiety disorder per mother (American Public Health Association)
the reality
Your employees and their families need support, Ovia Health can help
Families use Ovia Health to get the digital, virtual, and personalized care and support they need every day. Ovia Health is providing innovative solutions with navigation to self-care, preventative care, and childcare for families through:
Our hope is that employers continue to recognize their increased responsibilities during this time, and act proactively to avoid compromising the careers of an entire generation of working parents, particularly working moms who seem to be the most impacted so far. If you’re an HR leader looking for more ways to support your working parent populations during this time, please don’t hesitate to get in touch to find out how we can help.
For more information about COVID-19 and how Ovia Health can help you, email enterprise@oviahealth.com.
Author: Gabriela Perez
While there is little doubt that genetics and lifestyle choices play critical roles in influencing someone’s health, researchers are increasingly demonstrating how environmental conditions in which people are born, live, and work, play equally as important a role in shaping health outcomes.
Being aware of these broader conditions that influence people’s health supports a more respectful and human-centered level of care that incorporates lived experiences, optimizes health outcomes, improves communication and helps reduce health inequities. Research shows that as much as 50% of a person’s health outcomes are determined by these factors, better known as social determinants of health. Recognizing their importance can help us better understand our communities, effectively communicate about health-related conditions and most importantly improve health outcomes.
Social determinants of health have been shown to directly impact many reproductive and family conditions like preterm birth, unintended pregnancy, infertility, cervical cancer, maternal mortality, amongst others. The COVID-19 health emergency as well as recently-heightened focus on racial justice have underscored health disparities, particularly among Black and Latino populations in the U.S. Social determinants of health such as income level, education, housing status, racial discrimination, and exposure to violence have been shown to directly impact birth outcomes.
This public health crisis is accelerating due to COVID-19. Our own research has shown that post-COVID, maternal healthcare inequities may increase further, with a disproportionate impact on Black women. Black women in general experience higher rates of preterm birth compared with non-Hispanic White women, and their newborns experience up to three times higher mortality rates. During the pandemic, we found that over 30% of prenatal appointments were modified or canceled, and Black women were more likely to be asked to modify their visits. Once rescheduled, 61% of Black women felt that their modified visit covered less care/information compared to a normal visit.
Healthcare institutions and policy makers have long-understood that social determinants directly impact health, but to truly solve these issues, greater collaboration between researchers, institutions and communities are needed.
Given our vast reach and the fact that Ovia accompanies families throughout pregnancy, Ovia Health has the unique opportunity to contribute invaluable data to the scientific study of women’s health, as well as the social determinants of health. Since our founding, we have been working closely with researchers to explore and help improve various determinants of health outcomes and are constantly optimizing our clinical programs to better meet the varying needs of our community.
Through investments in research and advocacy, access to health services, mental health coaching, prenatal care adherence, and social/expert support, we continue to do our part to address social determinants of reproductive and family health. But in order for us to successfully chip away at these challenges, employers, health plans and institutions must work together to understand the ways social determinants of health impact their populations and then offer customized solutions that improve outcomes.
One of the most rewarding aspects of growing the Ovia community and expanding our offerings during the past eight years has been the ability to partner with various health plans and organizations who share our mission to improve the world for women and families.
Our clinical research group studies patient outcomes and associated risk factors to understand gaps in care and how to better serve patients, and has been able to establish invaluable partnerships with institutions across the U.S. We recognize the interplay between certain social determinants of health — for example, incarceration, education and poverty — and have adopted a holistic approach when it comes to addressing these issues. An approach that entails combining point solutions with an overarching, guiding philosophy to ensure that our apps meet industry-leading standards of accessibility and personalization.
When it comes to education, communication barriers are often the biggest drivers of health disparities. This is why Ovia’s in-app content is designed to be at a middle-school reading level, to allow members access to crucial healthcare information. We have also translated our apps into Spanish and made them accessible for those with disabilities, further broadening our ability to serve our member population.
We also understand how powerful social and community learning can be to influence behavior, which is why we created Ovia Community, a vibrant and supportive community of new and expecting parents with over 300K daily posts & responses. We also launched Health Coaching to provide tailored one-on-one support to our members. We wanted to design features that foster safe relationships between members who may be going through similar experiences and also offer the option for personalized health coaching to provide high-touch support whenever needed. Our health coaches work from evidence-based care plans to provide members with the highest quality support for all of their health questions and decisions. Additionally, we offer predictive coaching where coaches automatically reach out to members to provide guidance if they enter a specific data point or reach a milestone that, coupled with their existing health profile, could indicate a risk factor for a health complication.
In light of increasing accessibility and interactions with the healthcare system, we provide our members with a directory to help them find a quality in-network healthcare provider, with whom they feel comfortable working. Then, we support them further by offering tracking tools to best plan for upcoming appointments and follow-ups.
While the concept of social determinants of health is not new, the current crisis has highlighted and magnified existing health disparities. It is essential that healthcare providers and solutions seek out opportunities that aim to fill these critical health gaps. Ovia will continue to push barriers and forge partnerships in line with our commitment to make a happy and healthy family possible for everyone.
COVID-19 has overloaded the healthcare system and upended access to care. But as restrictive rules about care delivery have been adjusted to fit this new reality, the healthcare community has a chance to usher in a new, more inclusive future of care, one in which virtual support plays an increasingly important role.
Since the beginning of the pandemic, 30% of prenatal care has been modified or cancelled, while a 215% increase in planned home births, and 70% drop in children vaccines, indicate that regardless of care modifications, people are opting to stay home to avoid in-person visits. Increasing access to virtual support services is the only way health plans and employers can get ahead of the fall out from COVID-19, and beyond.
The notion that increasing access to virtual support can improve health outcomes is not a new one. Dr. Joia Crear-Perry, Founder and President of The National Birth Equity Collaborative, has long envisioned a future of medicine in which access to providers, social support, and case management is all possible virtually. She’s been fighting to provide virtual care to under-resourced communities for years. Concern about how virtual settings could impact care quality historically obstructed virtual care delivery, but now, providers are opening virtual options, and they’re finding that in many cases, virtual care is just what the doctor ordered.
Reimagining care delivery through virtual care
As the healthcare community begins to reimagine care delivery, Dr. Crear-Perry notes that we must be extremely thoughtful to avoid deepening or perpetuating inequalities. This begins by investing in and designing accessible, inclusive programs. Inclusivity is essential, especially today, as Black women are 1.4 times more likely to be asked to modify their visits. Simultaneously, 61% of Black women report that their modified visit covered less information compared to a normal visit. ¹
Virtual support is a key pillar of inclusive care. By prioritizing and investing in virtual support, the healthcare community has a chance to center the experiences of individuals who are unable to access traditional forms of care, rather than retroactively incorporating these perspectives. And still, even as we normalize virtual support, we must expand the definition beyond video calls to include asynchronous chat with providers, self-monitoring functionality, appointment reminders, and fetal movement tracking.
As Dr. Joia Crear-Perry reminds us, it is essential to meet people where they are. This will require patience as widespread comfort with virtual care delivery increases, but one thing is clear: the days of episodic care delivery are over.
Three important takeaways
1. Virtual care and support is not one-size-fits-all
As the pandemic has reinforced existing barriers to in-person care, it has also demonstrated the importance of providing preventative care across various channels. The most impactful virtual support options are built around individual needs and preferences, providing access to clinical education, local and virtual providers, and social support. Solutions that include remote monitoring, health tracking, adherence, and educational tools to meet individuals where they’re at — quickly — and prevent adverse health outcomes are the future of equitable care.
2. Patient advocacy through clinical education must take a front seat
Empowering patients with accessible clinical education is more important than ever before. With limited in-person care options, it has become essential that patients feel empowered to take control of their health, and for their health plans and employers to provide solutions with the tools to enable them to do so. To ensure positive clinical outcomes as we shift to virtual settings, members need access to personalized clinical information that resonates and considers social determinants of health as well as culturally-relevant support.
One of the biggest opportunities for growth here is mental health support. Mental health support is increasingly important as the pandemic exacerbates existing challenges. Effective solutions encourage members to take control of their mental and physical health and empower them to advocate for themselves in their personal lives, in their communities, and to their healthcare providers.
3. Conduct an assessment of your organization and prioritize trainings
Finally, ask your organization to look internally. In order to fundamentally shift the way the healthcare community thinks and works, it’s imperative that organizations address the ways they perpetuate inequalities and that they commit to weaving accessibility and inclusion into organizational goals. Host racial equity trainings and look for solutions that are actively addressing inequalities with tools that make an impact: clinical education, resources, guidance, and social services. By offering trainings and by committing to creating a more equitable company culture, you also encourage organizational leaders to sustainably shape a more accessible and inclusive future.
For more information on building an equitable future, download our webinar with Dr. Joia Perry
Dr. Joia Crear-Perry, Founder and President of The National Birth Equity Collaborative, joined Ovia Health in June for a critical conversation on the current state of birth equity, how changes in our healthcare system due to COVID-19 threaten to impact communities of color, and what health plans and employers can do to mitigate and prevent adverse outcomes. You can download the complete webinar here.
- For more information on what health plans and employers can do, download the webinar with Dr. Joia Perry here.
- To learn more about Ovia Health’s social support services and access to community care networks for employers, click here.
- To learn more about Ovia Health’s social support services and access to community care networks for health plans, click here.
¹ Ovia Health survey data
The coronavirus pandemic has increased workplace challenges and health care barriers for women and mothers.
The strain on working parents is clear and disproportionately affecting mothers, who are taking on the extra share of childcare and home-schooling.
Five months into the worst global pandemic nearly all of us have ever seen, the topic of women’s health remains a major focus. Health plans and employers, everyone from small to Fortune 100, need to be taking women’s health and child wellbeing immensely more seriously now than in previous decades. Some are, and these forward-thinking trailblazers are ones that I encourage others to follow.
So why is women’s health such an important focus for chief medical officers, chief people officers, chief commercial officers, chief diversity officers, leadership, founders and the board room now? Shouldn’t it have always been, and shouldn’t it always be?
COVID-19 has exposed gaps, inequalities and disparities within every facet of our society including the health care system. However, exposing health care inequities could result in positive and long overdue changes. Granted the hundreds of thousands of deaths, the millions of infections, and the entire global shift of our daily way of life as we knew it has changed – and I am in no way saying that this pandemic is a positive, far, far from it. But, if this once-in-a-hundred-years type of public health crisis continues, and forces the aforementioned corporate leaders to focus more on, adapt, and dedicate more resources to physical and mental health — especially for women — then perhaps this is some tiny, tiny silver lining.
There are a few major reasons why the need for employers to focus on women’s health care is of the utmost importance now more than ever. And each is only going to be more important as the summer winds down, we try to somehow tip-toe into and reenter the annual back-to-school transition and even head back into the office every morning.
Mental health for expecting and new mothers
The strain on working parents is clear and disproportionately affecting mothers, who are taking on the extra share of childcare and home-schooling. The lines between our work-selves and family lives have blurred, increasing the gender gap by 20 to 50% for women in heterosexual couples.
New and expecting mothers face increased stress, with the effects of COVID-19 on the baby in utero still opaque. Parents are being sent home 24 hours after giving birth, and medical distancing protocols may negatively impact the ability to screen patients for perinatal mood disorders in the postpartum checkup visit. A recent study published in the American Journal of Public Health found that the cost of untreated perinatal mood and anxiety disorders (PMADs) totaled $14 billion USD in 2017, with an average cost of $31,800 per mother-child pair.
Digital support systems that deliver EPDS and PHQ-9 depression tools combined with mental health social workers and coaching teams are immensely valuable today. These are strange and challenging times, and health care platforms utilized by employers need to be there every day to provide trustworthy information and virtual support to improve the chances of a healthy childbirth outcome and family.
Health care inequities for women and moms of color
A recent survey administered by Ovia Health and March of Dimes revealed 61 percent of black women reported receiving less frequent, and lower quality care (compared to 52 percent of white women) during the COVID-19 pandemic. Maternal health outcomes pre-COVID-19 revealed a racial divide that’s devastating: Black women are three times more likely to experience maternal mortality than white women.
In a recent virtual event hosted by Ovia Health with Dr. Joia Perry, founder and President of the National Birth Equity Collaborative, Dr. Perry discussed birth equity as the assurance of optimal conditions for birth for black mothers, “so that we don’t have people just survive pregnancy and say, ‘Oh, thank God I made it through,’ that they should have the right to thrive and live their best lives.”
Relationship violence puts maternal outcomes at risk
At the start of the pandemic, there was a national surge in calls to police and domestic violence hotlines. Relationship violence impacts one in five women nationally and is associated with adverse health outcomes like preterm delivery (CDC.) Social distancing combined with the recessionary environment threatens the family dynamics, which is why we identified it as an imperative to focus on mental and social wellbeing for our community.
We introduced new tools to self-monitor relationship stress in a private, digital environment with concierge navigation to mental health providers and Intimate Partner Violence (IPV) hotlines.
Impacts on childbirth
Parents are questioning their birth plans and hospital choices due to fears of delivering alone or contracting COVID-19. We saw a 400% increase in interest in home births in the wake of the shut-down order. Developing a birth plan, utilizing things such as one-on-one virtual support systems, can help new moms feel more confident and in control when they go into labor.
Additionally, economists predict that there will be a decline in the birth rate due to the pandemic for a multitude of reasons. from heightened uncertainty to the ongoing challenges of being a working parent in the U.S., to additional burdens falling on certain racial groups, all of which will affect the decision to start or grow a family.
The coronavirus pandemic has increased workplace challenges and health care barriers for women and mothers, and could very well threaten childbirth outcomes and the long term wellbeing of the family. Women and families are living in fear. Wondering if they should delay getting pregnant or if they can breastfeed, as well as concerns about shortages of diapers, formula and other WIC eligible resources. It is imperative that companies take urgent action to prioritize women’s health and family well-being now in order to preserve and improve the future for generations to come.
Your working parents are likely under immense pressure to make return to work and school decisions and they desperately need your support.
If ever was the right time to show support for working parents who are juggling work, child-care and schooling-from-home responsibilities, it’s right now. We recently commissioned a survey of 18,000 Ovia Health members to find out just how working parents are navigating childcare, return to work, and back-to-school decisions this fall. What we discovered is that most parents feel anxious, uncertain, and want more support from their employers in navigating these unprecedented matters.
Here are some of the most urgent takeaways from our new research that shed light onto the challenges that parents are facing right now:
Access to childcare for return to work scenarios
First among those challenges is widespread anxiety relating to not having access to childcare. 42% of parents expressed concern regarding not having the childcare support they need this Fall and beyond. Limited in-class schedules and childcare capacity could mean that parents will need to stay home with their children for the foreseeable future, and that can have long-term impacts on their careers.
Return to work landscape
Parents with minor children make up around one-third of the national workforce; any economic recovery will undoubtedly rely on their continued participation in the labor force. 18% of parents are worried that they won’t be able to return to work when they need to and another recent study showed that nearly 75% of parents plan to make major changes to their careers to accommodate the lack of childcare. Some parents even reported that they are considering leaving the workforce altogether. Needless to say, this can have a disproportionate impact on women, as women often take on the brunt of childcare responsibilities and are more likely to drop out of the workforce than men in order to take care of children.
Fear of exposure
Another extremely common fear among Ovia parents is bringing the virus home. 56% of Ovia parents surveyed are worried that their partners or support people will contract COVID-19, and a whopping 73% are worried that their kid will get sick.
Job security
As September approaches and uncertainty looms, the pandemic is quickly threatening to harm an entire generation of working parents, with 30% of parents expressing concern about finances and/or job security. It’s vital for employers to recognize these specific challenges in order to set the right course of action and implement actionable and targeted solutions.
Whether it’s navigating the risks and benefits of sending kids back to school, best practices to ensure family’s safety or even emotional support during the process, working parents could use all the support they can get. This is why we quickly shifted our priorities at Ovia Health to maximize and scale our support for our communities. In the process, we upended our offerings to ensure unparalleled levels of support both for our parent populations and enterprise partners.
During the past few months, we identified some of the most pressing and relevant topics concerning our communities and developed a multi-lever offering to address them. This consists of virtual one-on-one support from our clinical team of health coaches, a COVID-19 support center for parents with the latest resources concerning the pandemic, and virtual events that highlight best practices, the latest science and guides to challenging topics like childbirth during a pandemic, breastfeeding, emotional wellbeing and many more.
We also established a COVID-19 support center for our Enterprise partners that include school and daycare planning to facilitate decision making for parents throughout the pandemic. Our coaching team is now providing virtual support for parents with children (pre-K and school age) who are navigating school and daycare decisions in accordance with clinical protocols, personal and cultural considerations. We’re also constantly providing parents with digital resources to ensure their children’s health and development as well as activities to do with their toddlers to promote cognitive development, child nutrition and general pediatric wellness.
Finally, responding to the high levels of reported anxiety and depression amongst working parents during this time, we introduced digital depression tools and concierge services to help our participants navigate virtual health care, as well as emotional health coaching offered by our in-house coaching team of mental health social workers, now available 7 days a week.
Never have we felt more grateful to have access to and the trust of 15 million families, who are sharing with us their most pressing concerns and we’re getting straight to work in helping them feel supported and empowered to tackle them. We’ve always been advocating for increased employer support of populations navigating fertility, pregnancy and parenting journeys, and are now fully prepared to help employers be proactive and act with empathy.
Our hope is that employers continue to recognize their increased responsibilities during this time, and act proactively to avoid compromising the careers of an entire generation of working parents, particularly working moms who seem to be the most impacted so far. If you’re an HR leader looking for more ways to support your working parent populations during this time, please don’t hesitate to get in touch to find out how we can help.
To learn more about Ovia Health’s COVID-19 support center and evidence-based clinical programming for employers, click here.
To learn more about Ovia Health’s COVID-19 support center and evidence-based clinical programming for health plans, click here.
Dr. Joia Crear-Perry, Founder and President of The National Birth Equity Collaborative, recently joined Ovia Health for a critical conversation on the importance of Doulas, the current state of birth equity, how changes in our healthcare system due to COVID-19 threaten to impact communities of color, and what health plans and employers can do to mitigate and prevent adverse outcomes. You can download the complete webinar here.
Health justice advocate, Dr. Joia Crear-Perry, spoke with Ovia Health recently about the importance of doulas, social support and personalized care for birthing parents, particularly for Black mothers and families.
Health disparities among Black families
Black families experience disproportionately worse maternal and infant health outcomes for a number of reasons including dismissal of pain (Black mothers, who are twice as likely as white mothers to report that they were ignored by the health system), limited access to care, and higher rates of underlying health conditions, among others. Many of these barriers to care have been exacerbated by COVID-19, like the building fear of hospital delivery. The combined impact of these factors and others creates a misguided feedback loop that centers the blame for health disparities on individuals rather than the systems that created and continue to perpetuate them.
Incongruent care
One of the factors that perpetuates health disparities is incongruent care, which results from discrepancies between those who make the decisions about healthcare priorities and norms and the recipients of care. Incongruent care can lead to communities feeling disregarded by and uncomfortable with the healthcare system. For example, there are marked inconsistencies between how individuals envision their delivery experiences and how hospitals restrict delivery rooms, even before COVID-19.
Dr. Joia Crear-Perry notes that for many communities the delivery experience is one of celebration and includes extended family in the delivery room. This preference is typically incongruous with hospital protocols that limit the number of the people permitted in a delivery room. These restrictions — often grounded in assumptions of norms rather than safety precautions — have rippling effects. “Norms” stretch beyond hospital walls and are encoded in policy, fortifying a set of standards that disregards individual and community needs and preferences.
Delivery Decisions
When it comes to delivery decisions, many Black families are left to weigh the advantages and disadvantages of delivering at a hospital, where they may be required to sacrifice their comfort level, personal preferences, and needs. The result is a dramatic overrepresentation of Black families who opt for a more personalized delivery experience at home. (With the onset of COVID-19, for the first time, many white families are experiencing restrictions to their birthing preferences, shining a light on existing restrictive practices.) Note: Ovia Health’s Clinical team is monitoring the impact of the pandemic, and has found that while 40-50% of birthing parents had someone beyond a partner with them during delivery pre-COVID-19, that number has now gone down to 14%.
The healthcare system’s failure to equitably support, include, or prioritize Black families calls attention to the need for new solutions, grounded in social support, that center community perspectives and values.
Dr. Joia Crear-Perry emphasizes the importance of advocating for and investing in resources that prioritize congruent and personalized care — and organizations like Mamatoto Village, in Washington D.C. that works with local Community Birth Workers or doulas to offer emotional, educational, and physical support.
The reason for Community Birth Worker or doula success in many communities, particularly those overlooked by the healthcare system, often lies in that they provide personalized social support before, during, and after delivery. This extended social support from conception through postpartum creates a stronger relationship with the patient and facilitates a deeper understanding of a birthing parent’s unique needs and wishes, while also ensuring their health and safety. This heightened opportunity for connection with patients throughout the pregnancy journey not only broadens access to care, the personalized experience dramatically improves clinical outcomes.
Impacts of a Doula
According to a study in the Journal of Perinatal Education, “doula-assisted mothers were four times less likely to have a low birth weight baby, two times less likely to experience a birth complication involving themselves or their baby, and significantly more likely to initiate breastfeeding.” Despite the evidence, lack of certification tends to act as a barrier for many health plans and employers to cover doulas; but certification itself limits access to these roles and is not always a useful check on the quality of services a doula can provide.
The prioritization of personalized care and social support services — whether it comes from a digital platform, doula, or both — is one area with a proven impact that health plans and employers can implement today to improve outcomes for their members and employees.
What health plans and employers can do:
Increase access to a doula and community care networks
Whether it’s covering the cost of doulas and birth centers, or at minimum, making sure your members can easily tap into a network of trusted doulas, employers and health plans need to incorporate these critical support services into their offerings if they want to improve health outcomes for their entire population.
If covering the cost of doulas is too large a hurdle, providing access to peer care providers who have shared experiences with patients is an impactful first step for health plans and employers. For example, in addition to being registered nurses, many Ovia Health coaches are mothers and peers and often share their personal experiences with patients to create deeper connections with members and facilitate the best possible care.
Prioritize digital social support services and doula services
Social support can exist in the delivery room, in the form of extended families or birthing teams, but it is equally important in the months leading up to and following delivery. These months are critical to helping moms, babies, and families thrive.
During the pandemic, online communities and virtual support have played a particularly important role. Health plans and employers should prioritize solutions that emphasize community, enabling people to connect with each other and increase access to care.
Address diverse, personalized needs
Implement an offering that prioritizes personalized care and is informed by diverse needs, preferences, and experiences. Health plans and employers that offer a solution with personalized care are also empowering members to identify helpful resources, encouraging them to advocate for themselves, and providing them with essential social support to ensure more inclusive, equitable, and healthy outcomes.
For more information on what health plans and employers can do, download the webinar with Dr. Joia Perry here.
To learn more about Ovia Health’s social support services and access to community care networks for employers, click here.
To learn more about Ovia Health’s social support services and access to community care networks for health plans, click here.
Dr. Joia Crear-Perry, Founder and President of The National Birth Equity Collaborative, joined Ovia Health in June for a critical conversation on the current state of birth equity, how changes in our healthcare system due to COVID-19 threaten to impact communities of color, and what health plans and employers can do to mitigate and prevent adverse outcomes like birth disparities. You can download the complete webinar here.
Data on health outcomes have long been collected, disaggregated, and analyzed by broad categories, like race. However, the Human Genome Project proved long ago that race alone is not an indicator of health. In order to identify more useful insights into health outcomes, healthcare leaders need to dig deeper into the data to better understand and analyze the ways more critical factors, like access to health services, public safety, social support, and quality job training—or social determinants of health (SDoH) — impact health outcomes.
Social Determinants of Health and birth disparities
Health justice advocate, Dr. Joia Crear-Perry, and her organization, The National Birth Equity Collaborative, have been working to change the disaggregation of health outcome data. For the last five years, they’ve been fighting to ensure that health data is disaggregated beyond race so the healthcare community can focus on impacting critical issues, like the staggering Black and infant mortality rate, through more causal factors, (i.e. SDoH), and preventative care.
What employers and health plans can do to reduce birth disparities
By analyzing SDoH data, we can develop a more complete understanding of the factors that influence health outcomes. For instance, we know that Black women and infant mortality rates are 3x higher than white infant mortality rates. This is only a piece of the picture. For example, given the opportunity to further segment the data, we can also see that air pollution is linked to pregnancy risks, which impacts Black women at a higher rate, as they are more likely to live in highly polluted areas.
Dr. Perry links our healthcare system’s inability to address health and birth disparities to long unfounded beliefs of a biological basis for race. Conclusions drawn from data disaggregated only by race perpetuate this bias, resulting in attitudes and policies that place the onus of adverse health outcomes on individuals.
Collecting, disaggregating, and analyzing data beyond race to examine SDoH enables the healthcare system to identify the root causes of adverse health outcomes, craft preventative programs and policies, and improve quality of care for all, especially communities of color.
By confronting healthcare leaders with data points that prove that SDoH are the prominent factors in health outcomes, Dr. Perry is hoping to help the healthcare community unpack and unlearn their biases and move away from policies and programs grounded in assumptions from data disaggregated only by broad racial categories.
How to improve outcomes for Black mothers and babies at an organizational level
Dr. Perry acknowledges that addressing racial and social disparities in maternal and infant health will take time; so what can health plans and employers do today?
Acknowledge and take action to reduce implicit bias internally
Regular racial equity trainings (including trainings baked into the onboarding process) encourage individuals and organizations to think practically about the ways they can help create and support diverse and inclusive workplaces. We know this isn’t easy, which is why when Ovia Health started this journey, we enlisted the help of Dr. Perry, to conduct a racial equity training.
Creating a diverse and inclusive workplace isn’t just the right thing to do. According to a recent McKinsey report (May 2020): “In the case of ethnic and cultural diversity, our business-case findings are equally compelling: in 2019, top-quartile companies outperformed those in the fourth one by 36 percent in profitability, slightly up from 33 percent in 2017 and 35 percent in 2014”
Get to know the disaggregated data
Understanding data disaggregation opens up opportunities for the healthcare system to act on factors that influence health outcomes and identify more impactful ways to support their members and reduce birth disparities. At Ovia Health, we use SDoH data (i.e. food insecurity, access to transportation, access to care, substance abuse, etc) to inform our clinical services, member experience, and overall digital solution.
For example, The Ovia Health Clinical Research Group works with researchers from the University of Wisconsin, Madison to better understand the relationship between pregnancy loss and individual and environmental factors, including SDoH. Using data collected by Ovia, the research illuminated disproportionate rates of pregnancy loss among members exposed to violent crime, living in under resourced areas, struggling with substance abuse, experiencing stress and anxiety, and experiencing unsafe relationships, to name a few.
Informed by this work and in an effort to create solutions that equitably improve outcomes, Ovia Health has developed programs that address many SDoH. Recently, we added an intimate partner violence program to our solution after learning that during the pandemic, many members reported unsafe home environments at a higher rate than previously reported. This program helps health plans and employers identify and mitigate the experience of — and adverse outcomes associated with — members’ unsafe home environments and relationships.
Examine your maternity and family benefit offerings
When auditing your program, or looking for new partners, ask yourself:
- Does this solution partner take into account diverse experiences?
- Does this solution partner prioritize health equity within their own organization and design equitable solutions, delivering unique experiences to each member based on their own unique needs?
- How does this solution partner address SDoH and preventative care? Are they effective?
- Can the solution partner deliver proof of sustained engagement for these populations?
Making a long-term commitment to improve birth outcomes and reduce birth disparities for communities of color is a significant undertaking. It is beneficial to share the work with an impactful and values-aligned solution partner.
At Ovia Health we are committed to birth equity. To date, we’ve designed and participated in many leading research endeavors that aim to uncover the driving factors behind devastating healthcare disparities. We have created a solution that recognizes the uniqueness of each member, meeting them where they are to improve their chances of having a happy, healthy pregnancy, birth, and postpartum recovery.
For more on addressing birth equity in healthcare, download our webinar with Dr. Joia Crear-Perry “Birth Equity, COVID-19 and the future of healthcare: the impact on women of color”.To find out more about Ovia Health’s women and family health solutions, click here.
Published: American Psychiatric Association (APA)
Author(s): Dr. Adam Wolfberg
Clinical Pathways is a new series on the Ovia Health blog highlighting the research conducted by our clinical team. In this article, we explore perinatal depression and parental mental health.
Led by Dr. Adam Wolfberg — practicing OB/GYN, Maternal Fetal Medicine specialist, and Chief Medical Officer of Ovia Health — the Ovia Health clinical team has made important contributions to further the fields of women’s health and reproductive science. They have published manuscripts in the leading fertility and maternal health academic journals and presented their research at 22 conferences, including the American College of Obstetricians and Gynecologists (ACOG) and the American Society for Reproductive Medicine (ASRM). This study examines parental mental health and perinatal depression rates.
* The total number of screeners taken exceeds 520,000 — this is the total taken in just one year.
Parental mental health – the facts
Mental health is under-researched and often overlooked, this is especially true for women who are pregnant or postpartum. To address this gap in care and provide support for under-served populations, the Ovia Health clinical team has made mental health research a top priority. They’ve studied the ways mental health uniquely impacts women on the parenthood journey, factors that affect a woman’s risk of developing perinatal depression, and the role digital tools can play to fill in gaps in mental health screening and support.
In May of 2019, the team shared some of their findings at the American Psychiatric Association’s annual conference, with a presentation titled Risk of perinatal depression among women screened within a mobile application. By delivering validated clinical screeners (i.e., PHQ-9 and EPDS) through the Ovia Health mobile solution, the clinical team discovered an incidence rate of perinatal depression that is nearly three times the rate cited by the CDC.
The research and findings
Perinatal depression is depression experienced at any point from pregnancy to one year after birth. Most women in the U.S. are only screened for perinatal depression once, per clinical guidelines — at their six-week postpartum follow-up visit with a healthcare provider — but the onset of depression can occur at any point during the perinatal period.
This study aimed to identify when depressive symptoms most often occur during the perinatal period. Ovia Health administered a perinatal depression screener (the Edinburgh Postnatal Depression Scale) to users of Ovia Pregnancy and Ovia Parenting.
The screener was delivered five times between April 2017 and May 2018 — twice during pregnancy and three times in the first year after birth. A total of 202,948 women took the EPDS screener during this time — 164,237 (81%) of women elected to take it once, and 38,711 (19%) elected to take it at least twice. Among the women who took it once, 47.6% scored greater than or equal to 10 on the scale, which indicates symptoms of depression. Among women who took the screener more than once, 79.5% resulted in the same score; 10.6% scored higher — showing more signs of depression; and 9.3% scored lower — showing fewer signs of depression.
Our clinical team concluded that EPDS scores were lowest during the three months following delivery, which is typically the only time most women are screened for perinatal depression. They also concluded that fluctuation in depressive symptoms is common, meaning that earlier and more frequent screening may help identify more women with depressive symptoms at a time when early intervention and disease avoidance is possible.
Why this is so important
Patients are falling through the cracks due to insufficient screening, and more women are suffering from perinatal depression than previously thought. By increasing screening and making it more accessible through a digital solution, our clinical team was able to detect a 29% incidence rate of depression — nearly triple the rate cited by the CDC (11.5%). This is an important first step for those with perinatal depression to find resources, support, and treatment.
Ovia Health’s clinical mental health solution and its impact
Our health solution includes robust screening tools — both the EPDS and the nine-question Patient Health Questionnaire (PHQ-9) — deployed at many points throughout the reproductive health journey.
We also offer members a curated library of content dedicated to normalizing and de-stigmatizing perinatal mental health. Depending on screener scores, women are granted access to additional customized content. This content includes information about how to identify signs and symptoms of perinatal mood disorders, understand available treatment, and access care, including through Ovia Health coaches.
For a glimpse into the impact of our solution: between August 2018 and August 2019, members completed over half a million EPDS and PHQ-9 screeners in the Ovia apps and read millions of pieces of educational content each month.
The bottom line
Mental health is a hugely important facet of women’s health. Ovia Health’s clinical team is continuing to identify women at risk; normalize, de-stigmatize, and educate on issues of perinatal mental health; and provide women with the resources they need. The clinical team’s research is shining a light on how digital solutions can improve health outcomes, reduce healthcare costs, and support women and parents as they grow their families alongside their careers.
About Ovia Health
Ovia Health has helped over 14 million women and families. We offer a comprehensive maternity and family benefits solution from preconception and pregnancy through return-to-work and parenthood.
Ovia Health:
- Engages women early, and sustains long term daily participation
- Actively encourages partners to participate in the process
- Includes predictive coaching and mobile alerts for identified health issues
- Supports return-to-work with a proven approach
- Boosts utilization across an employer’s benefit ecosystem
- Drives behavior change and reduces maternity costs
Consumers are turning to digital health tools in higher numbers, and a recent study from Ovia Health published in the leading infertility journal, Fertility and Sterility, validates the efficacy of digitally collected, patient-reported health data. Digital health solutions can play an important role in helping women track their cycles and pinpoint their fertile windows — but not all fertility tracking and pregnancy planning solutions are created equal. Ovia Health’s consumer products and benefits solutions were developed with healthcare specialists and designed for members at every stage of life, filling in gaps in care while encouraging members to see their doctors.
Millennial women are looking to technology to fill gaps in care now more than ever. They are research-oriented, tech-savvy consumers, and 14 million of them have chosen Ovia Health’s digital solutions precisely because we provide clinically backed tools and expert content to guide important fertility, pregnancy, and parenting decisions. Ovia Health’s members are drawn to our user-centered design and log on an average of 30 sessions per month.
All this information enables Ovia Health to continuously improve our proprietary fertility algorithm and fill in gaps in care. Far from attempting to replace a member’s doctor, our solution serves as a companion tool, directing members to consult their doctors when Ovia identifies certain risk factors. We know Ovia Health members choose their primary care and pediatrician providers thoughtfully – Ovia is not a replacement for that in-person care.
But sometimes, and especially now during COVID-19, going into a doctor’s office is not a member’s best option. For fast, at-home guidance, members can speak with Ovia Health-employed, registered health professionals. Ovia Health’s care is revolutionizing health outcomes by providing proactive, preventative, and consistent care at every hour of the day, often before a member even thinks to book an appointment. Our approach means significant decreases in ART utilization, preterm birth, and other preventable health conditions.
Ovia Health gives members the guidance and reassurance they need – which is essential during the COVID-19 crisis. As gaps in care expand, our members need access to education, tools, and resources to make informed decisions. Digital health tools are playing a crucial role right now. And Ovia Health is at the forefront of women’s health because from the very start, we incorporated healthcare specialist input, designed and redesigning for our user, and have always positioned ourselves as a supplement, not a replacement, for in-person doctor’s appointments.
If you’re an HR professional looking for an effective solution to improve health outcomes for your employees or health plan members while reducing your costs, let’s talk.
Authors: Adam Wolfberg, MD and Dani Bradley, MPH
How is COVID-19 impacting prenatal care and the delivery experience around the United States? What are women telling their doctors? What are women worried about? We asked thousands of women and this is what they told us.
These data come from a survey of 2,212 pregnant women in the United States conducted March 25-27, and from a digital tool to help women decide if symptoms they are experiencing are concerning – based on guidance from the Centers for Disease Control and Prevention (CDC). Over 112,000 women used our tool between March 20-27, 2020.
How has prenatal care changed?
- Nationwide, 21% of prenatal visits in the past two weeks were impacted, either canceled, rescheduled, or conducted remotely (phone or video). 26% of appointments scheduled in the next four weeks are similarly impacted.
- In New York, more visits were impacted (24%) in the past two weeks, and 33% of upcoming visits will be changed.
How are women thinking about their delivery?
- Before the COVID-19 pandemic, 1.3 percent of women nationwide were planning a home birth, with the remainder planning a hospital birth (94.8%) or a delivery in a birth center (3.9%). At this time, 4.1% of women nationally are planning a home birth, and 5.3% are now planning a birth center birth in order to avoid a hospital delivery (90.6%).
- In New York, none of those surveyed were planning a home birth prior to the COVID-19 pandemic, and now 3% are considering that option.
- Even if they haven’t made plans, 28% of American pregnant women are thinking about delivering at home, and in New York, 34% are thinking about home birth.
What about visitors and delivery support people?
- Although American women still overwhelmingly expect to have their partner present at delivery, fewer women expect to be able to have a doula (Down from 9.2% to 5.7%) or other family members present at delivery (46.9% to 17%). In New York, only 11.9% expect to have family members present at delivery.
How are doctors doing when it comes to communicating with their patients?
- Not very well. Only 41% have received information about the impact of COVID-19 on their prenatal care, and in hardest-hit New York, only 36% report receiving this information from their healthcare provider. Nationally, only 26% report being very satisfied with the communication they are receiving from their healthcare provider.
What are women hearing from their healthcare providers?
- The most common policy change is that hospitals are prohibiting visitors other than the woman’s partner (87%). Nationally, few are being told they will have to labor alone (7.6%), although this is a more common practice in New York (35%).
What are the top concerns about the postpartum experience in this time of coronavirus?
- Health and safety for baby – the top concern by far
- Availability of childcare resources
- Health and safety of family or support people
- Being stuck inside with a new baby and siblings
- Impact on breastfeeding
- Impact on my postpartum visit
Ovia also launched a digital tool to help women decide if symptoms they are experiencing are concerning – based on guidance from the Centers for Disease Control and Prevention (CDC).
The initial results are below, but a few findings stand out:
- Pregnant women frequently experience shortness of breath as a normal part of pregnancy, particularly in the third trimester, and many had difficulty distinguishing normal shortness of breath from the same symptom caused by COVID-19.
- A relatively large percentage of women had one or more symptoms that are common with COVID-19, however very few had a fever. We recommended that these women contact their healthcare provider to see if testing or further evaluation is appropriate.
- There is potential significant overlap between other symptoms of pregnancy and warning signs of COVID-19, including cough, gastrointestinal symptoms such as nausea, and vomiting, and resulting dehydration.
- In spite of enough concern among so many Ovia users that took the survey, fewer than 1% had been tested for COVID-19 (fortunately, most were negative).
Ovia Health is working to provide resources for the millions of women who look to our products for education and support, and we encourage OB/GYNs and midwives to reach out to their patients during this challenging time with information, specific education, and answers to the questions that are coming up every day.
Highlights from the first 112,000 responses:
- 64% of survey respondents are pregnant.
- 62% of respondents reported no symptoms indicative of COVID-19.
- 16% of respondents (13% of pregnant respondents) reported a combination of symptoms and health conditions suggesting they could be seriously ill with COVID-19 or another medical condition.
- Nearly 27% of respondents reported a cough, which can be a sign of COVID-19 or entirely normal.
- 2% reported a fever.
- 9% reported new onset shortness of breath.
Patient Experience of Obstetric Care During the COVID-19 Pandemic: Preliminary Results From a Recurring National Survey
Author: Journal of patient experience
Throughout the pandemic, Ovia Health has been monitoring the patient experience so that we can adapt our services to best meet the needs of our members. More than 70,000 members have responded to a survey we’ve been running each week since the Spring of 2020. As a result, we’ve uncovered that 30% of all prenatal care across the country, has been altered over the course of the pandemic.
We published our preliminary findings in the Journal of Patient Experience and continue to adapt our services and products to meet the needs of our members, including offering remote patient monitoring devices, such as blood pressure cuffs to enhance the virtual care patients continue to receive.
About Ovia Health
Ovia Health has helped over 14 million women and families. We offer a comprehensive maternity and family benefits solution from preconception and pregnancy through return-to-work and parenthood.
Ovia Health:
- Engages women early, and sustains long term daily participation
- Actively encourages partners to participate in the process
- Includes predictive coaching and mobile alerts for identified health issues
- Supports return-to-work with a proven approach
- Boosts utilization across an employer’s benefit ecosystem
- Drives behavior change and reduces maternity costs
Ovia Health is proud to announce the launch of our Maternity Manager Training Resource Center: a hub of comprehensive training and tools for managers.
The resource center — available to all Ovia Health enterprise partners — contains three toolkits spanning pregnancy, parenting, and return to work. Each toolkit is specifically designed to help managers support their employees through the unique stages of working parenthood.
Creating a family-friendly environment
Creating a family-friendly workplace isn’t just the right choice, it’s the savvy one: 83% of millennials would change jobs for better benefits. When managers are trained to proactively communicate company benefits and celebrate working parenthood (and all the steps in between), their employees are more likely to return to work and remain with the company. In fact, 43% of women who left their job after parental leave felt that their employer could have made changes that would have kept them in the workforce. But implementing a maternity manager training program can help.
Enhancing your family benefits solution by offering maternity manager training
The Manager Training Resource Center enhances and complements Ovia Health’s maternity & family benefits solution by consolidating all the information managers need to support and advocate for their employees in one place. The toolkits include guides for each stage of a parent’s journey (from thinking about pregnancy to managing work-life balance), forms to organize work coverage, and checklists to ensure nothing gets forgotten along the way.
Organizations succeed when they consider the needs and celebrate the advantages of working parents. Ovia Health is committed to finding new ways to support women and families. To gain access to all the resources and tools Ovia Health offers, join us by visiting oviahealth.com or emailing enterprise@oviahealth.com to learn more about our work and our personalized maternity benefits solutions.
Findings from a mobile application–based cohort are consistent with established knowledge of the menstrual cycle, fertile window, and conception
Published: Journal of Fertility & Sterility
Authors: Dr. Adam Wolfberg
Clinical Pathways is a new series on the Ovia Health blog highlighting the research conducted by our clinical team.
Led by Dr. Adam Wolfberg — practicing OB/GYN, Maternal Fetal Medicine specialist, and Chief Medical Officer of Ovia Health — the Ovia Health clinical team has made important contributions to further the fields of women’s health and reproductive science. They have published manuscripts in the leading fertility and maternal health academic journals and presented their research at 22 conferences, including the American College of Obstetricians and Gynecologists (ACOG) and the American Society for Reproductive Medicine (ASRM).
Recently, the Ovia Health clinical team replicated a landmark fertility study by investigating components of the menstrual cycle and fertile window. Notably, our team conducted the study by analyzing digitally collected, patient-reported data. The results were published in the September 2019 volume of Fertility and Sterility, one of the field’s leading journals.
The study
The original study was published in the New England Journal of Medicine (NEJM) in 1995 by Wilcox et al. and included 221 women (contributing 625 cycles). The result of the study was the identification of the fertile window and the day of the cycle with the highest probability of conception.
Ovia Health replicated the study by analyzing five years of data: 225,596 menstrual cycles from 98,903 women — the largest sample size ever published on the topic. The original NEJM paper relied on traditional methods of data collection, asking participants to provide urine samples and keep a written log throughout their cycle. Ovia was able to collect these same data, without depending on the same onerous data collection processes. Instead, Ovia users simply used the Ovia Fertility app to report details about their cycle, leading to a reinforcement and expansion of the NEJM paper’s original and important findings.
We learned that:
- The greatest likelihood of conceiving occurs the day before ovulation, not the day of ovulation — something that researchers continue to debate.
- The “typical” 28-day menstrual cycle is not so typical after all; many women have longer, shorter, or more irregular cycles than traditionally thought.
- Conditions such as PCOS, endometriosis, and uterine fibroids make it more difficult to conceive, but they’re not definitive impediments. For women with and without these conditions, the ability to track menstrual cycle phases and associated symptoms is an important step to recognize signs of ovulation.
These findings demonstrate that to accurately predict ovulation, those with irregular cycles or cycles longer or shorter than 28 days require a more nuanced approach than traditional calendar methods. Ovia Health’s fertility program is an effective cycle monitoring tool for women trying to conceive — accommodating unique cycles, identifying menstrual phases, and tailoring fertility projections to each user.
Beyond the important synergies between our findings and the landmark NEJM publication, Ovia Health’s conclusions and methods are shifting the conversation around data collection, advancing the field of women’s health by proving the power of digitally-collected, patient-reported data.
Ovia Health’s clinical team is the backbone of our maternity & family benefits solution. The work of our expert clinicians, analysts, and researchers dictates the design of our clinical pathways, helping change behavior and improve outcomes for our members. The team is continuously looking for new ways to make an impact on the health of women and families around the world. Ovia Health’s findings in fertility science, C-sections, mental health, preterm delivery — among many other areas of research — are validating the efficacy of digital health solutions and redefining the maternal and reproductive health landscape.
Validating self-report hospital C-section rates collected in a pregnancy mobile application
Published: American Journal of Obstetrics & Gynecology
Authors: Bradley, Danielle MS, MPH; Noddin, Katie; Wolfberg, Adam MD, MPH
Access to quality indicator data is necessary for informed healthcare decision making. In a publication and presentation at the Society for Maternal-Fetal Medicine (SMFM), Ovia Health validated our own data against gold-standard, hard-to-access datasets and found our data do not differ. Ovia’s datasets are now being used to inform crucial healthcare decisions our members make everyday.
About Ovia Health
Ovia Health has helped over 14 million women and families. We offer a comprehensive maternity and family benefits solution from preconception and pregnancy through return-to-work and parenthood.
Ovia Health:
- Engages women early, and sustains long term daily participation
- Actively encourages partners to participate in the process
- Includes predictive coaching and mobile alerts for identified health issues
- Supports return-to-work with a proven approach
- Boosts utilization across an employer’s benefit ecosystem
- Drives behavior change and reduces maternity costs
Patient misconceptions about midwifery care may limit utilization
Published: American College of Nurse Midwives
Midwifery care is known to improve outcomes, including avoiding unnecessary medical interventions, preterm birth, and neonatal death. However, only 8-9% of births in the US are attended by Certified Nurse Midwives (CNM). Ovia’s research findings from over 3,000 women, published and presented with the American College of Nurse Midwives, showed many women have misconceptions about the types of conditions midwives can manage or co-manage, and therefore unnecessarily self-select out of midwifery care.
Ovia educates our members about the qualifications and capacities of all types of providers, including encouraging and navigating members to care by Certified Nurse Midwives (CNM).
About Ovia Health
Ovia Health has helped over 14 million women and families. We offer a comprehensive maternity and family benefits solution from preconception and pregnancy through return-to-work and parenthood.
Ovia Health:
- Engages women early, and sustains long term daily participation
- Actively encourages partners to participate in the process
- Includes predictive coaching and mobile alerts for identified health issues
- Supports return-to-work with a proven approach
- Boosts utilization across an employer’s benefit ecosystem
- Drives behavior change and reduces maternity costs
Findings from a mobile application–based cohort are consistent with established knowledge of the menstrual cycle, fertile window, and conception. Journal of Fertility & Sterility, vol. 112, issue 3, P450-457.E3
Ovia tracked over 225,000 menstrual cycles from almost 100,000 users to prove that Ovia’s fertility window predictions are consistent with clinical literature values, and that mobile applications like Ovia align with clinical standards.
Time to conception and the menstrual cycle: an observational study of fertility app users who conceived
Published: Journal of Human Fertility
Authors: Danielle Bradley 1, Erin Landau 1, Noreen Jesani 2, Brett Mowry 3, Kenneth Chui 4, Alex Baron 1, Adam Wolfberg
Leveraging millions of data points, Ovia Health investigated the interaction between cycle length and cycle irregularity, and their joint association with the amount of time it takes a couple to conceive.
This was the first study to interact cycle length with cycle variability to better understand conception probability.
This paper identified cycle characteristics most closely associated with delayed time to conception and helps members understand how to track their cycles for optimal conception likelihood.
Ovia’s fertility program is a more accurate and sophisticated cycle monitoring method for most women who are trying to conceive.
About Ovia Health
Ovia Health has helped over 14 million women and families. We offer a comprehensive maternity and family benefits solution from preconception and pregnancy through return-to-work and parenthood.
Ovia Health:
- Engages women early, and sustains long term daily participation
- Actively encourages partners to participate in the process
- Includes predictive coaching and mobile alerts for identified health issues
- Supports return-to-work with a proven approach
- Boosts utilization across an employer’s benefit ecosystem
- Drives behavior change and reduces maternity costs
Predicting the likelihood of delivery preterm using data collected from a pregnancy mobile app
Published: American College of Obstetricians and Gynecologists (ACOG)
Authors: Bradley, Danielle MS, MPH; Landau, Erin; Wolfberg, Adam MD, MPH; Baron, Alex PhD
Risk for preterm delivery is largely only identified among women with previous preterm deliveries or explicit risk factors, like insufficient cervix. But for the other group of seemingly low risk women who end up delivering preterm, there are very few proven methods for identifying risk in time to intervene.
Ovia Health’s data science team applied machine learning methodologies to determine our ability to detect the likelihood of delivering preterm. We were able to detect 41% of cases with 75% positive predictive value. The results of which were peer-reviewed and presented at the American College of Obstetricians and Gynecologists (ACOG) annual conference.
About Ovia Health
Ovia Health has helped over 14 million women and families. We offer a comprehensive maternity and family benefits solution from preconception and pregnancy through return-to-work and parenthood.
Ovia Health:
- Engages women early, and sustains long term daily participation
- Actively encourages partners to participate in the process
- Includes predictive coaching and mobile alerts for identified health issues
- Supports return-to-work with a proven approach
- Boosts utilization across an employer’s benefit ecosystem
- Drives behavior change and reduces maternity costs
Cervical length screening: barriers to, and patient perception of, cervical length measurement
Published: American College of Obstetricians and Gynecologists (ACOG)
Authors: Bradley, Danielle MS, MPH; Cobb, Christina; Landau, Erin; Wolfberg, Adam MD, MPH
One of the most demonstrably effective ways to determine risk for preterm delivery is to screen for a ‘short’ or insufficient cervix. However, this screening is not universally applied to all pregnant women, even though universal screening is known to be cost effective.
Ovia set out to understand the barriers patients face to receiving this crucial screening. Results indicate that a large majority of healthcare providers are simply not offering a cervical length measurement to their patients and that patients feel uncomfortable requesting the screening.
Ovia’s comprehensive education, self-advocacy, and patient-provider communication programming has shown a two fold increase in the number of patients receiving this crucial screening.
About Ovia Health
Ovia Health has helped over 14 million women and families. We offer a comprehensive maternity and family benefits solution from preconception and pregnancy through return-to-work and parenthood.
Ovia Health:
- Engages women early, and sustains long term daily participation
- Actively encourages partners to participate in the process
- Includes predictive coaching and mobile alerts for identified health issues
- Supports return-to-work with a proven approach
- Boosts utilization across an employer’s benefit ecosystem
- Drives behavior change and reduces maternity costs
Time to conception and the menstrual cycle: an observational study of fertility app users who conceived. Human Fertility, vol. 24, issue 4, pages 267-275.
This paper identified cycle characteristics most closely associated with delayed time to conception and helps members understand how to track their cycles for optimal conception likelihood. This paper also proved that Ovia’s fertility program is a more appropriate cycle monitoring method for many women who are trying to conceive.
Posts to an anonymous digital health platform may help assess depression risk among pregnant women
Published: American Journal of Obstetrics & Gynecology
Authors: Danielle Bradley, Erin Landau, Adam Wolfberg, Alex Baron
Leveraging the millions of questions and comments posted to Ovia Health’s Community, our research team used machine learning to identify trends in depression risk based on commonly used terms and phrases. The results of which were peer-reviewed and presented at the Society for Maternal-Fetal Medicine (SMFM) conference.
Understanding personal risk for developing depression during or after pregnancy is an important first step in accessing resources to reduce risk.
This research demonstrates the important role support networks play in the likelihood of a mother developing perinatal depression. Ovia Health ensures all of our members receive resources and support when they present as at-risk for perinatal or postpartum depression.
About Ovia Health
Ovia Health has helped over 14 million women and families. We offer a comprehensive maternity and family benefits solution from preconception and pregnancy through return-to-work and parenthood.
Ovia Health:
- Engages women early, and sustains long term daily participation
- Actively encourages partners to participate in the process
- Includes predictive coaching and mobile alerts for identified health issues
- Supports return-to-work with a proven approach
- Boosts utilization across an employer’s benefit ecosystem
- Drives behavior change and reduces maternity costs
Digital tools fill a gap in mental health screening and support, particularly for women lacking strong social networks
Published: Connected Healthcare Conference
Authors: Dani Bradley 1 ; Christina Cobb 1 ; Adam Wolfberg 1, 2
Ovia investigated patient perceptions of being screened for depression digitally, compared to being screened by their healthcare providers in a clinical setting. We also assessed the role providers, family/friends, and Ovia plays in supporting women’s mental health. The survey had over 2,000 respondents and the results were peer-reviewed by the Journal of Medical Internet Research (JMIR) and presented at the Connected Health Conference.
We found that unmarried women are more likely than married women to select digital screening and support tools as key components in their mental health support network, demonstrating the role digital solutions play in filling gaps in perinatal mental health care.
About Ovia Health
Ovia Health has helped over 14 million women and families. We offer a comprehensive maternity and family benefits solution from preconception and pregnancy through return-to-work and parenthood.
Ovia Health:
- Engages women early, and sustains long term daily participation
- Actively encourages partners to participate in the process
- Includes predictive coaching and mobile alerts for identified health issues
- Supports return-to-work with a proven approach
- Boosts utilization across an employer’s benefit ecosystem
- Drives behavior change and reduces maternity costs
Does Comparing Cesarean Delivery Rates Influence Women’s Choice of Obstetric Hospital?
The American Journal of Managed Care, vol 25, iss 2
Ovia partnered with researchers at Ariadne Labs to design a randomized control trial. The trial included educational content and an interactive tool that allowed members to search hospitals in their area and review their quality data, namely, C-section rates. We found that women given access to quality data were more likely to consider C-section rates when selecting their hospital.
Using mobile health applications for the rapid recruitment of perinatal women. Arch Women’s Mental Health 22, 305–308 (2019).
Ovia’s research partners independently analyzed Ovia as an innovative recruitment mechanisms for clinical research and found that Ovia is a successful recruitment lever to exceed enrollment expectations and achieve demographic diversity in research studies.
Uncovering State Sharing Practices for Birth Method-of-Delivery Data in the United States
Published: American College of Obstetricians and Gynecologists (ACOG)
Authors: Bradley, Danielle MS, MPH Candidate; Landau, Erin; Jesani, Noreen MPH Candidate; Baron, Alex PhD; Wolfberg, Adam MD
Access to quality indicator data is necessary for informed healthcare decision making.
In a publication and presentation at the American College of Obstetricians and Gynecologists (ACOG) annual meeting, Ovia Health uncovered just how difficult it is for the average patient to access live-saving quality data to inform their healthcare choices.
In order to bring these data to patients and help inform decisions to improve outcomes, Ovia has created our own validated dataset of quality indicators. These tools can help patients avoid adverse outcomes, like unnecessary intervention and C-sections that often lead to dangerous and costly complications.
About Ovia Health
Ovia Health has helped over 14 million women and families. We offer a comprehensive maternity and family benefits solution from preconception and pregnancy through return-to-work and parenthood.
Ovia Health:
- Engages women early, and sustains long term daily participation
- Actively encourages partners to participate in the process
- Includes predictive coaching and mobile alerts for identified health issues
- Supports return-to-work with a proven approach
- Boosts utilization across an employer’s benefit ecosystem
- Drives behavior change and reduces maternity costs