Birth control start-ups hit the US amid abortion protests

2019-06-11 02:05:09

Elina Berglund had just finished pitching her fertility app, Natural Cycles, at a tech event in New York, when a man approached to chide her for suggesting the use of condoms.

"It was something that I've never encountered in Europe. I was quite stunned," the Swedish entrepreneur says. "His point of view is that it is wrong to encourage women to use a condom. I think it came from a religious angle."

There's a war playing out over birth control in America. This year, 28 out of 50 states have made it more difficult to get an abortion and Alabama has passed a law banning it outright.

Conservative religious groups are becoming increasingly opposed to contraception. Meanwhile, maternal mortality rates in the US are rising.

Attempts to restrict abortion have led to a response from tech giants. Last week, Netflix said it would "rethink" its investment in Georgia if a recently signed law goes into effect.

But a new wave of tech start-ups are also entering the birth control market directly. Berglund, who moved to the US last September, is aware that she has arrived at a particularly fraught time for women's healthcare. But she believes that Silicon Valley might have at least some of the answers.

Alongside Natural Cycles, Swiss wearable start-up Ava, which is based in San Francisco, is moving into birth control, having previously focused on helping women get pregnant.

The company makes a bracelet that is worn overnight to sense pulse and heart rhythms, which it claims can detect the presence of hormones and thus women's fertile windows.

Natural Cycles is an app and thermometer, readings of which must be input daily to alert a woman when she is fertile and predict when she should use contraception. Both say they offer an alternative to women who dislike hormonal contraception because of its impact on their physical or mental health.

Ava co-founder Lea von Bidder says that health tech aimed at women has been one long "disappointment".

"We don't see innovation in birth control or new products for menopause and we are only seeing companies adding fertility trackers after people started to call them out," she says.

Both Apple and Google, which offer health-focused wearables, were late to add features that looked at women's fertility. Garmin and Fitbit have recently joined the club, with period trackers for female customers.

Device designers such as Apple have been accused of treating women like an afterthought when it comes to the size and shape of devices, although one might note that they have been very quick to design an appropriately feminine colour scheme.

When asked about the abortion debate in the US, Ava's largest market, von Bidder says that plenty of the company's customers live in Republican, or red, states and even support recent laws.

"Our user base is from liberal to conservative all across the spectrum. I think women want to understand their body, even if they might support conservative bills on abortion."

The US market is "really promising," says Berglund, whose company was hit by bad press last year after a Facebook advert, which called the method "highly accurate", was banned by the UK's Advertising Standards Authority and the app was investigated by a Swedish medical regulator. The company no longer uses the offending advert and the investigation found that the rate of unwanted pregnancy was in line with the advertised efficacy rate (with typical use) of 93 per cent.

"We can help a lot of women here because the situation is more complicated when it comes to birth control and the cost and reimbursement. There are many women that don't have access or it's too expensive because they don't have the right health insurance," she says.

​Berglund says they have met the country's largest reproductive healthcare provider, Planned Parenthood, to talk about including it in discussions with women about their options.

Despite controversy over "femtech", Ava has raised around US$40 million (NZ$61 million) in funding and has helped 22,000 pregnancies, and Natural Cycles has raised almost as much.

Ava is currently applying for regulatory approval to advertise itself as a contraceptive, something Natural Cycles has already secured.

The debate is unlikely to disappear anytime soon, von Bidder admits. But in the meantime, it appears that a lot of the work is in the hand of "tiny start-ups," says von Bidder.

"We are a tiny Swiss company and we are doing the research. It is ridiculous when you think there are companies that spend millions on research and we are doing what we can on whatever budget we have."

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