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Why we need to start prioritising postpartum care

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With some studies suggesting as many as six out of seven women miss vital postnatal visits, FemTech World investigates why we need to change the narrative around postpartum recovery.

Sandra Wirström was working in the digital health sector in Sweden when she had her two daughters. She experienced birth injuries both times and she was surprised by the lack of data and support around post-natal care.

“I had to fight for every single piece of information and every single doctor appointment. I was extremely frustrated that nothing has been digitalised when it comes to the postpartum care,” says Sandra.

Sandra’s experience applies to hundreds of women across the UK. Recent figures show that six out of seven new mothers in England are not getting a check-up of their health six weeks after giving birth, despite such appointments becoming a new duty on the NHS. Of those who attend one, only 15 per cent have a dedicated consultation with a GP to discuss their physical and mental health, according to the National Childbirth Trust (NCT).

Another US study from the American College of  Obstreticians and Gynecologists revealed that as many as 40 per cent of women do not attend a postpartum medical visit after giving birth.

“Nothing has been done when it comes to postpartum digitalisation,” says Sandra. “So, about a year ago when I was on one of my walks with my second daughter, I thought ‘okay, we need to do something about this and change the narrative around postpartum care’.”

Soon after that Sandra met Astrid Gyllenkrok Kristensen, who was as passionate about women’s health as Sandra and like so many other mothers out there, struggled with the physical and emotional recovery process after giving birth.

They decided to set up LEIA, an app co-developed with midwives and medical experts that offers women personalised physical and mental health support during the postpartum months, also known as the fourth trimester.

“There are hundreds of apps to help you during pregnancy and everyone asks you how you feel,” says Astrid. “Post-delivery, you are left on your own in what seems to be the most overwhelming and sometimes traumatising time of your life. Out of 140 million women giving birth each year 90 per cent will experience emotional or physical difficulties, from breastfeeding complications to postnatal depression and pelvic dysfunction.

“When we started looking into this, we found that there were a couple of key issues leading to women struggling in silence,” Astrid continues. “The lack of digitalisation that Sandra mentioned is one of them, along with the lack of medical experts. Women do not get the information they need. They end up self-diagnosing and they have no idea who to turn to. There’s no structure and globally, the healthcare chain is very fragmented.

“There’s also a massive stigmatisation in society surrounding postpartum. The narrative, especially in Sweden, is that you’re supposed to give birth, and then within a week, go for power walk and have friends over.”

A study from the polling company Survation, revealed that 85 per cent of the 893 mothers in England interviewed over a month said their appointments were mainly or equally about the baby’s health and they did not get the chance to talk to the GP about their mental wellbeing.

Astrid says: “One of the problems of women are not getting the health care they need is because the healthcare system is not focused on the women’s perspective and is not based on their needs.

“Studies show us that suicide is now one of the leading causes of death in new mothers, up to one year after giving birth and this is something that shows the acceleration of the problem. The system is broken.”

The pandemic has only amplified this. Research by the Maternal Mental Health Alliance shows that more mothers than usual have been struggling during the pandemic because restrictions on social contact means they have been denied support from family and friends, which has led to more anxiety and loneliness.

LEIA is an app based on science and self-lived experiences of motherhood. Astrid explains that: “Together with both private and public health care, we created a medical advisory board to make sure that we achieve our primary focuses to create a solution and meet the needs of new mothers.”

“Before going into the product, what we wanted to do was to create an app that would help by giving women AI or data driven insights about their emotional and physical health, to help understand what’s going on in their head, what’s going on in their body and what the recovery process in the fourth trimester is.

“But we also wanted to include the partner within that experience, because men are also getting diagnosed with depression. Seeing it as a unit and not just pinpointing the woman, is something that we feel is integral for a healthy recovery.”

Astrid highlights how crucial postpartum check-ups really are when it comes to mental health.

“One of the key things during these visits is to screen women for postnatal depression, which is normally done face-to-face with a questionnaire called EPDS – Edinburgh Postnatal Depression Scale. With LEIA, we’ve digitalised screening models for both postnatal depression, but also pelvic dysfunction, identifying women in risk at a much earlier stage. This means even before giving birth, we’ll be able to identify women at risk of postnatal depression.”

However, changing the narrative around postpartum care is as important as offering women the support they need.

Astrid says that: “Most people understand the first three trimesters and the changes in the women’s bodies because that narrative has been established.

“So, we want to establish a narrative around postpartum as well. People need to know that there’s a physical recovery and it takes a year for the body to recover after childbirth. We think that by educating people about the recovery process we can normalise it and start breaking down the stigma.”

Sandra adds: “There’s been a boom in the femtech market focusing on fertility and pregnancy.

“In the past years, there has been a digital transformation in areas such as fertility,  period tracking and menopause. However, there are still a lot of things to do, especially when it comes to postpartum care. We’re still not getting educated enough about what is happening in our body after giving birth.”

LEIA’s data-driven approach aims to influence improvements in public health.

Globally, research data on postpartum care is limited. Amid a lack of awareness of postpartum conditions, however, investment in further studies and in developing options which address postpartum symptoms is also limited, says Astrid.

“We all know that politics is driven by economics,” she says.

“By collecting this data, we will be able to show how the lack of investment and support is actually affecting women. We have to put a number on the problem before they actually start looking into it.”

Sandra agrees: “It’s not only our perspective and our motivation, we are in fact putting the mothers in focus in everything we do by building an app for the mothers out there.”

Clearly, fundamental changes will be required to adequately address postpartum challenges in future. The success of LEIA in starting a conversation around postpartum care is, however, an important first step in driving this change.

Find out more about LEIA here.

 

 

 

 

Sorina Mihaila is the Femtech World editor, covering technology, research and innovation in women's health. Sorina is also a contributor for the neuro-rehabilitation magazine NR Times.

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What Iceland can teach the world about gender equality in tech

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Áslaug Arna Sigurbjörnsdóttir speaking at the Nordic Women in Tech Awards in Reykjavík

The recent surge in artificial intelligence (AI) is reviving the tech industry, but gender bias is preventing women from joining the sector. Sorina Mihaila travelled to Reykjavík to find out what needs to change.

When, as a 24-year-old lawyer, Áslaug Arna Sigurbjörnsdóttir ran as the secretary of the Independence Party in Iceland she had one goal: to make an impact.

Eight years later, in a packed conference hall in her native Reykjavík, Sigurbjörnsdóttir, now Iceland’s Minister of Higher Education, Science and Innovation, maintained she has the same mission.

“I was lucky to be born in a world where a female was president of Iceland,” she told a crowd of 200+ delegates at the Nordic Women in Tech Awards, referring to Iceland’s former president, Vigdís Finnbogadóttir, the first elected female head of state in the world.

“Icelandic women have changed the world and I believe we can do it again.”

In the light of October’s “kvennafrí”, the country’s first full-day women’s strike since 1975 when women stopped work in protest at gender inequality, Sigurbjörnsdóttir echoed many Icelandic women’s view when she said equality is still far from being achieved. 

“Iceland has been ranked the best country in the world for gender equality by the World Economic Forum for 14 years in a row. But we need to do more,” she explained.

Touching on the role models that helped her become the person that she is today, Sigurbjörnsdóttir told the audience that she believes in innovation and she believes progress in innovation means recognising women for their contributions.

It was truly an empowering atmosphere – a beautiful way of celebrating women in the world’s most gender-equal country.

As I’ve come to realise during my time in Iceland, Icelanders are receptive to innovation and therefore adoption of new technology in this small island nation happens quickly. Focusing on women in tech feels, in this context, not only necessary but essential.

One organisation that caught my eye in this sense was WomenTechIceland, the non-profit behind this year’s Nordic Women in Tech Awards.

Started as a Facebook group, WomenTechIceland was officially registered as a non-profit organisation in 2021 by founders Paula Gould and Valenttina Griffin and dedicated its work towards encouraging equality in the tech industry.

Since 2017, the organisation has been working with visiting businesses, dignitaries, personas and influential voices in tech to host special events, panel discussions and online events to connect Iceland’s tech ecosystem with the global tech community.

Sigurbjörnsdóttir echoed many Icelandic women’s view when she said equality is still far from being achieved

Reykjavík-based venture capital firm Crowberry Capital is too on a mission to support women building businesses around technology advances.

As the only major Nordic venture fund headed by an all-female team, the firm has achieved recognition for focusing on backing founders who have traditionally not had access to capital.

In 2021 the company, led by founders Hekla Arnardottir, Helga Valfells and Jenny Ruth Hrafnsdottir, launched a US$90m fund to invest in technology start-ups in the Nordics, with a focus on supporting businesses in emerging tech sectors, with a particular emphasis on encouraging inclusivity.

Their reason? “To demonstrate that the region can also show the way in terms of inventive venture support.”

Whether it’s IT, sustainability, femtech or digital health, the tech industry unarguably needs more gender diversity to continue thriving.

For starters, gender diversity encourages divergent ways of thinking, which can improve quality in the ideas output. This, in turn, drives innovation and growth.

Countries like Iceland have shown us that improving gender equality is a great place to start, but there’s still some way to go.

Women must be able to see that they can have an exciting career in technology and succeed. That means fostering an inclusive work culture, advocating for better representation and introducing more family-friendly policies.

As minister Sigurbjörnsdóttir rightly put it on stage: “If we want to make an impact, we need to engage, participate, campaign and put words into action.”

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‘I went undiagnosed for 15 years’ – the researcher leading the fight against endometriosis

The lack of research in endometriosis and her experience of the disease have prompted Dora Koller to study the condition herself

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Dora Koller, postdoctoral fellow at the University of Barcelona and Yale University School of Medicine

When Dora Koller noticed her first endometriosis symptoms, she was 14, but it wasn’t until she turned 29 that she got a diagnosis.

“They say diagnosis time is between four and 11 years. In my case, it was 15,” she explains.

One might have thought her background would have made a difference – Dora is a postdoctoral researcher in computational genomics at Yale University and the University of Barcelona. However, it didn’t.

“I had to keep insisting because I knew something was wrong,” she says.

“I understand biology, but I can’t imagine how it must be for someone who doesn’t have my background.”

One in 10 women of reproductive age has endometriosis, yet often their primary care doctors do not know what it is and the specialists to whom they are sent are ill-informed.

Vast numbers of women go undiagnosed or under-treated, with some scientists arguing endometriosis is an example of “undone science”. However, Koller thinks the issue goes beyond research.

“Often patients with endometriosis get diagnosed when they present with infertility and the fact that women are not properly represented in the medical profession is partly responsible for that,” she says.

“Gynaecology has been a very male-dominated field and [conditions like endometriosis] have not been a priority. The priority was for us to procreate. When that didn’t happen, they may have started thinking about what’s happening to us. Otherwise, pain wasn’t important.”

The under-representation of women, the lack of research in endometriosis and her experience of the disease have prompted Koller to study the condition herself.

“I work in the field of psychiatry, but having endometriosis made me interested in knowing as much as possible about it,” she says.

“I wanted to connect the two and understand the link between endometriosis and mental health.”

Her latest research – the largest epidemiological study to date on the psychiatric factors that can accompany endometriosis – has demonstrated that depression, anxiety, and eating disorders are not only a result of the chronic pain endometriosis generates, but also have their own underlying genetic mechanisms.

“It’s a great result, because now we can say that it’s not women’s fault.

“For a long time, researchers thought endometriosis was just a gynaecological disease — that it didn’t affect anything but female reproduction, and so women were often only treated when they presented with infertility.

“Now, we have to acknowledge that the effects of endometriosis extend far beyond reproduction.”

Although she thinks understanding the impact of endometriosis is important, Koller says diagnosis and treatment should remain a priority.

“The fact that it’s 2023 and the only available diagnostic method for endometriosis is surgery is unacceptable.”

‘This is not just a conversation between scientists’

There is still a long way to go to address the challenges in diagnosing and managing endometriosis, but by raising awareness the researcher believes we can open up the conversation.

“I always like to talk about this based on what happened 10 years ago with breast cancer,” she says.

“We saw women and campaigners talking about breast cancer and now everyone is aware how common it is. I think something similar is happening with endometriosis.”

However, not all countries are involved in this discussion. According to the World Health Organization, in many places, the general public and healthcare providers are not aware that life-altering pelvic pain is not normal, leading to a normalisation and stigmatisation of endometriosis.

“The change is happening mostly in the West, but we need to make more efforts to bring it everywhere and raise awareness everywhere,” Koller agrees.

“Most of the things [we are seeing] appear in English or Spanish which makes it harder to reach people who don’t speak those languages. We need to translate that information to other languages to reach as many people as possible.

“Scientists, myself included, also need to work on translating the information to the public, because often we’re using difficult language that people can’t understand.

“This is not just a conversation between scientists. This is a conversation that needs to involve patients and the general public.”

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Female empowerment: A bra for the pelvic floor? Yes, please

Your pelvic floor is essential to daily function. So why are we still not talking about it?

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We know how vital your bra is. What if we told you there’s one for your pelvic floor? Sorina Mihaila speaks to the founders behind the groundbreaking innovation.

Pelvic floor health is a critical aspect of a woman’s overall wellbeing. The pelvic floor muscles, located at the base of the pelvis, consists of muscles and connective tissues that support important organs, including the bladder, bowel and reproductive organs.

Weak or dysfunctional pelvic floor muscles can lead to a range of health issues, including urinary incontinence, pelvic organ prolapse and sexual dysfunction.

According to UChicago Medicine, at least one in three women will experience a pelvic floor disorder in her lifetime, with one in four over the age of 20 suffering from pelvic floor symptoms.

Despite this, a UK survey found that 69 per cent of women had not spoken to their health professional about their pelvic floor health. In many cultures, it is still considered taboo or embarrassing, leading to shame and a lack of discussion about it.

Anna Maria Ullmann, Yair Kira and Kaven Baessler, founders of the Berlin-based start-up YoniCore, think the stigma and lack of awareness are the biggest obstacles preventing women from seeking help.

“Many women are simply not used to take care of their pelvic floor and look at conditions affecting their pelvic floor,” says Ullmann.

With little innovation happening in this space, the trio is committed to disrupting the market and improving the quality of life of millions of women. Their product? A small device that supports the pelvic floor and improves bladder control with one press of a button.

“We call it the bra for the pelvic floor,” says Ullmann. “Women with pelvic floor dysfunctions are often not able to enjoy everything they used to so with YoniCore, we wanted to solve that and help them get their lives back.”

The device, which inserts into the vagina like a tampon, inflates to fit a woman’s unique body structure and provide optimal support. Used with the accompanying app, it also promises to help users do their pelvic floor exercises and strengthen their muscles.

Empowerment and education

While the immediate relief is important, Ullmann says their real mission goes much further than that.

“We want to come and say, Hey, it’s okay to talk about your pelvic floor, it’s okay to take care of it and put it on our priority list.

Anna Maria Ullmann and Yair Kira, founders of YoniCore

“We think this is an issue of education and a societal problem. As a business, we really want to be part of this societal shift and change how women perceive their body.

“We aim to build a community to empower women to educate themselves and learn about their body and create the biggest database on pelvic floor health,” she continues.

“We believe that there are many other conditions we could look at. With a big database, we can start treating other diseases and for us, that’s really empowering.”

Kira, her co-founder, acknowledges the challenges of bringing the product to market, but he’s optimistic.

“Not getting enough support is frustrating, but we are hoping to fulfil our mission regardless” he explains.

“We are already seeing changes in society. Women are a lot more comfortable using menstrual cups and tracking their cycle. My mother is in her 70s and she uses a smartwatch,” he laughs.

“Here in Berlin, there are many companies developing products to change the way our society deals with women’s health. So, we are really proud to be part of that.”

The entrepreneurs have big plans. After bagging the Deep Tech Award Berlin last month, the duo announced a collaboration with the health tech company Thaumatec to build an MVP for their application and get support with building the first version of the YoniCore app.

“We are also in fundraising,” adds Ullmann. “We are trying to go through this with more validation and we are also focusing on kicking off our marketing strategies to build this community that we think will be very important in our mission with YoniCore.

“In addition, we are focusing on going into R&D with our suppliers that will then produce the product.”

If approved as a medical device, the futuristic pelvic floor bra could be available as soon as 2025.

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