Women’s healthcare has made progress, yet it remains outdated and frequently falls short, even in the 21st century–a consequence of longstanding bias. In 1977, the FDA banned women of childbearing age from phase 1 and 2 clinical trials, “unless they had a life-threatening condition.” Then in 1993, “Congress passed a law requiring the inclusion of women in clinical research.”

“How did we get here? Well, you know women aren't small men. You might have heard that, but the FDA did not agree with that. The FDA in 1977 banned women from being part of research. So anything that applies to a man research-wise, applies to a woman as well. [In] 1993 we’re finally invited back in, which is great. However, we still have work to be done. We’re very behind,” said Kerri DiCicco, vice president of business development at Progyny where she partners with consultants and employers to provide end-to-end family- building solutions.

DiCicco spoke on the topic of women's healthcare at a From Day One’s Denver Conference in a thought leadership spotlight about “Bridging the Gap: Evolving Benefits to Support Women’s Health Milestones.” She specifically touched on fertility, pregnancy, postpartum, and menopause, and how to make it more tailored to women's experiences.

The Impact of Health Gaps

DiCicco says access to providers who specialize in women's healthcare isn’t easy. “Everyone has probably heard that women live longer than men, right? But it's true, we do live longer than men. But the flip side of that is that we spend 25% more of our lifetime in debilitating health. And one of the things that happens is it takes us a lot longer to be diagnosed with illnesses,” said DiCicco.

Yet, even though women are back in the picture, outside of oncology, only 1% of research dollars go towards women’s health research. Furthermore, DiCicco says it took another 14 to 16 years for infertility to be recognized as a disease. “And infertility, even when it's male factor-infertility, the woman is the one that's going to bear the treatment for that.”

DiCicco points to the fact that we’re starting families later in life and that “one in six people are going to need help conceiving.” “Because of the lack of research we come to childbearing years with chronic conditions. So it takes, on average, 10 years for a woman to get a diagnosis of PCOS (polycystic ovary syndrome) or endometriosis, which when it goes untreated, really impacts your ability to conceive without assistance.”

The struggle to have a child, DiCicco says, is often more stressful than a death in the family, “but less than 7% of women are able to get support.” There needs to be a full episode of care to cover what is needed, and it needs to happen at the right time.

DiCicco gives the story of Jessica and Ashley, a same-sex couple, who want to start a family. “It’s a hard journey to start, and if you're in a same sex relationship, there’s additional nuances.”

In this scenario, Jessica’s employer offers equitable fertility benefits, so they’re assigned a patient care advocate (PCA). This advocate acts as their guide, helping them find appropriate clinics, offering emotional support, helping them understand their options, and scheduling appointments.

The benefits of targeted, proactive care extend beyond health: Data shows that 80% of employees who receive fertility benefits stay loyal to their employer, seeing the support as invaluable. “And you think about that also through the lens of DEI–it’s a very connected journey, and we took the gaps out.”

With pregnancy and postpartum care, DiCicco says the U.S. is not doing its job to take care of women, and that the maternal death rate has risen.

Proactive Postpartum Care

Broadly speaking, DiCicco says we know postpartum is deadly, but it's still up to women to seek out that help. “And that's really hard, because at that point she's just trying to keep a seven pound human alive.” Instead, DiCicco says that proactive, early care is better.

In another example, Katie, a new mom in her 30s who went through fertility treatment, is struggling with postpartum anxiety while caring for her baby alone at home. Her employer's program connects her with a PCA who knows her background and stays involved after the birth. This advocate, along with a pregnancy coach, checks in on Katie, helping her understand that her struggles are common. 

“As she gets closer to [returning] to work. Her patient care advocate helps her with that, so she has the ability to go back on a schedule that really works for her, works for her family and takes the stressors out of it.”

Navigating the Symptoms of Menopause

The final issue DiCicco covered was menopause, which she says gets misdiagnosed all the time. “If you have an employee that comes into your office and says, ‘My heart won’t stop racing.’ You’re going to tell her to go to the ER. The cardiologist is going to see her and say, ‘I don't know what it is. Let's refer you here, here, and here,’ not even thinking that you’re 37 years old, and this is perimenopause.”

There are 34 symptoms related to menopause and according to DiCicco nearly 47% of women go through 15 different providers before they get a correct diagnosis. Most women are told to go see their OB-GYN, who are primarily trained to “have a healthy mom and a healthy birth. Less than 7% of the OB-GYNs in this country get any training at all in menopause.”

DiCicco's final example is Nicole, a 42-year-old working mom and executive, who is struggling with classic menopause symptoms. She first goes to her primary care physician, who doesn’t recognize the symptoms as perimenopause-related. “Why would she ever think about menopause or perimenopause?” 

Luckily, Nicole’s employer provides a comprehensive health benefit that covers menopause care. This proactive care not only eases symptoms but also saves women from multiple office visits, keeping them focused and productive at work. By offering targeted proactive support, employers can avoid unnecessary claims and help retain valued employees who might otherwise be affected by unmanaged symptoms. “And when we close the gaps in menopause with the right care, with the right specialist, that's what's going to happen.”

Closing the gaps in women's healthcare is key, and highly beneficial to employers. “Really think about ‘what gaps do I have, and how can I close those?’ Because when you close the gaps we just touched on, you're going to see that financially, it’s going to make sense.  Don’t put the onus on women to navigate a system that wasn’t created by or for women. We need to choose equitable coverage, coverage for everyone. And make sure it's intentionally designed for the specific concerns of women.”

Editor’s note: From Day One thanks our partner, Progyny, for sponsoring this thought leadership spotlight. 

Matthew Koehler is a freelance journalist and licensed real estate agent based in Washington, DC. His work has appeared in Greater Greater Washington, The Washington Post, The Southwester, and Walking Cinema, among others.