Defining the new standard of care for women in a post-Roe America

At a time when it seems like everyone — from Supreme Court justices, to gubernatorial candidates, to HR benefits managers — is vying to define the healthcare experience for women, Tia has turned to real women in the world to tell us what they want from our healthcare system and from policymakers and elected officials. We believe that listening to women and empowering them as makers and shapers is essential to positive transformation in our healthcare system and society at large.

On the eve of America’s midterm elections and as a testament to our deep rooted belief in listening to women, Tia commissioned a national survey of 1,000 American women aged 18-65 to help us define the new standard of care for women in post-Roe America. The research offers a blueprint for providers, policymakers, and healthcare leaders to expand quality and access in real women’s terms when the stakes have never been higher.

Survey findings

Finding #1: The end of Roe v Wade has further eroded women’s trust in the US healthcare system while also pushing reproductive health to the top of their priority list as voters.

What real women told us:

• 69% of women agree that lawmakers are not making decisions based on what women really want since the end of Roe v Wade
• 55% of Gen Z and Millennial women trust the US healthcare system less than they did before the end of Roe v Wade
• 79% of women say that public funding to support access to family planning and birth control is a priority
• 76% of women say that passing a national law that would require all states to keep abortion legal is priority for them
• 68% of women say improving access to abortion pills is a priority

Finding #2: Women don’t feel listened to or taken seriously by traditional healthcare, leading to mistrust, delays in care, and poor outcomes. Black women and women of color reported the highest rates of being ignored or dismissed by the healthcare system.

What real women told us:

• 63% of all women and 70% of Black women have been seen by a doctor who wasn’t listening to their concerns
• 69% of all women and 73% of women of color don’t think their doctor takes into account personal factors like trauma, family history, or finances when making recommendations for treatment
• 48% of all women and 58% of Black women have had a doctor ignore or dismiss their symptoms

Finding #3: Women report being treated as a reproductive part or positive pregnancy test, and not a whole person - leading women to piece together care across a fragmented system.

What real women told us:

• 59% of women strongly agree that mental health should be a core part of primary care
• 40% of women said their healthcare didn’t include screenings of their physical, mental, and emotional health
• 25% of women seek care from four or more providers per year

The survey results paint a clear picture: women as a group — 51% of the population who control more than 80% of the U.S. healthcare dollars — feel neglected by a healthcare system that’s been designed by and large for men. This data is corroborated by macro data on worsening outcomes and rising costs, which demonstrates the serious consequences that distrust, fragmentation, and barriers to access have on the health and wellbeing of women, their families, communities, and our economy and society at large.

Tia's blueprint for the new standard of care for women

While these harrowing statistics point to the negative cascade of the Dobbs ruling — from the exam room to the boardroom and to our companies’ and country’s “bottom line” — we see an opportunity to pave a positive path forward with a new standard of care that’s defined by real women. Informed by this research and years of real world care delivery coast to coast, Tia is putting forth the new standard of care by and for women that can serve as a blueprint for policymakers and healthcare leaders to expand access and improve quality in a post-Roe America. The core tenets are:

1. Healthcare that hears you

While listening to women should be table stakes, unfortunately, it’s the exception not the norm for the majority of American women. Put simply, listening is the bedrock of effective diagnosis, treatment, and trust. Moreover, women want to be empowered as their own best advocates, with education, tools, and supportive clinical partners who can help women define their path to optimal health, for themselves. That includes:

• Training for providers and sufficient appointment time that enables them to listen to women, to take their concerns seriously, and to make decisions with, not for, them
• Training on bias and cultural competency to take into account the diversity of women’s lived experience across race/ethnicity, gender identity, sexual orientation, sexual trauma, size, and more
• Patient education to complement care and improve body literacy, reduce stigma, and ensure women can make empowered decisions inside and outside of the doctor’s office

2. Care for whole people & whole lives

Women know they are not an assortment of symptoms or a set of reproductive life events, but whole, interconnected people. Women want healthcare that treats them as whole people, across their whole lives. That includes:

• Integrated physical, mental, and reproductive healthcare, that’s inclusive of but not limited to abortion or becoming a parent
• Prevention-focused healthcare that treats root causes, not just sickness or symptoms
• Relationship-based care that grows with and provides continuity for women from puberty through menopause and beyond

3. Connected primary and specialty care

While expanding access to comprehensive women’s primary care is essential to giving women the “homebase” they’re looking for (and critical to improving outcomes and reducing costs), women also want and need access to coordinated specialty care. That includes:

• Access to exceptional specialists when appropriate, whether for heart health and cancer care or obstetrics and gynecological surgery
• Smooth coordination and communication between specialists and their primary care provider with a shared electronic health record that travels with them
• Price and insurance transparency to help women plan and manage the finances around their care and that of their families

4. Care through community

Women’s health can be lonely, isolating, and all-too-stigmatized. At a time when mental health, stress, and loneliness are at record highs and disproportionately impacting women, women want healthcare that builds relationships, meaning, and connection — both with providers and with other women with shared experiences. That includes:

• A unified care team of providers specializing in different modalities who collaborate and give patients “multiple tools” to manage their whole health
• Community-based care such as group therapy, support groups, and educational classes that connect women with other women
• Intentionally-designed clinics that make you feel comfortable talking to your provider about stigmatized topics

Women have and will continue to vote in elections and with their dollars to demand the new standard of care that centers their wants and needs. It’s time that we listen.

Survey methodology

Tia conducted a representative quantitative survey of 1,171 women across the US ages 18-65 balanced to the U.S. Census in terms of demographics. Respondents were surveyed online from September 21, 2022 to October 4, 2022 and asked about their personal experiences with, and opinions about, the traditional healthcare system.

Profile of the survey respondents. Of the 1,171 respondents:

• Gender: 100% identified as female
• Age: 39% were ages 18-39, 31% were ages 40-54, and 30% were 55 years or older.
• Region: Northeast 25%, Midwest 24%, South 28%, West 22%
• Race: American Indian or Alaskan Native 1.5%, Asian 4%, Black or African American 8%, Native Hawaiian or Other Pacific Islander .3%, Spanish/Hispanic/Latino 6%, White 75%, Prefer not to answer 3%, Multiple ethnicity/other 2%