A Letter from our CEO on a “Post-Roe” America

Last night, amidst celebrating the opening of Tia’s flagship in San Francisco and new collaboration with UCSF Health, a draft opinion from the Supreme Court was leaked indicating their plan to overturn Roe vs. Wade, which would remove the federal protection for abortion that’s been central to women’s reproductive and human rights since 1973. The news hit while I stood inside Tia’s newest clinic amongst some of the most prominent female leaders in San Francisco — Mayor London Breed, UCSF Health’s Department Chair of Obstetrics, Gynecology & Reproductive Sciences, Dr. Amy Murtha, Oasis for Girls’ Executive Director, Anu Menon, and the Director of the San Francisco Department on the Status of Women, Kimberly Ellis.

The stark contrast between the diverse coalition of women championing investments in women’s health and women-led businesses, and the heartbreaking news alert on my phone is not lost on me.

While devastated by this news and the likely outcome, I am, sadly, not surprised. Felicity and I, Tia’s leadership team, and our Board of Directors have been preparing since last year for a “post-Roe” America. We are ready — not only to support our patients with access to abortion services, but to do our part to amplify broader community efforts as a leader in women’s healthcare.

I want to provide transparency into Tia’s efforts underway over the last several months, and why I believe it’s imperative, now more than ever, that Tia and other primary care and women's healthcare organizations stand up to support abortion as healthcare, period.

What Tia is doing:

#1: Tia is expanding our scope of practice to provide medication abortion through virtual visits — this service offering will open for booking shortly for patients in states in which we operate and where it's allowed by law, specifically in New York and California.

Since day one, Tia has not been shy about our views on reproductive rights, explicitly supporting abortion access by providing our patients with counseling covering any and all options (parenting, adoption, and termination), mental health support, and for patients who choose termination, well-coordinated care to trusted, high-quality abortion providers — just like a referral for fertility services or obstetrical care.

While erosion of reproductive rights and access has been underway for decades, in December 2021, we witnessed a set of legal and regulatory “tailwinds” on the national stage that compelled us to re-address our scope of practice — (1) SCOTUS’ initial hearing of Dobbs vs. Jackson, which we saw as the “canary in the coal mine” end of Roe to come; and (2) the FDA’s decision to lift the medically-unnecessary in-person dispensing requirement for mifepristone, a drug used for medication abortion.

Facing the dual possibility of both more restrictions and also potential for more access to medication abortion via telemedicine, Tia committed to expand our scope of practice to include medication abortion via our growing virtual care platform in states in which we operate and where it’s allowed by law, which today includes New York and California. 

#2: In Arizona, where abortion via telemedicine is not permitted, we’re deepening our partnership with a local abortion clinic on the ground.

Tia was motivated to enter Arizona due to its primary care and mental healthcare shortage — with only enough primary care providers to service 40% of the state's population, and ranking 49 out of 50 states in terms of access to mental health services.

We established Tia with the belief that all women deserve access to comprehensive primary care, regardless of their political or religious affiliation. We recognize, too, that Arizona is a restrictive state when it comes to reproductive health services, with burdonsome barriers that limit access to both patients seeking abortions and clinicians motivated to deliver high quality and safe abortion services, including legal restrictions preventing abortion via telemedicine and special licenses that are nearly impossible to obtain in the current political environment. That’s why we chose to tailor our approach to the local context by partnering with an established and highly respected abortion provider with strong roots in the Phoenix community. Our trusted partner provides abortion services for Tia patients, and we, in turn, provide primary care services for their patients. 

#3: We’re deepening our collaboration with leading health systems like UCSF who are leaders in reproductive healthcare.

Last night, Dr. Amy Murtha, UCSF Health’s Department Chair of Obstetrics, Gynecology & Reproductive Sciences, spoke to the values that UCSF and Tia share — clinical excellence, and a commitment to equity and access — and the work our organizations have been doing over the last 18 months to establish a one-of-a-kind primary <> speciality care collaboration that will raise the standard of women’s health for more than 40,000 women across the Bay Area. Foundational to our alignment is our shared belief that abortion is healthcare, period, and an integral part of women’s comprehensive primary care. Together, we’re committed to innovating within the confines of a post-Roe America — integrating our healthcare services in a way that upholds our values, and enhances access to whole person care that’s inclusive of but not limited to abortion.

Re-anchoring on abortion as healthcare, period.

As a woman and citizen, I am still anxiously awaiting the final ruling from SCOTUS on Dobbs vs. Jackson, and sincerely hoping for an outcome that saves Roe. Yet, as a women’s healthcare founder and CEO, I am preparing for a more restrictive future that I anticipate to define a post-Roe America. I recognize that neither Tia nor any one company or organization can “fix this'' on their own. Yet, I also believe that primary care and women’s healthcare companies have a responsibility to step up, now, ahead of a post-Roe America. By re-anchoring on abortion as healthcare, we can amplify the efforts led by community organizations who’ve been doing this work for decades, and help preserve access to essential abortion healthcare services in a post-Roe America.