Have you ever wondered what it takes to succeed as an underrepresented founder in the world of entrepreneurship? In this episode of The Angel Next Door Podcast, host Marcia Dawood engages in a riveting conversation with guest Alison Greenberg, the co-founder of Ruth Health, a virtual care platform for pregnancy and beyond. Alison shares her journey as an entrepreneur and her mission to revolutionize the healthcare space by making maternity care more accessible and affordable as well as caring for all. She discusses the challenges of raising capital as an underrepresented founder and provides insightful advice for both entrepreneurs and angel investors. Alison discusses her passion for addressing the gaps in maternity care and her entrepreneurial journey in founding Ruth Health. With a focus on developing the doula workforce and embracing telehealth, Ruth Health aims to transform the landscape of birthwork, advocating for the recognition and importance of doulas in improving pregnancy outcomes. Alison's insights into the fundraising journey and the significance of having a clear investment thesis provide valuable perspectives for entrepreneurs and angel investors alike. Tune in to this episode to gain a deeper understanding of the challenges faced by underrepresented founders in healthcare and entrepreneurship, and to learn from Alison's impactful journey of building a mission-driven company. Whether you're an aspiring entrepreneur, an angel investor, or simply passionate about making a difference in healthcare, this episode is a must-listen for its inspiring narrative, practical advice, and thought-provoking insights into inclusive capitalism and the impact of innovative healthcare solutions.
Have you ever wondered what it takes to succeed as an underrepresented founder in the world of entrepreneurship? In this episode of The Angel Next Door Podcast, host Marcia Dawood engages in a riveting conversation with guest Alison Greenberg, the co-founder of Ruth Health, a virtual care platform for pregnancy and beyond. Alison shares her journey as an entrepreneur and her mission to revolutionize the healthcare space by making maternity care more accessible and affordable as well as caring for all. She discusses the challenges of raising capital as an underrepresented founder and provides insightful advice for both entrepreneurs and angel investors.
Alison discusses her passion for addressing the gaps in maternity care and her entrepreneurial journey in founding Ruth Health. With a focus on developing the doula workforce and embracing telehealth, Ruth Health aims to transform the landscape of birthwork, advocating for the recognition and importance of doulas in improving pregnancy outcomes. Alison's insights into the fundraising journey and the significance of having a clear investment thesis provide valuable perspectives for entrepreneurs and angel investors alike.
Tune in to this episode to gain a deeper understanding of the challenges faced by underrepresented founders in healthcare and entrepreneurship, and to learn from Alison's impactful journey of building a mission-driven company. Whether you're an aspiring entrepreneur, an angel investor, or simply passionate about making a difference in healthcare, this episode is a must-listen for its inspiring narrative, practical advice, and thought-provoking insights into inclusive capitalism and the impact of innovative healthcare solutions.
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Marcia Dawood
Well, hi, Allison. Welcome to the show.
Alison Greenberg
Hi, Marcia. Thank you for having me.
Marcia Dawood
Well, I'm really excited to have you talk to us today a little bit about Ruth Health and how you got started, a little bit about your journey. And then also, I would love it if you could help our listeners understand a little bit about your journey, raising money, and maybe even some advice that you could give to our listeners. So how about if we just start with, how did you get started with Ruth Health? A little bit about your background, all that good stuff?
Alison Greenberg
Sure. Yeah. So, Ruth Health is a virtual care platform for pregnancy. And like any great startup story, there have been many iterations, and we've had a long journey over the last three years. Today, we really focus on developing the doula workforce and supporting patients and clinicians through our birth navigators. So you can think of a birth navigator as a virtual doula meets a care navigator. We create really easy access for patients, escalate emergencies for clinicians, and we're trying to change how birth work looks in this country so that it's more accessible and affordable, both for the patient and the provider, as well as the payer and larger entities like healthcare, health insurance companies, and Medicaid. And my journey with Ruth Health really kind of started from birth, because I grew up talking about vaginas at the dinner table.
And I was raised in women's health. My first job was in an obstetrics and gynecology clinic, working alongside the team of my mom, who's been an OBGYN for over 40 years. And we're very fortunate that she sits as our chief medical officer at Ruth Health. But I had a career in the corporate world coming out of college. I graduated from Yale and then moved right to New York, started working in pharma and healthcare advertising and brand strategy. I got to start my career on a really exciting high science bio oncology pipeline with Genentech, and just was very fortunate that I was working on a molecule in cancer that ended up with FDA breakthrough status. And so taking that to market and then moving more towards brand strategy and working with clients like CVS Health, Edwards Life Sciences. Stryker worked on the merger between Summit and Citymd.
I really got a sort of 360 degree look at how healthcare companies show up in the world, not just their inner workings, but how they present their brand. And I think it was both surprising and not surprising. You're working in the business world, and you're thinking, how can these entities, with so much money and so much power and such brilliant clinicians and business leaders show up in the world with such a negative reputation. But then, anyone who's ever been a patient knows healthcare is not enjoyable to engage with. And so that just really always stuck with me. I started my first company after that time in the corporate world in conversational AI, building chatbots and voice experiences when those systems were pretty dumb, honestly, it was before Chat GPT, before the conversational AI revolution as we know it. And then after two years of a profitable, from day one, bootstrapped company in that space, it was a conversational AI design studio. I realized that I wanted to come back to healthcare.
I wanted to come back to doing the work that I felt had a human impact every single day. And for me, a no brainer was making sure that I built in women's health. So I teamed up with my co founder, Audrey Wu, and we built Ruth health during early Covid, really trying to serve our mission of more accessible, affordable care during the pregnancy journey.
Marcia Dawood
Wow, that's all extremely amazing. So one of the things you said that was super interesting, other than all the other things, was about the FDA breakthrough status that one of the companies got. So I know a lot of our angels have invested in companies that have to go through FDA approvals and things like that. So tell us a little bit about that journey and what that was like.
Alison Greenberg
Sure. Yeah. I mean, this was super early in my career. It was actually an internship I had in college that turned into a job offer. I was working on what they call in pharma a molecule. So it's before a drug becomes a drug. At that time, it was called MPDL 32 80 a. Right.
So it's not something that any consumer or even any clinician would have name recognition on. But this in particular was a drug for PDL, one non small cell lung cancer. I think it was also counterindicated for some breast cancers, and it was an immunotherapy drug. And so we see a ton of immunotherapy across the healthcare and biotech space right now. But back then, in 2013, 2014, immunotherapy was just starting to boom. So I was working on the sort of account team behind Genentech's agency of record, and we were advertising the drug to doctors, trying to get them to enroll clinical trials. And so when the FDA gave that molecule breakthrough status, it meant that the drug was so effective that FDA wanted to really expedite its process to market. And now it's a drug in market called tecentriq, I believe it's pronounced, and it's really incredible.
It's given some people with very short time to live exponentially more. And I think the FDA process was something Jen and tech went through. But as their agency, as the team responsible for kind of bringing it to doctors, we were constantly having to crunch new information and make it digestible. And I think that's something I carried with me through my entire career and into Ruth health. With Ruth health, we've tried to educate the entire birthwork and venture capital landscape on the power of doulas. And it never ceases to amaze me that even nurses on the floor in labor and delivery, some of them don't know what a doula is. So our efforts to scale doulas and to educate on what these subclinical providers do and how they're evidence based, they can really improve birth outcomes and pregnancy outcomes. I think I learned a lot of that from working on early stage oncology drugs, because it's such complex stuff, and you have to simplify it for anyone who's listening.
Marcia Dawood
I love that. Can you then, for our listeners, explain exactly what a doula is? And also this word birth work, that's kind of new to me. I don't know that I've heard that used before.
Alison Greenberg
Yeah, absolutely. So birth work is kind of the catch all term for anybody who works in and around the perinatal journey. So pregnancy, postpartum. But let's not forget loss and miscarriage as well. It's all really part of the experience of pursuing parenthood. And birth workers include the often marginalized or forgotten folks who work so hard every day to improve the experience of pregnancy and postpartum. And that's not just doulas in some cases, those are community health workers. Those are traditional midwives.
We had the opportunity at one point to make contact with some traditional dene or navajo midwives at the changing woman initiative out in. You know, these folks are not necessarily credentialed providers. They're not certified nurse midwives, but they're birth workers. And on their reservation, they're delivering babies, just like certified providers are in a hospital here in New York City. So birth work is a great term because it includes the entire medical establishment. It includes doulas, which are non medical birthing support providers. And doulas historically were considered more fringe. Doula is actually an ancient greek word, and there were always support providers attending births in ancient Greece.
Fast forward through the particularly women of color and black women, who are overwhelmingly providing the midwifery and nursing workforce and really sort of paving the way for reproductive justice as it relates to pregnancy. And then doulas popularized a lot more in the last 20 to 30 years. So they're somebody who can attend your birth, provide support prenatally, and be there for you postpartum. A lot of in person doulas make home visits, support home births. But what we're about at Ruth Health is ensuring that doulas get the credit they deserve, which is that they're not just subclinical or support providers or not just non medical. A lot of doulas are actually multi certified. They may be nurses certified breastfeeding specialists, case managers, like our director of clinical operations, Ray Paris. She's a certified doula and she's also got clinical certifications.
And then there's plenty of doulas who don't have clinical certifications, but who advocate for the birthing person. And in doing so, we have great evidence on doulas being evidence based, meaning they improve pregnancy and birthing outcomes, they lower the chance of c section, the likelihood of preterm birth, they increase birth readiness, birth literacy, they improve the likelihood of mental health issues during and around pregnancy. And so we've focused on scaling doulas, because the only challenge with in person doulas is they're wonderful. They're not paid a living wage though. And right now, twelve states in the US provide Medicaid subsidies, but many private insurers don't even cover doulas. And so doulas can really only work with a client if they're paid a living wage. Too many doulas aren't making that living wage and there's only 9000 doulas in the US. So we look at this as an opportunity to leverage the power of telehealth and the power of doulas as evidence based support providers.
And we put our doulas to work in birth navigators, bridging the gap between patient and clinician. So they not only support the birthing person via telehealth, but they also support the clinical care team. So we work alongside OBGYN's midwives and nurses, and especially important, is developing an escalation policy. So if we're text messaging with the patient and one of our birth navigators catches wind that the patient is experiencing heart palpitations, or one patient, we had even felt like she was peeing in her pants at 25 weeks, that was an emergency, but the patient doesn't necessarily know that. And so within 3 hours of texting her birth navigator about this leak, which turned out to be a membrane tear, we had her in labor and delivery triage, and that was an emergency. She and her baby both could have been seriously harmed, or even this even could have been a case of morbidity. Instead, they were treated for a severe vaginal infection. And by the way, she was diagnosed with COVID So these are just some of the things that a doula can do when the rest of the obstetrical care team is really burnt out and doesn't necessarily have time to catch things that might fall through the cracks.
Marcia Dawood
Wow, that's incredible. I know a couple of my friends who have used doulas, and they raved about how important it was and how much it helped them in their whole experience. Amazing. So take us through a little bit about how you've then been fundraising for Ruth Health. I mean, you're clearly very good at explaining all of this, because that was an amazing explanation of what a doula is, how they're important, and how Ruth health is in the middle of all that. But take us a little bit through the fundraising journey and what you've had to go through.
Alison Greenberg
Yeah, absolutely. Well, Marcia, as an angel investor, I think you know better than most the struggles that any underrepresented founder goes through to raise. And I think you in particular, being a female investor, probably see your fair share of deals from women entrepreneurs. And that is really where my fundraising journey began. When we first started to conceptualize Ruth Health, our initial goal was actually to scale at home ultrasounds. So I think fundraising is an interesting journey because you start, we were preseed. You start with an idea, and then throughout that path of pitching and meeting investors and fine tuning your pitch, and like you said, just having to be a good storyteller, having to explain things clearly, you start to realize that the system is a little bit rigged, but also that your ideas may experience pushback. Right? May experience lines of question you never expected.
And more so than anything, fundraising is about educating. You have to be a good educator. So our precede journey started in early 2021. We were all still kind of trapped inside quarantining. Covid was raging, and we set out to raise a preseed\
round after starting to get a proof of concept on our at home ultrasound idea. And we got really lucky. We had a fluke encounter on social media with a celebrity, and we were able to deliver her an at home ultrasound. We filmed the whole thing.
It went viral on Instagram, seen by millions of people. And that's when we said, okay, it's time to strike while the iron is hot. We want to create more accessible maternity care, starting with these at home ultrasounds. But we already had a roadmap built out that included pelvic floor care, which was a huge unmet need. We wanted to bring lactation support into the mix. We wanted to bring doulas into the mix. From day one, when we went out to raise that precede, we had almost no validation. It was really challenging.
And we spent seven, eight months pitching to every angel, every fund who would listen. A lot of them laughed in our faces. A lot of them didn't believe that women's health was a valuable place to put their investments.
Marcia Dawood
Wow.
Alison Greenberg
Things have changed so much today. But I do think in 2021, we were just starting to see the market change. And eventually it became the hottest market for VC in human history and the easiest time to raise in human history. But the sea change wasn't there, I would say, until just after summer. So when we went out to raise that precede round, eventually we were able to raise seven hundred and twenty five k. Like I said, it took seven, eight months. It was absolutely grueling. I was pitching to anyone who would listen.
Do you remember clubhouse, Marcia, were you?
Marcia Dawood
Yeah, sure.
Alison Greenberg
Yeah. So clubhouse became my training. Know, before Ruth Health, I had never engaged with venture capital. Like I said, my first company was a bootstrapped, profitable conversational AI studio. It was a small business. My second company, with Audrey as well, was a medical device company that was fully funded by grants funded by the FDA. So by the time we got to this idea of becoming a venture backed health tech company, there was so much I had to learn. And Clubhouse, while we were all quarantining, was actually a wonderful place to learn.
And I pitched night and day. I mean, the joke was with my friends and family was that I actually ended up getting an iPhone. I'm a diehard Android user, but I had to get an iPhone that I called my clubhouse phone because clubhouse didn't have an Android app yet.
Marcia Dawood
That's right.
Alison Greenberg
All I knew was that clubhouse was where investors went to talk to one another. And it was know Sophia Amarusso was on there, just casually hanging out. Randy Zuckerberg would take conversations with mean. I remember even Andrew Yang showed up when he was sort of a hot name after his presidential bid and was just chatting around on Clubhouse. So I pitched every single investor I could find on there, and that's actually how we found our first pre seed investors. So shout out to one venture, Varun Ramdevan and Varun Kumar, two amazing men who work in health tech. They were the first people to believe in us. And then from there, we were able to scrounge together that seven hundred and twenty five k.
And then it wasn't until we were accepted into Y Combinator's summer 21 batch. And following after that, the UnitedHealthcare accelerator powered by techstars. I think those two accelerator programs were really how we were able to raise a proper seed. And that was. I give all credit to Y Combinator. People say what they want to say, but YC was very powerful, as it was rocket fuel for fundraising. And that raise in September of 21, we had more interest than we knew what to deal with, which I know is a massive privilege in women's health. And as a female founder, I never could have imagined that investors would be coming to us. But it was truly thanks to YC.
Marcia Dawood
Wow, that's amazing. So did you go through YC in New York?
Alison Greenberg
Yes. This was the second, I believe, remote batch in. I mean, I've. I've been to the YC reunion this past. I've. I've connected so well with the YC community. It's an incredible bunch of founders and entrepreneurs and leaders, but at that time, we did it from home. So I still, to this day, have never actually been to y combinator or to their new headquarters in Silicon Valley.
Marcia Dawood
That's interesting. Well, I've heard, you know, mainly great things about Y Combinator, so I'm glad to hear that your experience was really good also. So what kind of advice do you have then, for angels who maybe don't have a healthcare background and are looking at a healthcare company like Ruth Health?
Alison Greenberg
That's a great. It's. I think even growing up in healthcare and having worked for a lot of large healthcare players, I wouldn't know the first thing about assessing a biotech deal. Right. Or a diagnostics company. So I think what's crucial when it comes to angels having conviction, which I know from pitching hundreds and hundreds of angels, all you want is for that angel to have conviction. And it could be from a personal connection to your mission. It could be from their career experience, their subject matter expertise, finding conviction.
I think you need sort of a board of directors of your own. You need folks that you can consult who can help you build that conviction. So I would never have expected to pitch an angel and have them say yes from square one unless they had some sort of personal connection to the mission or as you're saying, they had some healthcare experience or some connection to pregnancy and postpartum. I think consulting outside sources is really powerful. At the end of the day, though, you need to have your own thesis. And that's where we found traction. And quick decision making with angels was when an angel had a very clear thesis. In many cases, it was investing in women founded companies that serve women.
In other cases, it was investing in minority and underrepresented founders. And so myself being gay woman, my co founder being an AAPI woman, in some cases, that's actually what they need to see to feel like their dollars are going where they want them to. But, yeah, at the end of the day, just having folks to consult who give you a good sense of the space and a good sense of where innovation is needed, really could help angels. Because just relying on Googling around, I can't tell you how many angel investors would google the latest current event in maternity health and send it to us, and they're like, oh, did you hear about this company, Maven? We've heard about this company Maven. No. And I don't fault them. I think in some cases, they're just getting their own education. They're just getting started.
But we don't expect angels to be experts in every single pitch they get. Our hope was always that they had folks they could reach out to. And usually angel investors like you have an incredible network reaching out to folks, you know who could give you a yay or nay and a gut reaction on a deal.
Marcia Dawood
Right? Yeah. I love what you're saying about having a clear thesis. That's one of the things that I think all angels should have. Whether you're in a group, in a fund, we all should have our own personal thesis, which I know when I started doing angel investing, I did not have. So I really wanted to over. As time went on, I really wanted to say, hey, wait a minute. I think I need to sit myself down, have a little chat with myself so we could figure out what is it that I care about? What are the things that I really want to invest in and then not just have this kind of random, oh, I like this founder, and I like what they're doing, so I'll think about investing in them. But I think funds. I know that you know Naseem from ventures and I know that she's on your board, right? And she's an investor in your company. And their thesis is very clear. And you usually see that with a fund, but with individual angels, and even sometimes within an angel group, if it's smaller, you don't really have that thesis. And I think you're spot on with if you have that or especially if you're a founder and you find angels and you're looking for that and, you know, to look for that, that can be super helpful.
Alison Greenberg
Absolutely. Yeah. You're mentioning some of the most incredible investors I've had the privilege of meeting. The Emily Ventures folks. Naseem, Lakeisha and Azeem. Yes. Naseem is one of our board observers. And I think when we met Naseem and the folks at Emeline, it was clear from moment one we actually met them at our precede and they knew exactly what they were looking for.
So not only is that I think of huge benefit to the investors, because it gives you a really easy framework for saying yes or no. It's so valuable to entrepreneurs, it's so valuable to founders. It is very clear when an angel is not fully convicted of even their own ability to invest. And that's okay, everybody gets their start somewhere. But if you have that thesis, it's actually going to provide sort of product market fit, so to speak, with the entrepreneurs that are pitching you. They're going to see that you know what they want and that you know what you want. And with Emily Ventures, I think it was like a know, to borrow from Damon John, like Fubu, right. For us, by us, Emily was so clear and sharp.
It was the same with our lead investors at, you know, Giant Ventures was investing in the future of health and education and housing. They were really laser focused on mission driven founders. And so, you know, now that's evolved to, they only invest in, I believe, climate health and what they call inclusive capitalism. Giant has built a brand and so having worked in branding, I think it's actually something that all angel investors should think about for themselves. What's your brand strategy? What's your positioning? And what are your three core tenets of what you believe in and what you want to invest in? It's going to give you clarity on what you want to see and what you actually put your money into. And it's going to give folks pitching you clarity on whether or not the pitch is worth their time. I always feel a little bit badly, but sometimes when I meet with an angel investor and they don't have a thesis, this has even happened with funds. If there's no clear thesis or if there's an inkling that we're not a fit for them, maybe they've never invested in health tech and they're entertaining the thought.
I will often five minutes into a call saying, you know what, thank you so much for your time. I don't think this is going to be a fit for us because it's not worth either party's time to go through that whole 30 or 45 or 60 minutes pitch without having a roadmap from the start of where is the bar?
Marcia Dawood
That is some outstanding advice for both angels and entrepreneurs. I love that. And this inclusive capitalism. I love that phrase.
Alison Greenberg
Yes. Giant are one of several funds that I think have come up in the last year, last five years. They actually just announced $250,000,000 in new funds. So I have to plug the folks at Giant, our investors, John Dashotsky and Cam McLean, they believe in mission driven founders, and they're really seeing dividends. So I think you really align with this well, Emily. And aligns with this well. Several of our investors do look at inclusive capitalism, or what I've always called the double bottom line. Right.
Alison Greenberg
It's, can you do good and do well?
Marcia Dawood
Yes. Doing good while doing well. That is the mission. Absolutely. Well, Allison, this has been awesome. Thank you so much for coming on the show and giving us all these pearls of wisdom about what you're doing to help with maternal care, as well as what you're doing to set the example for entrepreneurs everywhere, especially underrepresented entrepreneurs.
Alison Greenberg
Thank you, Marcia. I'm really excited to follow your journey as well.