Why most abortion care employee benefits fail when they're needed most

We had a Slack channel called #support. It was the kind of channel where people shared miscarriage stories, grief notes, links to therapy resources, and advice for navigating fertility treatment. It felt like a safe space. So when Roe v. Wade was overturned in the United States, I expected a flurry of posts—questions, concerns, maybe even a few personal disclosures. Instead, the channel went dead silent. Not a single post. Not even a private DM.

This was two weeks after we’d launched our new abortion care benefit.

That silence wasn’t just eerie—it was revealing. It forced me to confront something I hadn’t understood clearly as a founder. Just because you’ve created a benefit doesn’t mean your team trusts it. And when the benefit is related to something as intimate, emotionally charged, and legally risky as abortion care, trust isn’t a given. It’s something you earn through design. Not words. Not values. Not policies. Design.

When we rolled out that benefit, we thought we were doing the right thing. We moved quickly, drafted clear language, consulted legal, and added the clause to our employee handbook. The wording was clean and progressive: “Employees residing in states with restricted access to reproductive care may request financial support for travel, accommodation, and related medical services.” We announced it with the right tone—firm, empathetic, values-aligned. For a moment, I thought we’d done the responsible thing. But no one used it. Not for months. And when someone finally did come forward, it wasn’t to ask for help. It was to tell me that she had needed the benefit—but was too afraid to use it.

She lived in Texas. She didn’t want to be pregnant. She was scared and alone. And even though we had a policy in place, she decided to handle everything herself—travel, cost, logistics, time off—without telling a soul at work. Not even HR. When I asked her why, her answer was devastating: “Because it felt like I’d be asking for permission.”

That one sentence stripped our well-meaning policy of all its good intentions. We hadn’t built care. We’d built a liability. And we had no idea.

Here’s the hard truth most founders don’t want to admit: If your support system requires someone to be brave, it’s not support. If it relies on trust they haven’t had time to build, it’s not protection. If it depends on disclosing something they may feel ashamed, judged, or legally vulnerable about—it’s not a benefit. It’s a test.

We designed our abortion care benefit the same way we designed dental or mental health coverage. Add a clause. Make it reimbursement-based. Route it through HR. Document the process. Stay compliant. Signal our values. But abortion care isn’t dental. It’s not wellness. It’s not a lifestyle perk. It’s a crisis event. It’s high-pressure, emotionally volatile, and—in many states and countries—legally treacherous. People don’t need a reimbursement form. They need speed. Safety. Discretion. And certainty.

And here’s the deeper layer: in most companies, HR is not the right entry point for sensitive care access. Not because HR professionals are unkind or untrustworthy—but because HR is still seen as an extension of the employer. And when the thing you need support for could affect how others see you, or expose you to scrutiny or shame or job insecurity, you don’t file a claim. You go quiet. You figure it out yourself. You take the burden alone. That’s what she did. And I now know she wasn’t the only one.

As I looked back, the signs were clear. We had employees in Texas and Florida—states where abortion access had been dramatically restricted. We’d hired them fully remote, with full knowledge of their location. We had the legal resources to draft a compliant policy, the budget to fund it, and the values to back it publicly. But we failed to understand how all that support looked from the inside—when someone was actually in crisis. When someone had to ask, “Am I safe to use this? Who will know? Will this change how my manager sees me? Will there be a record of this request? Could this affect my immigration process or insurance access? Could this leak?”

If you’ve never had to make a decision like that under legal pressure or personal trauma, you might assume the answers are obvious. But they’re not. Because fear, especially when it involves reproductive health, is amplified by every form, every name on a policy, every line of documentation that makes the experience feel visible—and not in a good way. What feels transparent to a founder can feel exposing to an employee. What we see as inclusive might register to them as dangerous.

After that conversation, I started tearing our policy apart—not out of anger, but out of necessity. I needed to understand every friction point, every moment that created uncertainty or fear. I walked through the policy as if I were a scared, junior employee in a red-state zip code. The flaws were obvious. First, it required contacting HR. Second, it was reimbursement-based, which meant paying upfront and submitting receipts. Third, it didn’t specify timelines, which meant someone might not know how fast they’d get help. Fourth, it lacked clarity around discretion—would the manager know? Would finance see the line item? Would it show up in the employee’s internal file?

We had failed at the exact point where the benefit needed to work hardest: in moments of real-world emotional and logistical chaos.

I started talking to other founders. Quietly. I asked how their teams had responded to similar policies. I heard the same story again and again: No one’s using it. Not because no one needs it—but because it’s not built for use. It’s built for compliance. It’s built for PR. It’s built for investor decks and values slides and “we support women” statements. But when you scratch beneath the surface, the structure collapses. People don’t use benefits that feel risky. They don’t turn to systems that weren’t designed for them in their most vulnerable moments. They go silent.

We scrapped our old system and rebuilt from scratch. This time, we started with care, not compliance. We partnered with an external care provider that offered direct access to abortion care support, including travel coordination, medical referrals, and logistical assistance—without going through HR. The system required no manager approval, no receipt submission, and no documentation inside the company. It was opt-out, not opt-in. Everyone was pre-enrolled. The support was quietly available, always on, completely confidential. No Slack announcement. No values statement. Just quiet architecture, waiting for the moment it was needed.

And when it was needed, it worked.

The first time someone used it, I didn’t know. HR didn’t know. Finance didn’t know. We only found out because the person messaged me months later and said, “I never thought I’d need it. But I did. Thank you for making it safe.” That’s when I knew we’d finally done the right thing. Not because we got applause. But because we built something that didn’t require courage to use.

This is the lesson most companies miss. Offering abortion care employee benefits isn’t about signaling your politics or pleasing your team with progressive policies. It’s about designing a system that works under pressure. It’s about assuming fear, not trust. It’s about removing every unnecessary step, every layer of exposure, every point of friction that turns help into hazard.

And more importantly, it’s about acknowledging that the people who might need this benefit most are often the least likely to raise their hand.

So if you’re a founder who wants to get this right, start by asking one question: If someone needed this tomorrow—scared, alone, unsure—could they access it without asking for permission?

If the answer is no, then you haven’t built care. You’ve built theater. And when the stakes are this high, theater doesn’t protect anyone. Systems do. Systems that are quiet. Systems that are fast. Systems that don’t ask for courage to function. This isn’t a “perk.” This is emergency infrastructure.

If I could go back, I’d spend less time drafting policy copy and more time pressure-testing the user journey. I’d stop thinking about what made us look supportive—and start thinking about what would make someone feel safe. I’d recognize that the most effective policies aren’t the ones that get retweeted. They’re the ones that get used quietly, by someone who needed help, and didn’t have to explain themselves to get it.

Because when someone is facing an unwanted pregnancy in a hostile legal state, what they need most isn’t applause. It’s clarity. Speed. Safety. And the knowledge that when they reached out for help, the system didn’t flinch.

That’s the standard.

If you’re not meeting it yet, you’ve got work to do. Not next quarter. Not when you’re bigger. Now. Because someone on your team might already be navigating this in silence. And what they need isn’t a message from the CEO or a line in the benefits doc.

They need the door to be open—quietly, reliably, safely—before they even know they’ll walk through it. No permission required. No explanation necessary. Just care, designed right. And that’s not optional anymore. That’s the baseline.