In periods of political uncertainty, innovation remains one of the few strategies that gets stronger, not weaker. New care models, tools, products, and technologies can continue moving forward—and build durable pathways that can outlast a particular policy environment.
The reproductive health field confronted this reality in 2022 when the U.S. Supreme Court overturned the federal constitutional right to abortion. Almost overnight, providers, patients, and advocates faced a landscape of rapid legal changes, heightened risk, patient confusion, and operational disruption. In response, the Packard Foundation — which has supported reproductive health and rights since 1967 — recommitted to innovation not as a “nice to have,” but as a pragmatic way to sustain progress in an unstable environment.
This is not a claim that innovation replaces policy efforts, or that technology alone can resolve structural inequities. Rather, it is a hopeful assertion that investing in innovation plants seeds, and that even in difficult seasons, seeds can take root and sow the fields for the future we want.
Uncertainty narrowed some traditional paths, but innovation stayed viable
After the Supreme Court overruled Roe v. Wade in 2022, certain strategies became less feasible, at least in the near term. Federal litigation, long a reliable tool for protecting access to abortion, became far less predictable as a strategy for safeguarding care. Likewise with national policy solutions. Work shifted to the state level, where progress remains both possible and essential—but is often constrained by limited scalability, uneven timelines, and the risk of reversal.
By contrast, reproductive health innovation can often advance without triggering the same level of counter-mobilization because it tends to:
- Be embedded in service delivery and operations (workflow, staffing, distribution, customer experience) rather than solely in legislation.
- Move iteratively, allowing teams to test, learn, and adapt before scaling.
- Diffuse across many nodes—startups, clinics, supply chains, telehealth infrastructure—making it harder to disrupt wholesale.
This is not to assert that innovation is “risk free” or inherently “safe.” New models can become targets, and health innovations can face regulatory scrutiny, market barriers, and misinformation. But compared to a single high-profile policy challenge, innovation often offers more breadth with multiple approaches, adaptability through faster iteration, and resilience to drive progress even when one pathway closes.
Innovation is a long game and uncertainty is the reason to plant seeds
When the future is unclear, it is tempting to pause investments or shift every available dollar to immediate response. Direct support is indispensable in acute moments, and innovation takes time, given the need for testing, iteration, trust-building, implementation, and scaling. Yet the investment pays off over the longer term. The worst time to stop investing is the moment when you most need future options.
There’s a saying: the best time to plant a tree was 20 years ago; the second best time is today. The same is true for innovation. We don’t get “future-ready” solutions unless we begin building them before we know exactly how they’ll be needed.
Take Opill, the first over-the-counter birth control pill. In 2015, the Packard Foundation made a $12 million investment to help facilitate this effort. That helped ensure Opill received FDA approval for over-the-counter status in July 2023, roughly a year after the Supreme Court’s 2022 decision. Back in 2015, we could not have predicted the post-2022 landscape, but we understood the timeline reality: meaningful innovations require sustained capital and patience. Because investment came early, an important access option was able to be ready when it became urgently needed.
This is the “planting seeds” case for mission investing: not every seed sprouts, but some do bloom. For example, in 2010 we made founding mission investments to build Afaxys as a deeply mission-driven private company to ensure stable pricing and dependable access to products and services that safety net providers rely on to care for patients seeking reproductive and sexual healthcare. Through our early investment, Afaxys has been able to grow from a start-up company into one of the largest providers of contraceptive access through public health clinics nationally. And as the company has gotten to scale, it has become self-sustaining from its own revenues. Now, Afaxys is a durable market platform to counteract ongoing legal and regulatory attacks into the future.
Mission investing can be a strategic way to strengthen the private sector infrastructure of access—especially when the public sector is constrained and commercial capital is not aligning with public health goals.
What you can do: Join us in building the innovation seed bank
Over the past two years, the Packard Foundation and the Education Foundation of America have brought together grantmakers and impact investors to identify gaps and opportunities in innovation across abortion and contraception. Those convenings helped catalyze the Reproductive Health Capital Network, designed to help capital holders across grants, Program Related Investments (PRIs), Mission Related Investments (MRIs), and beyond find aligned innovation opportunities suited to their priorities and risk tolerance.
We welcome others who want to plant seeds now. This will ensure that in the years ahead, whenever the environment shifts again, access doesn’t disappear with it. Innovation is not a retreat from the hard work of policy and systems change. It is part of how we build a bank of ideas that will be ready in the future in time for when we need them most.
This piece was originally published on the Mission Investors Exchange (MIE) website, as part of an impact investing thought leadership series related to the MIE 2026 National Conference.
