E07 for review- Making the case for fertility benefits to leadership, with Elastic
[00:00:00] Nancy: Maybe you've been listening to this podcast and you're pretty convinced on the value of fertility benefits. If you're not, keep listening! But either way, learning about fertility benefits and finding the right option for your workforce is often only half the battle. You also have to make the case to your leadership team. That might start with demonstrating how many employees you predict will use the benefit.
[00:00:28] And talking about what goals the benefit can help your company reach like improving employee retention. And of course the cost of everything will definitely come up as well. Today on our podcast, I talk with Leah Sutton at Elastic about what she sees as the true value of fertility benefits and how she makes the case for them at her company.
[00:00:49] Then I talk with a fertility physician about how expanding. Says to culturally competent care is another way. Fertility benefits can improve outcomes for employees. Let's hear from [00:01:00] Leah.
[00:01:08] Leah: I am Leah Sutton and I'm the SVP of global HR at Elastic. And
[00:01:13] Nancy: can you tell me a little bit about Elastic
[00:01:15] Leah: and what you do? So Elastic is a company that helps other companies. We're a software company make meaning of the data. So we have a set of solutions built on a platform, Elastic around enterprise search security and observability.
[00:01:29] We started as an open source company. So we've been around for about 10 years and it's a very popular open source project. So a lot of people know Elastic search. And as you know, data's a growing industry, people are taking in tons of data. So helping people. Make meaning of their data, whether it is a bank doing fraud detection, the Mars Rover, taking in all the data from Mars and understanding what's happening there, trying to optimize a search on Wikipedias tell people you go to Wikipedia and you search.
[00:01:52] You're using Elastic. So tons of different solutions for our businesses that we support. And it's a very global company. We have employees in, I think, 42 [00:02:00] countries and growing and a fun place to work.
[00:02:02] Nancy: I didn't expect your answer would include Mars. That's really cool. Yeah. indeed, indeed must be so important to find the right people for your open roles.
[00:02:12] So do benefits play a big part in that and kind of recruitment and retention?
[00:02:16] Leah: They do. One of the things I'm most proud of at Elastic is that we offer truly comprehensive benefits and take a very global view. So a lot of companies will say, well, we have our us benefits and our international benefits.
[00:02:27] And the reality is like, we are a, a global company in the U.S. as part of. And so for us really understanding what's meaningful in every jurisdiction that we operate in has been certainly, as you might imagine, challenging, but I think also enabled us to get really creative. So as we think about what's most important, we started with a baseline around what are the things that regardless of where you are, are critical to you.
[00:02:47] So when you think of things like healthcare, right? Making sure your basic healthcare needs are met things like maternity paternity, parental leave, right? So things. Everyone can utilize retirement. So whether it's a pension in like in the UK [00:03:00] or a 401k in the us, making sure that we have people thinking about their futures and then finally job protection.
[00:03:05] So if something goes wrong, do you have leave to support you in that time when, when you've got a problem and you can't work so income protection. So thinking about kind of basic buckets that are global in nature, although they may manifest differently in different countries, really making sure. That we're taking that global view.
[00:03:22] And obviously, as we think about the parental benefits, Carrot's a big part of that. And certainly the global aspect of that is, is critically important to us as well.
[00:03:30] Nancy: When you decide to start looking into fertility benefits, what kind of inspired the sort of that search? What did you have
[00:03:37] Leah: in place before.
[00:03:39] Yeah, we didn't have anything I think is the answer. And so family formation had come up as the next wave is perhaps the wrong word, but the next set of benefits that are gonna be really critical to people. And if you look at the demographics, sort of, of our company, the average age is 38. So the bulk of our employees are right in that kind of those years where that family formation piece is critically important.
[00:03:58] So that was something we'd been talking [00:04:00] about a long time and then started as we started to look, Carrot came up and again, I mentioned the global aspect, really making sure that we had a solution that we could utilize globally. And when I look at Carrot, our utilization is used around the world. So in the us, it's about 50% of our utilization.
[00:04:13] Europe's about 30%. APJ is about 10% and Canada broken out as another 5%. And that's very reflective of where the employees, our employee population sits overall. So it meets us where we are in terms of an employer. And has been something that's just been deeply appreciated by our people. Was there
[00:04:30] Nancy: anything you were looking for in addition to the global
[00:04:33] Leah: piece, I think making sure that we had something that supports any kind of family formation, and I think that's a piece for us that I think people have been maybe a bit surprised about in a positive way.
[00:04:42] And even that the sort of, Hey, we're on this journey. We're not sure where we wanna go. So we, we really love that a good chunk of people that are using Carrot are also. That path, finding that exploration, like what is their journey to parenthood going to look like? So finding a benefits provider that could really support our [00:05:00] people where they were at, regardless of what that family formation looked like was really, really important.
[00:05:05] Yeah. I
[00:05:05] Nancy: think path finding is a great example. It's something I think a lot of people don't think of, but for Carrot that can look like. Helping people with ovulation tracking or doing initial tests, you know, maybe you're someone who you haven't really started the process, but you wanna learn more about where you
[00:05:21] Leah: are.
[00:05:21] Absolutely. So I think that piece of it for us, and even the split of how, from an expense perspective, like that's a meaningful part of the split. And I think that's something we've gotten a lot of feedback on cuz folks just didn't know where to start. And so giving them that starting point is something that we've gotten a lot of appreciation for.
[00:05:37] Nancy: Yeah. Speaking of costs, there definitely is a belief, it's natural, when you first think of fertility treatments, you think of IVF. I think a lot of people imagine multiple births, maybe twins, triplets. Those are really the common associations, even though a lot has changed over the years in terms of how that care is done.
[00:05:53] What did you think about the costs before you started looking into it and what you thought changed or, or what did you learn in the process?
[00:05:59] Leah: One [00:06:00] thing that people have heard me talk about before sometimes is like, when we think about benefits, it's very easy for me to, you know, rather than have to make a really complex business case.
[00:06:07] It's like, this is the right thing to do. This is the benefit that's critically important to our people. So when you have that as your first frame, like it's just the right thing to do. It's not that the cost is secondary entirely. Right? You have to look at that, but it helps you frame it up in a different.
[00:06:21] What is the impact on our people, right? What is that impact? You've got this very stressful part of your life that you're trying to navigate. If we can help you in that, that only builds loyalty, that only reinforces that strong relationship between how we support you as employee and the path that you're on.
[00:06:36] To me, it was a bit surprising that it wasn't more expensive because of exactly what you've said, right? There's this thinking around, gosh, all these things could like IVF and it's tens and tens of thousands of dollars. And how does that look? And what portion are we taking? You go through any of the cost analysis that you would do with any provider.
[00:06:51] But I think understanding what our sort of expected usage was, how we thought it would play out regionally. I think we've been really pleased both from a cost perspective, but also just we've [00:07:00] had a really strong usage perspective. So I think that utilization is something we feel really good about. There can
[00:07:06] Nancy: also be a misconception that, oh, not that many people need to use this.
[00:07:10] I think a lot of people think it, it's just kind of women in a, a certain set of circumstances.
[00:07:15] Leah: Yeah. And it's interesting when I think of folks that have reached out to us, it's not just the moms, right? I think that has been something. If I look at the usage by gender, it's pretty evenly split between our female, identify employees, our male identify employees.
[00:07:27] And then there's another quarter that choose not to identify. Obviously our population is diverse and I love that that dads or potential dads are utilizing it and understanding like, Hey, this can be part of our journey as well.
[00:07:39] Nancy: Pregnancy is also part of what Carrot provides support for. So it was that a factor in your search as.
[00:07:44] Leah: It's the whole package for us often the most salient point is like how global is this? Often you'll see a great solution. Like that's wonderful, but there may be only in the us or in the us and Canada, maybe the UK. And for us given the diverse geographical [00:08:00] spread of our employee population, that is often one of the most important drivers.
[00:08:04] When we're looking at adding a new benefit.
[00:08:06] Nancy: Are there
[00:08:06] any stories that you've heard from employees on specific ways they've
[00:08:09] Leah: used. The most heartfelt things we've heard back from an employee was around adoption. And I'm gonna actually share this quote. Cause I think it just it's so personal and it's so I think indicative of, of how the impact isn't it says I write this email with tears in my eyes because a considerable amount of money was just deposited in my checking account through the Carrot app.
[00:08:27] My wife and I have tried to have a child for four years and decided that adoption was the best way for us to expand our family. It's a lengthy process that feels like the most complicated, bureaucratic job interview that's also an audit of your entire life. It's also expensive. So for Elastic to offer a reimbursement of up to $10,000 for adoption is not only massively generous, it's life changing.
[00:08:45] And now I'm crying like full on crying because I feel so much gratitude that I'm overwhelmed by it. And I just need to say, thank you. So we get notes like this, and I just, that just makes me cry yeah. From our employees. And so you realize in that moment, you're talking about it. From a financial consideration and you know, [00:09:00] like what's our utilization gonna be.
[00:09:01] And, you know, you sort of go through all this calculus and then you get a note like that, that you really understand the human impact of offering a benefit like this. So that is one that like I particularly love. And we also have had some really nice reach out from employees in Japan. That's been another place where it's been utilized and just that, that in there, it was more like we just didn't have confidence and this gave us the confidence to go on with our journey.
[00:09:25] We had a resource that we could finally really rely on and lean into.
[00:09:28] Nancy: Yeah. I love that. That's great. Wow. 42 countries. That really is a lot of locations. What is your strategy for communicating to all these locations about the support that they.
[00:09:42] We love to use that statistic.
[00:09:43] The reality is like 85% of our people are really in 10 countries. So it's pretty concentrated that said, we, I think do a pretty good job of, as we do rollouts of new benefits, like any good communication plan, you tend to take a stagger approach and you know, it may not be absolutely in all 42 countries, which is totally [00:10:00] fine.
[00:10:00] Leah: what we wanna do is make sure, and we will go country by country and let people know like, Hey, you've got this new benefit coming. The us is our biggest. It's about 55% of our employee population. We're about 3000 people. It's that email communication. We have a Wiki. We point people back to that. We've got several slack channels that are country specific.
[00:10:15] So we try to make sure we're hitting people in all sorts of different ways. Also just company newsletters, right? Cuz this is I think a good new story from a perspective. Also, I think the one piece, I think people free is like making sure our recruiters know about this. It's a huge benefit to us to talk about our benefits and our recruiters are on the front line of that when you're selling a candidate, right?
[00:10:34] Your salary is a piece of it, but we've got such a robust benefits package, making sure people understand that we're including things like this in what we send out to candidates. So when they're reflecting on the opportunity, they have the chance, not just to think about their salary. But also to think about all these benefits, cuz right now we, for the us, we're a hundred percent paid in terms of our benefits.
[00:10:51] We carry the full cost for employees and their families. That's a very valuable thing. And then you start to add in things like Carrot. And I think that becomes a really compelling [00:11:00] story. So making sure that we're using that, not just for our internal population, but that we're using it as a tool to attract talent as well.
[00:11:06] Nancy: In terms of people living in all of these different locations, can your employees live anywhere? I mean, that's cool on slack to have like different countries. We have regions, no New York, Colorado,
[00:11:16] whatever, but
[00:11:16] Leah: it's so funny cuz Airbnb of course got all this press around. Like, Hey, you can live anywhere now.
[00:11:20] And I was like, oh, we've been doing that. So we joke about, we were ahead of the curve in terms of being distributed. So now we talk about hybrid work. I think that wasn't in the vernacular two years ago, but with the pandemic, you know, we've got some new language to describe what Elastic has done from the inception of the company.
[00:11:34] I think the first 10 employees were in like five countries. By the time I joined, we were around 300 employees and we were already in 20 countries. And
[00:11:41] We do see a lot of internal movements. So folks moving from one country to another, I like to joke that we didn't have people in Italy until someone went on vacation from the UK and was like, actually, I'd like to just stay here. And we sorted it out.
[00:11:53] And now we have quite a number of people in Italy, So you can work pretty much work from.
[00:11:57] Nancy: Sounds like a lot of flexibility, just finding [00:12:00] absolutely people work, what works for them. It's nice. The idea to be able to just stay on your favorite vacation destination.
[00:12:05] know that would be, I know that happened. I was like, wow. How nice for you? right. Yeah, I imagine it was in like the middle of a rainy winter and just, gosh, this feels wonderful. And I'm never going home.
[00:12:15] Nancy: home. Speaking of international lifestyles, before we started recording, we were. Briefly mentioned you were in the peace Corps before.
[00:12:22] I would love to hear a little bit about your background and, and what brought you to HR and the benefits world.
[00:12:28] when I was in the peace Corps, I worked in maternal health.
[00:12:30] Nancy: Oh wow.
[00:12:30] Leah: So I was in west Africa, in Molly, And my path to HR was not a straight one. So after the peace Corps I lived in DC. With many of my former peace Corps friends, and then went to graduate school.
[00:12:40] Leah: So when I went and did my MBA, I was very interested in social entrepreneurship and doing good in the world and continuing on the path I'd been on, but ended up actually going to Deloitte and consulting by a twist of staffing, got placed on a human capital project and decided that I really liked the human capital side of Deloitte's business.
[00:12:57] And then had again, another kind. [00:13:00] Fortunate connection at a startup. And that was my first four into HR at a company called bloom energy. So I quickly cut my teeth at bloom and 18 months of that in India. So I feel like there's all these different connections back to yeah. Worked in an organic baby food company for a while,
[00:13:18] Nancy: [00:13:14] That's so interesting that you learned about maternal health and, and baby food. You had these little moments intersecting with the world of health. So did you think about anything you would learn from those past experiences when you were evaluating fertility benefit?
[00:13:28] Leah: Honestly, probably not. I'm a mom. I was very fortunate in that. I had, like, I got pregnant easily. I had a very easy pregnancy.
[00:13:35] I've got a great, healthy, somewhat surly, 12-year-old between to certainly age it's it's a age, but I think it's more just a, not a particular insight, but just an understanding of, my experience was one that was very fortunate. And I have friends that have had really difficult fertility journeys, whether it's with IVF or going through surrogacy with a gestational carrier.
[00:13:58] And so just having people in my [00:14:00] life that have had. Struggles and haven't necessarily had the support from a financial or company perspective to, to take that path. I think that was much more impactful for me in thinking about, okay, what is the right thing to do here for our company? Understanding that everyone's journey is different.
[00:14:14] And we wanna make sure that we are serving a very diverse and global population in the best way that we can.
[00:14:20] Nancy: Is there anything else you wanna add about fertility benefits or anything you'd want toshare with other HR leaders?
[00:14:26] Leah: I would say, just take a look, don't set the concern around cost aside and really understand impact right.
[00:14:33] Cost is absolutely a factor. You have to be able to think about it in your overall envelope from an affordability perspective, but really think about your employee population, what matters most to them and the impact that this can have, right? For you as a company and to employees. You can help on this sometimes very difficult journey that does generate a lot of loyalty and Goodwill.
[00:14:52] So there are benefits that can't be captured that way. I always encourage people like, please take a look and don't assume it's something that you can't [00:15:00] afford. It's one of those things you can't afford not to, um, be providing these kind of benefits to your people.
[00:15:05] Nancy: Thanks so much, Lee. I really appreciate you joining
[00:15:07] Leah: me.
[00:15:07] Thank you so much, Nancy, it's been great chatting.
[00:15:13] Nancy: We talk a lot on this podcast about how fertility benefits can help companies be more inclusive of the LGBTQ plus community and volume employees wherever they are in the world. But fertility benefits can also be an important part of supporting your BIPOC employees. That stands for Black indigenous people of color.
[00:15:31] My next guest is Dr. Okeigwe. We talk about some of the fertility concerns those in the Black community specifically may encounter and how doctors can provide better care. I wanted to bring her on the show to highlight another important way fertility benefits and having access to the right care, can impact employees, a powerful point to consider when making the case.
[00:15:57] Hey Ijeoma. Thanks for joining me. Thanks for [00:16:00] having me. Let's just start by having you say your name and your
[00:16:03] Ijeoma: title. I am Ijeoma Okeigwe I am a fertility physician here at spring fertility, and I am also the director of fertility preservation for our east bay division. And I'd love to
[00:16:16] Nancy: hear just a little bit about yourself and how you got into medicine.
[00:16:20] Ijeoma: I was definitely one of those kids who from a young age, was very interested in medicine and knew that I wanted to be a doctor. The type of doctor definitely evolved over the course of my life. But when I entered college, I majored in molecular and cell biology, which was definitely interesting as the traditional path that a lot of people take when they're interested in medicine.
[00:16:43] I knew I wanted to be a doctor, but I would say one of the curve balls that kind of came in my. Career was I became interested in public health. I took a detour and instead of going to medical school, after my undergrad, I actually got my MPH, a master's in public health. And I also [00:17:00] did public health research and worked.
[00:17:01] I had always been interested in women's health. I feel like women are the foundations and the rocks for a lot of families and communities. And so taking care of women has always been something that I've really enjoy. So initially I thought I was going to be a general OB GYN and then do policy work. But another detour happened in, uh, residency and I fell in love with reproductive endocrinology and infertility.
[00:17:26] So that's how I landed where I am now.
[00:17:30] Nancy: Do you think your background in public health informs your day to day as a doctor?
[00:17:35] Ijeoma: I do. I think one of the great things about public health is that you're not just focused on the kind of molecular or the individual. You really do have an opportunity to integrate and think about how a person's kind of social situation, cultural background.
[00:17:54] Economics how so many different factors actually impacts overall health. And so I like to [00:18:00] think that I'm a physician who thinks about the whole person and their whole experience. I definitely think it's informed me. It's also informed the research that I've done in the past as well.
[00:18:11] Nancy: I think that segues really well into something.
[00:18:13] We talk about a lot at Carrot, which is the value of culturally competent care. So I would love to hear what that means for you. Yeah.
[00:18:22] Ijeoma: So the concept of culturally competent care, I mean, it's definitely evolved over time and I think some people like the terms, some people don't like the term for me as a physician, I.
[00:18:35] Culturally competent care is really about having an awareness and respect for the social cultural linguistic needs of patients and also really working to meet those needs. And it's also really important to understand the historical kind of context and perspective that often shapes a lot of.
[00:18:57] Individual's current [00:19:00] situation. And so when I think about the Black community, for example, many people may not know that during slavery and even through the 1970s, many medical experiments were actually done on Black people that cause a significant harm. Some people may know about the Tuskegee syphilis experiments where black men were intentionally.
[00:19:22] Not treated for syphilis to allow the researchers to learn about the natural progression of syphilis, if left untreated. And that definitely caused significant harms. Now there's also stories of forced sterilization among Black women and even teens, some women as young as 14, a lot of people may not know about the history of Henrietta.
[00:19:45] Lax, you know, and the fact that it's her cervical cancer cells were the source of the first immortalized cell line. That's often used for many research studies and she certainly passed away. But even her family, no one knew for [00:20:00] many years that she was a source at these cell lines. And so. I think it's important to understand that a lot of the ills that have happened in the past are particularly to a lot of communities is carried over generationally and affects how, especially some black people may just interact with the healthcare field and decide whether or not they actually trust a person in front of them.
[00:20:23] Nancy: That history and just being aware of it is so important. Are there any other maybe misconceptions or false beliefs about infertility specifically in the black community that you come across?
[00:20:35] Ijeoma: One of the biggest misconceptions is that Black women are hyper fertile and don't experience infertility. And again, this narrative was certainly perpetuated from slavery even through the 1970s.
[00:20:49] But the reality is that we actually know that for black women, The incidence of infertility is actually 1.5 to two times that of white women, for example, oftentimes black [00:21:00] women, their time to treatment is also delayed. And that can be for various factors, but we know that the longer duration that one has between when they've been trying and when they see a.
[00:21:12] Fertility physician can definitely impact their overall success. A lot of this, these disparities are even true, independent of various confounders, like for example, education or socioeconomic status or weight or age, we see that Black race is an actual independent predictor for some of the poor outcomes that we see even with IVF, which is our most advanced form of fertility treatment.
[00:21:40] Nancy: does knowing that background, does that impact how you talk to patients or anything about the care that you provide to black patients specifically?
[00:21:49] Ijeoma: I always just make sure that I'm creating a space where patients know that I have their best interests at heart. And you know, there's a lot of stigma that comes.
[00:21:59] So some of it [00:22:00] there's definitely the institutional. More systemic factors. That definitely impact a person's decision to engage in fertility care. But there's also stigma, right? If historically, there's been this narrative that Black women are hyper fertile and then suddenly you're a Black woman and you're having difficulty conceiving.
[00:22:17] There's also that feeling of am I a woman? And. Some people have actually expressed that. And so there can also be that fear of just engaging in treatment. And so for me, I try to normalize the experience for patients. And then also I encourage them to, whether it's talking to a therapist, whether it's finding a friend or someone whom they feel comfortable with just talking about the journey, I think that often can be helpful.
[00:22:41] Thanks for
[00:22:42] Nancy: that. And I know you've done some of your own research on fibroids specifically in the Black community. Can you share a little bit about that? Sure.
[00:22:49] Ijeoma: So fibroids for people who don't know they're benign tumors, um, that form within the smooth muscle cells within the uterus, we know that black women have a higher [00:23:00] incidence of fibroids.
[00:23:01] They also tend to have more aggressive symptoms. Even starting at a younger age, we know there have been studies that have taken young women between like as early as 18 and who didn't have any symptoms of fibroids and just doing ultrasounds over time to determine what the incidence of fibroids would be in a group that did not have fibroids.
[00:23:23] We know that in women 18 to 31 city showed that the incidence was 25% in Black women versus in white women. I think it was about seven or 8%. And. We know that there's definitely a difference in, in how fibroids impact Black women haven't isolated solely to Black women, but just by nature of the fact that fibroids tend to affect Black women more aggressively, the participants tend to, you know, there's a higher number of Black women who participate, but I've looked at some of the.
[00:23:54] Health disparities and access to care. I've also looked at kind of patient [00:24:00] perceptions of the care that they received and how physician-patient interactions have actually impacted whether or not they decided to pursue treatment and their overall experience. On the flip side, I've also done molecular work.
[00:24:14] So looking really to understand the relationship between pathogenesis of fibroids and metabolism. And on the
[00:24:23] Nancy: patient experience side, what were some of your findings? Did you find that if they had a negative experience with a doctor, they were less likely to pursue.
[00:24:30] Ijeoma: This is where I think qualitative research is really lovely because you can capture amazing quotes and information.
[00:24:37] And in one of the papers, there were four main themes that came up and one of them was immediate counseling to proceed to hysterectomy. Definitely caused a lot of patients to just really characterize their experience with that provider as negative lack of discussion of alternative treatment options.
[00:24:59] For some [00:25:00] patients, it was feeling as though their symptoms were not being taken seriously. And then there was maybe about 25% of patients who were actually told not to pursue treatment. And that kind of goes along with, I'm telling you. My symptoms are bothering me yet. You're telling me that I don't need to do anything.
[00:25:19] Certainly when it comes to the hysterectomy part, I think that's something that a lot of providers just really need to have a keen awareness of the historical context, right? Like don't mention hysterectomy first, you know, in, in general, you know, it's just really important to be comprehensive and talk to patients about all of their options.
[00:25:38] Nancy: I know other research has been done too, that finds that black women's pain is less likely to be taken seriously. So exactly your findings align with
[00:25:47] Ijeoma: that. Yeah, exactly. I feel like we're hopefully given all that has happened, especially within the last two or three years, I think people are also starting to be a little bit more cognizant of the impact of race and especially [00:26:00] taking racism specifically seriously, because we can certainly talk about race.
[00:26:05] and how, you know, it may be an independent predictor and say for black women, it's this for white women, it's this for Latino women. It's that. But ultimately it's also really important that we start to really think about how kind of its systemic factors and racism actually impacts one's overall experience and whether or not even one chooses to engage in healthcare.
[00:26:26] Nancy: Thanks so much for this conversation. Is there anything else you want to leave our audience?
[00:26:31] Ijeoma: They can find me at Spring Fertility in Oakland, California.
[00:26:36] Nancy: Perfect. And Spring Fertility is a Carrot partner. So people get, I think, a little discount. easy booking. something like that. Great. Well, thanks so much. I really appreciate it.
[00:26:48] Ijeoma: you, Nancy. I really appreciate the opportunity to share my thoughts with you on hopefully it's been formative.[00:27:00]
[00:27:00] Nancy: If you're looking for more resources on making the case for fertility benefits, I've included a few links in our show notes, including a piece on talking to your CFO. I also added in a link about fertility care in the black community. If you're interested in learning more on that topic to learn more about Carrot fertility, visit Carrot@fertility.com.
[00:27:19] Baby Steps is produced and edited by Eric Montgomery and Christopher Olin. To get notified when new episodes are released, subscribe to baby steps on apple, Spotify, or wherever you get your podcasts. Thanks for listening.