When Marina Gerner took her new book to publishers, every single one of them said: “This is a great book, but are you sure about the title?”

It turned out sales teams would be embarrassed to pitch a book called The Vagina Business to retailers. As requested, Gerner came up with 16 alternative names. But none came close to capturing the breakthroughs discussed in her book that could revolutionise women’s health.

“Then I managed to convince them: the whole point is to normalise and destigmatise and we should have the word ‘vagina’ in the title and on the cover. It’s important. For me, it was always The Vagina Business.”

She swirls the straw in her iced latte. “But in a way, I shouldn’t be surprised that I had to fight for it, because I’ve written a whole book about how entrepreneurs face all these obstacles. It’s not surprising that I had to face the same, because there’s not just embarrassment in the investment industry, but also in publishing or bookstores…”
In her book, the author and award-winning journalist, who has been published in the JC’s own pages, discusses under-funded medical issues affecting women, from periods to childbirth and the menopause.

The focus is on solutions. “I read a lot of feminist books, and it’s important to know the problems and the gaps that exist in society, but often we fail to look for solutions,” she says. “I really wanted to find positive and inspiring stories and show that we don’t have to accept this attitude of ‘welcome to being a woman’, and ‘this is going to hurt’. Just because something is normalised, it shouldn’t be normal.”

The Vagina Business by Marina Gerner.

Gerner presents researchers, entrepreneurs and investors who are trying to create something new and improve healthcare for women. Those, for example, behind a bracelet that helps with hot flushes (Embr Labs) or a nipple shield that measures the amount of milk a breastfed baby takes (Coroflo).

Her first such discovery was of a smart bra showcased at a 2019 conference organised by MIT and King’s College London about health tech innovation, where as a freelance journalist she was looking for women’s issues to cover. Gerner asks me to picture someone who’s having a heart attack. Just as she anticipates, I’m instantly seeing images of an old man clutching his chest as pain radiates down his left side. That, she points out, is a typically male symptom, while female symptoms are extreme fatigue, jaw pain, and pressure on the chest that’s described as discomfort rather than pain. It’s an example of how our medical system was built around the male body.

“I learned that there’s a problem, and then I found the smart bra and realised there’s a solution,” says Gerner, explaining how the bra uses ECG technology to help the wearer monitor their own heart health and can also be used in clinical trials to collect data remotely. Excited by her discovery, she chased after the founder to request her business card so she could write about her. Then she pitched an article to her usual editors.

“But my inbox was empty,” she says, incredulously. “Tumbleweed. And people were saying, ‘It’s a bit niche.’”

Finally, after Covid drew attention to differences in health as men suffered worse symptoms than women, she placed her story in the Guardian. Off the back of that she was invited to chair a panel at the first femtech conference for wearables, organised by women. She stayed on because she was “so fascinated”.

“You think, ‘Oh, I know my body,’ but there’s so much more. I saw a statistic that women are in perimenopause for about three years before they realise.”

Now 36, Gerner has herself recently become a mother, and while she says she is sleep-deprived, her bright eyes and smooth complexion don’t tell that she has been breastfeeding her five-month-old, Noah, through the night.

Her decisions on how she will bring up her son start with Gerner and her partner sharing parental leave. “Just by living the way we do, I hope that’s what instils our values,” she says “I will talk about things openly, just like my mother did with me.” Her partner’s mother was the same, for which she’s grateful. “You can definitely notice the difference. He has a sister, and when she got her period they actually had a celebration. I have a very feminist mother-in-law and really value it.”

The subject of childbirth, therefore, is top of our conversation. Knowing she would soon want to have children, in her early 30s Gerner started her research into birth.

“I also knew that nine out of ten first-time mothers have a birth injury, which is something women talk about in hushed voices. Close friends might tell you, and others might say, ‘No, don’t tell her. You don’t want to put her off!’” Gerner thinks differently. “I don’t like this attitude. I prefer to know things so that I can know my options. Knowledge is power.”

What made her most angry during her research was the antiquated episiotomy (a cut to the vaginal opening to create more room for delivery) – because research shows that tearing heals quicker and is less likely to lead to infection. It is also avoidable.

Gerner is certain she tackled things differently in hospital as a result of her knowledge. Her detailed birth plan accounted for different scenarios, and she managed to achieve her dream water birth at a birth centre in the hospital which, for first-time mothers in the UK, is said to lead to the best outcome. Another decision based on research was hiring a doula. “I wanted somebody who was on my team, because there’s no continuity of care in the NHS, and research showed continuity of care is one of the most important things in low-risk pregnancies.”

She wants other women to feel just as empowered and informed as she was. “Even in my NCT class here, [the episiotomy] was completely normalised,” she sighs. “Nobody ever said, it may not be the best option.”

She was amazed to come across a company called Maternal Medical, which has created a birth dilator to help prevent birth injuries, and even more shocked to find out from the founder that the last big innovation in the standard of care in the birth space was the epidural, which was popularised back in the 1950s.

“That just blew my mind, because we don’t think of any other technology from the 1950s as being state of the art, the floppy disk or whatever. We don’t think of that as ‘wow, this is the best we have!’. But when it comes to giving birth, that is one of the greatest options we have,” she says. “And lots of my friends had children before me, and their stories of giving birth was salad forks and toilet plungers – the forceps and vacuum deliveries…”

Then she spoke to other founders in similar companies that look at vagina-centric innovation, and kept hearing that they struggled to raise money because investors don’t want to talk about vaginas. “This idea that we’re not getting the innovation that we deserve and need, because there’s a bunch of investors who are all men sitting somewhere in a boardroom, and their task is to fund innovation, and they’re like, ‘I don’t want to talk about vaginas with my other male partners in my Monday morning meeting’,” she laughs in disbelief. “To think that it’s embarrassment and shame that’s holding that back. I got very angry, and I wrote this story for Wire magazine called We Need to Talk About Investors’ Problem with Vaginas.” The story went viral, and she built the book proposal around it.

Marina Gerner. (Photo: Ivan Weiss)

Born in Kyiv in Ukraine during the Soviet Union era to Jewish parents, Gerner and her parents moved to Germany when she was three, under a rescue programme.

“Soviet Jews were discriminated against on a structural level,” Gerner says quietly, quickly correcting her use of “discriminated” to “persecuted”. Religious practice was outlawed, the synagogue in Kyiv had been converted into a puppet theatre and people were arrested and disappeared without explanation. Gerner recalls how at Pesach, her grandparents would illegally buy matzah and carry it home in a large pillowcase at nightfall.

“We didn’t move to Germany out of choice. My mother is an artist, and she had some dissident views, plus being Jewish was very difficult for us. My grandparents are academics, which, again, is not a great role to have in a society where you’re not supposed to say what you think.”

She grew up trilingual in Frankfurt and moved to the UK for university when she was 18. After a brief spell in New York while doing her PhD, she moved to London, where she’s lived since. She believes she is the first person in her family to have moved to a new country out of choice.

“Even when my mother’s family moved from the shtetl to the big city, that was not out of choice, that was because of the pogroms and so on.”

With her mother being an artist, her grandmother having worked as an economic engineer, her great-grandmother a doctor who read medicine in the 1930s, and her great-great grandmother running her own business, all their careers reflect the subject she covers in her work.

“I’m part of the feminist genre here in the West, but the women in my family have a history that’s different from most narratives I find here. While Betty Friedan was interviewing American housewives in the 1960s, the women in my family have had careers for over 100 years.” Her Jewish upbringing – from primary school to being a madricha in a youth group, which gave her skills in leadership and public speaking – are key to how she approaches her work. “My Jewish identity and values are the blueprint for how I see the world and how I act in it. One of the most fundamental Jewish ideas is that we’re co-creators in this world. We’re not here to be passive observers and swim along the currents of society. We’re here to make things better – and I want to show in the book that it’s our responsibility to turn Eve’s curse into a blessing.”

About one year into writing her book, Gerner realised there might be additional personal reasons for wanting to amplify the stories of inventors who succeeded against the odds. Her grandfather, Valerius, to whom she remains close, was an inventor in the Soviet Union and she grew up on his inspiring stories. He invented machines to test car brakes, and filed 30-plus patents that were commercialised. Of course he didn’t own any of his patents under communism; Gerner points out that she might otherwise be messaging from the Maldives. While Valerius specialised in car safety, it was not his initial choice, which had been plastics and materials – a field he was not allowed to pursue because Jews were pushed into the less popular automotive industry. Gerner concedes he must have saved lots of lives, but she still wonders if plastic pollution would be so diabolical today had Valerius been allowed to research materials.

She considers how the topic of her book will speak specifically to Jewish women. “There are certainly taboos around female bodies, just like in every other community, but there’s also ancient Jewish wisdom about menstrual cycles and a tradition of midwifery going back to Miriam.”

Gerner’s goal is to attract more people to this space, more investment, more research, more entrepreneurship and more awareness. “It’s a book of solutions and options. The whole point is for women to have more choices. I’m trying to show what’s possible, but we’re definitely at the beginning of this movement.” ■

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The Vagina Business is published by Icon Books, £25