The challenge

Perinatal care - the period spanning pregnancy, birth, and the early postnatal weeks - is one of the most clinically complex and commercially underserved areas of health innovation. Complications in this window carry lifelong consequences for children and families, and the cost to health systems is substantial. Pre-term birth alone is the leading cause of death in children under five globally.

Yet innovation in perinatal care has been fragmented and inconsistent. Most R&D activity has concentrated on treatment rather than prevention, in part because the multiple causes of different perinatal conditions remain poorly understood. The result is a landscape of promising assets - technologies, drugs, and devices - scattered across different development stages and commercial contexts, with no clear framework for understanding where the greatest unmet need lies or which assets have the most potential to address it.

Our client, a health investment organisation, wanted to change that. They needed a rigorous, ecosystem-grounded analysis of where value creation opportunities existed across European perinatal care - and a structured way to identify and evaluate the assets best positioned to address them.

What we did

Using Umio's Health Ecosystem Value Design framework, we conducted a comprehensive assessment of the perinatal care ecosystem across the EU5 - the UK, France, Germany, Italy, and Spain.

The work had four interconnected phases.

We began by mapping the full perinatal care ecosystem across all five countries - not just the clinical pathway but the complete network of services, actors, practices, and institutional relationships shaping how perinatal care is delivered, experienced, and funded in each national context. This revealed significant variation between countries in how the ecosystem was structured, where the pressure points were, and where the greatest gaps between clinical need and available innovation existed.

We then conducted a deep analysis of perinatal complications - their incidence, cost, trajectory, and clinical management - and modelled individual disease conditions against a pre-term, term, and post-natal timeline. This produced a clear picture of where to intervene, what the highest-value opportunities were, and what strategic posture would generate the greatest impact.

From that foundation we identified ten high-leverage value propositions - specific opportunity spaces where unmet clinical need was greatest, existing innovation was weakest, and the conditions for successful adoption were most favourable.

Finally, we searched for, profiled, and scored 52 technology, drug, and device assets against those value propositions - assessing each on commercial potential, strategic fit, market access, and ecosystem value criteria. This gave our client a structured and evidence-based framework for prioritising investment and entering deeper evaluation conversations with asset owners.

What we found

The ecosystem mapping revealed a striking mismatch between where innovation activity was concentrated and where the greatest unmet need existed. The majority of R&D investment was directed toward treatment of pre-term births and neonatal complications after they had occurred - while the earlier intervention opportunities, in screening, risk stratification, and prevention, remained significantly underserved despite representing the largest potential for impact reduction.

Four areas of innovation activity emerged as the most commercially and clinically significant: understanding and preventing pre-term births through advances in biological mechanism research, improving screening and diagnostics for at-risk mothers and pregnancies, delaying pre-term births to advance foetal maturity particularly of the lungs, and improving neonatal intensive care through advances in drug administration and monitoring technology.

Within each of these areas, the asset landscape was considerably more varied and more promising than standard market analysis suggested - but the value of individual assets was highly context-dependent. An asset that scored strongly on clinical evidence performed very differently in commercial and market access terms depending on the health system context, the reimbursement environment, and the competitive dynamics in each country. The ecosystem framework was essential to making those distinctions visible.

The outcome

The project equipped our client with a clear investment thesis - grounded in evidence of where clinical need, innovation gap, and commercial opportunity converged most powerfully across the European perinatal ecosystem. Armed with the ten value propositions and the scored asset landscape, they entered active discussions with asset owners and used the framework to guide their evaluation of new innovations as the landscape continued to evolve.

This project illustrates a dimension of Umio's work that is distinct from its lived experience and patient research programmes - the application of ecosystem mapping and innovation strategy to investment and asset evaluation decisions. The same capacity to see health and care systems in their full complexity, rather than through a single clinical or commercial lens, produces better investment decisions for the same reason it produces better product innovation: it starts from a more complete picture of reality.