Attn Grace products in sustainable chlorine-free packaging.
The inspiration to launch Attn: Grace came not only from the size of the incontinence market, but also the co-founders' desire to build an "authentic brand voice" for women. — Jorg Meyer

Why it matters:

  • Half of adult women deal with incontinence, yet there’s a deep stigma associated with it.
  • The global market for incontinence-related products is expected to reach $27.1 billion by 2029, and the North American market contributes a significant chunk.
  • Against that backdrop, startup disruptor Attn: Grace’s sustainable, ‘skin-safe’ incontinence products have landed national retail placement at Walmart and Target.

When the world is distracted by a global pandemic, how do you spread the word about your new product launch? Mia Abbruzzese and Alexandra Fennell, Co-founders of Attn: Grace, a line of incontinence products for women, decided to get creative: The married couple traveled to the country’s oldest outdoor antiques and flea market in Brimfield, Massachusetts, to reach their customers.

Such out-of-the-box marketing coupled with a measured business plan and plenty of grit caught the attention of the world’s largest retailer: Walmart. In May 2023, Attn: Grace announced the launch of its products in 1,574 Walmart doors nationwide and on The brand also announced its launch on at the same time.

The inspiration for Attn: Grace was Eileen, Abbruzzese’s mom. Abbruzzese remembers a lunch date where her mother, “an incredibly curated 89-year-old woman who still liked shopping at Saks,” struggled to dispose of her incontinence pad in a plastic bag. “I thought, ‘This is really such a degrading experience for someone who lives such a curated life in every other way,’” Abbruzzese told CO—. Fennell too had seen her father struggle with incontinence. “We bore witness to how degrading and difficult this condition is and how much shame and stigma it triggers for so many people,” she told CO—.

[Read: How WOC-Owned Startups Are Tapping the Multitrillion-Dollar U.S. Women’s Market for Growth]

Targeting an incontinence market dominated by CPG giants, yet ripe for disruption

Abbruzzese had launched and sold a children’s footwear company, Morgan & Milo (now owned by Zutano), so she had some experience in developing a retail business. Fennell, her patent attorney wife, had none. Married with four kids, two of them in diapers, the couple took a big leap of faith and started Attn: Grace, becoming co-founders and co-CEOs.

In doing so, the couple knew they would be butting heads against established giants like Kimberly-Clark and Procter & Gamble. But in retail, upstart Davids taking on Goliaths is nothing new. Stories of startups gaining market share abound: Harry's razor brand was already showing it could play with big boys like Gillette and Schick, for example.

The incontinence market—with a global valuation is expected to hit $27.1 billion by 2029, according to market research firm iHealthcareAnalyst—was ripe for disruption. Twenty-five million adult Americans experience temporary or chronic urinary incontinence, according to the National Association for Continence (NAFC). Half of adult women suffer from incontinence. And while the problem does worsen with age, it’s a myth that only older people are afflicted.

The bigger challenge, especially prior to launching, was getting traction with investors. It’s an uncomfortable topic, and these products [are] for women—and the overwhelming majority of people we were pitching to in those early days were men.

Alexandra Fennell, Co-founder, Attn: Grace

Fennell pointed out that the 2015 Femifree Lifestyle report found that 49% of female adolescent athletes and more than half of pregnant women deal with incontinence, as do 40% of women with diabetes.

And there’s plenty of associated stigma: Half of the respondents in a survey conducted by the NAFC reported being uncomfortable talking with close friends or family members about incontinence.

The size of the incontinence market, and the couple’s fervent belief that they could build “a much more authentic brand voice” for women, sharpened their focus, the couple said. Their visit to the Brimfield, Massachusetts flea market proved they were on to something. “It’s amazing how many women came up to us and shared their challenges [related to incontinence]. This was a safe space for them,” Fennell said.

[Read: 4 Trend-Driven Ways Brands Are Tapping Personalization for Growth]

Putting sustainability front and center

Abbruzzese and Fennell also found that women were ready for a natural sustainability-driven product that did the job without skin irritation.

Even before launch, Abbruzzese and Fennell had noticed a migration toward natural and sustainable products in the feminine care space. Incontinence products fall into a category called “nonwovens,” which also includes diapers and period pads.

Industry research firm Smithers forecasts that the global market for sustainable fiber-based nonwovens to grow at a value of 5.6% (sales dollars) for the 2022 to 2027 period. “We saw naturals as a growing opportunity,” Fennell said. “We launched on a hunch that not only was there an opportunity to deliver a better experience for women, but also products that were free of a lot of the chemicals found in conventional products,” she added.

Attn: Grace is a certified B corp, which means it meets high standards set for social and environmental business practices. The products’ top and back sheets are made from upcycled sugarcane waste and without dyes or chlorine-based bleaches. Finding a manufacturer who would meet these exacting demands was a challenge: “We wanted to find a partner who [could] help us make a more meaningful product—not just in performance, but also by decreasing the amount of waste these products are creating because there’s no getting around the fact that they’re single-use disposables,” Fennell said. After some searching, the couple eventually found a Europe-based manufacturer who checked all the boxes.

 Headshot of Attn: Grace co-founders Alexandra Fennell and Mia Abbruzzese.
Alexandra Fennell and Mia Abbruzzese, Co-founders of Attn: Grace. — Ally Schmaling

Early struggles and the path to Walmart: ‘The big challenge was getting traction with investors’

“The bigger challenge, especially prior to launching, was getting traction with investors. It’s an uncomfortable topic, definitely not sexy, and these products [are] for women—and the overwhelming majority of people we were pitching to in those early days were men,” Fennell said. An initial $1 million round of funding led by Boston-based XFactor and Charles Hudson of California-based Precursor Ventures delivered momentum.

Abbruzzese and Fennell charted a systematic path to growth, starting in 2020, by selling direct to consumers from their website. Deciding to focus on removing stigma and providing guidance related to the management (and possible treatment) of incontinence, the startup’s website carries a nationwide directory of urologists and urogynecologists, acupuncturists, and pelvic floor therapists.

Shortly after Att: Grace’s DTC launch, the couple decided to sell on Amazon as a testing ground for retail. It would give them information about the strength of their value proposition. “On our website we’re not competing with anybody, but on Amazon you’re against everyone else. So capturing and retaining customers was us proving we can bring a new customer to the store,” Abbruzzese said.

Walmart was next on the path to scale. After many broker rejections, the co-founders met one who appreciated the sustainability aspect of Attn: Grace, and they made their way to a Walmart buyer. The timing was ripe: Walmart has been paying heightened attention to sustainability within its network of suppliers, so Attn: Grace’s environmental message was a winner. “It’s not easy for a big retailer like that to take a bet on a brand-new brand, but it helped that we could check a lot of boxes on a sustainability platform,” Abbruzze said.

Abbruzzese and Fennell are sensitive to the fact that single-minded devotion to a mission is extremely difficult for a startup business. The couple sold their house and for a good year and a half, lived off real estate investments Abbruzzese had made in her 20s. Their advice: “Find angels who can share their networks,” Abbruzzese said. “And even if nobody knows who you are yet, and you have to have a certain amount of revenue before they will even talk to you, just keep trying to find a way in.”

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