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The Tech Expanding Birth Control And Abortion Access Amid The Pandemic

This article is more than 3 years old.

Barriers to reproductive healthcare like abortion and birth control have grown during the pandemic. Some providers are trying to address those gaps by turning to technology. They’re using apps, websites, and online bots to get patients the time-sensitive care they need.

People have always faced obstacles to reproductive healthcare, especially people of color and those with lower incomes. Abortion restrictions in many states require two trips to the clinic, forcing patients to take two days off of work and find child care. Many people who need care are also uninsured.

Since March, millions have lost jobs, making budgets even tighter, and women have taken on the bulk of childcare during remote schooling, leaving them with even less time to care for themselves.

Dr. Colleen Krajewski, an OB-GYN and assistant professor at the University of Pittsburgh, says many of her patients have canceled their appointments because they couldn’t take off of work, they couldn’t find child care during the pandemic, or because they had to help their kids with remote school.

“[Even] when there's not a pandemic, it’s difficult to access abortion,” she says. “The societal factors that lead someone to need an abortion, when there's our lack of a social safety net... those are all exacerbated during a pandemic.”

Additionally, in the spring, state lawmakers in Texas, Louisiana, Ohio, Arkansas, Alabama, and a handful of other states tried to further limit access to abortion, arguing it wasn’t an “essential” medical procedure. Those efforts, along with constant legal battles over recent near-total bans on abortion create confusion about whether people can access care.

As a result, nonprofit Power to Decide launched the Abortion Finder, at AbortionFinder.org, a digital search tool that shows people a list of abortion clinics near them. It also includes state laws that might affect someone’s procedure. Gillian Sealy, CEO of Power to Decide, says the tool will help people more quickly get the care they need.

“In a time when resources are limited, you want to make sure that people have the resources that they can to access reproductive healthcare,” Sealy says.

Another nonprofit reproductive healthcare provider, carafem, launched a Virtual Visit Center in August. The platform allows patients to set up a visit with a physician through secure video conferencing, says Melissa Grant, chief operations officer. Then carafem can mail abortion pills directly to clients with a mailing address in Maryland, Washington D.C., Illinois, or Georgia.

“carafem has seen over an 80% increase in clients asking about this model of care to avoid an often lengthy drive to a carafem health center for abortion care,” Grant says. “It also allows people to receive an abortion safely at their own home without the needless potential exposure to the virus during the pandemic.”

carafem clients can also use a “personalized Virtual Health Assistant” called Cara.

“Cara is part of a secure text program that allows carafem clients the opportunity to get step by step instructions for using medication abortion care at home after a virtual or in-clinic visit,” Grant says.

After talking to a carafem physician, Grant says Cara sends the client a welcome text and can help them track their abortion pills in the mail. Cara can also send can a list of comfort options patients might want to have ready.

“Cara has helped to talk clients through the experience of using medication abortion care at home in a very personal and client-centered way,” Grant says. “Cara also walks each client through her aftercare instructions and explains how to complete her abortion follow up plan at home, to prevent an unnecessary return trip to a health center.”

In the past, some of carafem’s centers reported that as many as 50% of their clients traveled over 100 miles to the health center, Grant says. Cara helps increase accessibility, in addition to preventing long trips during the pandemic.

In Chicago, Juno4Me is another digital platform that helps people access free birth control. Kai Tao, the director and founder who worked as a nurse and midwife for 15 years, co-created the platform with high school students in 2019. It started out as a website that helped people get free IUDs and implants by connecting them with quality healthcare providers, often through federally-qualified health centers.

In the spring, they expanded to help provide people with access to all contraceptive options, including the pill, birth control patch, vaginal ring, contraceptive injection (most often known by the brand name Depo-Provera), and emergency contraception.

“Because of the pandemic, we were kind of on an express train to try to meet the needs of our community,” Tao says. “We're hearing from users that their usual place where they go get their Depo shot is suddenly closed, or they're not taking patients unless you're really sick with COVID.”

Public transportation has also been affected by the pandemic, and many young people don’t feel comfortable asking their parents for a ride, Tao says. So Juno4Me also started offering free Lyft rides (up to $70) to and from providers’ offices.

“We've just greatly morphed,” Tao says. “We want to make sure all options are available to all people without costs, barriers.”

Providers hope that the expansion of online tools will help close gaps in access not just during the pandemic, but even after it’s over. Dr. Krajewski says that in the future she’ll be able to talk to patients about their birth control options over the phone, and then they could come in for a procedure, such as an IUD insertion, if needed.

“A lot of my patients do travel quite a bit to see me, and so being able to offer telemedicine to patients who might be one, two, three hours away, it's just wonderful,” she says. “I really do hope it makes getting to the doctor easier in the future.”

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