A new class of health care startups has emerged in response to the US Supreme Court’s decision to overturn the federal right to abortion last year. These “digital abortion clinics” connect patients with health care providers who are able to prescribe mifepristone and misoprostol, a course of care commonly described as the “abortion pill.”
These services, many of which were founded before Dobbs v. Jackson, are poised to eliminate a major paradox in the field of reproductive health: Medication abortion is currently the most common way to terminate a pregnancy, yet only 1 in 4 adults are familiar with it, according to a recent study by KFF.
These clinics operate in different ways—some provide live video visits with doctors and nurse practitioners, while others offer asynchronous counseling—but many have experienced a record number of patient orders (and increased VC funding) over the past year. According to Elisa Wells, cofounder of the nonprofit Plan C, their appeal is straightforward. “Their pricing is quite affordable, and there’s convenience in placing an order and getting pills delivered to your mailbox in three to four days,” she says.
Recent data suggests that telehealth clinics have been effective in expanding access to abortion care, especially for people living in remote areas or in states where the procedure has been criminalized, a finding that Wells’ team corroborates. Thanks to a new series of “shield laws” protecting clinicians from out-of-state prosecution—passed in 12 states, including New York, Maryland, and Illinois—these clinics are positioned to expand their reach even further.
Following the lead of other companies in the femtech space (a category that includes everything from kegel trainers to period-tracking apps), leaders at digital abortion clinics like Hey Jane and Choix have publicly expressed their commitment to users’ privacy as they grow. In a recent interview with Vogue, Hey Jane cofounder Kiki Freedman said that the service is “HIPAA-compliant and encrypted.” In an interview with Ms. magazine this January, a representative from Choix highlighted its “HIPAA-compliant texting platform,” while another interviewee suggested that “most telehealth providers are not checking IP addresses.” (Read more about how HIPAA actually works here.)
A common belief about virtual clinics is that they offer more discretion than their brick-and-mortar counterparts. “There’s definitely a privacy factor—these sites don’t ask a lot of questions,” says Wells. In a 2020 study of over 6,000 abortion seekers, 39 percent reported choosing a telemedicine option specifically to preserve their privacy. While some providers’ intentions seem genuine, privacy experts have pointed out that their services may not be as secure as users expect them to be (even if they are compliant with US law).
This July, a team of researchers at the Markup reported that Hey Jane’s site passed along user information to Meta and Google, the world’s largest digital advertisers. While providers may not restrict access via IP addresses, our analysis found that most providers readily collected them. For telehealth abortion clinics, HIPAA compliance is just one part of the puzzle.
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