Roe v. Wade, the case guaranteeing the right to choose an abortion, has officially been reversed by the Supreme Court, leaving the decision to states. This means the option is or soon will be illegal in half the country. While the fight for reproductive rights will continue in courts and capitals, this is an opportunity for startups and tech to play an important role in keeping abortion safe, convenient and private.
(Editor’s note: This piece was first published on May 4, after the decision was leaked. We have republished it in the context of the official announcement.)
While it’s dangerous to rely on private companies for such important matters, they are the only ones capable of doing what needs to be done on short notice; the government is a lost cause, large corporations are equivocating and the medical and insurance establishment will simply follow the money.
Technotopianism is a dangerous illusion, but founders and startups are in the right place at the right time to make a difference. Here are 8 ways they can help.
1. An easy to use, totally private app for contraceptive options
You can open an app and get practically anything delivered to you next day, so why not abortion pills? There are certainly some web-based services that do this already, like Plan C, Hey Jane and others. That is fantastic. But if you search for “abortion” on the app store, you get sexual health tracking and clinic-listing apps. There should be an app that makes this process as easy as checking your prescriptions or ordering contact refills.
It’s not that apps are totally necessary for this, but we’re at the point where health care of all kinds is being digitized from end to end and apps are potentially the most convenient and secure way of doing that. This opportunity should be embraced in every aspect of the healthcare world, including reproductive health.
The question is, what rules will it break and how will new laws apply? Will Apple permit it on the store? Will Google? Will payment providers balk the way they have with other state-by-state permissions like cannabis? I hope that someone will say damn the torpedoes and just go for it.
2. Easy abortion benefits and other contraceptive care (for all employees)
Companies large and small are increasingly offloading their benefits processes to others that specialize in providing them. Will those companies step up to the plate and make abortion care — and covering the costs of leaving the state to get it — part of their standard offering?
Whether they do or not, this may require a new or improved layer connecting benefits companies with providers of contraceptive care of all kinds. Costs and methods will differ widely depending on states and incoming laws. But front-loading that work and making it easy on those big corporate customers makes it that much more likely that they’ll opt in.
Worth adding here is that this should be provided, like other benefits, to all employees, including those in the hourly and contractor categories. People without job security or other benefits are especially vulnerable and need this form of support as much or more than others. (Looking at you, Amazon. We all know you can afford it.)
3. Legal defense mechanisms
Some states’ measures against abortions include legal consequences or even actual charges for people seeking or providing care (of course this is not without precedent — just a return to barbarity). Being threatened with these will no doubt have a chilling effect and potentially irreversible consequences for many people.
However, some startups have begun to make money by the occasionally dubious process of automated contesting of tickets and other legal disputes. If, as seems likely given the rather shaky, ad-hoc status of these anti-abortion laws, there is a standard method of responding to and defanging these legal threats, an app or simple online process like those used to contest parking fines would be a great use of resources and one that would likely see support by many advocacy organizations.
This, like the app for finding abortion services, must be free and easy to use; people in the position of choosing between an unwanted pregnancy and charges from the state often lack resources and this process must accommodate that.
4. Glassdoor for reproductive care
Whether an employer is willing to provide or cover the cost of abortion care is going to be a very important question for prospective workers, likely for at least a few years. Making that information available ahead of time will save everyone a lot of grief. Since most companies won’t want to advertise this widely, for fear of appearing to take a political stance, it will likely be necessary to have a third party tracking this information.
Transparency is as important for reproductive care as it is for anything other condition of working at a company. And if companies are having their policies leaked anyway, they might decide to be more public about what they offer.
5. Funds (and funding seekers) take a stand
Venture capital funds have a huge influence on what startups make it past the idea phase. A commitment from some of the major ones to back reproductive health startups would be helpful in creating a community of confidence around this sector.
As a startup, it may be worth considering who you pitch and how, since some funds or groups may consider this along the lines of sex tech instead of health tech. That’s wrong and indicative of a worldview that likely does not match up well to a company looking to change how we approach contraception and reproductive health. The last thing you want is a board member pressuring you to go in a different direction in deference to their institutional scruples.
For that matter, it’s several kinds of disaster when it’s discovered that an investor or board member is also investing or advising something antithetical to your mission and ideals. It’s not about establishing political compliance but choosing people to back you who actually share your values and priorities.
6. Privacy guarantees from Big Tech
At this point every aspect of our lives is tracked and recorded by companies like Google, Meta and Amazon so they can better target us for products and services. The difference is that it’s not illegal in any state to find and receive treatment for diabetes or an STI. The last thing we need is nosy authorities pressuring data brokers and tech companies for up to date lists on which of its citizens have asked for directions to abortion clinics, searched for and visited care providers, and other strong indicators of what they will likely have defined as conspiracy to get an abortion. (This information is already tracked and available for purchase.)
We need strong assurances from leadership in the tech world, and where required, adjustments to EULAs and other documents, that abortion will not be a targetable or tracked item to be mixed in with the 500 other sensitive categories that advertisers and others can buy and peruse. Sadly I doubt we can convince data brokers to do what’s right, since they seldom if ever have done so; in the meantime, minimize your attack surface with some quick changes to settings and preferences.
7. Vote with your HQ (or support from outside)
As we’ve seen, some companies care more about tax benefits than about taking part in a community that reflects the values they theoretically espouse. Don’t compromise your ethics for a sweetheart deal from a corrupt governor.
There are plenty of places in this country where a startup can make a home and not pay the astronomical rents of the top five or six metro areas. It may be cheap or trendy to shift to a state like Texas or Florida, but consider what it means going forward when it comes to recruiting the best in the industry. Sadly, the many and various advantages of these large and diverse states and municipalities are being overbalanced by policies clearly more concerned with political posturing than the welfare of their citizenry.
Of course in this new office-free world, it may be that you don’t really have an HQ at all. In that case the advice is different: Hire people where they are, but support them as noted above so that they have the resources should the need arise.
8. Normalize, don’t criminalize, abortion on all platforms
There will be pressure by state authorities to limit or remove discussion, promotion or offers of abortion care on platforms like Facebook, Tiktok, even maps (remember this?). This pressure must not be bowed to. Companies like Apple and Google wield enough power to defy such requests and it would be forward thinking to expand access rather than limit it.
When someone asks Siri or Google Assistant for directions to an abortion clinic, give them. If #shoutyourabortion is trending, let it. If the top app in the health category is for abortion pills, keep it. Sexual and reproductive health is being restricted in the real world, but in the online platforms we use should be kept free from the zealotry and censorship currently ascendant in many states.