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Could femtech offer creative solutions for women seeking abortion care?
With one in four women accessing abortion during their lifetimes, we examine if femtech’s interest in fertility could provide options for abortion aftercare
Femtech is taking on the fertility market by providing options for women who have been disappointed by the care already on offer. One of the ways in which it excels in considering all areas of fertility however controversial or difficult. This includes discussions on discharge health, miscarriages, depression and the difficult subject of abortion care.
The demand for abortion care is rising thanks to the pandemic and also, new laws such as the Texas restrictions passed last year. A study by researchers at the University of Texas found that requests by people in the state to an international humanitarian organisation, Aid Access rose by almost 1,200 per cent the same week that Senate Bill 8 went into effect.
When it comes to offering care options, femtech is perfectly positioned to offer help to women considering their options. It can offer communication with healthcare professionals via telemedicine links and platforms with detailed care or education options. It may also offer ordering options for pills, therapies or pain medication through virtual reality stores or clinics. All of which allows women to make their own decisions, at home, with loved ones and feel supported.
So what are the ways in which femtech companies are approaching abortion care?
Women First Digital on Whatsapp
Women First Digital (WFD) is not just a predominately female-run platform for safe abortion information but also offers contraceptive, sexual and reproductive health advice. The platform recently released a WhatsApp bot extension for Ally, which was the world’s first-ever abortion virtual assistant. It connects women across the globe to accurate information on abortion care or services.
The biggest benefit of using WhatsApp chatbots in healthcare is the immediate reach. It can be used by consultants for everything from reminding patients to take their medication on time to providing health data. It also reaches patients in their own environment to empower them to take control of their own healthcare. It allows women to make informed decisions with information on demand, as needed and furthers communication with experts in the field on offer through the app.
WhatsApp also provides complete protection to the data and identity of all parties through two-factor authentication, end-to-end encryption, and business verification.
Tisha Gopalakrishnan, Executive Director of WFD said: “Women First Digital inhabits the intersection between technology and reproductive healthcare with eHealth platforms intended to minimise barriers, improve reach, and strengthen women’s decision-making power. That’s why we’re excited to announce the expansion of our HowToUse chatbot Ally to WhatsApp, a tool that will help more women access the information they need to create opportunities for better lives.
On WhatsApp, the Ally bot has the potential to reach women on a device and application they frequently use and give them quick, tailored, and easy-to-understand information with safety and discretion.”
The chatbot, Ally, has had over 35,000 conversations with roughly 30,000 unique users from around the world through both the home site and Facebook messenger since March 2020.
“In the past five years, WFD platforms have had more than 13 million site visits with users from over 180 countries helping to reduce the rate of unsafe abortions and broaden contraceptive awareness. Ultimately, we work every day towards a world in which all women have access to sexual and reproductive health services that are safe, reliable and individually tailored,” concludes Gopalakrishnan.
Hey Jane virtual Clinic
Hey Jane offers ‘modern abortion care, without the clinic’ according to their website which looks similar to wellness sites. They are currently only operating in certain parts of the US such as New York or Illinois with their pills by post platform. Women who are pregnant up to ten weeks can log in, chat with a licensed provider through text or video depending on a person’s preferences and request an unmarked box of pills delivered at home.
The care does not stop with just the pills but creates a community where women can chat. Often abortion is not discussed due to stigma or religious beliefs or pressure, so the community can be crucial to women going through it alone.
The platform was created by the co-founders, Gaby Izarra and chief executive officer, Kiki Freedman. The company raised $2.2m in a funding round and saw its customer growth increase by 300 per cent between Q1 and Q2 of 2020. The founders believe that currently, abortion care is too difficult to access in terms of logistics, financial constraints, and from a stigma and emotional perspective.
Abortion pills by post
Covid changed a lot about the way that we approach healthcare including telemedicine and appointments over the phone. One way in which it changes the abortion care industry in the UK is that it made pills available for the first time by post by the NHS. Abortion law was amended in 2020 to allow women the right to take the pills at home during the lockdown.
However, Maggie Throup, the public health minister, confirmed on Thursday that women seeking to terminate a pregnancy by taking the two pills involved at home would lose that right at the end of August. However, Wales has announced it will make the move permanent citing the reduction in numbers accessing NHS care. Doctors, midwives, pro-choice groups and abortion providers in the UK have voiced opposition to this move requesting that the pills by post scheme be kept.
If this is introduced in August, tech may have even more of a part to play in helping women to access their options.
Read more: Why are femtech companies embracing the wellness industry?
Simultaneous exposure to toxic chemicals and climate-related heat may be worsening fertility harms across humans and wildlife, research suggests.
The review of scientific literature looks at how endocrine-disrupting chemicals, often found in plastic, together with climate-related effects such as heat stress, are each linked to lower fertility and fecundity, meaning the ability to reproduce, across species including humans, wildlife and invertebrates.
Though the reproductive harms of each issue in isolation are well studied, there is little research on what happens when living organisms are exposed to both.
“Together, the two issues are likely to pose a greater threat to fertility, and the additive effect is “alarming”, said Susanne Brander, a study lead author and courtesy faculty at Oregon State University.
“You’re not just getting exposed to one, but two, stressors at the same time that both may affect your fertility, and in turn the overall impact is going to be a bit worse,” Brander said.
The paper looked at 177 studies.
Shanna Swan, a co-author on the new paper, co-produced a 2017 study that found sperm levels among men in western countries had fallen by more than 50 per cent over four decades. Other research has suggested human fertility has been declining at a similar rate.
The University of Washington’s Institute for Health Metrics and Evaluation has previously said the world was approaching a “low-fertility future”, with more than three quarters of countries below replacement rate by 2050.
The new paper’s authors focused on the effects of endocrine-disrupting chemicals and substances, including microplastics, bisphenol, phthalates and PFAS.
These are thought to cause a range of serious reproductive problems, disrupt hormones and be a potential driver of falling fertility.
Brander said the harms linked to these chemicals are often similar across organisms, from invertebrates to humans.
Phthalates, for example, have been linked to altered sperm shape in invertebrates, spermatogenesis in rodents, meaning sperm production, and reduced sperm counts in humans.
PFAS are also thought to affect sperm quality, and both have been linked to hormone disruption.
The chemicals are widespread in consumer goods, so people are often regularly exposed.
Meanwhile, previous research has shown how rising temperatures, lower oxygen levels and heat stress, among other effects linked to climate change, may also worsen infertility.
Heat stress has been found to affect human hormones, and is linked to spermatogenesis in rodents and bulls.
Research shows temperature also plays a role in sex determination in fish, reptiles and amphibians.
The species has evolved to choose which sex it produces in part based on temperature, and the heating planet can “push it too far in one direction or the other, which overrides that evolutionary benefit”, Brander said.
Similarly, many endocrine disruptors may alter environmental sex determination.
The study set out some of the overlapping effects of chemical exposure and climate change across taxonomic groups, from invertebrates to humans.
In birds, for example, exposure to increased temperature, PFAS, organochlorines and pyrethroids may each individually cause abnormal sperm, increased fledgling mortality, abnormal testes and population decline.
“What happens if they’re exposed to more than one of those stressors at the same time? There has been little exploration of that question.
“Even if there have not been a lot of studies looking at these simultaneously, if you have two different factors that both cause the same adverse effect, then there’s a likelihood that they are going to be additive,” Brander said.
Katie Pelch, a senior scientist with the Natural Resources Defense Council nonprofit, who was not part of the study, said the authors had reviewed high-quality science.
She said she wanted to see more examples of the overlap in impacts, but agreed with the overall premise.
“It is likely [multiple stressors] would have an additive effect, at very least, even if they have different mechanisms of harm,” Pelch added.
The solution to the systemic problems would involve tackling climate change and reducing the use of toxic chemicals.
The study cites the global reduction in the use of DDT and PCBs achieved under the Stockholm Convention as an example of an effective measure, but Brander said much more is needed.
“There is enough evidence in both areas to act to reduce our impact on the planet,” she said.
Home blood pressure checks after hypertensive pregnancy could cut the risk of heart attack, stroke and potentially early death, research suggests.
Women who regularly monitored their blood pressure in the weeks after giving birth, and had doctors tailor their medication if needed, had better functioning arteries nine months later than those who received routine care.
When the medication was adjusted to account for blood pressure changes, the women ended up with less stiff arteries, an effect researchers estimated could reduce the future risk of heart attack or stroke by 10 per cent.
Paul Leeson, professor of cardiovascular medicine who led the study, said the findings suggested that the weeks after birth provided a “powerful and often overlooked opportunity” to protect women’s future health.
“By simply monitoring blood pressure at home, new mothers with hypertensive pregnancies can protect their bodies from future damage,” he said.
High blood pressure, in the form of gestational hypertension or pre-eclampsia, where there are signs of organ damage, affects 5 to 10 per cent of pregnant women.
The condition can damage the mother’s organs and endanger the baby’s life.
Beyond the immediate threat to mother and baby, hypertension in pregnancy can raise the risk of long-term problems, with women three times more likely to develop high blood pressure and twice as likely to have heart disease later in life.
The Oxford team recruited 220 women who developed hypertension in pregnancy. All were on blood pressure medication but were due to reduce their dosage and eventually stop taking the drugs.
In the study, 108 women had standard care in which their medication was reduced based on a few blood pressure checks in the eight weeks after giving birth.
The remaining 112 women used a monitor to check their blood pressure at home each day.
They entered the readings into an app shared with doctors who, if needed, changed their medication day to day, with the aim of giving them better control of their blood pressure.
The new approach led to much better control of the women’s blood pressure, and in tests six to nine months later the women had less stiff arteries.
Stiff arteries are less effective at expanding and contracting, which can drive high blood pressure and ultimately the formation of clots that can block blood vessels and cause heart attacks and strokes.
Trials are now under way to find effective ways of rolling out blood pressure monitoring to women after hypertensive pregnancies. One option is for specialist NHS clinics to deliver the care.
Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation, which funded the work, said the results highlighted a crucial window after birth when paying close attention to blood pressure could help protect women’s heart health for years to come.
“We now look forward to seeing results from larger studies with longer follow-up to see how this might save women’s lives,” she said.
Weight loss jabs are being studied to see if they could help women with polycystic ovary syndrome (PCOS)
The condition, which affects up to one in ten women, changes how the ovaries work and is linked to infertility and weight gain.
Dr Shagaf Bakour has won a £60,000 NHS research grant through Sandwell and West Birmingham NHS Trust to look at whether drugs such as Mounjaro and Ozempic might help.
“The research could lead to earlier support, better long-term health, and more joined-up care for a condition that affects many women but is still often overlooked,” she said.
Women with PCOS have higher levels of male hormones and can suffer from irregular periods and symptoms such as excess body or facial hair, the NHS said.
Associated weight gain can also lead to an increased risk of diabetes and heart problems.
Bakour, a gynaecologist and director of medical education at Aston Medical School, will work with a team to evaluate the effect of the weight loss medicines on metabolic and reproductive outcomes.
The drugs mimic a hormone called GLP-1, which suppresses appetite.
Bakour, alongside Dr Hoda Harb, a consultant obstetrician and gynaecologist at the NHS trust, will review existing evidence on their use and assess how they help patients with PCOS.
“The aim is to give women with PCOS evidence-informed, clearer treatment options and more consistent care,” she said.
“The project hopes to show whether these medicines can improve both general health and fertility health, while also helping local services develop clearer care pathways.
Prof Elizabeth Hughes, director of research and development at the NHS trust, said the effects of PCOS, including infertility, were “very emotive subjects”.
“We should be doing all we can within research and development to advance healthcare for women and to better help future generations with this condition,” she added.
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