Is the 'tech bro-ification' of abortion here?

Since the Supreme Court overturned Roe v. Wade in 2022, abortion tech has emerged as a potential solution for an increasingly prohibitive reproductive rights landscape, where people seeking care are forced to navigate ever-shifting abortion legislation, online misinformation about reproductive rights, and a confusing and complicated process if abortion is banned in their state. At the same time, the sexual and reproductive health, rights, and justice fields have experienced a sharp drop in funding, resulting in waves of layoffs across abortion funds and reproductive health organizations, even before the Trump administration gutted reproductive care across public health. 

This exclusive Prism investigation delves into the role of tech in reproductive health care, finding gaps in how abortion workers are served by tech initiatives, a clash between funding abortion tech and industry layoffs, and tension in how best to address the changing legal landscape for abortion. Interviews with a dozen reproductive health workers, tech specialists, abortion fund staff, and reproductive rights advocates further revealed a lack of investment in backend tools for abortion support workers navigating a progressively underfunded field.

From abortion bots like Charley and digital billboards used by Mayday Health to period-tracking apps and the expansion of telehealth services, it’s a new, more complex era for people seeking abortion care. But during a time of rising technofascism and in a landscape dominated by tech conglomerates that power domestic repression, is investment in bots and abortion telehealth initiatives post-Dobbs fundamentally at odds with abortion access for all? 

A solution post-Dobbs

The idea for an abortion chatbot came about shortly after the Dobbs decision. Charley, an abortion tech product often referred to by the mainstream media as an “automated abortion finder,” was created by a team of reproductive health experts and abortion advocates, including former Planned Parenthood president, the late Cecile Richards. According to Charley’s project director, Nicole Cushman, the product felt urgent after Dobbs because, with abortion criminalized and less access to abortion clinics and doctors, people in need of care turned to the internet for information.

“We wanted to better understand what kinds of questions abortion-seekers are asking when they go online, what search terms do they use in their queries, and then what do they find as a result of those queries? What websites, what information rises to the top?” Cushman told Prism. “What we found is that people are looking for answers to pretty straightforward questions.”

But search results are often unhelpful, Cushman said, especially in states with restrictions or bans. 

Searches for basic questions usually return confusing news articles about the changing reproductive rights landscape. Kate Bertash, executive director of the Digital Defense Fund, cited nationwide crisis pregnancy centers (CPCs) as frequent purveyors of abortion misinformation both online and in real life, even in states where abortion is ostensibly legal. Bertash also emphasized that the tech ecosystem where products like Charley are being developed is not hospitable to abortion-seekers. 

“I think we’re all still nibbling around the edges of a larger problem,” Bertash said. “Everything we do in the abortion space has way too much impact on the patient experience.” 

Front-line abortion access organizations like Reprocare, a peer-supported abortion health line, echoed Bertash’s concern. Co-directors Phoebe Abramowitz and Lupita Sanchez cited abortion stigma and delays in care as a “huge issue” for their callers, usually as a result of misinformation from anti-abortion groups and CPCs. 

With the goal to direct people to accurate, already-existing resources, Charley simulates a conversation with users who need information about the legal status of abortion. According to an adviser on the project, Plan C Co-Founder Amy Merrill, abortion access experts were consulted when developing the bot’s user flow. 

“It was a very generative process,” Merrill told Prism. “They started by asking the big, bold question of: What would it look like to guide someone through their needs around their abortion, no matter where they lived and without collecting any private information, and give them the type of experience that you would expect in navigating any other everyday need or service?”

The bot does not collect data beyond location and the first day of the user’s last period, and links users to two databases powered by the organizations I Need an A and Abortion Policy API. In the first year and a half of operations, the Charley website received 330,000 visitors, and over 50,000 people used the chatbot, according to Cushman. Charley was also made to be hosted on external websites, meaning that some users can find Charley on abortion fund sites such as the Carolina Abortion Fund (CAF), which includes Charley on its “Abortion FAQ” page. 

Credit: iStock

Because of the product’s commitment to data privacy, it’s impossible to assess the efficacy of Charley’s ability to connect abortion-seekers to the appropriate services. Cushman said there is a survey in the works to collect user feedback. 

Bertash said it’s essential for the abortion space to exist online, even if imperfectly. 

“We are currently in this tide where CPCs are going to continue to fill up the space over and over again,” she said. “We have to have continuous pressure and continuous pushback, and a continuous culture of experimentation.”

“The innovative pitch to donors”

Across the tech field, there’s a tendency to create public-facing products that purport to revolutionize the user experience, but at the same time, there is a lack of backend tech tools that make the work in a particular industry easier. While abortion tech is experiencing a boom in growth and funding, according to Bertash, “There is a huge gap in making resources and tools that are for people who do the work.”

“It is an extraordinarily underserved community who is buried in paperwork,” Bertash said, using hotlines as an example. From repro legal helplines to abortion fund hotlines, abortion support networks that provide direct services are still lacking “privacy-first hotline software,” said Bertash. 

“The fact that we are absolutely starved for end-to-end encrypted privacy-first intake tools—it’s like this gaping hole in the market,” Bertash explained. While it’s understandable that most abortion tech is geared toward users in search of care, Bertash said the field also needs more tools so that workers “can do their work more safely.” 

Garnet Henderson, co-founder of the worker-owned reproductive rights and justice publication Autonomy News, has reported extensively on layoffs at organizations that provide abortion support. She told Prism that she is concerned about the compounding impact of the abortion tech race that is fully underway. 

“It definitely concerns me because of the shunting of labor off to volunteer organizations that are disproportionately staffed by women, people of color, and queer and trans people,” Henderson told Prism.

The rush to create supposedly revolutionary tech tools at a time when there is no constitutional right to abortion has, in some cases, resulted in unkept promises and layoffs. 

This is what happened at Just The Pill, a reproductive health organization that made headlines in 2020 with the promise of mobile abortion vans that could provide reproductive health services at the borders of abortion-ban states. In January, the organization laid off 14 workers, eight of whom were in charge of patient care. In interviews with Prism, laid-off workers revealed that the mobile clinics—a large part of the organization’s marketing to funders—had not been used since at least 2022. 

I think it’s always about the innovative pitch to donors and what sounds good to donors, and not what actually is needed by abortion-seekers.

Nadine, former employee at Just the Pill

“Everything is donor-based, philanthropic,” said Nadine, a laid-off worker using a pseudonym for fear of retaliation in the repro field. “I think it’s always about the innovative pitch to donors and what sounds good to donors, and not what actually is needed by abortion-seekers. Ultimately, I think the most useful thing I did the entire time I was there was being on the phone with all of these people in banned states, just being a human being talking to them.”

Before working at Just The Pill, Nadine exclusively worked at clinics that refused to innovate or think radically to fight growing abortion restrictions and bans. At Just The Pill, it seemed to Nadine that her employers were promising an innovation they could not actually deliver. Ultimately, Nadine said it’s best for people in need of abortion care to speak to a real person when exploring their options and creating a plan of action, because while digital tools such as I Need An A and Plan C can be useful, they are not a replacement for human guidance. 

“I talked to abortion-seekers every single day, and I don’t know anyone using [digital] resources,” Nadine said. 

“I have never heard anyone ever bring up Charley, and nobody knows what Mayday Health is,” she continued. “They know what Plan C is, and I always give them I Need An A, which is a very useful database and abortion finder.” 

Test case 

When testing the Charley chatbot, Prism had mixed results. As a test case, we searched for abortion care near Ansonville, in central North Carolina, and indicated 10 weeks as the first day of last period. In North Carolina, abortion is legal until 12 weeks. 

The bot loaded slowly and was thorough in its responses, covering legal barriers in North Carolina, options for pursuing legal exceptions, and even options for traveling internationally for abortion care. However, the bot stalled out when we indicated that a later abortion was needed, blocking us from selecting any date beyond six months. We had no other option but to select “I’m not sure” and offer the bot a more general answer of “6-12 weeks ago” as the last period. 

The bot alerted us that the information we provided made us “very close to your state’s legal limit” and that said we “may still have options in other states.” The bot offered links to I Need An A and Aid Access, as well as a resources page that listed Reprocare, the M+A Hotline, the Repro Legal Helpline, and Abortion Freedom Fund, a standalone national fund that funds abortion pills by mail. While these are all trusted resources, the bot did not actually offer the necessary information for accessing abortion care at 10 weeks in North Carolina or any surrounding states. At I Need An A, we were counseled to drive an hour to Charlotte, North Carolina, or order abortion pills online.

“I see money spent on these new tools, and it’s like, why would the money not get just put into an existing service that works?” Henderson said. “If you want to give I Need An A money to do a huge ad campaign, cool. Why do we need a new organization to do that?”

Carolina Abortion Fund also uses I Need An A, but when we ran our test case by a worker at the fund, they offered insight not shared by Charley or I Need An A. 

“After 10 weeks, medication abortion is no longer an option for [abortion-seekers]. They are limited to the surgical option. I would also counsel them that they’ll have to have two appointments,” said Jess, a staff member at CAF using a pseudonym for safety reasons. In North Carolina, the abortion law requires a 72-hour mandatory delay and also forces patients to attend two different in-person appointments. “They’re going to do the ultrasound to see if you really are 10 weeks, if you’re more or if you’re less. If you are more, you can do the surgical,” Jess explained.  

As part of CAF’s process, Jess said they would talk an abortion-seeker through their options based on their location (in our test case, Ansonville) and the date of their last period, and make it clear that Virginia might be the best option. It’s incredibly difficult to schedule two separate appointments in North Carolina while still remaining under 12 weeks of gestation. This is because of current scheduling delays and existing capacity issues at nearby clinics, which serve many people coming from South Carolina and other states with six-week bans. In Virginia, abortion is legal up to 26 weeks and six days of pregnancy. 

From there, Jess’ co-worker Kay, who also requested a pseudonym for safety reasons, told Prism that they would help an abortion-seeker navigate whether two in-person appointments in North Carolina were possible, factoring in the timeline, the cost, and also helping to coordinate transportation, child care, and food, if needed.

For Prism’s test case, Charley and the CAF staffers provided a vastly different experience with seeking abortion care information. The series of links and lack of detailed and direct information from the bot forced us to sort through even more information. The errors in date selection also prevented us from receiving more specific information relevant to our needs.

When asked about errors that Prism and multiple sources experienced when using Charley, Cushman, the project’s director, said errors happen but are “not a common experience.” 

“We’re not aware of any common or frequent glitches,” Cushman said. “But I certainly want to know if it’s happening frequently for folks. It can be really hard to replicate a technical error when we don’t know details of exactly where someone is trying to access it. Is it on our side or someone else’s side?”

Even supporters of technologies like Charley told Prism that digital tools can fall short because of lack of details, incorrect information due to tech errors, or failing to account for quickly changing abortion laws. 

Jean, a Charley consultant using a pseudonym so they could speak freely about the bot, told Prism during the course of this investigation that the team behind the software recently “slowed progress.” 

Rebecca Wang, legal support counsel at If/When/How: Lawyering for Reproductive Justice, the legal organization that houses the Repro Legal Helpline, provided further context: “Laws are constantly changing, media stories about abortion might confuse or scare people There is so much harmful rhetoric from anti-abortion policymakers, and there are also really well-meaning people doing their best to spread helpful information that can sadly sometimes be outdated or incorrect.”

Hypothetical accessibility 

As workers watch chatbots and other abortion tech stumble into a previously human workspace, there is fear emerging that abortion access may become gig-ified. Reproductive health care business models from Wisp to Hey Jane are steering away from the kind of community health centers now under attack by the Trump administration and turning instead toward the profit-hungry worlds of companies such as DoorDash and Hims, an online platform that offers a “concierge approach” to telehealth. According to Renee Bracey Sherman, founder and co-executive director of We Testify: “The techbro-ification of abortion is coming.”

“I think it’s going to be worse than the gig economy,” said Henderson of Autonomy News. “I think a lot of organizations know that they can get away with just not paying workers, because there are people who are so passionate and care so much that they will do the work for free. And I think you see all the big, moneyed groups just taking advantage of that again and again, often while paying massive executive salaries.”

The recent embrace of telehealth services developed as a result of the pandemic. Tools like Charley or efforts like Just The Pill can offer similar convenience and anonymity in the aftermath of Dobbs, which can be especially appealing to people in need of quick, private digital access to abortion resources, such as affordable and discrete abortion pills they can receive in the mail. The hypothetical accessibility and privacy of a smartphone-order abortion can offer a simple and profitable solution to abortion criminalization.

But there are growing concerns about how apps and consumer data more generally might be used to criminalize people seeking, providing, and supporting abortion care. 

Credit: iStock

According to reporting by the Center for American Progress (CAP), the Dobbs decision emboldened right-wing legislators and state prosecutors to monitor the digital footprint of abortion-seekers, providers, and advocates. 

“As many people increasingly turn to telemedicine and online options for abortion care, weak protections for digital information may put hundreds of thousands of abortion seekers and their providers at risk of criminal prosecution or individual harassment,” CAP reported. “In states where abortion is banned, law enforcement agencies are increasingly turning to information obtained online to prosecute those who seek or provide abortion care. This prosecution is likely to become more common as digital data becomes more easily accessible.” Out-of-state doctors are already being targeted by states such as Texas for prescribing abortion medication via telemedicine. 

While warnings from experts about the dangers of consumer data and criminalization are largely ignored within big tech, in the reproductive rights field, it could result in the surveillance and incarceration of marginalized people, both those who seek and provide abortions.  

The disconnect between abortion tech and the workers who make abortions happen also seems to grow when brand visibility and fundraising trump the delivery of holistic, effective, safe abortion care. During the course of Prism’s investigation, multiple sources cited Mayday Health, the high-profile digital billboard company focusing on abortion pills, as an example of this dynamic. (Mayday did not respond to Prism’s requests for comment.)

According to co-founder Olivia Raisner, Mayday aimed to fill a gap in abortion access when it launched the day of the Dobbs decision. “We kept hearing from groups, activists, advocates that abortion pills were going to be the future in a post-Roe era, but that very few people knew about them,” she told Time magazine in December 2022. “A lot of groups couldn’t take on the risk of spreading the word.” Mayday, the brainchild of two Harvard graduates and a Biden White House staffer, was born. The first mobile billboards released by the organization targeted college students attending universities in the South.

Raisner is correct in that many abortion support groups are concerned with the risks associated with self-managed abortion, especially in banned states. But this is because many of these groups actually aid and abet abortions. Mayday spreads vital information via innovative campaigns, but the nonprofit’s safety is ensured under the First Amendment because the group doesn’t actually distribute the abortion pills it advertises. As Raisner said, Mayday “doesn’t prescribe, provide, or even handle abortion pills.” Abortion funds, clinics, and organizers do. 

“All Mayday has done is basically ad campaigns in the United States, and then they have a website that just links you to existing resources,” said Henderson. “I really fail to see how that’s helpful.”

The Mayday website does offer a step-by-step tool on how to get abortion pills. When Prism ran our North Carolina test case through Mayday, the process took under 30 seconds. We selected “Abortion,” then “Under 12 weeks.” We were then directed to find our state on a map, which marked “red states” and “blue states.” North Carolina was marked in the same shade of blue as New York, California, and Illinois. Still, we followed the directions for “blue state,” and Prism was, yet again, navigated to I Need An A. When testing the red-state option, we were funneled toward different ways to order abortion pills. 

While guidance of when to stop taking abortion pills sometimes varies, unlike the personalized information we received from staffers at CAF, Mayday’s website does not take into account the complexities of accessing abortion care in states with bans. Mayday also did not provide as many resources as Charley in response to our test case. The other information Mayday offered was listed in small type as FAQs that included a broken link to the Abortion Coalition for Telemedicine, a link to Plan C, and a link to another informational abortion pill site, Red State Access. The crux of the information we gleaned from Mayday was from getting sent to I Need An A.

Still, Mayday has positioned itself as synonymous with abortion pills. According to co-founder Sam Koppelman, Mayday appears at the top of search results in banned states, making it one of the first resources for a desperate person seeking abortion care. This outsize presence in the abortion access landscape has gained Mayday a significant amount of support in the post-Dobbs philanthropy rush. According to 2023 tax filings, Mayday holds more than $2 million in revenue, including reportable compensation of $245,838 for the executive director and $173,294 for Raisner as “head of creative.” 

Mayday’s funding could go a long way to help abortion funds, which routinely lack money and capacity. 

Abortion funds also face demonization from Congress and the Trump administration, targeted attacks from foundations in response to pro-Palestinian statements, uneven investment from their own movement, and attacks on labor. Funding abortions is a constant uphill battle that extends beyond state borders. While accurate information is necessary, the lack of dollars available to actually fund abortions remains the most important issue. 

Serving existing needs

The abortion information landscape is complex, and while some people might prefer not to interact with a real person when seeking abortion care, others might want to speak to another human being about what they’re going through. Abortion fund workers are experts in navigating an ever-changing abortion landscape, cutting through the noise of databases and complicated legalese. Prism spoke to staffers at three abortion funds to better understand how abortion tech fits into their daily work. 

While funds have received increased media and public attention since Roe v. Wade was overturned, organizations like Reprocare and CAF have been around since the 1990s. Even when abortion was a constitutional right, the Hyde Amendment barred public insurance from covering abortion care, keeping abortion out of reach for millions of poor and working-class people on Medicaid, Indian Health Services, and Tricare, among other health care programs. After Planned Parenthood v. Casey in 1992, which instituted further state-based restrictions, 22 funds formed the National Network of Abortion Funds. The mission, vision, and organizing power of abortion funds have expanded for over two decades, especially since the fall of Roe.

“If there’s a resource that we just don’t know off the top of our heads, we’re going to do everything we can to get that resource and connect with that person,” said Cathy Torres, organizing manager at the Frontera Fund, an abortion fund serving the Rio Grande Valley and the Texas borderlands. “That is something that we have always done.”

But funds have also been forced to adapt to a constantly changing legal landscape, even before the Dobbs decision. Targeted restrictions on abortion providers, mandatory delays, gestational age limits, abortion deserts, and the 2021 passage of SB 8—which banned abortions after about six weeks and put enforcement in the hands of civilians—made Texas a hostile state. Serving the borderlands meant that the Frontera Fund had to build infrastructure away from the eyes of the state. This meant not recording information about callers’ immigration status, age, or other demographic information.

“Our community, like our neighbors here on the border, come from mixed-status families,” said Torres. “Our neighbors are undocumented. Maybe that’s why it’s just common sense for us to be as accessible as possible and as human as possible.”

Direct conversation with callers is also important to Reprocare. “Our focus is always going to be on sharing the basic information with anyone calling us, and then creating space for more follow-up questions,” said Phoebe Abramowitz, one of the co-directors. “For us, one of the benefits of peer support is not suggesting what we think is best for someone, but just sharing good, accurate, nonjudgmental information. And then people can decide from there what’s best for themselves.”

Funds such as Frontera, Reprocare, and CAF emphasize the importance of having open-ended conversations, rather than the kind of multiple-choice options offered by bots and other abortion tech. Kay of CAF shared their strategy when trying to piece together funds for a caller: “I will ask people: Do you need support outside of procedural costs? Because that can sometimes free up some funds for people or take one less barrier out of their access.” In practice, this means offering money for groceries or gas to help offset some of the burden. “I think you have to have that real personal conversation to get to that information,” added Jess of CAF.

I don’t think we need any more tools. I think we need money to get funneled into service provision.

Garnet Henderson, Co-Founder of Autonomy News

For funds in the South hit hard by abortion bans, conversations with callers are often tinged with anxiety. “A lot of what folks hear is the risk of criminalization, which is a real risk,” said Torres. The environment in banned states—especially ones with bounty hunter laws—is partly why privacy-forward chatbots like Charley feel necessary to developers and movement leaders. But when it comes to abortion tech, actual abortion support experts are wary.  

“While it helps streamline activities and information, it also lends a hand in surveillance,” said Torres.

Surveillance is a particular concern for organizers and activists in a movement demonized by the Trump administration in lockstep with the systematic crackdown on pro-Palestinian student activists. “In border areas specifically, a lot of technology that’s used here at our checkpoints and our ports of entry—just throughout random corners here in the valley—has been utilized in places like Palestine,” Torres said. “I feel like that does shape how we approach tech.”

As the federal government rolls out increasingly draconian policies—including a registry for migrants and a proposed law that allows for the removal of a nonprofit’s 501(c)3 status—abortion funds are on high alert. To protect callers from law enforcement and Immigration and Customs Enforcement surveillance, CAF and other funds steer clear of specific tech tools. “We don’t need video surveillance. We don’t need a lot of things that some tech and government are pushing for,” Jess said.

Kay agreed: “If the prioritization is the safety of abortion seekers and the ease of accessibility, then there is room [for tech]. But if we’re framing it as some kind of tech race,  I don’t think that there is a lot of space for that.”

For movement workers, experts, advocates, and other insiders, the presence of tech in abortion support is all about the approach. “Are you creating something because venture capitalists with money told you they thought that you needed this thing, that we need AI or a bot for everything? Or are you actually part of the community that’s providing abortions?” asked Maya, a pseudonym for an abortion advocate who distributes abortion pills across the country.

Despite its issues, Charley is an example of a technology built to send people to informational sites they already visit. “Abortion-seekers should be able to have access to that information in places they’re already comfortable using,” said Sanchez of Reprocare. “Whether that’s online, Reddit, their period tracking app, or their student health care center.” 

“Sometimes, digital safety is about helping people operate where they are, [with] what they have, and meeting them where they’re at,” said Bertash of Digital Defense Fund. “And I think there’s a lot of really incredible insight and even joy that can come from that.”

But advocates and workers like Maya are frustrated by the lack of investment in on-the-ground organizations in favor of instead funneling funds to new abortion tech companies.

“You’ve got $2 million, and you’re linking out to the rest of us doing the fucking work,” said Maya, who expressed having similar resentment toward Mayday Health because of the organization’s focus on limited information, instead of the safety of people considering self-managed abortion in states with bans. “Y’all got $2 million and you’re not going to put up my bail.”

“I don’t think we need any more tools. I think we need money to get funneled into service provision,” Henderson of Autonomy News told Prism. 

Instead of investing in new tech projects, workers say tech experts could shore up existing orgs’ digital workflow, databases, and firewalls. Abortion funds like Frontera and CAF told Prism that they are willing to give tech a chance if it serves existing needs. 

“I think anything that’s giving us some of our privacy and data security back, we will definitely be interested in seeing that,” Jess said. 

Moving forward, Bertash said she wants technology and workers to coexist and build on each other. “I hope at some point we get that you can learn a lot from trying to build tools for the end abortion-seeker,” Bertash told Prism. 

In the meantime, Bertlash said she continues to be a believer in abortion tech, seeing it as one more tool to fight disinformation and fascism—as long as people don’t become too discouraged from the experiments necessary to identify tech that actually serves the movement and people seeking care.

Editorial Team:
Tina Vasquez, Lead Editor
Carolyn Copeland, Top Editor
Rashmee Kumar, Copy Editor