Over the past few months, abortion pill startups have tried to cope with huge spikes in demand while navigating a tangled web of new regulations and privacy concerns. Since the Supreme Court’s decision to overturn Roe vs. Wade first leak in may, Hey Jane, an online startup that provides abortion pills in seven states, reported a tenfold increase in traffic to its website. And demand has doubled for its mail-order abortion drugs, a combination of misoprostol and mifepristone who can induce a safe abortion during the first 10 weeks of pregnancy in the privacy of her home.
In addition to Hey Jane, other abortion pill-focused telehealth providers like Choice, Just the Pill, Abortion on Demand saw site traffic and interest skyrocket from 600% to 2,000% after the fall. of roe deer end of June, according Axios. Prior to the Supreme Court ruling, more than half of abortions were medically performed, reports the Guttmacher Institute, specializing in reproductive health policy. Today, many states are trying to ban telehealth services and even the pills themselves.
Last month, the Biden administration took regulatory action to try to prevent states from banning access to the abortion pill by mail order, saying it is beyond the scope of states’ rights given the position of the Food and Drug Administration (FDA) that it is safe, effective, and does not need to be dispensed in person from a pharmacy.
But the obscurity of federal law presents challenges. For example, a telehealth provider like Abortion on Demand uses software that must confirm a patient’s physical location before allowing them to schedule a telehealth appointment to be prescribed an abortion pill by mail. If they live in a state where access to the telehealth service itself has been restricted, as 19 states had already done before Dobbs decisionthey should find a way to travel to a state where these services are still permitted in order to use digital platforms given the location verification requirement.
This hurdle becomes even more difficult given the relatively short window for receiving abortifacient drugs, which are only permitted during the first 10 weeks of pregnancy, just weeks after many women may even know they are pregnant. A period of just a few weeks to travel to a site where access to telehealth abortion services is even legal is a complication in itself, which is why Hey Jane co-founder and CEO Kiki Freedman said that one strategy could be to create demand in blue states where in-person abortion remains relatively accessible in order to free up in-person appointments for women who may have to travel across state lines for an appointment.
“While we have geographic expansion plans underway (we recently expanded into New Jersey and will soon be expanding into Connecticut), our top priority has been to meet the significant increase in demand in states in which we are currently located,” Freedman says fast company in an emailed statement.
This could be a growing effort as more states attempt to prohibit access to abortion-inducing drugs and telehealth appointments for these services, or allow members of the family of drug recipients to sue drug suppliers. These legislative efforts are fueled in part by anti-abortion groups such as the National Right to Life Committee and Life of America, which have developed model legislation to restrict access, the Washington Post reports. And red state legislatures are heeding the call of these activist groups – lawmakers in South Carolina, for example, have already introduced the “model law” concocted by National Right to Life in the wake of the Dobbs decision.
“Hey Jane is currently in states where telemedicine abortion will continue to be legal, and we are strategically positioned in these 7 states that account for the majority of abortion volume nationwide after Roe and are receiving an influx of patients who need to travel to get care now that Roe is knocked down,” Freedman says, adding that helping overstretched in-person clinics by focusing on those who would benefit from medical abortion is a top priority for the startup.
These efforts will undoubtedly become essential for a growing number of women as state anti-abortion laws are implemented in the months and years to come. But fledgling women’s health businesses in the space may need to build trust with those they serve, given privacy concerns over such sensitive and personal information. For instance, markup reported last month that Hey Jane advertises its services on Google and Facebook and was found using pixel trackers and visitor data which was then sent to analytics companies, payment processors and major search engines and social media platforms, potentially putting women’s privacy at risk. The company reportedly addressed the issue soon after the report, including ceasing to use Facebook parent company Meta’s Pixel tracker, citing an “increasingly hostile” regulatory environment.
“Having supported our 10,000th patient this month, I am proud of the work Hey Jane has done and will continue to do,” says Freedman. That number is almost certain to rise, as will the hostility of state anti-abortion laws and regulations.
Sy Mukherjee has reported on the health industry for a decade. He is a communication consultant and architect at IDEA Pharma.