Reproductive Health Technologies: From Design Feature to Defect
By Katie Gu
In the post-Dobbs world, the accessibility of modern reproductive technologies is morphing from an intentional design feature into a dystopian defect.
Many modern reproductive technologies were created with an explicit intent of returning reproductive freedom and agency back to individuals. These technologies — which generally encompass electronic devices, software, and other technology relating to women’s health — are designed to address disparities in reproductive healthcare and health outcomes by empowering individuals to assert greater control over their reproductive lives. Similarly, the adoption of electronic medical records was intended to give individuals greater access to and control over their personal medical health information.
The immediate impact of modern reproductive technologies, such as telemedicine, period tracking apps, and medication abortion, is to broaden access to this right for marginalized groups. That these individuals are at the receiving end of these technologies is explicitly emphasized in the publicity of some reproductive health technology companies. For example, the mission statement of GenBioPro, the manufacturer of the first FDA-approved generic form of mifepristone, is “putting access into practice.” It advertises itself as an “innovative pharmaceutical company dedicated to putting reproductive health care within reach” by “decreasing barriers, increasing access, and advocating for providers and patients alike.”
Beyond its initial targeting of abortion clinics and surgical procedures, the post-Dobbs war against reproductive autonomy has now identified modern technologies — in particular, those designed for underserved communities — as its next target. The vast digital realms of health information contained in phone activity, web searches, period tracking apps, geolocation data, and medical records are now subject to heightened state surveillance, targeting, and exploitation. In a prominent case last June, a Nebraska detective obtained access to Facebook messages sent between a mother and daughter, the latter of whom was managing a late-term medication abortion, and used these digital communications to charge the pair with a series of felonies and misdemeanors.
This example highlights how technologies that were explicitly designed with the intent of broadening access now pose risks post-Dobbs, which are primarily borne by oppressed and marginalized groups.
In their article Femtechnodystopia, Leah Fowler and Michael Ulrich emphasize how femtech is transitioning from its origins as choice-preserving tools designed with the “potential to enhance bodily autonomy in the pockets of anyone with a smartphone” into law enforcement technologies that disproportionately police poor people of color. With regard to electronic medical records, Carleen Zubrzycki has noted in The Abortion Interoperability Trap that data portability, formerly a design feature and strength, now grants law enforcement easy access to sensitive data, paving the way for greater surveillance and criminalization of pregnant individuals.
Conclusion
Dobbs has accelerated a re-examination of modern reproductive healthcare technologies. What happens when, due to changes in the law, the impact of a technology begins to contravene its originally designed purpose? Whose responsibility is it to drive the redesign or reconsideration of such technologies?
As Fowler and Ulrich argue, a diverse set of stakeholders can (and should) divide this responsibility. Lawmakers can introduce requirements, such as those in the My Body, My Data Act, that force a redesign of modern reproductive technologies to address new privacy and security concerns. On the back end, technology companies can incorporate data minimization and deletion best practices to reduce the aggregate amount of sensitive data available for state surveillance and exploitation. While these companies have significant profit-based incentives to maximize data troves, Fowler and Ulrich note that corporate social responsibility and consumer goodwill can also induce a form of self-regulation within the technology industry. Individual actors, including lawyers and grassroots advocates, can raise public awareness regarding privacy protections and precautionary measures needed to safeguard the post-Dobbs digital future.
Collectively, these actions can prevent the democratic design purposes of reproductive health technologies, centered around equity and accessibility, from mutating into dystopian design defects.
