With policies currently in Congress that might lead to the closure of even more reproductive healthcare clinics, including services from cancer screenings to STI testing, the need to keep patients informed of how to get the care they want has never been more dire.
We might discuss the emotional journey of an abortion seeker around getting them from confusion and disorientation to understanding and relief, regardless of their choices.
At the same time, Crisis Pregnancy Centers, or fake clinics that pose as counseling centers for pregnant people, persist in their anti-abortion messaging and are funded nationwide at five times the rate of abortion clinics and funds. Through the language of free testing and counseling, they encourage patients to enter illegitimate medical clinics, by talking about abortion decision-making despite the fact that they do not provide it, or any other form of medical care.
Their latest move has been to go digital, expanding their already vast and well-funded footprint into a mobile chat experience that utilizes the language of values-based decision-making and regret avoidance to deter those seeking real support amid a complicated landscape.Their goal is clear: be the first to reach abortion seekers confused by the complex legal landscape when they go online looking for information. They then delay, deter, and redirect them away from real medical care.
The punchline is that their latest innovation is a rip-off. Planned Parenthood’s Chat and Text program has paired website visitors with sex educators for the past 15 years, and the M+A hotline has operated a phone line staffed by doctors and volunteers since 2019. And post-Dobbs, the internet abounds with even more determined activist-innovators. There are comprehensive resource websites for those seeking medication abortion by mail, awareness campaigns, brave providers shielded by their state’s laws, health centers with stronger telehealth capabilities, and abortion doulas and hotlines stitching pieces together with the patient’s needs in mind.
Knowing that most users’ journeys start with a Google search on their mobile devices, it’s important to ensure that emotional support tools are easily accessible in a variety channels like web chat, text, Signal, or WhatsApp, and through completely low-tech options, and ensuring immediate connection to a person who can help no matter how someone prefers to communicate. These crucial organizations engage users compassionately and non-judgmentally. Powered by counselors, volunteers, and care providers, they are digital communities formed to listen, validate, and educate, without pathologizing the user’s emotional state. Engaging emotionally also helps users talk through social and legal stigma, misinformation, and education needs no matter where they live.
Reprocare is a peer phone and textline that offers comprehensive support at every phase of the process including informed landscape navigation for people who need detailed hand-holding and practical support, and the care team sends care packages directly to users who are alone and who express a need for resources and a human touch. Reprocare’s sister company, Autonomie, also builds technology that quickly matches users with abortion funds that help them access care.
Aya Contigo calls their bilingual chat tool “an abortion doula in your pocket,” and it first launched in the U.S. in Spanish, primarily using WhatsApp to reach vulnerable Latino communities. Designed in Venezuela with feminist organizations and 1,000 co-creators, it brings lessons from the Latin American feminist movement to our country, including the tradition of “acompañantes” or accompaniment as a framework. Using bilingual educators on WhatsApp chat and the asynchronous resources on their downloadable app, Aya Contigo ensures patients are never alone, that they have check-ins and follow-ups and are treated gently and compassionately for the days and weeks following their medication abortion.
Exhale Pro Voice is a post-abortion counseling program that offers a non-judgemental support text line for after-abortion support. Exhale also promotes its services for partners, parents, and friends of those who have had an abortion, in order to meet their unique emotional needs and also learn to be a support system for the person in their lives. Exhale is also a crucial resource for counselors, providers, and reproductive health workers seeking a confidential space outside of their work to sustain their well-being, especially important after three years of confusion and challenging, uphill work.
All-Options goes a step further, with a reproductive justice framework that understands that access to abortion has always been inequitable, be it because of location, resources, family, or tradition. Through their talk line, users are given emotional support to understand their access abortion care, and can also speak with a spiritual counselor, access adoption resources, pregnancy resources and infant care support, and a diaper program in their Indianapolis community.
Meeting the emotional impact of bans means considering a reframing of what we could term “the journey map” of an abortion seeker. The Turnaway Study highlights the mental health impact on those denied abortions over a period of 10 years. It elevates an important point: The most common emotion after an abortion is a sense of relief. Framed this way, we might discuss the emotional journey of an abortion seeker around getting them from confusion and disorientation to understanding and relief, regardless of their choices.
Today, researchers are only beginning to track the mental health impact of the Dobbs decision, and recent studies highlight depression and anxiety among women of reproductive age in general. Nearly 25% of women 18-25 years old have had a major depressive episode in the past year, and women of reproductive age in states where abortion is banned report increased anxiety. Further behaviors among young adults post-Dobbs, like increased permanent contraception like tubal ligation and vasectomy in banned states, are proof of the social pressures and sense of personal insecurity, and a lack of bodily autonomy created by bans.
Emotional support is key not just to providing immediate care, but to transforming the abortion access landscape. The coalition building of organizations that prioritize emotional and cultural competency can provide innovative, scalable solutions to a complex societal problem. While funders understand emotional support as a component of the wider access landscape, they don’t always see it as a fulcrum for change and outsize impact. Investing in innovators who have built this direct accompaniment ecosystem, powered by real, caring humans, is vital to maintaining access for critical abortion and reproductive healthcare.
