If you thought an app that delivers contraception to your door would barely register on the radar of anti-reproductive rights activists, you’d be wrong. In this current climate, where we face daily threats to both safe abortion and contraception access, the anti-choice contingent is targeting all laws and initiatives that give women access to the reproductive health care.
The latest target is the California-based company Nurx, creator of a telemedicine app of the same name that delivers contraceptives — including emergency contraception — to people without the need for a visit to a doctor or pharmacist. Nurx, sometimes referred to as the “Uber of birth control,” is available in 15 states and Washington DC and is looking to expand.
Nurx is easy to use: you answer a series of questions about your health, then select the prescription you’d like, or select the option to get a doctor’s advice on which method might work best for you. The request is reviewed by a doctor in your state, who then writes a prescription that is filled and delivered to you within three to five business days. Nurx accepts health insurance and is also available to people without insurance.
If Nurx is all about contraception, why are anti-abortion activists angry? Because Nurx also delivers emergency contraception (EC). EC, also called “the morning after pill” and sold under various brand names including Ella and Plan B, prevents pregnancy after sex. It works primarily by inhibiting ovulation (preventing or delaying the release of an egg), or preventing sperm from fertilizing an egg.
Yet anti-abortion activists have falsely claimed for years that emergency contraception causes an abortion. Many believe that life begins at the moment of conception, and that using emergency contraception is akin to homicide because it prevents a fertilized egg from implanting in the uterus.
According to the Office of Population Research at Princeton University, there is no evidence to suggest that either Ella or Plan B work after an egg is fertilized. In an article on Nurx and its opposition, Susan Wood, an associate professor of health policy at George Washington University, and a former assistant FDA commissioner for women’s health, explains that anti-abortion activists assume that “a fertilized egg is the same as pregnancy and is the same as a person.” But about half of fertilized eggs never implant in the uterus, and women aren’t actually pregnant, Wood says, until the egg is implanted and stabilized.
Neither the evidence on how emergency contraception actually works nor the scientific explanation of pregnancy sway anti-abortion activists who oppose EC or who purposefully conflate it with “the abortion pill” (also known as a medication abortion). As Nurx rolls out its service into more conservative states, including Texas and North Carolina, it’s attracted the ire of state anti-abortion groups. John Seago, legislative director of Texas Right to Life, told Stat News:
We believe life begins at fertilization. That’s the point where we have an individual, and morally that’s who we want to protect.
With science and medicine not on their side, anti-abortion groups are leaning on yet another tactic in their fight to slash access to contraception: telemedicine laws. Anti-abortion rights activists claim that these regulations are too lax and should be tightened.
It’s a claim that’s easily disputed, according to Stat News:
Much of the fight hinges on a particularity of how the morning-after pill was dispensed before Nurx came along. The Food and Drug Administration has approved a popular brand, Plan B, for over-the-counter sale in all states for women who pay out of pocket. But if a woman is using her insurance benefits to cover the drug, she’ll typically need a prescription for Plan B. And a newer emergency contraceptive, Ella, is only available with a prescription. The app, then, short-circuits this divide and lets insured women easily get the morning-after pill in a way more akin to the over-the-counter interaction. [emphasis mine]
Nurx says that patients receive more medical attention than those who purchase emergency contraception over-the-counter. But anti-abortion activists are pushing ahead with their attempts to legislate telemedicine providers like Nurx, starting in North Carolina, where they hope Nurx will get reviewed as part of legislators’ efforts to study and potentially revise current state telemedicine laws.
We face unprecedented threats to contraception access in the United States. A leaked White House memo recently suggested massive cuts to our federal family planning program, Title X. And President Trump has set his sights on dismantling Obamacare’s mandate that insurance companies must cover birth control without a copay. Fighting telemedicine apps like Nurx is part of a coordinated effort, on the part of anti-abortion activists, to continue to strip away access to contraception for people who need it.