Date of Award

May 2021

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Sociology

First Advisor

Noelle Chesley

Abstract

Telemedicine has skyrocketed to national attention with the COVID-19 crisis, raising questions about how to best use virtual tools to support public health. One emerging sector of telemedicine is the rise of telecontraception platforms, such as Nurx, Pill Club, and Planned Parenthood Direct. Known as “the Uber for birth control”, these platforms represent a growing market and innovative approach that aim to address barriers to obtaining birth control such as geography, cost, time, and gatekeeping by providing contraception and other sexual and reproductive healthcare services directly to consumers (Sundstrom et al. 2019; Grindlay and Grossman 2016; Chuck 2017; Stormo et al. 2011). Contraception historically was and currently is riddled with red tape for women trying to access critical care they need to make decisions about their own bodies and lives. Telecontraception represents an important potential solution to these long-standing issues, yet its impact on women and health care has not yet been studied in depth. What are telecontraception platforms adding to the current landscape of reproductive health care? What problems are they solving and where are they falling short? Using mixed methods, this research aims to address this gap by exploring the accessibility, affordability, and equitability of these growing platforms. Findings illustrate telecontraception alleviates many existing access barriers. Yet there are mixed findings regarding affordability and equitability. Cost, insurance, and state availability limit the scope of telecontraception and mirror existing systemic challenges women face on the ground. This carries important implications because this research also found that the majority of women across the United States expressed strong pregnancy avoidance attitudes regardless of subgroup. Having a large presence of women legislators alongside other state conditions was linked to telecontraception availability in Republican and Democrat politically controlled states, suggesting that gender and having women in positions of power, in combination with other political, social, and economic state-level factors, is another growing and important factor to consider in advocating for issues related to women such as reproductive rights and policy. Overall, this project identifies areas of progress and opportunities for improvement not only for telecontraception but for health apps and telemedicine more broadly.

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