Reproductive Health – Population Matters-USA

FemTech is a new word for me. It isn’t the name of a female robot, but rather describes technology for the needs of women’s reproductive health.

There are many types of FemTech. One of the earliest and most common form is various apps women use to keep track of menstrual periods. That information can be useful to help a woman know when she is most fertile and trying to conceive—or when she is least likely to conceive, if her goal is to avoid pregnancy. Unfortunately, that type of app is a good illustration of how technology can lead people astray. There are several potential problems with these simple apps.

Let’s look at the case of a woman who is trying to conceive, but her husband has a low sperm count. They have read that it is best if he saves up those precious sperm until she is ready to ovulate. She looks at her phone one morning and realizes that she is at her most fertile. Her husband is drinking his morning coffee, reading the newspaper and on his way to work. She runs up to him and says:

“Honey, today’s the day! Let’s do it!”

Under those circumstances, sex can become a chore instead of being fun. Furthermore, recently it has been found that it is more productive for a couple to have intercourse more frequently and not just when the wife is more fertile.

There are other problems for couples who are trying to avoid pregnancy. One is that the pregnancy rate is much higher than with most modern contraceptive methods. Another is problem is more pernicious: poor security. Some of the apps do not take adequate measures to keep women’s data secure. Thus, if a woman who lives in a state where abortion is illegal misses a period and might be pregnant, law enforcement might find out. Then, if she tries to go to another state to abort the pregnancy—or perhaps to just visit a friend—she can be tracked. This may seem too Orwellian to occur in the USA, but already laws have been proposed to prevent crossing a state border in order to obtain abortion care.

Natural Cycles is the only app that earned FDA approval for contraceptive purposes. It uses a combination of period information and the rise of a person’s temperature when ovulation occurs, so it is more accurate than period-tracking apps. It claims to be 93% effective with typical use—which means that as many as 7 out of 100 women will conceive in a year of using this app for birth control. This is pretty good compared to other natural family planning methods, which have a failure rate up to 25%.

FemTech gets more sophisticated than just a calendar and thermometer. High tech fertility tracking with finger rings that measure temperature and home tests for progesterone which can help tell when ovulation has occurred. There are even expensive kits that measure 4 different hormones for the same purpose. Another high tech device uses vaginal probe that notifies the user when her cervical mucus is ready to assist sperm on their journey.

For an unintended pregnancy, FemTcch can help women lower barriers to self-managed abortions. A chatbot named “Ally” uses artificial intelligence to do this. Ally provides information for safe abortions using pills. It is available in several languages and has been used by people in over 170 countries.

This is just a sample of FemTech; I’m sure that much more will be developed in the future. Unfortunately, new ways of invading our privacy will also proliferate.

©?Richard Grossman MD 2026

PS: After posting this essay I realized that the FDA has approved another app for contraception, “Clue”.

Image courtesy of Plan C

Michael McLachlan walked up the steps of the US Supreme Court Building alone, with his mind set for the trial, while his family watched from the oval plaza outside. McLachlan was the Colorado Solicitor General in 2000, and was intent on keeping abortion access safe.

Colorado’s “safe access zone (SAZ)” law was at stake. It says that no one could approach closer than 8 feet of a patient without the patient’s permission. This applies when the patient is inside a 100 foot zone, based on the door of a clinic. This law, enacted in 1993, did not limit speech—it only limited unwarranted approach. The law was contested as interfering with the First Amendment right to free speech but was supported by the Colorado courts.

When I asked Barbara McLachlan, Michael’s widow, about the actual trial with the Supremes, she told me about one question asked by Judge Scalia:

“Why is the limit 8 feet?”

McLachlan was always sharp and ready for anything, so replied “Because that is the maximum distance a person can spit.” And Scalia laughed!

Colorado has been very supportive of access to abortion care. It was one of the first states to legalize abortion (1967), before access became legal nation-wide (1973). Although there have been several attempts to decrease this access, we recently provided protection to this right by passing an amendment to the Colorado constitution. It prohibits state and local governments from denying, impeding, or discriminating against that right to abortion. It also repeals the prohibition against using public funds for abortion services.

Unfortunately, many other states have limited access to abortion or completely prohibited this vital part of medical care. Many women are coming to Colorado for abortions. In addition, women are also receiving abortion pills by mail from Colorado-based telemedicine.

Some of the states that forbid abortion care try to keep their women from having abortions. Some laws try to forbid a pregnant woman to leave her state to go to a more liberal state. Nevertheless, abortion providers in Colorado and New Mexico see a lot of patients from Oklahoma and Texas.

Pills have caused a revolution in abortion care. Pills can be mailed to a pregnant person living in a restrictive state; organizations have been started for just that purpose. Plan C (www.plancpills.org) is one of the organizations started to inform women about the availability of abortion care by telemedicine. When contacted by someone who is pregnant and who desires an abortion, Plan C will ask them to fill out a form about their medical history, then (if they qualify) refer them to a site where they can purchase pills for an abortion. This system can be used by anyone in any state in the union, but people in restrictive states are most likely to use it.

The people who actually supply the medication are at risk of retaliation by authorities in restrictive states. Perhaps the worst example is Texas. It has an malevolent law the purpose of which is to intimidate non-Texans who provide medication abortion pills to Texan women. The law would levy a fine of at least $100,000 to someone who prescribes or mails abortion pills to a woman in Texas. This law encourages Texans to spy on each other and relies on fear. The differences of abortion laws in different states has incited interjurisdictional abortion wars.

Coloradans who prescribe abortion pills to people in restrictive states risk being indicted for breaking the law in the other state. Last spring the Colorado legislature voted for a law to offer them protection. The name of the prescriber must be left off the medication. In addition, The new Colorado law shields abortion patients and providers from actions initiated by other states.