How technology could preserve abortion rights

Abortion rights advocates are exploring how technology might preserve or even expand women’s access to abortion if the Supreme Court scales back Roe v. Wade.

A nonprofit group is testing whether it’s safe to let women take abortion pills in their own homes after taking screening tests and consulting with a doctor on their phones or computers. Because the study is part of an FDA clinical trial, the group isn’t bound by current rules requiring the drugs be administered in a doctor’s office or clinic.

The group, called Gynuity Health Projects, is carrying out the trial in five states that already allow virtual doctors to oversee administration of the abortion pill, and may expand to others. If the trial proves that allowing women to take the pill at home is safe — under a virtual doctor’s supervision — the group hopes the FDA could eventually loosen restrictions to allow women to take pills mailed to them after the consult.

If FDA took that step, it could even help women in states with restrictive abortion laws get around them, potentially blurring the strict boundaries between abortion laws in different states if — as is likely — the Senate confirms a high court justice who is open to further limits on Roe.

Telemedicine “will become much more of a flashpoint because medication abortion is a method so many patients [are] looking to use,” said Elizabeth Nash of the Guttmacher Institute, a research group that supports abortion rights.

Right now, even in states that allow a licensed provider to administer the abortion pill by video hookup, the provider must watch, in person or by video, as a woman takes the first medication in a clinic or other health care setting. The drugs abort the fetus without surgery but are safe and effective only in the first 10 weeks of pregnancy. If the group’s study shows it’s safe for women to administer the drug themselves after an online consultation with a health care provider, it will petition the FDA to lift the requirement.

If that were to occur — a big “if” under a Republican administration — states with more permissive abortion laws could expand access to the procedure to clinics served by video hookups, effectively reducing the long distances many women often travel to find a provider.

But it could also potentially boost access for women living in states with more restrictive laws as they might have an easier time obtaining prescriptions by mail, besides having a greater number of telemedicine clinics to go to if they were able and willing to travel across state lines.

“We know even now that some women are accessing these medications online — it may not be strictly legal, but people are doing that,” said Daniel Grossman, a University of California, San Francisco researcher who has studied the safety of telemedicine abortions. “It would be a hard thing to crack down on.”

Grossman notes that women in other countries that prohibit abortion have used the internet to buy abortion pills by mail and get around restrictions.

Not everyone is convinced, however.

“It could open some doors,” Nash said. “Still, people [in restricted states] would have to jump through hoops.”

For example, restrictions on waiting periods and a counseling requirement would apply, and doctors who prescribe the pills would still have to be licensed in the state where the patient resides — though patients don’t usually face penalties for failing to comply with state abortion laws.

“All of the burden falls to the provider,” she said. “But if the state wanted to, there’s potential for women to be charged in some way.”

Anti-abortion lawmakers in Texas wouldn’t speculate on whether they might change state law to impose penalties on patients if the FDA loosened regulations on telemedicine abortion, but they believe existing restrictions in the state’s telemedicine law, which are being challenged in court, would prevent women from obtaining the medicines remotely.

Gynuity, which is currently enrolling patients in Maine, Hawaii, Oregon, New York and Washington state, plans to expand the telehealth-abortion study to women in other states where telemedicine for abortion has not been outlawed.

From trade wars to climate change, farmers’ prospects are increasingly dire. Can tech provide the solution?

One by one, founders of food- and ag-tech startups entered from stage left, wearing black hoodies or a casual blazers over t-shirts emblazoned with their companies’ logos. Their entrance music — personally selected — was drowned out by cheers and applause in the packed 3M Auditorium at the Minnesota History Museum on the first night of Food, Ag, Ideas Week.

It’s the kind of enthusiasm you expect around tech unveilings, but the guy on stage is usually talking about iPhones, not cow udder health.

A little over three months ago, nine startups rolled into downtown St. Paul for the first Techstars Farm to Fork accelerator, during which they acquired mentors, built out their visions at breakneck speed, and crafted the messages they would use to woo investors. They drew energy from their shared ambitions to “disrupt” the food system with data insights, mobile apps, and products that bring solutions to outsized issues like food waste and financing.

During their demo day on-stage pitches, they gave a glimpse of how they’re working to leverage the hundreds of millions of dollars investors are pouring into ag-tech to solve the practical problems perplexing farmers around the country.

“There’s nothing better than thinking about what a farmer needs and the problems they’re facing,” said Lauren Pradhan, managing director of Grow North, the University of Minnesota initiative that spearheaded Food, Ag, Ideas Week. Food, Ag, Ideas was designed to connect people across the food system, from Fortune 500 companies to startups, from retailers to farmers to state workers. Grow North started two years ago to foster a more collaborative region in the areas of food and agriculture innovation.

Efficiency pressure

Across the river less than 24 hours after Techstars’ demo day, a different, much more somber and sparsely populated session showed why approaching innovation from a farmer’s point of view is a big deal.

Sitting in a neat line on a Guthrie Theater stage, a panel including two dairy farmers, a corn and soybean farmer, and two fresh vegetable farmers took turns sharing the biggest threats they’ll face in the next five years. It was the same day the IPCC’s latest climate report was splashed across the front pages of major news outlets, warning of major climate changes inside three decades. Farmers were frank and sometimes pessimistic. They face perpetually low prices and oversaturated markets, trade wars that exacerbate their situations, and weather patterns that keep everyone who works in a field wracked with anxiety.

Alise Sjostrom, who started Redhead Creamery on her parents’ dairy farm five years ago, and Meg Moynihan, an organic dairy farmer, worked hard to focus on opportunities and the role consumers can play in supporting local farms. But Moynihan knows dairy farmers are calling it quits by the dozens. And Sjostrom said robotic milkers — the tech her family dreams about as they face a labor shortage — are completely unreachable because of the cost.

Harold Wolle, board member of the Minnesota Corn Growers Association, said his combine keeps getting stuck in the mud. “Despite what people in the administration think, I believe climate change is real.”

Rodrigo Cala, an immigrant from Mexico City who worked in a factory until he could start his own farm in Turtle Lake, Wisconsin, said he makes more money teaching other farmers than selling his crop.

Jack Hedin of Featherstone Farm, who penned an op-ed for the Star Tribune about the danger the weather poses specifically to local food producers, wondered if the never-ending quest for efficiency will ensure farmers can’t afford to keep at it.

Afterward, with his arms folded across his chest, Hedin said he felt like the guy at a NASA convention where everyone is rallying around a mission to Neptune while he contemplates the problems needing attention right here on Earth. If farmers can’t get a fair price that allows them to maintain an operation that provides high quality food while properly stewarding the land, “does what I’m doing really matter?” he asked.

Connecting local markets

Sam Eder, founder of Big Wheelbarrow, one of the Techstars’ nine ag-tech companies, would say yes, it does, and his are the kind of concerns that compelled the company forward in the first place.

Big Wheelbarrow works with buyers who want to source more locally produced food for their grocery stores, restaurants, cafeterias, meal kits, etc., by consolidating inventory lists from small farmers in and around cities, making it available all in one place for buyers to review and place orders. He knows small farms across the country are trying to find stable markets in their region for local products – an area of increasing demand that fetches higher prices. By making it easier for buyers to stock locally grown food, he believes he’s addressing a piece of that.

“When you’re in the trenches, you see that pain and it feels like it’s not getting any better,” Eder said. By rerouting supply chains and cutting out the brokers and distributors that each take their cut, he believes there will be more money for farmers. “That’s really what’s driving us.”
Whether helping farmers access new markets, like Big Wheelbarrow, or eliminating paperwork or replacing ancient equipment and techniques, startups see opportunities to use new technology to help farmers. Meanwhile, farmers need them to approach those opportunities with an eye on the repercussions if their new great idea goes belly-up in a couple of years, Jan Joannides, executive director of Renewing the Countryside, said after leading a lunchtime discussion on local food’s role in revitalizing rural economies.

“Tech does have so much potential… there is so much potential and there are a lot of things tech can bring to make farming better and easier,” she said. “But it can also add risks.”