From Cervical Cap to Mobile App: Examining the Potential Reproductive Health Impacts of New Technologies

Web- and application-based prescription services have been heralded as "Uber for birth control," offering patients the convenience of obtaining hormonal contraceptives at the touch of a smartphone screen. This innovation stands poised to disrupt a system that currently fails to meet the contraceptive needs of many women, particularly adolescents and those who are rural or low-income. The creation of online contraceptive prescribers provides a new and promising avenue for increased access to hormonal birth control. However, the reach and coverage of these services, as well as their implications for public health goals, including unintended pregnancy and various health screenings, remains unclear. In this article, we describe the current landscape of online contraceptive services and identify the potential impacts on unplanned pregnancy and other health outcomes. We find these services may reduce geographic and logistical barriers for rural and low-income populations. However, their impact on access for adolescents is likely to be minimal, as more than half the services do not prescribe to minors. Furthermore, increasing use of telemedicine may reduce rates of screening for public health concerns, including interpartner violence, sexually transmitted infections, and cervical cancer. We offer specific recommendations for future research to evaluate the impact of these services on unplanned pregnancy and other public health outcomes.