Implementing digital sexual and reproductive health tools: Challenges and recommendations post-Dobbs.

Abstract

Abysmal sexual and reproductive health (SRH) outcomes in the United States persist due to multiple factors, including diminishing SRH care access and inequities in care for socially or economically marginalized populations. Digital innovations have the potential to address gaps in SRH care as scalable, low-cost, patient-centered solutions that supplement the formal healthcare system. Our multidisciplinary team has developed a suite of patient-facing digital tools to help address suboptimal SRH care delivery for marginalized individuals capable of pregnancy, including those with chronic medical conditions. These tools-MyPath for reproductive preferences, prepregnancy health, and contraception; MyVoice for SRH needs of people with rheumatic/autoimmune disease or cystic fibrosis; MyDecision for tubal sterilization; and MyHealthyPregnancy for tailored pregnancy support-are guided by principles of community engagement, person-centeredness, and health equity. In the wake of the Dobbs v. Jackson Women's Health Organization 2022 Supreme Court decision overturning federal abortion protections, as well as the rapidly shifting policy landscape under the current administration, there are new considerations for use and implementation of digital SRH tools. In this commentary, we draw directly from lessons learned in our work to discuss emerging concerns related to data privacy and pregnancy criminalization, trust in healthcare providers and systems, and research. We then propose recommendations for researchers seeking to create, implement, and evaluate these tools with the goal of safeguarding reproductive autonomy and achieving health equity in this new policy context.