by Juliana Friend, Claire D Brindis, Ushma D Upadhyay
Contraception, https://doi.org/10.1016/j.contraception.2025.111241. Open access.
From text in press, corrected proof.
Abstract
“Objectives – While the implications of AI for health care are frequently discussed, AI’s relationship to abortion has received limited attention. This paper surveys research on AI and abortion to date, adapts AI ethics principles for abortion contexts, and proposes a research agenda for abortion and AI.”
“Study design – We conducted an exploratory literature review, identifying peer-reviewed and grey literature relevant to AI, abortion and/or reproductive health and rights by iteratively searching academic databases. We identified pioneering articles on the implications of AI for reproductive health and two branches of empirical work: AI tools tailored for abortion, and assessments of ChatGPT’s responses to questions about abortion. We compared abortion AI tools included in the category ‘FemTech’ with ChatGPT vis-à-vis their ethical implications for abortion access. Building on this analysis, we propose an Abortion AI research agenda.”
“Results – The rapid development of AI holds both promise and challenges in sensitive and stigmatized areas like abortion. While existing AI tools allow humans with clinical expertise to review user-facing content for accuracy, concerns have been raised about abortion misinformation propagated by ChatGPT. Likewise, while ChatGPT’s data use raises concerns about privacy and consent, precautions taken by specialized abortion AI tools highlight opportunities for harnessing AI while mitigating privacy risks in an era when abortion seekers’ digital data has been used in criminal cases against them.”
“Conclusions – Existing AI applications designed for abortion support privilege contextual appropriateness over technological novelty, avoiding more sophisticated forms of AI when they do not serve patient needs or undermine bodily autonomy. Such choices help mitigate risks of AI misinformation and privacy breach.”
“Implications – With commitments to privacy, accuracy, and meaningful consent, AI can be harnessed to advance abortion access and reproductive autonomy and should be explored with the same rigor as it is in other fields. Community-engaged methodologies are well-positioned to explore appropriateness of AI to community needs.”
Excerpts from the Introduction
“The 2022 launch of ChatGPT, an Artificial Intelligence (AI)-powered chatbot that can generate remarkably human-like text, brought the implications of AI for health care to the forefront of public discussion. Health care systems have noted the exciting potential of AI, and more recently, tools like ChatGPT, to reduce clinician burnout, accelerate clinical research, and improve patient care…”
“How might such a general-use AI application support over-burdened reproductive health clinics seeking to accommodate patients traveling from out of state? Given the increase in self-managed abortion (SMA) after Dobbs, could ChatGPT be a source of information for people taking steps to end pregnancies outside of the formal health care system or without clinical supervision…?”
“Health care systems are increasingly discussing the promise of AI alongside possible risks posed. Such risks include amplifying misinformation, weakening patient data privacy, and expanding health inequities, for example, by training machine learning models on datasets that under-represent medically marginalized communities… Algorithmic injustice – a term describing how AI may intentionally or unintentionally cause discrimination against and/or disproportionate harm to marginalized groups – is receiving greater attention in health care fields. For example, one algorithm designed to assess patients’ level of health care need systematically classified Black patients as having lower health care needs than white patients with comparable markers of health… Numerous other fields, from mental health to radiology, are exploring the potential and limitations of AI for patients and providers. However, with notable exceptions, AI’s relationship to abortion and abortion equity has received limited attention…”
Editor’s Note: This is a long, complex paper, worth every minute to absorb the full implications. Note in the reference list how much the language is being changed by online technology as well.