ABORTION CARE: VENEZUELA & USA & (SOON) GUATEMALA – ‘A virtual abortion doula in your pocket’: Aya Contigo helps Latinas find abortion care

U.S. abortion bans impact 6.7 million Latinas in the United States—the largest group of women of color impacted by these bans. Many lack insurance, cannot travel and face language and cultural barriers to reproductive healthcare.

To address these barriers, two Canadian physicians—Dr. Roopan Gill and Dr. Genevieve Tam—co-created Aya Contigo, an app with an embedded live virtual chat to help people access contraception and abortion. A project of Vitala Global, the app provides resources for obtaining and using abortion pills, and the chat is staffed by professional counselors who walk users through the process.

Launched originally in Venezuela, Aya Contigo began serving the United States in September 2023 with plans to expand to Guatemala.

Roopan Gill explains why they launched the app in the U.S.:

I presented at a National Abortion Federation conference. People from M+A Hotline and Hey Jane came up to me after and asked, when can this come to the U.S.? How can we work together?

When the Dobbs decision happened, we rolled up our sleeves and asked, what does Aya Contigo look like in the United States? We adapted and launched the app for Latinas and Latinx folks in the United States because our app is in Spanish already and we knew that the vast majority of folks that are being impacted by the Dobbs decision are Latinas and Latinx folks, especially those in Texas, Florida, Arizona—those in the most challenging contexts.

We talked to many stakeholders that work with Latinas who said: ‘We need a Spanish-first resource. There’s nothing like this that exists in the United States, nothing that’s Latina-first.’ We partnered with Planned Parenthood Federation of America through their Innovation Accelerator to test out the emotional support functionality of Aya Contigo, which helped us adapt the app quickly and launch it in the U.S. in September 2023.

We made it super user friendly and accessible for the Latina/Latinx user. We translated it into English. We got it onto the Google Play Store as well as the Apple Play Store and other places. We refer users to quality service providers online or in person, to get the pills or surgical abortion. We also have practical support.

We launched the chat in the U.S. in February of 2024. We have bilingual counselors that are providing support through the chat. People connect with us through the in-app chat or web chat, and they can also access us through a What’sApp number. When people contact us, our team responds right away, usually within five to ten minutes….

We have a strong belief in movement building and community engagement. We learned this when we were in Venezuela before even launching the app, that to build trust and increase our referral network, we needed a local team.

We’re doing this in the U.S. through PPFA, Plan C, through our social media, through going to a bunch of events, through local partners that are working directly with Latinas, like the National Latina Institute for Reproductive Justice. We have met with a ton of organizations working with undocumented migrants and groups that are not necessarily abortion-specific but are working with the most marginalized communities. This is what we’re wanting to do more of this year. We’re focusing on Texas and Florida and some of the more restrictive states.

The app is a seven-step process. When you enter, Aya Contigo greets you as if it’s one of your best friends, saying, “Hola, I’m Aya Contigo, I’m here for you.”

The seven steps are based on the WHO recommendations that a person can self-assess eligibility, self-administer and self-assess for successful completion. So the user can put in their last menstrual period and answer a few questions related to contraindications to the pills, and then the app will tell them, great, you can do an abortion with pills, and then it’ll take them to the subsequent steps on what to expect: what are the things you may want to have around you, in terms of pain control, nausea, heating pad and food.

Then it shows them how to take the pills, whether it’s mifepristone and misoprostol or misoprostol alone. We also advise the user what to do in case of emergency, what not to say and what to say if you have to go to the hospital, and then self-assessing that you’ve successfully completed the abortion.

And finally, we have a post-abortion contraception checklist that they can use to basically guide them on personalized contraceptive decision-making, and we have a self-care section, which we really feel is important, to provide personalized support. The chat will pop up in different parts of the app, and then users can connect with us.

We will soon be redesigning the app to make it an even more seamless experience for users….

Seventy percent of our conversations have been to support our users to access pills. We refer them to partner providers for access, depending on where they are.

If they’re in a banned or restrictive state, we refer them to the telehealth provider Aid Access or to Las Libres, a community network that mails free abortion pills.

If they’re in a state that is a shield state, then we’ll collaborate with the telehealth provider Abuzz.

We try to refer to providers that won’t charge anything, like Las Libres. A lot of our users are undocumented. They can’t travel across state lines, they don’t speak English perfectly, and maybe don’t even have health insurance. So for them, Las Libres is the best option. We have a pretty good relationship with them so that we can ensure that the loop is closed.

If a user on the app goes to the resource section, we share resources depending on whether or not the user has a credit card or not. So, for example, if they don’t have a credit card, it makes sense to have them go to Las Libres right away. We don’t even bother sending them to Aid Access or Abuzz because they would have to go through an intake process and there is a lot of fear, particularly amongst those who may be undocumented, to share specific details.

What’s really nice is our users come back to us. We support them to get the pills and then they come back and complete the process with us. So we really are filling this gap of accompaniment, empowering our users, giving them the trust they are not alone….

My co-founder and I are both ob-gyns, and I worked with the World Health Organization. I know so much about all of these activists and feminists, not only in Latin America but globally, because I have had the chance to work with them, listen to their experiences and account for them as we worked on WHO guidelines. We have built trust. It also helps that I led the process for the WHO to get mifepristone and misoprostol on the Essential Medicines List so we ourselves have high standards to ensure the partners we refer to are supplying quality-assured medications. Las Libres are making sure it’s quality-assured.

When asked if they charge for their services, Gill replied: “No, we don’t. Our mission is really clear: making sure the most underserved can access our solution.” But they are exploring revenue generating partnerships with online pharmacies and providers.

When asked how many people they’ve served so far, up to the end of May 2024, she said: “The Aya app has reached 447 new users across 45 states, including Puerto Rico and Washington, DC, since September 2023. With the chat, we have served 175 users in 207 conversations across 32 states since February. About one third of our users have extended conversations with us over several days.” Their counsellors are in Canada, not in the U.S.

“We’re on a mission to fill this massive gap that exists around abortion access. We want to empower our users and eliminate stigma. We want no person to have to die of an unsafe abortion.

SOURCE: Ms Magazine, by Carrie N Baker, 26 May 2024.

[The full article is much longer and well worth reading the whole.]