by Emma M Gordon, Emma G Garzella, Steph Kraft Sheley, Kathryn J LaRoche
Contraception
Volume 164, December 2026, 111517, https://doi.org/10.1016/j.contraception.2026.111517
Abstract
Objectives
We reviewed text messages sent to Right By You (RBY), a Missouri-based, youth-focused reproductive health navigation service that connects texters to care and resources related to abortion, adoption, birth, contraception, and parenting. We aimed to illuminate the specific informational and navigation needs to accessing quality, timely care for abortion, contraception, and pregnancy in Missouri and beyond.
Study design
We carried out content and thematic analysis with all anonymized text messages RBY received between April 1, 2022, and October 31, 2023.
Results
RBY received texts from 345 unique texters, most of whom (n = 210) did not report their age. Seventy-four texters identified themselves as minors under 18 years old. The most common topics asked about were locating a provider and securing funding for abortion care, locating a contraceptive care provider, and accessing contraception without parental involvement. Texters who identified themselves as minors frequently asked questions about navigating the social aspects of scheduling appointments and expressed concerns about privacy. Financial barriers to abortion care were a recurring concern, particularly for minors and people seeking later abortion care.
Conclusions
Relying solely on digital resources to share SRH information is inconsistent with the realities of privacy and navigating social interactions raised by texters. Patient navigation services like RBY serve a critical role of real-time navigation support to bridge gaps that the formal systems fail to address.
Implications
This study documented a need for personalized, responsive support around appointment scheduling, privacy, and abortion funding, which underscores the importance of tailored health navigation services. Text messaging phone lines, like Right By You, offer a promising, low-barrier platform to deliver this support in a youth-friendly, confidential manner.