U.S. abortion bans affect 6.7 million Latinas in the USA—the most important group of girls of coloration impacted by these bans. Many lack insurance coverage, can’t journey and face language and cultural boundaries to reproductive healthcare.
To handle these boundaries, two Canadian physicians—Dr. Roopan Gill and Dr. Genevieve Tam—co-created Aya Contigo, an app with an embedded reside digital chat to assist folks entry contraception and abortion. A venture of Vitala International, the app gives sources for acquiring and utilizing abortion drugs, and the chat is staffed by skilled counselors who stroll customers by way of the method. Launched initially in Venezuela, Aya Contigo started serving the USA in September 2023 with plans to increase to Guatemala.
Ms. spoke with Gill, an OB-GYN with superior coaching in advanced household planning about her work with Vitala International and Aya Contigo.
Carrie Baker: Why did you develop Aya Contigo?
Roopan Gill: I’ve all the time wished to work in contexts which might be essentially the most difficult as a result of if we don’t tackle the problems of essentially the most underserved and marginalized, then we’re actually not going to maneuver the needle.
I labored with Docs With out Borders in Yemen and Nigeria, in addition to with the World Well being Group on their Stopping Unsafe Abortion workforce. I used to be concerned in creating a few of their pointers and in addition getting mifepristone and misoprostol on the Important Medicines Checklist.
All these organizations are doing superb work, however in terms of actually creating one thing that’s localized and built-in and addressing entry to abortion in a few of these most difficult contexts, there was one thing lacking.
Baker: How did you develop Aya Contigo?
Gill: We began in Venezuela in 2019. We obtained funding by way of Grand Challenges Canada to co-create Aya with over 1,000 Venezuelan ladies and a dozen native grassroots and formal healthcare supplier organizations.
We made no assumptions of what Aya Contigo was going to be. We wished to see, is it possible to have a digital resolution to help folks to self-manage their abortions? So, we went by way of this rigorous, human-centered design course of and had been capable of actually perceive what’s it that the ladies themselves want to have the ability to entry care.
It’s primarily an abortion doula—a digital abortion doula in your pocket. That’s what ladies wished. They wished an answer that makes them really feel like they will belief it, so it was actually helpful that it was primarily based on evidence-based data by the World Well being Group. However in addition they wished to have the ability to really feel like they’re speaking to a buddy. That it’s accessible to them. Aya Contigo is precisely that.
Additionally, we labored with cybersecurity consultants and legal professionals to guarantee that our app was fully safe and protected for customers in Venezuela, the place abortion is unlawful.
They wished an answer that makes them really feel like they will belief it, so it was actually helpful that it was primarily based on evidence-based data by the World Well being Group. However in addition they wished to have the ability to really feel like they’re speaking to a buddy.
Dr. Roopan Gill, OB-GYN
Baker: How does Aya Contigo work?
Gill: It gives customers end-to-end accompaniment from self-assessing that they may do the abortion with drugs, all the best way to taking the drugs and self-assessing that they’ve accomplished the method. It’s not simply an app by itself. Individuals have any individual they will speak to that’s actual. We’ve got a digital chat that’s embedded throughout the app and now we have our Aya Care Crew—counselors which might be nameless and obtainable 12 hours a day, seven days per week, to offer psycho-emotional, and navigational help to our customers.
We’ve reached near 9,000 customers although the app in Venezuela and accomplished over 1,000 chats there.
Baker: Why did you resolve to convey Aya Contigo to the U.S.?
Gill: I introduced at a Nationwide Abortion Federation convention. Individuals from M+A Hotline and Hey Jane got here as much as me after and requested, when can this come to the U.S.? How can we work collectively?
When the Dobbs determination occurred, we rolled up our sleeves and requested, what does Aya Contigo seem like in the USA? We tailored and launched the app for Latinas and Latinx of us in the USA as a result of our app is in Spanish already and we knew that the overwhelming majority of parents which might be being impacted by the Dobbs determination are Latinas and Latinx of us, particularly these in Texas, Florida, Arizona—these in essentially the most difficult contexts.
We talked to many stakeholders that work with Latinas who stated, ‘we’d like a Spanish-first useful resource. There’s nothing like this that exists in the USA, nothing that’s Latina-first.’ We partnered with Deliberate Parenthood Federation of America by way of their Innovation Accelerator to try it out, which helped us adapt the app shortly and launch it within the U.S. in September 2023.
We made it tremendous consumer pleasant and accessible for the Latina/Latinx consumer. We translated it to English. We bought it onto the Google Play Retailer in addition to the Apple Play Retailer and the opposite locations. We refer customers to high quality service suppliers on-line or in particular person, to get the drugs or surgical abortion. We even have sensible help.
We launched the chat within the U.S. in February of 2024. We’ve got bilingual counselors which might be offering help by way of the chat. Individuals join with us by way of the in-app chat or net chat, they usually also can entry us by way of a WhatsApp quantity. When folks contact us, our workforce responds immediately, often inside 5 to 10 minutes.
Baker: How do folks discover Aya Contigo?
Gill: We’ve got a powerful perception in motion constructing and neighborhood engagement. We realized this after we had been in Venezuela earlier than even launching the app that to construct belief and enhance our referral community, we wanted a neighborhood workforce.
We’re doing this within the U.S. by way of PPFA, Plan C, by way of our social media, by way of going to a bunch of occasions, by way of native companions which might be working instantly with Latinas, just like the Nationwide Latina Institute for Reproductive Justice. We’ve got met with a ton of organizations working with undocumented migrants and teams that aren’t essentially abortion-specific however are working with essentially the most marginalized communities. That is what we’re eager to do extra of this yr. We’re specializing in Texas and Florida and a few of these extra restrictive states.
When the Dobbs determination occurred, we rolled up our sleeves and requested, what does Aya Contigo seem like in the USA?
Roopan Gill
Baker: Are you able to clarify how the app works?
Gill: Certain, it’s a seven-step course of. Once you enter, Aya Contigo greets you as if it’s one in all your finest associates, saying, “Hola, soy Aya Contigo, I’m right here for you.”
The seven steps are primarily based on the WHO suggestions that an individual can self-assess eligibility, self-administer and self-assess for profitable completion. So the consumer can put of their final menstrual interval and reply a couple of questions associated to contraindications to the drugs, after which the app will inform them, nice, you are able to do an abortion with drugs, after which it’ll take them to the next steps on what to anticipate: what are the issues it’s possible you’ll wish to have round you, by way of ache management, nausea, heating pad and meals.
Then it exhibits them learn how to take the drugs, whether or not it’s mifepristone and misoprostol or misoprostol alone. We additionally advise the consumer what to do within the case of emergency, what to not say and to say if you must go the hospital, after which self-assessing that you just’ve efficiently accomplished the abortion.
And at last, now we have a post-abortion contraception guidelines that they will do to mainly information them on personalised contraceptive decision-making, and now we have a self-care part, which we actually really feel is vital to offer them personalised help. The chat will pop up in numerous components of the app, after which customers can join with us.
We are going to quickly be redesigning the app to make it much more seamless of an expertise for customers.
Baker: What do folks ask about?
Gill: Seventy % of our conversations have been to help our customers to entry drugs. We refer them to associate suppliers for entry, relying on the place they’re.
In the event that they’re in a banned or restrictive state, we refer them to the telehealth supplier Help Entry or to Las Libres, a neighborhood community that mails free abortion drugs.
In the event that they’re in a state that may be a defend state, then we’ll collaborate with the telehealth supplier Abuzz.
We attempt to seek advice from suppliers that received’t cost something, like Las Libres. Lots of our customers are undocumented. They will’t journey throughout state strains, they don’t communicate English completely, and possibly don’t even have medical insurance. So for them, Las Libres is the most suitable choice. We’ve got a fairly good relationship with them in order that we will make sure that the loop is closed.
If a consumer on the app goes to the useful resource part, we share sources relying on whether or not or not the consumer has a bank card or not. So, for instance, in the event that they don’t have a bank card, it is sensible to have them go to Las Libres immediately. We don’t even trouble sending them to Help Entry or Abuzz as a result of they must undergo an consumption course of and there’s a lot of worry, notably amongst those that could also be undocumented, to share particular particulars.
What’s very nice is our customers come again to us. We help them to get the drugs after which they arrive again and full the method with us. So we actually are filling this hole of accompaniment, empowering our customers, giving them the belief they don’t seem to be alone.
Baker: With Las Libres, are you assured that they’re mailing top-quality drugs?
Gill: Sure. My cofounder and I are each OB-GYNs, and I labored with the World Well being Group. I do know a lot about all of those activists and feminists, not solely in Latin America however globally, as a result of I’ve had the prospect to workwith them, take heed to their experiences and account for them as we labored on WHO pointers. We’ve got constructed belief. It additionally helps that I led the method for the WHO to get mifepristone and misoprostol on the Important Medicines Checklist so we ourselves have excessive requirements to make sure the companions we seek advice from are supplying quality-assured drugs. Las Libres are ensuring it’s quality-assured.
What’s very nice is our customers come again to us. We help them to get the drugs after which they arrive again and full the method with us.
Roopan Gill
Baker: Do you cost something for these companies?
Gill: No, we don’t. Our mission is absolutely clear: ensuring essentially the most underserved can entry our resolution.
Nevertheless, we’re exploring ways in which we will create revenue-generating partnerships, with on-line pharmacies or suppliers, like Deliberate Parenthood, who can be keen to pay for this service so it’s obtainable for all their subsidiaries and all their customers. I really need all these companions that we work with to see the worth in order that they don’t need to reinvent the wheel and create a brand new factor however can combine the app of their current applied sciences and subsidize the price of our care workforce. That’s how we’re envisioning to remain sustainable and scale and develop, whether or not it’s the U.S. and even for Latin America and globally. However proper now we’re counting on grants, philanthropic donations, particular person donors and household foundations.
Baker: How many individuals have you ever served within the U.S. up to now?
Gill: The Aya app has reached 447 new customers throughout 45 states, together with Puerto Rico and Washington, D.C., since September 2023. With the chat, now we have served 175 customers in 207 conversations throughout 32 states since February. About one third of our customers have prolonged conversations with us over a number of days.
Baker: Are you apprehensive about legal guidelines banning abortion?
Gill: We’re a Canadian-based group and our counselors should not in the USA. We’re offering hurt discount companies. Persons are going to get abortions whatever the regulation. Simply because you may have made it restricted, doesn’t imply that persons are not going to do it. They’re simply going to do it extra unsafely.
We’re offering data that’s vetted by docs and by the World Well being Group, in order that people who find themselves going to do it, no less than they need to do it safely with the precise data, which isn’t unlawful to offer.
Persons are going to get abortions whatever the regulation. Simply because you may have made it restricted, doesn’t imply that persons are not going to do it.
Roopan Gill
Baker: What suggestions are you getting from the folks you serve?
Gill: We’ve got a really strong monitoring and analysis course of. Our customers are mainly 99 % happy with the care that we offer.
One stated, “Thanks very, very a lot for accompanying me in these tough moments. I’m very grateful to have discovered this chat. Simply having somebody to speak to who isn’t judging me and isn’t concerned in my life giving me goal data is truthfully an enormous aid. Really an exquisite factor you’re all doing in such precarious occasions.”
We had one other consumer from the U.S. who was making an attempt to entry care in a not-restrictive state, however the girl was Catholic and was dealing with a tough determination as a result of it was an undesirable being pregnant. She had two different youngsters. Her husband promised to have a vasectomy, however didn’t. He forgot. They had been pregnant once more. The workforce supported her and talked about her issues and regrets.
She stated, “Thanks for all of the help and simply speaking issues by way of with me. It was so useful and I felt so significantly better afterwards.”
She self-managed her abortion with us, although it was in a less-restrictive state, as a result of she didn’t need folks to know and he or she was navigating the guilt of being a Catholic girl.
Simply having somebody to speak to who isn’t judging me and isn’t concerned in my life giving me goal data is truthfully an enormous aid.
Aya Contigo consumer
Baker: Are there every other companies much like yours within the U.S.?
Gill: We’re the primary to particularly attain out to Latinas. The M+A Hotline is offering medical help, and Reprocare is offering emotional help, however we’re the one which has an app, and the chat, and we’re additionally co-created. We’ve got centered our work round co-creating with customers and communities to make sure it’s built-in throughout the current ecosystems. Our care workforce represents our customers. Individuals wish to see themselves, somebody they will belief, even when it’s an nameless dialog.
All of us convey worth in numerous methods—M+A Hotline, Reprocare, Chat with Charley, Euki and Aya Contigo. We’d like all of us as a result of not one group goes to have the ability to entry everybody.
Baker: What would you like abortion suppliers in the USA to know?
Gill: I would love them to know that self-managed abortion is protected, accessible and efficient, as a result of I believe lots of abortion suppliers within the states are divided on this situation.
I need folks to additionally know that self-managed abortion is just not the panacea. It needs to be an possibility amongst different choices. So, if we’re selling SMA, we additionally want to make sure that folks can have entry to high quality suppliers in a clinic setting.
I need all abortion suppliers to obtain Aya Contigo and share it, not only for SMA, however for anybody of their abortion journey.
Baker: Is there anything you’d like Ms. readers to learn about Aya or your work?
Gill: We’re on a mission to fill this huge hole that exists round abortion entry. We wish to empower our customers and eradicate stigma. We wish no particular person to need to die of an unsafe abortion. Our work at Vitala International is demonstrating by way of Aya that although we’re targeted on localization, it’s a globally related situation. We’d love folks to observe us, and share Aya Contigo as a lot as potential with your mates, your loved ones and everyone.
Aya Contigo is out there on Aya Contigo web site in addition to Google Play Retailer and Apple Play Retailer.
You may make a tax-deductible contribution to help Aya Contigo at Buddies of Vitala.
