Reproductive health care faces legal and surveillance challenges post-Roe – new research offers guidance

Pregnancy Panopticon — S.T.O.P. - The Surveillance Technology ...

Long before Roe v. Wade was overturned, reproductive justice advocates had been sounding the alarm about the increasing number of women subjected to criminal investigation for suspected abortion, stillbirth or miscarriage. These cases were often initiated by health care providers and bolstered by state laws used to prosecute women for having abortions.

Newer laws, however, incentivize people outside of health care, including friends and family members, to report someone they suspect of having an abortion or helping someone else with an abortion. Coupled with the unprecedented access that authorities now have to digital information, these laws create new avenues for prosecution.

In the post-Roe era, people capable of pregnancy face growing threats. Health care providers, family, friends, information on personal devices and virtually any activity that can be observed or recorded pose privacy risks that can lead to prosecution. I study online privacy. This vast scope for potential surveillance and privacy intrusion is a key focus of the research my colleagues and I conduct.

In a recent paper, we surveyed reproductive health care providers about their privacy and security practices. We used the results to map the path of a hypothetical “Jane” to illustrate how people can identify privacy risks in their own situations. This choose-your-adventure approach helps readers navigate the potential legal, digital and personal challenges involved in accessing reproductive health care – and reveals the grim stakes.

Privacy protections

Historically, health care providers who opposed abortion have been the primary sources for reporting patients suspected of seeking abortions. While they remain a significant threat, additional risks to patient privacy have emerged. For example, state laws increasingly compel providers to hand over medical records.

This circumvents new Health Insurance Portability and Accountability Act protections meant to shield protected reproductive health information from use in investigations when people seek abortions in states where the procedure is legal. Authorities might also be able to access records across state lines where abortion is legal – for example, when different electronic health record systems can share data.

It is also possible that, in the future, electronic health records could be seized across state lines. Last year, in a letter to the U.S. Department of Health and Human Services, 19 state attorneys general protested the new federal data privacy rules. Texas followed up with a lawsuit against the Biden administration over the rule.

Even so-called shield laws adopted by some states meant to protect people seeking abortions from record seizures have loopholes.

Under the Biden administration, the U.S. Department of Health and Human Services added a privacy rule to protect reproducitve health data.

Privacy…

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