Building healthy families and futures depends on digital equity

In a pandemic, a lot of things in our lives get put on hold. But essential health care can’t wait. And it doesn’t get much more essential than sexual and reproductive health care — the very services that allow people to plan whether and when to get pregnant and to build the healthy families and futures of their dreams.

That’s why, when COVID-19 hit Maine, we at Maine Family Planning (MFP) sprang into action to expand our existing options for telehealth care. We operate 18 clinics around Maine, and for many patients, we are their only source of regular health care. From Fort Kent to Lewiston, Norway to Machias, and lots of places in between, folks rely on us for high-quality, affordable birth control, diagnosis and treatment for sexually transmitted infections, routine gynecological care, transgender health care, and abortion care, all in their local communities.

Thanks to our long-standing investment and expertise in telehealth, we were able to shift many types of care online. We reworked protocols so that patients can now access more of the care they need from home (or the car, backyard, front stoop, barn or wherever they are). For overwhelmed parents, struggling Mainers, college students, and people who live rurally, these Virtual Visits have made it possible to stay on top of their sexual and reproductive health, even as other aspects of life seem to spin out of control.

Furthermore, caregiving via telehealth allows us to reduce foot traffic and virus transmission at our clinics. In Maine, which has the nation’s worst Covid-19 racial disparity, we have a heightened responsibility to provide essential care in a way that helps keep our Black neighbors safe and healthy.

Notably, telehealth actually expands access to care for some patients who previously faced different hurdles, such as finding transportation to the clinic or having to schedule medically unnecessary appointments. We are beginning to recognize the potential of telehealth in our field, and it is very exciting.

But we know not everyone can access care this way. The peace of mind and continuity of care that telehealth provides – all the time, and especially amid social upheaval – is only available to people with reliable, high-speed Internet, as well as proper devices and a certain amount of digital literacy.

In other words, those without the ability to connect virtually during the pandemic don’t have the same health care options as their better-connected peers. They are forced to either seek in-person care (regardless of their comfort or ability to do so) or forego care altogether. Unsurprisingly, disparity in who has access to quality Internet service falls along entrenched lines of inequity, with rural, low-income, and Black, Indigenous and other people of color less likely than white, urban, and middle- or upper-class peers to have reliable Internet access. This connectivity gap merely compounds other factors that make it hard for some patients to access our services in the first place, and it could have profound consequences. In a moment when 65 percent of U.S. adults say now is a bad time to get pregnant, uninterrupted access to birth control and other reproductive health services from a trusted provider is a matter of survival and fundamental well-being.

The last few months have brought the “digital divide” into sharp relief in most areas of our lives. One critical way to start to close that gap is to invest in our communities by expanding high-quality, high-speed Internet access in Maine. That’s why MFP urges voters to say Yes on Question 1, a statewide bond question which would provide much-needed funding to expand Internet infrastructure in unserved and underserved parts of the state.

We see digital equity as an important component of reproductive justice, which is the human right to bodily autonomy, to have or not have children, and to parent the children we have in safe and sustainable environments. Of course, access to high-quality, affordable, evidence-based care should not depend on your income, race, zip code, gender identity, insurance status or Internet connection. Beyond the provision of health care, we know Internet access affects education (including comprehensive sexuality education, which has suffered in the age of remote learning), employment and economic security, civic participation, mental health and recovery, and more. Every aspect of our ability to plan our reproductive futures and raise healthy families intersects with our ability to be online.

We want so much more than for people to survive — we want them to thrive. Better internet access is required for both.

Photo: Maine Family Planning nurse practitioner Sara Hayes holds a Telehealth appointment. | Molly Haley Photography