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.
Ms. spoke with Gill, an OB-GYN with advanced training in complex family planning about her work with Vitala Global and Aya Contigo.
Carrie Baker: Why did you develop Aya Contigo?
Roopan Gill: I’ve always wanted to work in contexts that are the most challenging because if we don’t address the issues of the most underserved and marginalized, then we’re really not going to move the needle.
I worked with Doctors Without Borders in Yemen and Nigeria, as well as with the World Health Organization on their Preventing Unsafe Abortion team. I was involved in developing some of their guidelines and also getting mifepristone and misoprostol on the Essential Medicines List.
All these organizations are doing amazing work, but when it comes to really creating something that’s localized and integrated and addressing access to abortion in some of these most challenging contexts, there was something missing.
Baker: How did you develop Aya Contigo?
Gill: We started in Venezuela in 2019. We received funding through Grand Challenges Canada to co-create Aya with over 1,000 Venezuelan women and a dozen local grassroots and formal healthcare provider organizations.
We made no assumptions of what Aya Contigo was going to be. We wanted to see, is it feasible to have a digital solution to support people to self-manage their abortions? So, we went through this rigorous, human-centered design process and were able to really understand what is it that the women themselves need to be able to access care.
It’s essentially an abortion doula—a virtual abortion doula in your pocket. That’s what women wanted. They wanted a solution that makes them feel like they can trust it, so it was really valuable that it was based on evidence-based information by the World Health Organization. But they also wanted to be able to feel like they’re talking to a friend. That it’s accessible to them. Aya Contigo is exactly that.
Also, we worked with cybersecurity experts and lawyers to make sure that our app was completely secure and safe for users in Venezuela, where abortion is illegal.
They wanted a solution that makes them feel like they can trust it, so it was really valuable that it was based on evidence-based information by the World Health Organization. But they also wanted to be able to feel like they’re talking to a friend.
Dr. Roopan Gill, OB-GYN
Baker: How does Aya Contigo work?
Gill: It provides users end-to-end accompaniment from self-assessing that they could do the abortion with pills, all the way to taking the pills and self-assessing that they’ve completed the process. It’s not just an app on its own. People have somebody they can talk to that’s real. We have a virtual chat that’s embedded within the app and we have our Aya Care Team—counselors that are anonymous and available 12 hours a day, seven days a week, to provide psycho-emotional, and navigational support to our users.
We’ve reached close to 9,000 users though the app in Venezuela and done over 1,000 chats there.
Baker: Why did you decide to bring Aya Contigo to the U.S.?
Gill: 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 to English. We got it onto the Google Play Store as well as the Apple Play Store and the 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 WhatsApp number. When people contact us, our team responds right away, usually within five to 10 minutes.
Baker: How do people find Aya Contigo?
Gill: 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 these more restrictive states.
When the Dobbs decision happened, we rolled up our sleeves and asked, what does Aya Contigo look like in the United States?
Roopan Gill
Baker: Can you explain how the app works?
Gill: Sure, it’s a seven-step process. When you enter, Aya Contigo greets you as if it’s one of your best friends, saying, “Hola, soy 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 the case of emergency, what to not say and to say if you have to go 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 do to basically guide them on personalized contraceptive decision-making, and we have a self-care section, which we really feel is important to provide them 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 even more seamless of an experience for users.
Baker: What do people ask about?
Gill: 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.
Baker: With Las Libres, are you confident that they’re mailing top-quality medications?
Gill: Yes. My cofounder 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 workwith 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.
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.
Roopan Gill
Baker: Do you charge anything for these services?
Gill: No, we don’t. Our mission is really clear: making sure the most underserved can access our solution.
However, we are exploring ways that we can create revenue-generating partnerships, with online pharmacies or providers, like Planned Parenthood, who would be willing to pay for this service so it’s available for all their subsidiaries and all their users. I really want all these partners that we work with to see the value so that they don’t have to reinvent the wheel and create a new thing but can integrate the app in their existing technologies and subsidize the cost of our care team. That’s how we’re envisioning to stay sustainable and scale and grow, whether it’s the U.S. or even for Latin America and globally. But right now we are relying on grants, philanthropic donations, individual donors and family foundations.
Baker: How many people have you served in the U.S. so far?
Gill: The Aya app has reached 447 new users across 45 states, including Puerto Rico and Washington, D.C., 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.
Baker: Are you worried about laws banning abortion?
Gill: We’re a Canadian-based organization and our counselors are not in the United States. We’re providing harm reduction services. People are going to get abortions regardless of the law. Just because you have made it restricted, doesn’t mean that people are not going to do it. They’re just going to do it more unsafely.
We’re providing information that is vetted by doctors and by the World Health Organization, so that people who are going to do it, at least they should do it safely with the right information, which is not illegal to provide.
People are going to get abortions regardless of the law. Just because you have made it restricted, doesn’t mean that people are not going to do it.
Roopan Gill
Baker: What feedback are you getting from the people you serve?
Gill: We have a very robust monitoring and evaluation process. Our users are basically 99 percent satisfied with the care that we provide.
One said, “Thank you very, very much for accompanying me in these difficult moments. I’m very grateful to have found this chat. Just having someone to talk to who isn’t judging me and isn’t involved in my life giving me objective information is honestly a huge relief. Truly a wonderful thing you’re all doing in such precarious times.”
We had another user from the U.S. who was trying to access care in a not-restrictive state, but the woman was Catholic and was facing a difficult decision because it was an unwanted pregnancy. She had two other kids. Her husband promised to have a vasectomy, but didn’t. He forgot. They were pregnant again. The team supported her and talked about her concerns and regrets.
She said, “Thank you for all the support and just talking things through with me. It was so helpful and I felt so much better afterwards.”
She self-managed her abortion with us, even though it was in a less-restrictive state, because she didn’t want people to know and she was navigating the guilt of being a Catholic woman.
Just having someone to talk to who isn’t judging me and isn’t involved in my life giving me objective information is honestly a huge relief.
Aya Contigo user
Baker: Are there any other services similar to yours in the U.S.?
Gill: We’re the first to specifically reach out to Latinas. The M+A Hotline is providing medical support, and Reprocare is providing emotional support, but we’re the one that has an app, and the chat, and we’re also co-created. We have centered our work around co-creating with users and communities to ensure it is integrated within the existing ecosystems. Our care team represents our users. People want to see themselves, someone they can trust, even if it’s an anonymous conversation.
All of us bring value in different ways—M+A Hotline, Reprocare, Chat with Charley, Euki and Aya Contigo. We need all of us because not one organization is going to be able to access everyone.
Baker: What do you want abortion providers in the United States to know?
Gill: I would like them to know that self-managed abortion is safe, accessible and effective, because I think a lot of abortion providers in the states are divided on this issue.
I want people to also know that self-managed abortion is not the panacea. It has to be an option amongst other options. So, if we are promoting SMA, we also need to ensure that people can have access to quality providers in a clinic setting.
I want all abortion providers to download Aya Contigo and share it, not just for SMA, but for anyone in their abortion journey.
Baker: Is there anything else you’d like Ms. readers to know about Aya or your work?
Gill: 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. Our work at Vitala Global is demonstrating through Aya that though we are focused on localization, it is a globally connected issue. We’d love people to follow us, and share Aya Contigo as much as possible with your friends, your family and everybody.
Aya Contigo is available on Aya Contigo website as well as Google Play Store and Apple Play Store.
You can make a tax-deductible contribution to support Aya Contigo at Friends of Vitala.
