Karley Sciortino, a sex influencer, former Vice columnist and the founder of the blog Slutever, is known for her unfiltered writing on kink and dating (a sample advice column is titled “Should I Be Double-Teamed by a Couple Twice My Age?”) . On Instagram, she occasionally posts sponsored content promoting personal lubricants and vibrators: short, confessional clips shot against her bright pink bedspread.
Last month, a company called Wisp approached her about promoting its emergency contraception product, which can be ordered online and delivered straight to patients’ doors. The ad she wound up producing for it is almost indistinguishable from her vibrator content, featuring Sciortino sprawled on her bed in hot-pink lipstick, recalling her visits to judgmental doctors to get Plan B as a teen. “Sometimes they’d be like: ‘Why do you need it?’ And it’s like: ‘Take a wild guess, bro,’” she jokes.
The video is in keeping with Wisp’s other marketing: pastel-pink Instagram posts, pop-art posters bearing images of blurred-out, cherry-red vulvas. On its website, birth control pills and emergency contraception are arranged appealingly on colorful blocks, a perfectly manicured hand holding a NuvaRing descending from the sky. The overall effect is “a little bit Glossier”, Sciortino said with a laugh.
Since the fall of Roe v Wade almost two-and-a-half years ago, direct-to-consumer women’s health companies like Wisp have flourished, offering birth control and emergency contraceptives on demand with the same glossy branding found in a Sephora aisle. The companies claim they remove much of the inconvenience, shame and stigma that often accompany a trip to the doctor or pharmacy, and provide alternate methods of access to contraception at a time when clinics are shuttering and legislators threaten to make providing even the most basic of women’s healthcare a crime.
But they also turn what is often a life-altering medication into a trendy consumer product; commodifying its use and spinning the social and political conversation around it into a marketing strategy. “These companies have a financial interest in patients they serve utilizing the medications they promote,” said Suzanne Bollmeier, a professor of pharmacy practice at the University of Health Sciences and Pharmacy in St Louis. “These are unchartered waters.”
Patients have been able to access contraceptives via telehealth for nearly a decade; Planned Parenthood started offering virtual care as early as 2016. But after the fall of Roe v Wade in June 2022, as lawmakers began restricting access to abortion and threatened to do the same for contraceptives, online providers said demand surged. (The telehealth service Nurx said it saw a tenfold increase in requests for emergency contraception in the months after Roe fell, according to CNN.) There was a corresponding rush of interest from venture capital investors: “That crisis put everyone on alert,” said Erika Seth Davies, the CEO of Rhia Ventures, a company focused on funding reproductive health. “There was actual attention on reproductive health needs because … all of a sudden it was under threat.”
Brands like Wisp, Nurx, Hey Jane and other playfully named competitors rolled out new services and bold marketing campaigns. The online pregnancy test retailer Stix started selling emergency contraceptives the same week Roe fell, later rebranding as Winx, a one-stop sexual health shop. Julie Schott, the marketing whiz behind Starface acne stickers, co-founded her own eponymous line of emergency contraceptives in September 2022, with the explicit purpose of reducing stigma around the product for younger generations. And Hey Jane, an abortion pill delivery service inspired in part by the success of direct-to-consumer erectile dysfunction drug providers like Hims, expanded to providing birth control and Plan B just this year.
These brands promise discreet, efficient care, ordered online – and in many cases, delivered straight to your doorstep. Some, like Julie, offer only over-the-counter medications like Plan B, while others, like Wisp, Winx and Nurx, offer online consultations with physicians, either on staff or outsourced from other companies. All avoid the kind of awkward interactions with physicians and pharmacists that Sciortino described, or the hassle of getting to a doctor’s office in an ever-shrinking landscape of women’s health clinics. “I didn’t realize that now you can just have the morning-after pill in your cabinet and you don’t have to talk to anybody,” Sciortino said of her interaction with Wisp. “I really do believe that is life-changing.”
Though delivered discreetly, the products are marketed boldly, with powder-pink packaging meant to be displayed and PR campaigns designed to start conversations. Julie, Schott’s emergency contraceptive brand, handed out free products at an Olivia Rodrigo concert this spring (although Rodrigo stopped the practice at later shows following a rightwing backlash). They also recently debuted a small, hot-pink handbag meant for carrying the product in public (“Saturday morning nightstand check”, read a recent Instagram post, showing the bag on a bedside table). Wisp, meanwhile, became the first company ever to use the word “vagina” on a billboard in Times Square last year. The audacious campaigns are part mission statement, part marketing strategy – a means of inserting themselves into the growing national conversation about reproductive health, according to Wisp’s vice-president of marketing, Jennifer Dwork. “We really just try to be as bold as we can be, because we only have a couple of seconds to grab people’s eyes and ears,” she said.
Other brands have leaned into the politics around their products, using the rollback of reproductive rights as fodder for TikTok and Instagram content. Winx hosted an activation at a “Hotties for Harris” event at the Democratic national convention and recently released a line of sweatshirts reading “vote with ur v@g”. (Its homepage currently features links to both buy the sweatshirt and check your voter registration.) The company’s founders, Cynthia Plotch and Jamie Norwood, said they felt called to this kind of activism: “We can’t morally and ethically run this business and advocate for what we advocate for without being involved in this conversation,” Plotch said. It’s also what a new generation of consumers demands: the brand’s social impressions increased more than 300% in the week after the Democratic convention, Norwood said.
The result has been a sea change not only in the way these products are delivered, but in how they’re viewed: not as shameful, or a secret, but something to be shopped and shown off. “The way women are delivered healthcare at the clinical level and the consumer level, it’s embroiled with shame,” said Kaitlyn Barclay, a branding and communications expert who works with companies including Hey Jane. These brands are “using really savvy marketing tools to destigmatize healthcare that everyone should have access to”.
But this shift also means that the first interaction many young women may have when accessing healthcare won’t be with a doctor, but a brand.
In some ways, this can be helpful: for relatively low-risk products, like UTI medication or even abortion pills, and especially for over-the-counter medication, like Plan B, there’s little risk to patients self-selecting their treatment. (As Sciortino points out, most women don’t need a doctor to tell them when they have a yeast infection.) With clinics overrun and healthcare costs surging, Anna Wexler, a professor of medical ethics and health policy at the University of Pennsylvania, said there was an argument to be made that contraception should be easier to access. But this model also risks breaking down the physician-patient relationship and encouraging “medication shopping” rather than a “holistic look at the patient’s overall health needs”, Wexler said.
Other researchers have pointed out similar concerns, noting that telehealth companies don’t provide the services offered by OB-GYNs in person, like pap smears, breast exams and even blood-pressure checks. Ordering birth control online, said the Rand researcher Lori Uscher-Pines, “could be a missed opportunity to get much-needed preventative care”.
Breaking down the doctor-patient relationship also means less of a barrier between patients and the companies trying to sell them a cure. The Food and Drug Administration (FDA) rules that regulate how pharmaceutical manufacturers advertise their products do not apply to the doctors and telehealth companies that sell them, noted Bollmeier. Neither are required to name an FDA-approved use of the drug or list its side effects, or balance a drug’s efficacy and its risks. A Wall Street Journal investigation into ads for online mental health companies found many of them used paid actors posing as patients and promoted uses other than those approved by the FDA.
But Amy Hagstrom Miller, the founder of Whole Woman’s Health, a national chain of women’s health clinics, said she wasn’t concerned about these drugs being prescribed online. “Let’s be honest – if men got pregnant, we would have abortion pills at Starbucks,” she said, noting that the two-pill regime is proven to be safer than Tylenol. For even lower-risk drugs like emergency contraception and birth control, she added: “The reason they’re being withheld is rooted in stigma, it’s rooted in shame.” Her clinics have been providing both in-person and telehealth services since 2009, she said. “There are some people who have been on a prescription, have had all the screenings, who know what they need, and others who need a doctor’s visit,” she explained. “I’m always a both-and kind of person.”
Indeed, the founders of many telehealth startups see their services as a complement to the work of brick-and-mortar clinics, not a competitor. Plotch, the Winx co-founder, noted more than a third of counties in the US are currently without an OB-GYN, a number that is only rising as clinicians flee states with restrictive abortion laws, fearing they will be arrested for simply doing their jobs. Brands like Winx are simply filling the gap that this dwindling number of in-person providers creates, she argued, adding: “We can’t pick one thing and say clinics are the only way to do it, because that’s not feasible.” Davies, the Rhia Ventures CEO, agreed, arguing that it “shouldn’t have to be this false choice of this binary”.
“We need all of it,” she said. “And we’re still half the population, so we should get all of it.”