Sure, the latest initiatives from the Teslas, Apples and Googles of the industry tend to dominate the tech news space — and with good reason. Still, the tech titans aren’t the only ones bringing innovation to the sector.

In an effort to highlight up-and-coming startups, Built In has launched The Future 5 across 11 major U.S. tech hubs. Each quarter, we will feature five tech startups, nonprofits or entrepreneurs in each of these hubs who just might be working on the next big thing. Read our round-up of D.C.’s rising startups from last quarter here.

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On June 24, the Supreme Court overturned Roe v. Wade, the landmark decision that asserted abortion care was a protected right under the Constitution. Now laws regarding abortion access fall under state jurisdiction, causing many states to restrict or all-out ban abortion procedures. For many, this is a devastating blow and means some organizations that previously provided abortion access have to cease procedures or shut down entirely.  

Despite this, there are still many organizations dedicated to continuing to make abortion care accessible. Carafem is one such organization. The D.C.-based nonprofit offers comprehensive reproductive healthcare, including at-home telehealth abortion care.

The nonprofit was founded by parent organization DKT International, which seeks to increase accessibility to family planning and HIV care in geographic locations most in need of such services. In 2013, the organization realized that the U.S. was experiencing similar gaps in reproductive and abortion care as seen in developing countries. This was due in large part to the shrinking availability of abortion providers. Chris Purdy, DKT’s president and CEO, thought some of the strategies learned internationally could be used to provide these services in the U.S., Melissa Grant, carafem COO, told Build In in an interview.

With that in mind, carafem was founded and opened its first clinic in Chevy Chase, Maryland, in 2015. Since then, the organization has opened additional centers in Atlanta, Chicago and Nashville. Carafem also offers telehealthcare options to patients in 14 states and D.C. and has done so since before the pandemic. 

“[Carafem] remains steadfast in continuing to provide abortion care and sexual and reproductive health care services to people who need them.”

While the organization provides a number of reproductive healthcare options, including birth control, family planning and STI and STD testing, carafem is best known for its medically supported at-home abortion options, something the organization doesn’t shy away from mentioning. Carafem’s marketing proudly proclaims, “Abortion. Yeah, we do that,” representing the organization’s unflinching dedication to making abortion care accessible and easier to talk about.

One of the reasons carafem offers medically supported abortion care at home is due to the number of restrictive laws around abortion as well as the lack of healthcare access in rural areas. Americans in need of abortion care travel an average of 11 miles to receive care and 20 percent travel more than 43 miles. Travel is enough of a barrier that there are multiple grants and funds Americans in need can apply for just to cover travel costs.

Carafem is dedicated to filling those gaps by offering abortion pills delivered directly to patients’ doors in states where it’s legal to do so. Patients simply schedule a telehealth appointment with a carafem physician and meet with them over video. Afterward, carafem mails the patient abortion pills that are discreetly delivered in one to three business days. 

Once the pills arrive, patients simply follow the instructions from their physician. Patients can also opt-in to an AI-enabled text-based “health bot” named Cara which will guide them through taking both pills, remind them when they need to take the second dose and answer any questions they may have. If Cara can’t answer someone’s question, it immediately connects them with a carafem physician. 

carafem consult room
A carafem consult room where patients can receive either in-person or virtual care. | Photo: Carafem

Grant said Cara makes it easier for patients to bring up any worries or questions that they might not otherwise feel comfortable mentioning to a doctor. 

“Having that reassuring presence to say, ‘There are no dumb questions; you can absolutely ask’ [is really helpful],” Grant said. “What this has done is decrease the amount of time when a client might sit at home, thinking ‘I’m not sure what to do,’ which is just emotionally excruciating for people. ... [With Cara] the questions are being answered much, much more quickly.” 

Since the overturn of Roe v. Wade, carafem says it has seen a large uptick in traffic to its website. Carafem is currently navigating the new climate of increasingly restrictive access to abortion care. At its Tennessee offices, where abortion is banned after six weeks, healthcare workers are trying to help as many people as they can, but many of their patients are now having to travel out of state to receive care.  

“Carafem is working to make appointments available as soon as possible in our health centers and for abortion pills through the mail after a video chat in states where that option is available. In some communities, we are able to make same-day appointments available; in others, we are striving to add appointment times as quickly as within a few days,” Grant told Built In in an email. “Carafem is also working to increase awareness of the nationwide support for abortion with our carafem BFF (Bodily Freedom Fighter) campaign. We believe that the majority of Americans support legal access to abortion care and making their support known helps not only pregnant people know who to trust but decreases abortion stigma nationwide.”

For those in states where abortion pills and telehealth appointments to receive such prescriptions are banned, carafem is doing its best to support these patients. Patients have the option of traveling across state borders to one of the 15 states carafem offers by-mail abortion pills. If they choose this option, their virtual appointment will take place in said state and their prescription will be delivered to an address in that state one to 3 business days later. It’s not a perfect solution, but is one of the few options for those living in restrictive states. 

“We are deeply concerned about the continued rollback of abortion access as extremists try to undermine our basic human rights. We take hope from the movement across the country to support our work and we will keep fighting until all people have the freedom to make their own decisions about their lives and their reproductive health,” Grant said. 

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