Wearables were starting to demystify reproductive health — then Roe fell

In early May, Ben Smarr published a new study showing that the Oura smart ring can detect pregnancy before most people take a test. It was an exciting finding — earlier detection of pregnancy based on wearable devices could, he wrote in the paper, “increase the agency of pregnant individuals.”

Smarr, a data scientist at the University of California, San Diego does research on wearable devices and health — including reproductive health. He’s working with Oura on other projects around pregnancy. His team is also looking to see if data from devices can detect miscarriages.

Reproductive health in general — and its intersection with wearables in particular — is an often underexplored area of research. The applications were exciting. But the work took on a new dimension in June, when the Supreme Court overturned Roe v. Wade. Now that there are no longer federal protections for abortion — and some states will prosecute people for seeking reproductive healthcare — Smarr and his team are taking a step back. In the new political landscape, they’re reconsidering the best approach to their research.

“Are we building systems that are going to be used to hurt women instead of help them? That’s pretty chilling,” Smarr says.

At the start of the COVID-19 pandemic, a flood of resources went into researching the ways wearable devices like smartwatches and smart rings can detect various changes in the body. Various researchers, including Smarr, started looking to see if the devices could detect early signs of COVID-19. It was difficult, though, because many of the signs of the illness were nonspecific — teams struggled to figure out how to distinguish COVID-19 from other illnesses.

Things like pregnancy and changes in pregnancy might be easier to tease out, says Jessilyn Dunn, a digital health researcher and assistant professor at Duke University. “Core body temperature is very accurate in terms of detecting ovulation and those sorts of things,” she says. “I think there’s a lot of promise here.”

While there is promise, research is still in its early stages. Smarr’s pregnancy detection study, done in partnership with Oura, was only an early look to see if that kind of detection would even be possible. And normally, Smarr says, he’d be trying to move as fast as possible. “In part, it’s selfish — you’re building a career,” he says. “But you’re moving fast because you want to make a positive difference.”

Now, under the new reproductive health and political landscape, he’s wondering if and how things might need to slow down. His team has started having conversations about what their work might be used for. Early pregnancy detection could, in theory, be helpful for people in places where there are limits on how far along in pregnancy someone can be and still get an abortion. But it also means there’d be clear data showing that someone was pregnant, which could be used against them if that pregnancy ends.

The research on miscarriage detection is even more concerning. “We’re probably the closest to building exactly the tool that you wouldn’t want to give the bad guys,” Smarr says.

Digital health researchers should always be thinking about the context that their work could be used in, Dunn says. “I think anything that criminalizes something that’s related to healthcare is dangerous,” she says. “And it makes it difficult as researchers to understand what our role is and should be in this space.”

Smarr says his team is still trying to sort out their approach going forward. He’s reached out to his colleagues at Oura as well. Oura CEO Tom Hale said in a statement to The Verge that the company is adding additional safeguards to data and preparing adjustments to its privacy policies.

But, no matter where the research teams land, other factors could slow research in this space. Digital health studies tend to have more participation from women than men, Dunn says. But the end of Roe v. Wade could have a chilling effect on how willing people are to share their data with research teams over concerns it could be used against them one day, Smarr says. And that alone could stymie what these teams are able to accomplish.

“I think we can expect that this will have a pretty serious negative impact on the rate at which we’re able to do research,” he says. “We are so bad at women’s health. We’re already so far behind. And the idea that you can use fear to keep people ignorant — it’s such a bleak vision for society.”