Commentary Contraception

Why I’m Skeptical of the Remote-Controlled Birth Control Chip

Abby Lippman

The device has the potential to remove control from women, since everything that can go wrong with remote-controlled devices could happen with this device.

If ever there was a dearth of really bad ideas, especially bad ideas masquerading as giving women “control” over their lives (dare I say, “empowering” them—a term on which I tend to choke), this one will fill the hole for many years.

What is this really bad idea? A Bill & Melinda Gates Foundation-funded “contraceptive implant with remote controlcurrently being developed, which is supposed to be ready for pre-clinical testing in the United States in 2015.

Referred to in the MIT Technology Review as a candidate for the elusive “perfect contraceptive,” this new wireless device will, once implanted under the skin, deliver via remote on/off control measured doses of levonorgestrel (an ingredient of birth control pills that are already on the market) daily for up to 16 years in the woman with the chip.

It’s hard to know where to start in enumerating all the imperfections of this device. But a couple of the problems include how it not only removes control from women, but places it in who-knows-who’s hands, since everything that can go wrong with remote-controlled devices could happen with this device. There really is no foolproof way to ensure that only “registered” people will have access to control the electric current needed to open the seal on the device to release the daily doses. Nor can there be guarantees that hackers won’t be able to access either the device itself or some interconnected computerized information or devices. And what about the potential mechanical failure of the device in the short or long term? What risks might there be from 16 years of use?

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The device, which can be turned on and off without a doctor’s assistance, eliminates the need for a woman to visit a clinic to obtain contraceptives. While some have been touting this as a positive thing, saying it puts the power in the users hands, it also means there will be no visits to ensure the safety of the drug in the woman’s system, no opportunity to ensure she is aware of the need for condoms to protect against sexually transmitted infections, and no way to stop the drug delivery on her own. In other words, just as with earlier implanted forms of contraception (for example, Norplant and more recent implants referred to as LARCs, or long-acting reversible contraceptives),a health professional must remove the device; the patient herself cannot. And though small, there will be visible scars where the device is inserted.

We’ve already been down this hazardous route with earlier versions of long-lasting contraceptive implants—and their often coerced use, especially among individuals thought not able to manage their bodies themselves (for example, teens and marginalized women). Despite beliefs that technology is the answer to women’s health needs, it is too often the case that technologies create even more needs from the damage they can do, especially when drugs are involved (such as diethylstilbestrol, a synthetic estrogen, which caused serious damage to children whose mothers had taken this drug while pregnant, or hormone treatment of women experiencing minimal symptoms linked to menopause, which has been associated with an increased risk for the later development of breast cancer and heart disease).

Yes, women, especially those in the global south or living in remote regions worldwide, do need safe, effective ways to ensure that they truly have a choice in their decision to have or not have children and to raise them as they want. With thanks to Loretta Ross for giving us a term for this, we need reproductive justice.

But it seems to me that this remote-controlled implant may be more likely to deliver injustice along with the hormones it releases, to the extent that it is likely to be tested on and applied to women for whom authentic informed choices may be limited because of their age or the circumstances of their lives.

The Gates Foundation and its partners might be better off investing in developing abortion and maternity services that are safe and accessible in all ways and access to health workers (not just physicians) for women.

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