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Robot uteruses and the quest to end unintended pregnancy

A robotic pelvis, a federal policy, and a huge shift in birth control access.

Byrd Pinkerton/Vox

In a refurbished bank building in Wilmington, Delaware, there’s a small classroom. It has a projector, neon posters on the wall, and several tables with pairs of plastic model uteruses scattered across them.

A dozen or so clinicians have come here to learn how best to insert IUDs into these uteruses. Once they’ve practiced on the low-tech models at their desks, they can try out a more high-tech model in the back. It’s a robotic replica of the female pelvic area, complete with a vagina, cervix, and uterus, that groans in pain when an IUD is inserted incorrectly. The staff has named it “Joan.”

The goal is to let the clinicians refine their technique on models like Joan instead of on real humans.

Sarah Kliff tries to insert an IUD into “Joan,” the pelvic simulator.
Sarah Kliff tries to insert an IUD into “Joan,” the pelvic simulator.
Byrd Pinkerton/Vox

All of this — the classroom, the models, the training — is provided by Upstream USA, a nonprofit that launched in 2014 to help health clinics provide their patients with a wide range of birth control options. And they work with the whole clinic staff. While clinicians brush up on insertion, everyone else, from technicians to receptionists, learns how to answer questions about the various birth control methods, including IUDs.

IUDs are a type of LARC, or “long acting reversible contraceptives.” These are forms of birth control that you can put in once and leave in for months or even years. Research shows LARCs are way more effective at preventing pregnancy than birth control pills: 18 of every 100 sexually active women who rely on the pill become pregnant within a year. For women who use IUDs, fewer than one in 100 will become pregnant over the same time frame.

On this episode of The Impact, we’ll talk about the work Upstream is doing, and how it’s been paired with a number of state and federal policies designed to make these LARCs more accessible.

These policies have helped to drive down abortion rates and teen pregnancy rates in several states. But they are under siege right now.

Subscribe to The Impact to hear this and other episodes. Leave us a review telling us what you thought — impact@vox.com. And read more of Kliff’s coverage of this issue.

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