When Bethany Edwards and Anna Simpson invented the world’s first flushable pregnancy test, they were trying to save the environment—not women. The idea was simple: Make a medically-accurate test out of sustainable materials instead of the non-biodegradable plastic that current manufacturers use. “Single-use diagnostics are only used for a few minutes and then discarded or incinerated,” Edwards explains. “Discarded plastic [pregnancy test] housings are landfill-bound, existing far beyond the product’s extreme short lifecycle.”
So together, Edwards and Simpson, who met at UPenn during grad school, formed Lia Diagnostics. The test—which is 99 percent accurate on the first day of a missed period, and has has been cleared by the FDA—is slated for online sale (at $10 a pop) starting mid-2018. The test is simple, really: It looks like any other pregnancy stick test, but pinched in the middle and with an edge that looks pin-pricked like a sanitary pad. Lia Diagnostics’ website claims it goes down as well as 3-ply, a toilet paper weight that rural plumbing can’t handle but that city toilets flush just fine.
This flushability, Edwards says, “was part of our very initial research; it was a clear, unmet need that drove the overall product design.” As she and Simpson conducted that research, asking women whether they’d use the test, they heard stories about people taking pregnancy tests at work to hide their results from someone at home. Some women told them about their need to hide sticks deep within the trash. That’s when Edwards realized the difference their product could make was much more than environmental.
“Reproductive coercion is definitely a part of intimate partner violence,” says Nancy Neylon, executive director of Ohio Domestic Violence Network, a Columbus-based non-profit assisting domestic violence shelters throughout the state. She defines reproductive coercion as a type of sexual abuse that manifests in many ways: “This can include forced, unprotected sex in order to ensure pregnancy, tampering with birth control, even threatening to have sex with another woman and get her pregnant. Abusers are sadly very creative as they try to achieve and maintain control over their partners.” In this sick quest for power, the same plus sign that brings some women joy brings an abuser new information they can use to control their partner.
The ability to keep pregnancy test results secret could save lives, National Coalition Against Domestic Violence (NCADV) associate director, Gretchen Shaw, tells me plainly. “[I]t’s not a perfect answer,” Neylon adds. “If [a woman was] pregnant and wanted to get away from the abusive relationship without the abuser knowing about the pregnancy, this would be helpful. Of course if she is, then there are other decisions she needs to make. But [she] could make those decisions more safely.”
After next year’s launch, the test will be available for purchase on pre-order at MeetLia.com. (If internet use is monitored at home, women can use incognito browser at the library.) Lia Diagnostics then ships it to you, thankfully, not in a conspicuous envelope. “We're working very hard to balance the FDA requirements and maintain discretion,” Edwards says. The test itself is thin enough to slip inside a traditional, discrete mailing envelope.
Neylon says 1 in 4 women who experience partner abuse—be it sexual, emotional, or physical—face reproductive coercion. The concern is so widespread, she believes it needs its own place on the Power and Control Wheel, a diagram listing patterns of abuse that domestic violence professionals use to guide victims through awareness of their situation.
“[Reproductive coercion] is very widespread but something women may not even recognize themselves,” Neylon says. “Women may not understand that abuse can be something other than physical violence. They may think if they are married that it’s his right to demand sex and have children. The abuser may damage the condom without telling her, the abuser may engage in unprotected sex with HIV or an STD without telling her, or she may have sex to avoid promised physical abuse.”
While a flushable pregnancy test can’t eradicate reproductive coercion altogether, it could help prevent forced abortions, or keep an abuser from literally beating the child out of someone—both real-life scenarios women have shared with me when I was working at domestic violence shelters.
Neylon says women’s health providers need to step up and do a better job of addressing reproductive coercion at large. “All healthcare settings should have a written protocol for screening and responding to intimate partner violence that includes reproductive coercion,” she says. And once they do, that protocol should be followed.
After an at-home positive, many women go to the doctor to verify results. Flushing a plus sign down the drain doesn’t help anyone if your partner follows you into the exam room or an overly cheerful nurse says congratulations to him in the lobby. “[D]octors’ offices or health clinics that have a relationship with the patient for reproductive health appointments [should ask] questions like ‘Has your partner ever pressured you to get pregnant, not let you use birth control, [or] refused to use condoms?’" she says. "This of course must be done privately and referrals to [domestic violence] programs should be available.”
Whether you’re worried about pregnancy or not, if your relationship is unsafe, seek help. If you’re not sure if you’re being abused, or if you don’t want to make a decision immediately, call 1-800-799-7233 to talk to someone at the National Domestic Violence Hotline. Live chat is also available 24/7 as well.
Correction: Due to an error introduced during editing, a previous version of this story incorrectly states that the Lia pregnancy test is FDA "approved." It is has been cleared by the FDA.
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