The average healthcare data breach now costs $9.8 million, but for reproductive health data, the stakes extend far beyond financial penalties. Healthcare providers now face potential criminal liability and staff reluctance to document care—not to mention the operational nightmare of maintaining different data practices across U.S. state lines.
As HIPAA faces mounting criticism from across the political spectrum and Americans’ trust in healthcare plummets to 40%, healthcare leaders face an urgent question: How can organizations protect sensitive data when the regulatory ground continues to shift? This article helps CIOs and CPOs build comprehensive reproductive health data governance frameworks that anticipate policy changes and prioritize patient trust, no matter the type of care.
How Dobbs created data chaos across state lines
The Supreme Court’s 2022 Dobbs v. Jackson Women’s Health Organization decision did more than just overturn Roe v. Wade—it exposed gaps, uncertainties, and challenges in HIPAA’s ability to protect reproductive health data. This has never been more apparent than in 2025, when the same data is treated differently depending on geography:
Abortion reporting requirements: Texas mandates extensive abortion reporting including patient demographics, payment methods, complications, reasons for the procedure, and compliance with state counseling requirements. New York, on the other hand, only reports if a patient specifically requests certain information.
Digital health app protections: Virginia prohibits search warrants or subpoenas for menstrual and fertility data from third-party apps. Conversely, states like Texas and Louisiana offer no such protections, leaving period trackers and fertility apps open to law enforcement requests during abortion investigations.
Interstate data sharing restrictions: Washington’s My Health, My Data act blocks sharing reproductive health data with out-of-state law enforcement if the data could be used to investigate or penalize care. Meanwhile, 17 states are suing to invalidate HIPAA protections, potentially exposing patients and providers to criminal liability across state lines.
If your healthcare system operates in multiple states, you already know how this regulatory patchwork leads to a volatile data governance situation. These conflicting requirements create serious business risks for organizations, with documented cases showing the increasing costs of inadequate preparation.
The business case for proactive data governance
As mentioned earlier, the financial and reputational stakes for protecting reproductive health data continue to escalate as existing frameworks fall short. Here are a few examples of actual liability cases involving healthcare organizations and breaches of reproductive health data:
Impermissible disclosure: In Pennsylvania, a patient authorized Holy Redeemer Family Medicine to release a single test result unrelated to reproductive health to a prospective employer. Instead, the provider disclosed the patient’s full medical record, including reproductive health information. The Office for Civil Rights (OCR) fined the organization $35,581 for impermissible disclosure under HIPAA.
Unauthorized access: Gulf Coast Pain Consultants in Florida allowed a former contractor to access 34,310 patient records, including reproductive health information. OCR found failures in risk analysis, access control, and monitoring, resulting in $1,190,000 in fines for multiple HIPAA Security Rule violations.
Network security breach: ORM Fertility in Oregon recently experienced a security breach involving unauthorized network access. While electronic medical records were reportedly not accessed, some patient data—including fertility-related lab data—was exposed. ORM reported the breach to HHS, and review is ongoing.
These incidents illustrate how reproductive health data governance failures create cascading risks that go far beyond initial breach costs. Healthcare leaders who implement technical safeguards can help their companies address vulnerabilities proactively rather than face penalties and investigations after incidents occur.
Technical safeguards for reproductive health data protection
CIOs looking to guide their companies through policy changes regarding reproductive health data should implement the following safeguards. These measures protect organizations from penalties and investigations while preserving patient trust:
Encryption standards and compliance: Conduct an immediate audit of all systems handling reproductive health data to identify encryption gaps, then implement current industry-standard encryption for data at rest and in transit with established guidelines.
De-identification framework development: Use research-based de-identification methods to scrub data of both obvious (e.g. name, contact information) and indirect identifiers (device IDs, usage patterns, location data) that could compromise patient anonymity. Train data teams on the heightened sensitivity of reproductive health information with clear approval workflows for data access.
Cloud storage jurisdiction management: Map current cloud storage locations and assess jurisdictional risks for reproductive health data across regions with different laws. Establish clear data residency requirements and create migration plans to move sensitive data to compliant regions, supported by monitoring systems that track data location and movement with real-time compliance alerts.
Third-party app integration security controls: Develop comprehensive vendor risk assessments specifically tailored to reproductive health app integrations, including period trackers and fertility apps. Select vendors that have adopted strong privacy safeguards, such as implementing data minimization practices or offering anonymous modes.
CIOs should recognize, however, that varying state regulations may limit vendors’ ability to maintain their commitments universally and should verify that stated policies align with actual technical implementations through regular audits and compliance reviews.
Implementation strategies from leading health systems
Effective reproductive health data governance requires more than just technical safeguards: CIOs and CPOs in the U.S. should look to leading health systems and professional associations that have integrated professional guidelines, staff training, and policy frameworks into their implementation strategies. The examples below prove comprehensive governance is achievable, even in complex regulatory environments:
Cleveland Clinic: Cleveland Clinic co-founded the MOBY.US consortium for male infertility data, demonstrating how to standardize high-quality reproductive health data sharing under strict use agreements and IRB oversight.
AccessMatters: Philadelphia-based public health non-profit AccessMatters partners with health organizations to deliver evidence-based training focused on trauma-informed, equity-centered reproductive health care.
American College of Obstetricians and Gynecologists (ACOG): ACOG develops national clinical guidelines and provides implementation toolkits including staff training modules, patient education materials, and policy templates.
CDC’s Division of Reproductive Health (DRH): Before its elimination by federal budget cuts, the DRH enabled public health researchers and practitioners to track maternal and infant health, evaluate interventions, and inform their own policies and clinical practice.
The dismantling of proven frameworks like the DRH makes coordinated governance even more critical, as organizations must now fill gaps left by reduced federal oversight. As it stands, healthcare leaders must take matters into their own hands to develop comprehensive frameworks for reproductive health data governance.
Key takeaways
As regulations continue to morph across state lines and the current administration axes critical federal resources, the window for action is narrowing. CIOs and CPOs must take the following critical steps to protect reproductive health data:
- Address vulnerabilities proactively to reduce financial exposure and maintain patient trust.
- Implement core technical safeguards: encryption, de-identification, cloud jurisdiction management, and secure third-party integrations.
- Build on the frameworks established by leading health systems and professional associations.
Organizations that act now will be positioned to navigate future regulatory changes while maintaining patient trust. Those that wait risk facing the escalating penalties and operational chaos that come with reactive compliance.
