The Supreme Court’s decision to curtail abortion rights has come to fruition. One of the outcomes that will be less discussed is how more people in states with heavy restrictions will turn to search engines and social media to figure out how now to manage their reproductive decisions, and will find themselves reading questionable information. The information they’ll find could be questionable; the number of false and misleading statements online about abortion has grown since the draft opinion on Dobbs v. Jackson Women’s Health Organization was leaked in May, and with the decision now handed down, it will undoubtedly increase.
Perhaps no medical procedure is subject to more misinformation than abortion, and social media and search engine companies have been too stagnant in their efforts to stop the spread. Access to safe abortion is reaching a point of no return, and we no longer have time for this level of inaction on abortion mis and disinformation. Internet companies need to stop accepting advertising money from groups that lie about abortion, and they need to do a better job of removing posts with false information. Such information isn’t just confusing or a nuisance. Misinformation has been shown to influence people’s decisions—and in this case the decisions being influenced are about reproductive health, with the potential to lead to tangible consequences such as shame around abortion decision-making and complicated, unsafe abortion.
First, some definitions: abortion misinformation is the unintentional spread of false or misleading information about the physical and psychological risks or consequences of getting an abortion. Abortion disinformation is similar but is intentionally spread to promote an antiabortion agenda. To be clear, the two cannot be fully dichotomized, as disinformation often (intentionally) begets misinformation when someone naively spreads falsehoods created by someone with disingenuous aims.
I am very familiar with disinformation and political agendas. Growing up in Texas suburbs and rural Alabama, I regularly heard the message in school, from doctors, and from community members that abortion was harmful and shameful. Now that I study health misinformation, focusing on online information about reproductive health, it’s clear to me that these admonishments were rife with disinformation and pushed by a religious and political agenda—not a public health one. But far too many people aren’t able to make these distinctions online.
I need only to turn to my phone to find the same narratives, posted by people such as nefarious antiabortion actors to concerned, religious mothers. If I search for abortion information on social media or a search engine, I quickly come into contact with false claims like “abortion is never medically necessary” and “women are at risk of injury, infertility, and possible death from the chemical abortion pill”
Research has made clear that much of the content people find online about abortion is not reliable, and commonly includes disinformation that seeks to misinform and thwart abortion access. Much like the messages I received growing up in the Deep South, these messages carry religious and political undertones that are difficult to distinguish from objective, evidence-based information. This is on purpose. Antichoice websites regularly publish intentionally misleading or false information about abortion in a manner that presents as objective in an effort to mask the fact that it’s antiscience. And depending on several factors, search engines sometimes push these sites to the top of result pages over more evidence-based ones.
This is the bleak future for science-based reproductive health decisions; the highest volume of online searches about abortion are in the states with the most restricted access. Even a change in local policies on abortion in the U.S. is associated with more attempts to find abortion information online.
Despite the federal change to health care rights, abortion shame and stigma and a lack of access to quality health information or care from professionals are already reasons why anyone might seek information online. Women of color and people with low incomes disproportionately experience reproductive injustice, and as a result their need for accurate abortion information is especially critical.
And should you think that social media platforms are passive bystanders in this problem, just conduits for information, think again. They regularly profit from it.
The Center for Countering Digital Hate reports that from January 2020 to September 2021, Facebook alone accepted between $115,400 and $140,667 for 92 ads promoting “abortion pill reversal”—the use of progesterone to reverse a medication abortion in its early stages. This procedure is unproven and unethical, and was stopped in clinical trials because it caused dangerous hemorrhaging. The center’s report also found that a whopping 83 percent of searches for abortion carried an ad for “abortion reversal,” meaning that the vast majority of Google searches on abortion when the study was conducted surfaced disinformation that was disguised as neutral and helpful. And while Google and Facebook have both worked to clamp down on the issue of false and misleading ads about abortion, they have not done enough.
And of course, the problem is not just ads. Social media posts and search engine results also yield misleading information about abortion. One 2021 study found that, of the five top results for “abortion pill” on Google, only one contained information that was scientifically accurate and moderately accessible—meaning written at a lower grade level in plain language that’s easy for a reader to digest. Three were from overtly antiabortion groups, and they spread disinformation and misinformation about abortion pills.
Another study found that over half of the Web pages on abortion surfaced by Google contained misinformation that could hinder a person’s decision to have one by pushing claims that abortion is unsafe and referring them to covertly antiabortion “health” centers using scare tactics.
As of this writing, a simple Google search of “abortion pill reversal” surfaced a Website endorsing the safety and efficacy of abortion pill reversal as the first result, listed above a webpage from the American College of Obstetricians and Gynecologists stating that this reversal process is not supported by science.
These search results primarily stem from crisis pregnancy centers, which are legal but unethical. Abortion misinformation and disinformation aren’t just inconvenient and misleading; they can affect a person’s ability to make informed health decisions and increase feelings of shame, confusion and stigma. Given that conducting causal research on misinformation and its effects is challenging, there are likely further, unknown health consequences.
These mis- and disinformation narratives online are mirrored in antichoice legislation. One 2016 analysis by the National Partnership for Women and Families found that 70 percent of state-level abortion restrictions introduced in 2016 were based on antiabortion lies.
This also applies to the Dobbs opinion. In the opinion, the justices cite the 2007 case Gonzales v. Carhart, which upheld the Partial-Birth Abortion Ban Act and signaled a shift in the court toward restricting abortion. They say that most abortions after 15 weeks “for non therapeutic or elective reasons [are] a barbaric practice, dangerous for the maternal patient, and demeaning to the medical profession.” The draft ruling also insinuates that fetuses feel pain before the third trimester and that restricting abortion preserves the “protection of maternal health” as well as “the prevention of discrimination on the basis of race, sex, or disability.”
Each of these statements is medically inaccurate. For instance, basing a decision off of abortions post-15 weeks is illogical and misleading considering that the vast majority of abortions (about 93% as of 2019 in the U.S.) are performed at or before 13 weeks. These misleading statements also represent the same narratives circulating on social media and stemming from antiabortion groups, such as crisis pregnancy centers and the group Live Action, which regularly makes claims online that abortion is unsafe.
This opinion signals the Supreme Court’s continued shift from decisions based on science and evidence to ones based on political and religious ideology, and reflects the increasingly blurred line between antiscience narratives that primarily spread online and real-world antiscience policy and legislation. The two directly and inextricably influence one another.
The rise of mis- and disinformation about abortion demonstrate how political and religious ideologues are able to successfully game an Internet system that has inadequate checks and balances, and how those narratives can go on to become “truths” that are legally codified. Social media companies are more than complicit actors—they are enablers. Now is the time to act. The people who use these platforms have a right to honest, factual information in making enormous life decisions such as whether or not to continue a pregnancy. The question at stake is not just what actions are we willing to take to protect abortion access, but how far are we willing to let technology influence not only our opinions, but our health and livelihoods?
This is an opinion and analysis article, and the views expressed by the author or authors are not necessarily those of Scientific American.
