On May 2, just hours before Politico published a leaked Supreme Court draft opinion to overturn Roe v. Wade , the anti-abortion group Focus on the Family released a series of alarmist ads on Facebook and Instagram. They contain assorted motifs from a now-familiar playbook of anti-abortion canon: In one, the words "I'M ALIVE" accompany a bright-eyed infant's photographed image; in another, an exhortation to "help a vulnerable mom choose LIFE!" is stamped over a baby's feet. But all are accompanied by the same fear-mongering caption ("Scared. Overwhelmed. Hopeless. These emotions and more pulsate through an abortion-minded woman.") and plea for money ("Just $60 saves a life!").
The ads would appear to violate Facebook and Instagram parent company Meta's policy against misinformation in advertisements: Research debunks a link between abortion and negative mental health outcomes either before, during, or after the procedure; and there is no scientific evidence of a monolithic emotional experience among abortion seekers (pregnant people are, after all, human beings capable of a plurality of thoughts and feelings) . Yet, with the Supreme Court's ruling on Dobbs v. Jackson Women's Health Organization poised to rock the legal landscape of abortion, the barrage of ads—complete with abominable caption—continue to circulate, with the most recent batch posted this week. Focus on the Family's social media campaign is just one exhibit in a seemingly endless stream of abortion disinformation content, the likes of which seem only to be proliferating now more quickly.
According to data from the social media insights firm Zignal Labs, abortion-related content from "less reliable sources" more than doubled on Facebook and Twitter in the week following the leak of the Supreme Court draft decision. On-the-ground abortion providers and advocates have likewise reported a swell in online disinformation, and confusion, over abortion legislation in states like Texas and California —states at opposite ends of the abortion debate, and whose pregnant constituents face dramatically different fates in a post- Roe world.
Misleading anti-abortion propaganda has long presented an obstacle to pregnant people seeking sound legal and medical guidance. Tech companies like Facebook, Google, and Twitter have meanwhile been the intermittent targets of criticism for allowing such content to spread. Now, with the end of Roe an all-too-real possibility, a growing number of legislators, advocacy groups, medical experts, and media analysts are calling for tech companies to take a more proactive role in flagging or removing abortion-related disinformation.
Tech companies have limited legal latitude to prohibit anti-abortion groups from publishing online. But all have tools at their disposal to mitigate potential confusion. Amid the onslaught of COVID-19 disinformation, social media platforms developed various methods to root out nonfactual information and redirect users to credible sources, from instituting automatic warning labels to enacting content removal and, in some cases, outright bans of repeat offenders.
Whatever the approach, Google, Facebook, and Twitter all have policies that prohibit the dissemination of misleading and inaccurate health claims. It's up to them to see that those policies get enforced.
Until that happens, it seems that the immediate course of action for abortion rights groups is to open up their open pocketbooks. Planned Parenthood Action Fund, NARAL Pro-Choice America, and EMILY's List have committed $150 million on ads, research, and polling in nine key states ahead of the 2022 midterm elections.
All the while, abortion-rights advocates are steeling themselves for whatever comes next. Many worry that, in a post- Roe future, the medical surveillance and criminalization of abortion seekers will increase as a direct result of unreliable abortion-related information—and so too, they fear, will the number of deaths of pregnant people.
"A lot of young women don't have accurate and adequate information about the natural processes of reproduction and don't know how to access the right care in many of the states where abortion will become illegal if this [Supreme Court draft] opinion goes forward as written," says Dr. Louise P. King, director of reproductive bioethics at the Harvard Medical School Center for Bioethics . "If they have no access to relevant information about where they could go to get care, in the context of abortion, the ultimate consequence is that people are going to die," she says.
"I've certainly been duped, and I'm an expert"
American anti-abortion movements have always trained their efforts on restricting the public's access to, and dissemination of, sexual and reproductive health guidance. From the passage of anti-vice laws in the late 19th century and into the present day, such efforts have targeted two parallel streams of information, says Lara Freidenfelds, a historian of reproductive health and parenting and the author of The Myth of the Perfect Pregnancy: A History of Miscarriage in America .
"One [target] is information on how to access contraception or abortion care," says Freidenfelds, the other involves efforts "to restrict people from even knowing that it's a thing people do, or that people can have access to."
Because the internet makes that first target very difficult to hit, anti-abortion crusaders have shifted their approach in favor of message muddling, using online disinformation to stoke confusion and fear about both the legal and medical realities of abortion. Often, that strategy works.
" People who disseminate misinformation are typically fairly savvy and know how to do so," says Dr. King . "I've certainly been duped, and I'm an expert in clinical assessment and use careful critical reasoning when I read data."
But even when tech platforms have policies that ostensibly safeguard against spreading disinformation, it remains unclear whether any given ad will be determined as having broken those rules and taken down. As reported by Protocol , the day after the Roe opinion became public, the anti-abortion group Live Action began running a Facebook ad warning that "Abortion pills are not safe," despite assurance to the contrary from the FDA. Meta reportedly would not comment as to whether the ad violated the company's rules against misinformation in ads—and it stayed up for another six weeks.
Irina Raicu, internet ethics program director at the Markkula Center for Applied Ethics at Santa Clara University, sees the matter as at least a partial consequence of an inadequate response on the part of Big Tech companies. Misinformation on hot-button political issues, from immigration and elections to vaccines, is often allowed to hide in plain sight until the collateral damage becomes too great to ignore. "Some major things that tech companies should probably have addressed long ago are now, suddenly, kind of emergencies," she tells Fast Company .
Then there's the profit incentive. For tech companies collecting ad dollars from anti-abortion groups, it has paid to look the other way in the face of dubious claims.
Last September, the Center for Countering Digital Hate (CCDH), a nonprofit that tracks online hate groups and disinformation campaigns, lambasted Facebook and Google for accepting money to run ads promoting "abortion reversal"—a procedure so dangerous that researchers once halted a study on its clinical efficacy before they were even able to evaluate results. Between January 2020 and September 2021, CCDH reports that Facebook accepted as much as $140,667 for 92 ads endorsing the procedure, which were viewed more than 18 million times and targeted girls as young as 13. The CCDH pointed to the ads as part of a larger pattern of lax content moderation, declaring that Facebook and Google were "once again failing to enforce their own rules."
In an emailed statement to Fast Company , a Meta spokesperson wrote, "We want our platforms to be a place where people can access reliable information about health services, such as abortion, advertisers can promote health services, and everyone can discuss and debate public policies in this space. That's why Meta allows posts and ads promoting health care services like abortion, as well as discussion and debate around them. Content about abortion, regardless of political perspective, must follow our rules, including those on: prescription drugs, misinformation, coordinating harm, bullying and harassment, violence and incitement, and violent and graphic content." (Google did not respond to Fast Company's request for comment.)
The report caught the attention of House Judiciary Committee Chairman Jerry Nadler, who, in February, issued a letter to Meta demanding transparency over its abortion-related advertisement standards. Nadler, a Democrat from New York State, also called out the company for reportedly circulating anti-abortion disinformation while also blocking accurate medical information about the procedure. The congressperson cited cybersecurity research that pointed to a larger pattern in which " regularly circulating misinformation 'confers a significant advantage' in 'outperforming non-misinformation sources’" on Facebook , noting that the disparity is reinforced by Meta's tendency to restrict partisan content from centrist or left-leaning organizations without holding right-wing content to the same standards of accountability.
The algorithmic over-performance of anti-abortion propaganda isn't limited to Facebook. Across today's online ecosystem, abortion-related search queries surface as much or more anti-abortion content than they do reliable, medically sound information. Last year, a team of public health researchers published a study in PLOS One on the clinical accuracy and practicality of the top five, text-based educational webpages surfaced by a Google search for "abortion pills." They found that four of the five top search results were sites they deemed to be low quality.
The prevalence of inaccurate information is a huge contributor to widespread confusion surrounding the legality and accessibility of abortions. In a 2018 survey of Americans seeking self-abortion information via Google, Guttmacher Institute researchers found that one-third of respondents either didn't know whether abortion was legal in their state or explicitly thought it was illegal. More than half of respondents were not sure if there was a healthcare facility within 50 miles of their home where they could obtain the procedure, which a Guttmacher policy expert attributed to a dearth of reliable information online.
Disinformation also fuels stigma, says Betsy Pleasants, a doctoral candidate in public health at UC Berkeley's School of Public Health and the lead author of the PLOS One study. If Roe v. Wade is overturned and the legal landscape of abortion is dramatically altered across the country, Pleasants says that the internet will only become "an even more important tool in people's abortion decisions and experiences"—an all-too-rare avenue for creating new channels of information-sharing and abortion support.
"Tech companies have a responsibility"
The potential post- Roe ramifications of abortion disinformation are more challenging to predict. Pleasants points out that there is "very limited" research on the public health effects from consuming different types of anti-abortion disinformation. Less ambiguous is the detrimental impact of disinformation on people's ability to navigate a legal and medical reality that is poised to become even more politically fraught.
"Abortion access in the U.S. is challenged by so many factors—state-level restrictions, national policies, and the commonality of abortion disinformation online," says Pleasants, "that create a lot of ambiguities and uncertainties for people navigating abortion decisions and care."
Those ambiguities and uncertainties extend to clinical providers, says Lauren Paulk, senior research counsel for the reproductive justice advocacy organization If/When/How . "Medical providers are worried about what they should and shouldn't say, and they're worried about what they should and shouldn't do," Paulk says.
As the rate of self-managed medical abortion has risen in tandem with state-level restrictions to clinical abortion access, Paulk says more people are now checking up with non-specialist medical providers after the procedure has taken place, many of whom are ill-equipped or unwilling to offer proper guidance. Paulk and other experts expect this trend to only accelerate in a post- Roe world.
"One of the main things that we really want [providers] to understand is that reporting self-managed abortion to the authorities is never necessary," Paulk says. "One of the leading ways that people are criminalized for their outcomes is because a healthcare provider reports them to the police."
While tech companies can't account for individuals' religious or ethical hang-ups, they can make legal facts easier to distinguish from agenda-driven noise. And, arguably, they should. "I do think that tech companies, and search engines, in particular—really, any companies that have a search function—have a responsibility to make sure that people are not misdirected to misinformation," says internet ethicist Raicu.
Until that happens, it's open season for malicious actors looking to sow confusion. Raicu predicts that, unless tech companies are swift to crack down on disinformation, it's only a matter of time before anti-abortion groups will begin to set up websites that function as honeypots to entrap, and criminalize, people seeking abortions. There's already some precedent for how this could play out: In 2020, a Mississippi woman's online search for abortion pills was used as evidence in a manslaughter case against her.
"I'm thinking pretty darkly, these days," Raicu says, "but these are things that can happen."
This story has been updated to include comment from Meta.
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