Abortion rights groups say tech giants thwart ability to reach public

Abortion rights groups say Facebook and other tech giants are making it harder for the public to access information about abortion pills by blocking posts and ads with credible information.

They say limited access to online information about self-managed abortions will be even worse for women if strict anti-abortion bans limiting access to care, such as Mississippi's, are upheld by the Supreme Court.

"People already have to jump through so many hoops to get abortion care, and it's likely to become even more difficult if not impossible for millions of people," said Dina Montemarano, research director at NARAL.

"People are going to need to rely on the internet for accurate information. I think this is even more true when it comes to medication abortion care and folks learning more about that. So [tech companies] really need to clean up their act and start caring about their users like they say they do in order for them to fix this," she added.

The concerns about social media are twofold - as the companies are blocking credible information, advocates say tech giants are allowing bad actors to spread false information about abortion care.

"More Americans are going to need accurate information on abortion, and how to access an in clinic procedure, or how to access abortion pills, how to use them, and what things they need to know about doing that," said Jennifer Holloway, communications director at Ipas, an international nongovernmental organization that increases access to safe abortions and contraception.

"But these platforms have algorithms that surface the opposition and misinformation and misleading content, and that seems to be advantaged by the algorithm over scientifically based or fact based information that sexual reproductive health groups are sharing," Holloway added.

Executives at Plan C, an organization that provides educational resources about abortion pills, said Facebook and Instagram routinely remove Plan C's organic posts and rejects their ads.

In November a post with information about effective abortion pills was taken down from Facebook for "not following the community guidelines." When a post is taken down, the page is blocked from posting any additional content for another two to three days.

Plan C was cut off from Instagram for several days in August, around the time Texas passed a strict abortion ban. The page was restored after an appeal, but the time-consuming process leaves Plan C unable to reach target audiences, Plan C's social media manager Martha Dimitratou told The Hill.

She said Facebook often rejects the organization's ads, despite being "long approved'' to run ads under Facebook's social issues, elections or politics category.

Plan C executives said Facebook rejects the ads under a policy that bans promoting "the sale or use of unsafe supplements, as determined by Facebook in its sole discretion," but Plan C co-founder and co-director Elisa Wells said the organization isn't advertising for pills, it's spreading information about access.

One rejected ad featured a cake with writing stating "abortion by mail is a reality in all 50 states." Another showed an illustration of a woman on her phone with the text "Your nearest abortion provider ... is in your pocket," according to copies of the ads shared with The Hill.

A spokesperson for Meta, the parent company for Instagram and Facebook, said that some Plan C ads being rejected doesn't reflect the vast sum of the organization's efforts on Facebook. A search through Facebook's ad library shows that Plan C does have active ads running on the platform.

The spokesperson also said Plan C's ads were rejected because the organization failed to indicate those specific ads were for a social issue, but in a screenshot Plan C shared with The Hill, Facebook notified the page that the ad was rejected because ads "must not promote the sale or use of unsafe supplements."

The spokesperson did not respond to direct questions about the removal of organic posts.

The issue goes beyond Meta's policies.

Earlier this month Plan C had its Google ad account suspended for several days, and in August Google-owned YouTube suspended the Ipas channel for about a week because of an informational animated video about self-managed abortion with pills. YouTube cited a policy violation of promoting an illegal medical procedure or directing users to drugs, but like with Plan C's content the video was providing information and not advertising for a drug, Holloway said.

Despite the hurdles they face with social media companies, advocates say the platforms are still the best way to reach the general public.

"We're well into the 21st century, and using electronic social media is a key way that advocates and others reach people who have a need for information, through the paid ads, through social media, through organic search results, all of those things are important to us. So when there are efforts or blockages that are imposed by these companies, that impacts our ability to get the word out," Wells said.

A spokesperson for Google did not respond to a request for comment.

As advocacy groups struggle to spread information about abortion access online, anti-abortion groups have been successful in spreading misinformation about abortion care on the platforms, according to a report from the Center for Countering Digital Hate (CCDH) released in September.

Facebook showed ads about abortion "reversal" methods to users up to 18.4 million times between January and September of this year, and Google had placed ads about "reversal" methods on 83 percent of searches for abortions, according to the report.

Montemarano, the research director at NARAL, said anti-abortion groups have "figured out a way to manipulate" tech companies into giving them "preferential treatment and bigger microphone" by using their playbook of "crying censorship."

"They are making a choice over who to prioritize over who gets special preferential treatment, even when that means that their users are then faced with inaccurate information and again, sometimes potentially dangerous information," Montemarano said.

After the report was released, Google took action to remove the ads with misinformation about abortion. The decision set off a stream of backlash from the anti-abortion groups and Republicans who accused the company of showing a bias by removing the misinformation.

Montemarano said the ads identified aren't just pushing a political anti-choice message, they're spreading dangerous and false information.

"I think there's a tendency to just pretend that it's actually all political even though it's a health care issue that's affecting people's real lives," Montemarano said.

The abortion pill groups such as Plan C are providing information about is a process of taking a series of two pills, mifepristone and misoprostol, which are both approved by the Food and Drug Administration (FDA). Last week the FDA expanded access to mifepristone by allowing patients to obtain it by mail instead of requiring in-person visits with health care providers.

A search through Facebook's public ad library shows that some ads from the pages identified in the CCDH report have been removed, but others promoting abortion reversal including from some of the groups identified in the report were not removed by the company.

The Meta spokesperson did not comment in response to the abortion reversal ads the platform did not remove.

CCDH CEO Imran Ahmed said platforms should be more transparent about their content moderation decisions to mitigate the challenges abortion rights advocates are facing.

"The lack of transparency around the terms of engagement on a key platform for public discourse allows the platforms to get away with a lot of public relations games around decisions that actually are life and death for some people," he said.