The 39 patients who asked Christie Pitney for abortion pills last week were not all pregnant. Some had an IUD or were taking a contraceptive, and they wanted to have the pills – an extremely safe, FDA-approved regimen that is now the most common way to terminate a pregnancy in the United States – at their fingertips, right at the case where. “They’re very, very worried and scared about what the future holds for them,” says Pitney, an advanced practice midwife who virtually prescribes abortion pills to patients.
The patients had found Pitney through Aid Access, an organization that connects people who want medical abortions with telehealth providers who can give them online consultations and order the pills for them. These providers include people like Pitney, who works with patients in states where telehealth abortion is legal, as well as Rebecca Gomperts, an overseas-based doctor who serves patients in states where it’s not. the case. In the week after Politics released the Supreme Court’s draft opinion that would overturn Roe vs. Wade, traffic to the Aid Access site soared to 114,000 visitors; that week, providers in the group ordered pills for 1,614 patients, about the same number as in the space of two months last year, Pitney data shows.
A few years ago, only 1 in 5 people even knew about medical abortion, which is something different from the “morning after pill”, and involves taking a progesterone-blocking drug called mifepristone followed by several doses of the anti-ulcer pill. misoprostol. Choice advocates are trying to address this lack of knowledge, spreading the word online about medical abortions and the existence of services like Aid Access.
This is a crucial task as the country prepares for the fall of Deer. Even in states with anti-abortion laws, people will seek discreet ways to end their pregnancy and they will need clear information on how to do so safely. But advocates seeking to share facts about safe, self-managed abortions say they face a daunting challenge: Big Tech companies are deleting their posts, suspending their accounts or deprioritizing their listings.
“In this postdeer scenario, one of the most important things is that people can get quality information online,” says Erin Matson, co-founder and executive director of Reproaction, a pro-choice activist group. Earlier this year, Facebook blocked Reproaction ads containing medically accurate information about abortion pills, then restored its posts after gaining media coverage. “It’s really about people with safe and effective access to care, so it’s outrageous that our content has been taken down,” Matson says. “It happens to a variety of organizations in the abortion industry.”
On Tuesday, amid the busiest week in Aid Access’ history, Instagram deleted the organization’s account, saying it went against the platform’s “community standards”. The group believe the problem stems from a message telling people that Aid Access was offering an “advance supply” of the pills “just in case you need them in the future”. Another account that attempted to repost his graphic discovered that Instagram had removed it for violating guidelines on “selling illegal or regulated goods”. (On Thursday, Instagram restored Aid Access’s account. A Meta spokesperson said it was mistakenly deleted.)
The incident was a minor incident for Aid Access, whose website gets most of its traffic from Reddit’s r/abortion forum, as well as Plan C, an online medical abortion information hub. Yet Plan C itself has had its posts and ads taken down multiple times by Instagram and Facebook, says Martha Dimitratou, the site’s social media manager. Last summer, days before a Texas law banning abortions after six weeks took effect, Plan C’s Instagram page was suspended entirely.
In February, an Instagram post by Plan C – a hot pink comic containing basic information about the safety and availability of abortion pills in the mail – was removed for violating guidelines for “selling illegal or regulated products”, according to screenshots provided by Dimitratou. Plan C Facebook ads containing phrases such as “Abortion pills belong to the people who need them” are frequently rejected for violating a “hazardous substances” policy, screenshots show.
It bears repeating that abortion pills are extremely safe, FDA approved, and legal to prescribe via telehealth under federal regulations. Only states politically hostile to abortion have imposed additional restrictions, such as requiring the first pill to be taken in the presence of a doctor, thus banning telemedicine for abortion. Plan C ads similar to those blocked by Instagram were recently allowed to plaster the New York City subway. And on the other hand, sponsored advertisements for hims, a telehealth company offering generic Viagra, are currently running freely on several Meta platforms.
Dimitratou says that since early 2021, Facebook and Instagram have banned about half of the ads she has attempted to post for another reproductive health service, Women on Web, Aid Access’ counterpart for people out of the states. -United. Sometimes platforms cite rules prohibiting “the sale or use of hazardous substances”; other times they refer to a ban on “products, services, programs, or offers using deceptive or misleading practices.” The screenshots show an announcement with the text “Unwanted pregnancy? We can help” was blocked for containing content that “asserts or implies personal attributes”. Sometimes when Dimitritou appeals blocked ads, they are restored; often they are not. “It’s a constant thing,” says Dimitratou. “There’s a point that we often reach with them where they’re like, ‘Well, that’s the way it is.'”
It’s not just Facebook and Instagram: on Twitter, Plan C can publish normal tweets, but no advertisements, because “we are dealing with sensitive content”, according to Dimitratrou. (Twitter did not respond to a request for comment.) Meanwhile, on TikTok, users repeatedly claimed that certain pro-abortion content was banned or removed. “It’s happened to so many of us, honestly,” said pro-choice TikTok creator Paige Alexandra. Jezebel last week after his account was banned for no reason. “Like, I could list people, but all I have to say is, if they’ve done an abortion video, they know what I’m talking about.” (The platform does not ban the topic of abortion, or “moderate or remove content based on political sensitivities,” a spokesperson said.) Pitney, who makes TikTok videos about abortion by telehealth, claims its videos were deleted for alleged “harassment” before being restored. She assumes they were reported en masse by anti-choice activists, as it is mainly her most popular posts that are affected. “My hypothesis is that the more people visit a certain post,” she says, “the more antis will also see it.”
Red states can pass laws that shut down abortion clinics. Big Tech may adjust its algorithms in ways that promote access to abortion or make it more difficult to access safe abortion resources. Just look at Google, whose search results algorithm was updated in May 2020. After the update, the Women on Web site appeared lower in search results, producing an immediate drop in 75% of traffic, according to data from Dimitratou, and a sharp drop in the number of people. access its services. “Our search ranking systems are designed to return relevant results from the most trusted sources, and on critical topics related to health issues, we place even greater emphasis on trustworthiness signals,” said one. Google spokesperson. “The improvements we make to Searches are not targeted to benefit or penalize any particular site.”)
So why are the content and advertising policies of the social media giants so unequal when it comes to access to abortion? A spokesperson for Meta, parent company of Facebook and Instagram, said the company does not have a single policy governing abortion and law enforcement teams can make “mistakes” when they applied a series of policies to publications on medical abortions. The meta-policies allow educational marketing of mifepristone and misoprostol, the spokesperson says, but prohibit the direct sale of pharmaceuticals.
The difficulty in maintaining posts about abortion access on Facebook is particularly ironic in light of the anti-abortion ads the company allows on its platform. The company sold up to $140,000 worth of space for ads about an unproven and potentially dangerous “abortion reversal” treatment, according to a report released last fall by the Center for Countering Digital Hate. (A 2019 study of abortion reversal treatment was halted after a quarter of participants suffered severe bleeding.) the platform, while some medically accurate abortion information does not were not. “I am concerned about recent reports that Facebook has routinely run anti-abortion ads promoting medical misinformation while simultaneously blocking medically accurate information about abortion services,” Nadler wrote. “Given the recent wave of abortion restrictions that state legislatures have passed or are considering across the country, it is imperative that women have access to medically accurate information regarding abortion treatment.”
It remains to be seen whether Big Tech companies will decide to block more pro-abortion ads once Roe is overturned, and whether state laws criminalizing this form of reproductive health care are allowed to go into effect. Dimitratou and others in his position are planning a meeting next month to discuss how to fix the problem and develop specific solutions as requested by social media companies. For now, they’re using workarounds — writing “ab0rti0n” (with zeros) instead of “abortion,” for example, or writing in Spanish — to get their information across to potential online censors. . “When you have to try to do these kinds of things, I think it might also subconsciously mean ‘it’s not quite right,’” Dimitratou says. “There is a bit of shame. Especially for the younger ones. »