Tech Firms Must Take Action Against Dangerous Crisis Pregnancy Centers

Keeping abortion-seekers safe in post-Dobbs America is a multi-pronged effort that requires vigilance from individuals and robust privacy regulation. Because such regulations are not in place at the federal level or in many states–and may not be for many years–abortion seekers are vulnerable right now. But search and social media platforms can take steps to ensure that they do not contribute to the spread of reproductive health disinformation, and that they do not send more patients to so-called crisis pregnancy centers (CPCs) for dubious information or healthcare services.

CPCs may be new to many tech advocates, but they are a painfully familiar foe to reproductive health professionals and advocates. These centers aim to “prevent abortions by persuading women that adoption or parenting is a better option." They have long used misleading tactics and outright lies to ensnare abortion-seekers who often do not realize they are not at a clinic that can provide abortion care. A 2018 American Medical Association (AMA) Journal of Ethics article states that CPCs “strive to give the impression that they are clinical centers, offering legitimate medical services and advice, yet they are exempt from regulatory, licensure, and credentialing oversight that apply to health care facilities.” That impression is generated by tricks like wearing white lab coats; using neutral, medical-sounding jargon; and offering free pregnancy tests. Once a patient is at an appointment at a CPC, they’ll hear a stream of disinformation about unproven complications of abortion, often accompanied by “disturbing visuals.”

The American College of Obstetricians and Gynecologists (ACOG) considers CPCs a threat to public health because they cause delays in accessing necessary healthcare, target vulnerable populations, and spread dangerous medical disinformation. Even the staid AMA adopted a policy that “any entity offering crisis pregnancy services truthfully describe the services they offer or for which they refer – including prenatal care, family planning, termination, or adoption services – in communications on site and in their advertising, and before any services are provided to an individual patient.”

Despite overwhelming agreement from medical professionals about the threat of CPCs, search and social media platforms continue to vacillate in their content policies and enforcement around CPCs’ content. Robust policies and enforcement regarding health mis- and disinformation is not novel for platforms; the COVID-19 pandemic forced them to install specific, actionable policies to prevent the spread of health mis- and disinformation about vaccines and the virus itself. In the face of a public health emergency, platforms acted. The US is years into another public health emergency surrounding reproductive health access that demands the same level of attention and resources from platforms.

Google has faced the most scrutiny for its role in funneling abortion seekers to CPCs. A 2023 report from the Center for Countering Digital Hate (CCDH) found that CPCs have an explicit strategy using Google ads, targeting search terms like “abortion pill cost” and “abortion clinic near me.” The report spotlights “a cottage industry of predatory marketing firms that promise to help anti-choice organizations misdirect ‘abortion-determined’ people to fake clinics – and even get subsidized by Google to do so.”

As of February 2024, Google’s advertising policies still allow CPCs to run ads. Legitimate abortion clinics and CPCs alike are subjected to the same certification process. After selecting whether or not their organization provides abortions, Google “automatically generate[s] one of the following in-ad disclosures for your abortion product or service ads: “Provides abortions” or “Does not provide abortions.”” These so-called disclosures are in a small font that is difficult to notice unless a user knows to look for it.

Clearer ad disclosures are an insufficient solution, as this still allows CPCs to reach abortion-seekers at the top of a search page. Google’s policies should prohibit ads from CPCs entirely. In fact, many practices common among CPCs are already banned. Misleading representation is prohibited, which includes “making misleading statements, obscuring, or omitting material information about your identity, affiliations, or qualifications.” CPCs have a documented history of this behavior, from using names similar to legitimate abortion clinics in their area to posturing as medical professionals.

Likewise, “content promoting harmful health claims, or content that relates to a current, major health crisis and contradicts authoritative scientific consensus” is prohibited as a misrepresentation. On the 51st anniversary of Roe v. Wade in January 2024, ACOG released a statement asserting its “members have witnessed the crisis perpetuated by abortion bans and the devastating cost to pregnant patients and our communities” – a clear declaration of the authoritative scientific consensus and ongoing major health crisis. Google should enforce its own policies, and prohibit CPCs from running ads. For even greater efficacy and alignment with scientific consensus, the company should explicitly outline this position, categorizing CPCs as misleading medical purveyors.

Search engines are a tool to funnel abortion-seekers to CPCs online, but social media platforms must also take action. YouTube has taken important steps in the right direction. YouTube’s policies prohibit “treatment misinformation,” including “discouragement of professional treatment.” This section explicitly prohibits “Content that contradicts local health authorities’ or the World Health Organization’s guidance on the safety of chemical and surgical abortion,” including the common claim from CPCs “that abortion commonly results in or carries a high risk of infertility or future miscarriage.” This came after public scrutiny about abortion-releated misinformation on the platform.

On the other hand, Meta has failed to address CPCs and does not reference abortion in its misinformation policies. As Meta’s policies are currently written, action against health misinformation pertains to vaccines and the Covid-19 pandemic. The post-Dobbs information health crisis in reproductive health access demands that Meta update its policies to include mis- and disinformation related to abortion, and effectively enforce those policies.

Inaction against CPCs is not just a violation of existing policies against harmful health claims, but a capitulation to the anti-abortion movement’s broader war on scientific consensus. In the face of overwhelming public support for reproductive health access – borne out in polls and elections – anti-abortion crusaders hope distorting language will make their extreme positions seem more tenable. Anti-abortion organizations fabricate medical-sounding terms like “pre-viable” to describe nonviable pregnancies. Search and social media platforms must follow scientific consensus rather than the cynical political machinations of anti-abortion activists.

Ultimately, abortion-seekers deserve more than adjustments to content policies of social media and search engines. Comprehensive privacy legislation would protect vulnerable people from having their data sold to nefarious actors desperate to make accessing care even more difficult. Congressional action to re-establish a nationwide right to abortion, accompanied by meaningful investments in opening fully staffed clinics in contraceptive care deserts would prevent women from relying on the whims of Google ads and social media algorithms to find their closest reproductive health provider. Social media and search companies can act now to ensure that those seeking care actually receive it, rather than confusing lectures, disinformation, and blame by prohibiting CPCs from advertising on their platforms, and removing their content when it contains medical mis- or disinformation.