Abortion Groups Say Tech Companies Suppress Posts and Accounts

The groups say they are increasingly confused and frustrated by how major technology platforms moderate posts about abortion services.

By Emily Schmall and Sapna Maheshwari

June 11, 2024

TikTok has briefly suspended the account of Hey Jane, a prominent telemedicine abortion service, four times without explanation. Instagram has suspended Mayday Health, a nonprofit that provides information about abortion pill access, without explanation as well. And the search engine Bing has erroneously flagged the website for Aid Access, a major seller of abortion pills online, as unsafe.

The groups and women’s health advocates say these examples, all from recent months, show why they are increasingly confused and frustrated by how major technology platforms moderate posts about abortion services.

They say the companies’ policies on abortion-related content, including advertisements, have long been opaque. But they say the platforms seem to have been more aggressive about removing or suppressing posts that share information about how to obtain safe and legal procedures since the Supreme Court ended the constitutional right to abortion in 2022. And when the platforms do restrict the accounts, the companies can be difficult to contact to learn why.

Susan B. Anthony Pro-Life America, an organization dedicated to abolishing abortion, said big technology companies had routinely limited its and other groups’ pro-life speech, suspending accounts and blocking ads with little explanation.

“Transparency is the main point,” said Jane Eklund, a fellow at the human rights group Amnesty International USA, which released a report on Tuesday calling on tech giants to clearly outline and explain their rules around abortion-related content. “Without clear guidelines, it’s difficult to hold them accountable for their actions that could be impacting users or to identify and address any content moderation that affects what people can find online.”

Concerns that some of the tech platforms are suppressing posts about abortion have led to changes in how women and organizations talk about it online. They intentionally misspell the term as “aborshun” or “ab0rti0n,” or replace the “bor” with a boar emoji in hopes of reaching more people.

But that can also make it harder for people to find information, and coded language risks adding stigma to the procedure, experts and content creators say.

“We shouldn’t have to substitute words — we shouldn’t have to censor ourselves,” said Ashley Garcia, a 24-year-old part-time creator, who made two videos promoting Hey Jane last year.

The tech companies did not detail how their moderation of abortion-related content may have changed since 2022, though TikTok said it had not made significant shifts. The companies said the issues with suspensions and flags of Hey Jane, Mayday Health and Aid Access were mistakes that they rectified.

TikTok said accounts can post about abortion. But it has a longstanding policy against advertising abortion services, which it counts as “unsuitable businesses, products or services,” along with plastic surgery and organ transplants. Instagram allows ads for abortion services.

The report released Tuesday from Amnesty International USA included details on how at least six organizations that promote or provide abortion services have had their accounts and posts moderated by Meta, the owner of Instagram and Facebook, and TikTok in the past two years.

For example, TikTok removed videos from the account for Hey Jane, which has 105,000 followers, for promoting “illegal activities and regulated goods” — including one that detailed the states where it operated and how it hoped to expand to other states. That video wasn’t restored.

Last month, Hey Jane struggled for days to determine why TikTok had abruptly banned its account. The tech company eventually reinstated the account; Rebecca Davis, Hey Jane’s head of brand marketing, said TikTok had told her that “the suspension was due to ‘over-moderation’ of their policy surrounding prescription drugs and it should not have been removed.”

“That’s pretty much all they can say — just that it was a mistake and they will try their best to not have it happen again,” Ms. Davis said.

TikTok declined to comment on details about Hey Jane’s experience.

Groups have complained about similar issues on Instagram. Last year, the social network removed a post from Ipas, a nonprofit that promotes abortion rights, that had shared the World Health Organization’s recommended protocol for having a medication abortion. Instagram said at the time that the post had violated Meta’s policy on the “sale of regulated goods or services.”

Instagram suspended Mayday Health’s account in March for a second time since 2022 “without any clear explanation or justification,” said Olivia Raisner, the group’s executive director. Mayday Health was told that it had violated Instagram’s guidelines for posting about “guns, drugs and other restricted goods.” The group appealed and regained its account, with more than 20,000 followers, after five days. Meta said last week that the Mayday and Ipas issues were errors.

“Our fear would be that for every day our accounts are down, there are fewer people in states with bans who don’t get information about how to get pills,” Ms. Raisner said.

Ryan Daniels, a spokesman for Meta, said Instagram allowed ads and posts of abortion services, as well as content by groups that oppose abortion. “We want our platforms to be a place where people can access reliable information about health services, advertisers can promote health services and everyone can discuss and debate public policies in this space,” he said. “That’s why we allow posts and ads about, discussing and debating abortion.”

Some women’s health groups, as well as some doctors and creators, say they fear the platforms are also suppressing the distribution of posts about abortion services.

Mayday Health said the number of people who saw its Instagram posts had plummeted this year. An infographic it posted about abortion pills reached 15,730 accounts in April 2023; a similar post from this March reached just 1,207 accounts, even though the account has more followers now.

Ms. Davis said TikTok representatives had explicitly told her that if videos or captions used the word “abortion,” content would be flagged and might not appear on users’ main feeds.

TikTok said it did not prohibit posts about abortion from appearing in personalized feeds, but did not address whether it limited such content. Instagram said this year that it would not recommend “political content” unless users opted into seeing it. Abortion advocacy groups haven’t received clarity on whether the topic is deemed political, and Meta declined to specify.

Abortion rights groups say the issues have also extended to search engines like Microsoft’s Bing.

Aid Access, based in Europe, is among the most prominent online suppliers of abortion pills in the United States, where medication abortions have been rising sharply. In a search query for abortion pills on Thursday, the Aid Access website was on the first page of Google results but not found within the first 10 pages of results on Bing.

A Microsoft representative said sources that were similar in relevance and quality were showing up instead.

For months, Bing erroneously tagged Aid Access with a red warning pop-up that said the organization was on the National Association of Boards of Pharmacy’s “not recommended” list. The pharmacy association removed Aid Access from the list in September after the organization switched the source of abortion pills from a pharmacy in India to providers in the United States approved by the Food and Drug Administration.

Bing kept posting the label even after Aid Access informed it about the change. The label was removed after an inquiry from a reporter at The New York Times in May.

In several Republican-led states where abortion has been sharply restricted since the Supreme Court’s 2022 decision, state officials have introduced measures to punish organizations that provide abortion pills or information on how to obtain abortions online.

Tim Griffin, the Republican attorney general of Arkansas, sent Aid Access a “cease and desist” letter in May, saying the organization was violating the state’s law on deceptive trade practices because its ads could be seen by women in Arkansas, where abortion is prohibited unless necessary to save the life of the mother.

Dr. Rebecca Gomperts, the founder and executive director of Aid Access, said the threat would not change the organization’s approach. The organization does minimal online marketing because of the challenges posed by big tech companies, she said, depending instead on word-of-mouth referrals from patients and physicians.

“It’s been a game, up and down, with all the social media and search companies,” Dr. Gomperts said.