Letter to Social Media CEOs - Reps. Blunt Rochester & Kuster Call on Big Tech to Combat Abortion Misinformation


Dear Mr. Pichai, Mr. Zuckerberg, Mr. Chew, and Mr. Agrawal:

We write to urge you to address disturbing reports and concerns over the proliferation of mis- and disinformation surrounding reproductive health care, including abortion care, and legal rights.

As patients and providers grapple with the Supreme Court's decision to strip the constitutional right to abortion in its decision in Dobbs v. Jackson Women's Health Organization, it is imperative for social media companies to ensure their platforms are not spreading dangerous and harmful misinformation that imperils the health, safety, and liberty of people across the country. Despite the substantial resources afforded to companies of your size, and the immense profit generated by these platforms, abortion mis- and disinformation not only remains prevalent, but there are also indications it has spiked since Dobbs. While we appreciate that your current social media content rules and guidelines implicitly cover these practices, the public safety and civic implications of your failure to prioritize the moderation of abortion mis- and disinformation puts millions at risk.

Despite the substantial amount of scientific and medical research and practice that proves abortion is safe, few aspects of health care have had as much mis- and disinformation surrounding them as abortion.1 Conflicting state laws, lack of public understanding about abortion care, and politics have led to widespread mis- and disinformation on abortion.2 Many anti-abortion websites publish false information to appear scientific and fact-based, giving them a false sense of credibility and legitimacy which then flourish on social media platforms.3

The prevalence of mis- and disinformation on internet search engines like Google is alarming. According to several studies, users seeking abortion resources on search engines, including

locations of abortion clinics or information on medication abortion, often see search results that lack scientific evidence or direct users to anti-abortion websites, including by coercive anti- abortion "crisis pregnancy centers."456 For example, one study found that in states with trigger laws, nearly 37% of Google Maps searches led to these fake clinics.7 Another analysis found internet searches mostly provided low-quality information on where to obtain an abortion, complicating a person's ability to make an informed choice.8 Those seeking to propagate mis- and disinformation know how to manipulate internet search algorithms, which often prioritize popular and highly-interacted content when populating search results, even if the information is credibly false or misleading. These phenomena are compounded by the prevalence of anti- abortion "crisis pregnancy centers," which already outnumbered abortion clinics by more than 3 to 1 pre-Dobbs.9

Much of this mis- and disinformation can be immediately dangerous for people, such as misinformation on "abortion pill reversal". Abortion "reversal" is a non-medical term used to describe a medically unproven protocol in which a high dose of progesterone is given after the first of the two medications used for abortion are administered. In 2019, the results from the first randomized control study on abortion "reversal" were published. This study had to be ended early because of significant safety concerns, namely heavy bleeding that in some cases required blood transfusions and even emergency surgery. Notably, the American College of Obstetricians and Gynecologists (ACOG), does not recommend the practice as it is not supported by the body of scientific evidence. One analysis found abortion reversal ads on Google and Facebook, including several ads on Facebook that were viewed by children aged 13-17 over 700,000 times.10

The dangers for people seeking abortions have grown because of significant barriers to information about self-managed abortion and proven medication-based options. Medication abortion is safe and effective, has been available in the U.S. since 2000, and is most often a regimen of mifepristone and misoprostol.1112 On TikTok, "herbal abortions" based on highly toxic herbs like pennyroyal, went viral after the Dobbs decision and the platform appeared to

take action only after being alerted by journalists at Rolling Stone Magazine.13 Prior to Dobbs, women in states with more restrictive abortion laws were more likely to search for out-of-clinic abortion options, like medication abortion.14 With increasing restrictions due to the Dobbs decision, it is a public health and safety imperative that you ensure accurate information on your platforms about safe and effective medication-based options.

We are also concerned by what appears to be a content moderation double standard surrounding abortion information on your platforms. While ads for dangerous abortion reversals are allowed to propagate on platforms like Facebook for months or years, we see immediate action taken to pull posts of people offering to mail abortion pills to women within a week after the Dobbs decision.15 We also note examples of legitimate, fact-based content being taken down by platforms like Instagram, including the suspension of an account that provided information on where to find access to an abortion provider.16 The failure to fairly apply your content rules and guidelines may contribute to abortion stigma already facing people seeking abortion. It is concerning that profit generated by interactions with content is prioritized over the health and safety of users seeking information about abortion.

Some prominent social media platforms like YouTube have recently committed to removing misleading information about abortion yet, in some cases, this is not even a consistent policy across all platforms owned by the same company.17 Women and all Americans deserve to know the concrete actions you have taken and will take to address these concerns on all your platforms. Please provide responses to the following questions by September 9, 2022:

1. How many enforcement actions on abortion mis- and disinformation have you taken since the Dobbs decision was announced?

2. What type of enforcement actions on abortion mis- and disinformation do you take? Is enforcement standardized for the type and frequency of policy violations?

3. Have you identified some of the abortion mis- and disinformation trends for your algorithmic filters to facilitate accurate and expedient enforcement?

4. Will you provide abortion specific training to your content moderators to enhance the accuracy of moderation of abortion care related content?

5. Will you commit to take affirmative steps to direct users to more verified sources of information after they have engaged with abortion mis- and disinformation?

6. Will you commit to take affirmative steps to provide factual information and/or label or remove posts when the platform is used for abortion disinformation?

7. Have you considered modifications to your content rules and guidelines to prevent users from manipulating your moderation filters, such as combating intentional misspellings of abortion or the use of euphemisms? Please provide an explanation for your decision.

Your platforms are visited by millions of Americans every day. You have a responsibility to ensure your platforms spread accurate information, foster responsible, civic discourse, and do not negatively affect the health of people that use your platforms.