TikTok temporarily suspended the account of Hey Jane, a popular remote abortion service, four times without explanation, Instagram also suspended Mayday Health, a nonprofit that provides information on accessing abortion pills, without explanation, and search engine Bing erroneously flagged the website of Aid Access, a leading online seller of abortion pills, as unsafe.
These groups and women's health advocates say these cases, which have occurred in recent months, show why they are increasingly confused and frustrated by the way big tech platforms moderate posts about abortion services.
They say companies' policies around abortion-related content, especially advertising, have long been opaque. But they say platforms appear to have become more proactive in removing or throttling posts that share information about how to obtain a safe, legal procedure since the Supreme Court struck down constitutional abortion rights in 2022. And even when platforms do restrict accounts, it can be hard to contact the companies to find out why.
Susan B. Anthony Pro-Life America, an anti-abortion group, said big tech companies routinely restrict pro-life speech from it and other groups, suspending their accounts with little explanation and blocking their ads.
“Transparency is key,” said Jane Eklund, a fellow at human rights group Amnesty International USA, which released a report on Tuesday calling on tech giants to clearly state and explain their rules around abortion-related content. “Without clear guidelines, it's difficult to hold companies accountable for actions that may affect users, or to identify and address content moderation that affects what people can find online.”
Concerns that some tech platforms are suppressing posts about abortion have led to a shift in how women and groups talk about abortion online, intentionally misspelling the word as “aborshun” or “ab0rti0n” or replacing “bor” with a boar emoji in the hopes of reaching a wider audience.
But experts and content creators say it can make it harder for people to find information, and the coded language could stigmatize the procedure.
“You don't have to replace words and you don't have to censor yourself,” said Ashley Garcia, a 24-year-old part-time creator who made two promotional videos for Hey Jane last year.
The tech companies did not elaborate on how their moderation of abortion-related content has changed since 2022, but TikTok said there hadn't been any significant changes. Both companies said the issues with suspending and flagging Hey Jane, Mayday Health and Aid Access were mistakes that they had fixed.
TikTok says accounts can post about abortion, but the company has a long-standing policy of banning the advertising of abortion services, calling them “inappropriate businesses, products or services” alongside plastic surgery and organ transplants, although Instagram does allow ads for abortion services.
The report, released Tuesday by Amnesty International USA, included details of how at least six groups that promote or provide abortion services had their accounts and posts controlled by Meta, the owner of Instagram, Facebook and TikTok, over the past two years.
For example, TikTok removed videos from the Hey Jane account, which has 105,000 followers, for promoting “illegal activity and regulated products,” including a video detailing the states in which the company operates and its hopes of expanding to other states. The videos were not restored.
Last month, Hey Jane struggled for days to figure out why TikTok suddenly banned her account before the company eventually reinstated it. Rebecca Davis, Hey Jane's head of brand marketing, said TikTok told her: “The suspension was due to 'excessive relaxation' of prescription drug policies and should not have been lifted.”
“All they can say is it was a mistake and that they will do their best to make sure it never happens again,” Davis said.
TikTok declined to comment on the specifics of the Hey Jane experience.
Groups have also complained about similar issues on Instagram. Last year, the social network removed a post by abortion rights nonprofit Ipas that shared the World Health Organization's recommended protocol for medication abortion. Instagram said at the time that the post violated Meta's policy on “the sale of regulated goods or services.”
In March, Instagram suspended Mayday Health's account for the second time since 2022 “without clear explanation or justification,” said Olivia Reisner, the group's executive director. Mayday Health reportedly violated Instagram guidelines by posting about “guns, drugs and other prohibited items.” The group filed a lawsuit and got the account, which has more than 20,000 followers, back five days later. Mehta said last week that the issue between Mayday and IPAS was a mistake.
“Our concern is that with every decrease in the number of accounts, there are fewer people in states that ban them who are unable to get information about how to get the drugs,” Reisner said.
Meta spokesman Ryan Daniels said Instagram allows ads and posts for abortion services, as well as content from anti-abortion groups. “We want our platform to be a place where people can access trustworthy information about health care services, where advertisers can promote health care services, and where everyone can discuss and debate public policy in this space,” Daniels said. “That's why we allow posts and ads about abortion, and posts and ads that discuss and debate abortion.”
Some women's health groups, doctors and creators said they were concerned the platforms were also throttling posts about abortion services.
Mayday Health said it has seen a steep drop in the number of people seeing its Instagram posts this year: An infographic about abortion pills reached 15,730 accounts in April 2023. A similar post in March of this year reached just 1,207 accounts, despite the company's growing follower base.
Davis said she was explicitly told by TikTok representatives that if the word “abortion” was used in a video or caption, the content would be flagged and may not appear in users' main feeds.
TikTok said it doesn't ban posts about abortion from appearing in its personalized feed, but didn't say whether it restricts such content. Instagram said earlier this year that it doesn't recommend “political content” unless users choose to see it. Abortion advocacy groups haven't been given a clear explanation about whether the topic is considered political, and Meta didn't provide details.
Abortion rights groups say the problem extends to search engines like Microsoft's Bing.
Europe-based Aid Access is one of the best-known online providers of abortion pills in the United States, where medication abortions are rapidly increasing. A search for abortion pills on Thursday showed Aid Access's website on the first page of Google search results, but not within the first 10 pages of Bing search results.
A Microsoft representative said that instead, it shows sources that are similar in relevance and quality.
For months, Bing mistakenly displayed a red warning popup for Aid Access, telling users it was on the American Pharmacists' “not recommended” list. In September, the Pharmacists' Association removed Aid Access from the list after the organization switched its abortion pill supplier from Indian pharmacies to providers approved by the U.S. Food and Drug Administration.
Bing continued to feature the label even after it was notified of the change by Aid Access, and removed it after a New York Times reporter contacted it in May.
In several Republican-led states where abortion has been severely restricted since the 2022 Supreme Court ruling, state officials have introduced measures to punish organizations that provide information about abortion pills or how to obtain an abortion online.
Arkansas' Republican Attorney General Tim Griffin sent Aid Access a “cease and desist” letter in May, saying the organization was violating state laws on deceptive business practices because its ads could be seen by women in Arkansas, where abortion is banned unless necessary to save the mother's life.
Dr. Rebecca Gomperts, founder and executive director of Aid Access, said the threat won't change the organization's efforts, which has kept online marketing to a minimum because of challenges posed by big tech companies and relies on word-of-mouth referrals from patients and doctors.
“There's a game going on between social media and search companies that has its ups and downs,” Dr Gomperts said.
