Activists use Google keywords as tools for abortion access, services, questions

Google searches for information began to surge immediately after Roe v. Wade was overturned. 

In the four weeks since the Supreme Court’s Dobbs v. Jackson Women’s Health Organization ruling, searches for “medication abortion pills” have gone up by 70 percent; “do abortion pills expire” are up 350 percent; “abortion pills Amazon” are up 80 percent. People Googling for “states where abortion is illegal map” has gone up over 1,050 percent in the past month.  

As more people search for information on abortion access in a post-Roe world, anti-abortion organizations have a leg up because of their long-time investment and savvy in the digital space. And as searches for information on abortion surge, abortion clinics and other services are trying to get accurate information in front of people. 

Crisis pregnancy centers, largely non-medical sites that aim to dissuade people from getting abortions, have been very effective in getting people seeking abortions through their doors, in part by billing themselves as medical clinics though they often have little to no medical staff. Many offer ultrasounds for free, but then present pregnant people with misleading or outright false information. 

Crisis pregnancy centers have invested heavily in Google Ads, a service that allows companies to pay for sponsored search results to turn up at the top. Their parent organizations often hire outside specialized anti-abortion digital marketing agencies or deploy their own staff to ensure that searches for abortion-related terms will surface their content. 

Emily Loen co-founded the Abortion Access Hackathon — a group using technology to help further reproductive justice — five years ago while doing education work at an abortion clinic in California. The group now works with a coalition of partners, including the Abortion Access Front, and has created #ExposeFakeClinics, a movement to leave honest reviews about crisis pregnancy centers on Yelp, Facebook and Google, documenting what services actually are and are not provided there. Because of the work of grassroots digital activists like Loen, Yelp no longer classifies the centers as medical clinics, and Google utilizes a small banner at the bottom of any search result that utilizes “abortion” as a keyword noting whether that business actually provides abortions. 

“Google is doing some of the heavy lifting now that activists have done for years,” Loen told The 19th. “It doesn’t solve the problem, but it adds a level of protection and awareness.” 

A recent Abortion Access Front project Loen worked on involved utilizing volunteers to simply click on the website for Plan C, a company that provides information on how people in the United States can access abortion pills online. Organic traffic can help raise a site’s rankings for search engine optimization (SEO). As of this writing, the top search result for “abortion pills online” is Plan C. It’s the first time this has happened for the six-year-old company — and it’s not a coincidence. 

Amy Merrill, the co-founder and digital director of Plan C, told The 19th that one reason is that post-Roe, the group is “paying a lot more attention to the ecosystem”: keywords, how people use search. They’re also putting heavy investments in informational Google ads. 

“We’re actively thinking about the future of search and what people are looking for and how tools like Google will respond or iterate as well,” Merrill said. She added that there has already been a documented shift in search trends, away from things like “abortion clinic near me” to “medication abortion” and “managing abortion.” 

Power to Decide, the campaign to prevent unplanned pregnancy, launched their AbortionFinder.org resource two years ago. Lauren Kernan, the director of content and UX strategy for the company, said that because of their site’s newness, it’s already an uphill battle when it comes to SEO. 

“We don’t have the same established site authority as other big-name sites in the space, and we have had to build up our search equity over time with search engines like Google,” she said.

Kernan said that the AbortionFinder.org social accounts also often get reported to the host platforms, leading these accounts to “go dark for a period of time” while under review, which further sets back their ability to simply be found easily online.  

“When a social account is deactivated or temporarily disabled, links back to AbortionFinder.org disappear as well. This drop in backlinks can also drop our SEO rankings, because backlinks are one of the most important ranking factors when it comes to search.”

Another complicating factor is that the way people consume information does not always go hand-in-hand with what content is prioritized by SEO, Kernan said. “Long-form content traditionally ranks better on search engines, but users looking for abortion information may be stressed out and overwhelmed, looking for brief, simple, clear information that is easy to scan. Long-form content is not the right fit for these users.”

In the days following the Dobbs ruling, Meta — Facebook’s parent company — faced criticism for taking down posts made by individual users about accessing medication abortion online from both Facebook and Instagram. A spokesperson for Meta told The 19th the company wants their “platforms to be a place where people can access reliable information about health services.” 

While the Meta spokesperson says the company allows posts and ads promoting health care services like abortion as well as discussion and debate around then, “all content about abortion, regardless of political perspective, must follow our rules” — including regulations around prescription drug content. While Meta allows discussion related to mifepristone and misoprostol, including making search results of hashtags using these terms available to users, the company restricts “search terms for mifepristone and misoprostol in our commerce products to prevent abuse.” The company also continues to “prohibit the direct sale of prescription drugs [like misoprostol and mifepristone] anywhere on Meta’s platforms.”

Jessica Ensley, the digital outreach and opposition research director for the reproductive justice group ReproAction, told The 19th that her organization has seen “quite a big boost in engagement across platforms and through organic searches” post-Dobbs. Traffic has especially been up on the organization’s pages related to self-managed abortion resources and their Fake Clinic Database, a resource the group constantly updates to track the locations of crisis pregnancy centers. The group’s focus on SEO is greater now than ever. 

“We want people to easily access through search our resources when they’re looking for content on abortion, abortion pills, medication, fake clinics — we want people to have access to that information on our site and we’re seeing a big increase in search around those terms now that Roe has fallen.” 

As more and more people search for information to allow them to vet whether a clinic actually provides abortion or is a crisis pregnancyc enter, Ensley said that resources like ReproAction’s Fake Clinic Database have to be methodical about the language they use to describe these places to optimize search results. 

Kernan also spoke to the challenge that exists between what people need to find and search terms being used. “Some best practices in terms of SEO are not always the best for user experience or user comprehension. So sometimes SEO and user experience can be calling for different headers, keywords and/or content.,” Kernan said. “For example, the most highly searched term for users looking for abortions is ‘abortion clinic near me.’ But not all abortion providers are [physical] clinics — such as telehealth providers, which we really want our users to know about and understand.”

In addition to searching for where to get abortion care, Kernan said that many people are searching for whether abortion is legal in their state right now. These types of searches then often lead people to Abortion Finder’s state-by-state guide, which provides up-to-the-minute information about the legality and accessibility of abortion in each state, along with assistance options that may be available to abortion seekers. These guides are optimized to address user queries that involve state-specific requirements and barriers.

Within two days of the Dobbs decision, the anti-abortion group National Right to Life Committee drafted model legislation that would criminalize those helping people self-manage abortion, including by providing them information online. “I expect the National Right to Life Committee and other anti-choice politicians and activists to [attempt] to criminalize factual information about abortion being shared online or digitally,” Ensley said. “It’s going to be an uphill battle, but we’re not going to stop because not only is it our First Amendment right, but also it’s the right of everyone to have the information that they need in order to best take care of their health.”