(CNN) — After a draft US Supreme Court decision in Roe vs. Wade, Dr. Joshua Trebach noted a troubling turn in the online conversation about abortion.
“I started seeing things on social media, like TikTok, Twitter, Facebook, Instagram, where people were like ‘oh, if Roe vs. Wade gets overturned, here are some secret, stealthy ways to have tea and get an abortion.’ Trebach said.
Now that Roe vs. Wade has been reversed and some states are placing strict limits on abortions, there is widespread confusion about whether the procedures are available and to whom. Doctors and poison control officials say they are concerned that people seeking abortions are turning to ineffective and dangerous methods shared online, which could delay or prevent safe and proven abortion care.
Social media companies told CNN they are taking a number of steps, including reviewing some abortion-related posts, elevating content from verified sources, and labeling or removing certain posts.
This kind of misinformation about abortion is “scary,” said Trebach, an emergency room physician and toxicologist in New York City. Some herbs that are described may not do anything at all. Others could have a number of medical effects or even be fatal.
Trebach said the online posts he saw came from unverified sources and described substances he only learned about during his toxicology training. In the United States, many herbs and supplements are regulated as foods, not drugs, which means there is no safety or efficacy data to support their use. The negative effects of an herb can’t always be easily treated, she said.
“In the end, nothing, no plant, no herb, no tea, no tincture, is going to be safer or more effective than the current medical standard of abortion, the medical therapies that we currently have,” he said. “Nothing is a fair substitute for that.”
Julie Weber, president of the board of directors of the American Association of Poison Control Centers, said that the centers have not seen an increase in exposure calls about people trying to have an abortion, but they are preparing for it. People can call the association at 1-800-222-1222 or contact the experts in poisonhelp.org if they have questions about a substance and its potential effects.
“When I hear or start seeing questions on social media, when I hear people talking about alternative medications or herbal products or supplements, I get concerned,” Weber said. “And I’m concerned about this, and we want to get that message across that it’s not necessarily a safe alternative or even going to be effective.”
Tech companies respond
Andrea Miller, president of the reproductive health advocacy group National Institute for Reproductive Healthhas seen misinformation about abortion online and said some of it may come from “well-meaning people who are outraged and fearful and want to help right now, but may be unknowingly sharing information that is not accurate or directing the people to vile resources without realizing it.
Miller is also concerned that some posts may be designed to misinform and confuse.
“There has been a calculated and damaging campaign of disinformation that has lasted for many decades by those who oppose reproductive freedom, and we anticipate that it is now going to intensify significantly,” he said.
A TikTok video, with hashtags such as #womenshealth and #womensrights, listed a number of fruits, herbs and other DIY methods it said could induce abortion. The post garnered more than 244,000 likes before it was flagged by CNN and removed by the platform last week.
TikTok says it is removing videos about abortion that violate its policy against medical misinformation, though it allows other content on the topics, such as videos that discuss access to the procedure, according to a spokesperson. The short video platform is also redirecting searches for certain hashtags like #herbalabortion and #naturalabortion to its Community Guidelines instead of displaying results.
Similar posts with misleading and potentially dangerous claims about inducing abortion have also been shared on Twitter and Facebook, though most appeared to have less reach and engagement than on TikTok.
A Facebook spokesperson said abortion posts may be reviewed by its third-party fact-checking partners, and content that is rated “false,” “altered” or “partially false” by fact-checkers will have a reduced distribution. Facebook Pages, groups or accounts that repeatedly share content debunked by fact-checkers may also see their reach reduced or lose the ability to advertise or monetize, according to the company.
As of Wednesday, two posts with potentially damaging claims about self-induced abortion that CNN flagged to Facebook had not been flagged by fact-checkers, who choose what content to review.
Twitter says it is working to “pre-check” misinformation by elevating reliable sources, including in its Twitter Trends and Moments features, according to a spokesperson. In general, Twitter’s rules do not prohibit discussion of abortion, contraception, or related topics; Under the platform’s disinformation policy, measures are taken against misinformation related to covid-19, civic integrity, synthetic and manipulated media, and crisis situations, but the policy does not mention abortion.
As of Wednesday, the platform had failed to label or remove several posts flagged by CNN that contained advice on the use of herbs or large doses of drugs that toxicologists say could be ineffective or harmful.
Miller advises people seeking abortions or information about the procedure to approach the topic the same way they would any other health issue: “That is, make sure you’re looking at reputable sources, or if you think ‘hey, that’s an intriguing post or thing, I might want to check it out’, make sure to do some additional research if you’re not sure of the source, even if it’s one of your closest friends and you’re not sure where they’ve found it. obtained and they are not sure of its origin”.
Distract from truthful information
Doctors CNN spoke with said they are concerned that videos containing abortion misinformation imply that there are no pathways to legal abortion, which could distract from available and safe options and create more confusion.
“I think we’re lucky today to have very safe medical abortion options, and I’m concerned that if misinformation is spread, people won’t know there are ways to access safe methods,” she said. Dr. Jody Steinauerdirector of the UCSF Bixby Center for Global Reproductive Health.
Although there are medications approved by the US Food and Drug Administration (FDA) to allow home abortion, some people may assume they cannot access them, said Dr. Nisha Verma, member of the American College of Obstetricians and Gynecologists and gynecologist specializing in complex family planning.
“Some people may also resort to unsafe abortion methods when they feel they have no other choice or based on information they pick up from social media,” Verma said.
Posts and content on topics that inspire emotions have a much higher chance of going viral on social media. And that can be dangerous when they contain false or misleading claims.
“Misinformation can be harmful because it can lead people to try to terminate their pregnancies in an unsafe way, potentially exposing them to serious bodily harm. While people can safely self-manage their abortions, the spread of misinformation about unsafe methods of abortion is incredibly dangerous,” Verma said.
However, since there is no federal constitutional right to abortion, access to abortion differs from state to state. The Biden administration is working across multiple federal agencies to respond to the repeal of Roe v. Wade.
On Tuesday, the Justice Department announced the creation of a task force aimed at identifying ways to protect reproductive rights in the wake of the Supreme Court’s decision that struck down the federal right to abortion. And last week, President Joe Biden signed an executive order aimed at protecting access to reproductive health services. The decree attempts to safeguard access to medical abortion and emergency contraception, protect patient privacy, and establish public education initiatives. It is also intended to strengthen the safety and legal options of those who seek and provide abortion services.
waste valuable time
Even before the Supreme Court decision, there was evidence that some people were attempting to self-manage abortions with things like herbs, physical trauma, and uterine trauma, Jenny Higgins saidprofessor of obstetrics and gynecology at the University of Wisconsin, Madison.
“We, of course, know that those techniques are ineffective and, in some cases, also harmful,” Higgins said.
When it comes to methods making the rounds on social media, he said, his biggest concern is that they take up valuable time.
“Someone could look at alternatives like herbs, spend time trying to gather information, get that substance, take the herb, take it again, and take it again, and by then, they’re further along in the pregnancy and maybe have less likely to access effective methods,” Higgins said.
“There is a real time constraint here,” he said. “The more advanced people are in pregnancy, the more effort it takes to abort.”
Being on the borderline of 10 to 12 weeks of pregnancy can make a big difference in whether someone can safely use FDA-approved abortion drugs, he said.
The methods available for self-managed abortion today are very different from those of the pre-Roe era.
“I want people to understand that we now have the same pills, the same FDA-approved pills that are used in standard abortion care, that can be ordered online,” she said. “There are self-managed techniques that are extremely safe and effective.”
— Clare Duffy and Jen Christensen contributed reporting.