Clinics, advocacy groups and individuals who share abortion-related content online say they are seeing informational posts being taken down even if the posts don’t clearly violate the platforms’ policies

FILE - A patient prepares to take the first of two combination pills, mifepristone, for a medication abortion during a visit to a clinic in Kansas City, Kan., Oct. 12, 2022. (AP Photo/Charlie Riedel, File)

Clinics, advocacy groups and individuals who share abortion-related content online say they are seeing informational posts being taken down even if the posts don't clearly violate the platforms' policies.

The groups, in Latin America and the United States, are denouncing what they see as censorship even in places where abortion is legal. Companies like Meta claim their policies have not changed, and experts attribute the takedowns to over-enforcement at a time when social media platforms are reducing spending on content moderation in favor of artificial intelligence systems that struggle with context, nuance and gray areas.

But abortion advocates say the removals have a chilling effect even if they are later reversed, and navigating platforms' complex systems of appeals is often difficult, if not impossible.

For months, the digital rights group Electronic Frontier Foundation has been collecting examples from social media users who've seen their abortion-related posts taken down or accounts suspended.

“The goal of it was to better understand the breadth of the problem, who’s affected, and with what consequences. Obviously, then once we had a better understanding of the trends, we hope to call attention to the issue, demand accountability and increase transparency in the moderation practices and ultimately, help stop the platforms from censoring this essential, sometimes life-saving information,” said Jennifer Pinsof, staff attorney at EFF.

The organization says it received close to 100 examples of content takedowns from abortion providers, advocacy groups and individuals on Meta platforms such as Instagram and Facebook, as well as TikTok and even LinkedIn.

It's not clear if the takedowns are increasing or people are posting more about abortion, especially abortion medication such as mifepristone, since the Supreme Court overturned Roe v. Wade in 2022.

“I would say there was a wave of take-downs shortly after the election that was noticeable enough that it resulted in multiple news stories. But again, it’s not something that’s very easy to measure,” Pinsof said.

Brenna Miller, a TikTok creator who often posts about abortion and works in reproductive health care, said she made a video unboxing an abortion pill package from the nonprofit carafem — where she talked about what was in the package and discussed the process of taking the pills at home.

She posted the video in December. It was up for at least a week before TikTok removed it, saying it violated the platform's community standards.

“TikTok does have an appeal process, which I tried to go through. And it just locked me out. It said that I didn’t have the option to appeal it,” Miller said. “So I started emailing them, trying to get in contact with a person to just even get an explanation of like, how I violated the community guidelines with an informational video. It took months for me to even get in contact with a person and I don’t even (think) it was really a person. They were sending an automated message for months straight.”

Eventually, the video was restored in May with no explanation.

“I work in public health in my 9-to-5 and we’re seeing a real suppression of public health information and dissemination of that information, particularly in the reproductive health space. And people are scared,” Miller said. “It’s really important to get people this medically accurate information so that they’re not afraid and they actually can access the health care that they need.”

TikTok does not generally prohibit sharing information about abortion or abortion medication, however it does regulate selling and marketing drugs, including abortion pills and it prohibits misinformation that could harm people.

On Facebook, the Red River Women's Clinic in Moorhead, Minnesota, put up a post saying it offers both surgical and medicated abortion after it heard from a patient who didn't know it offered medication abortion. The post included a photo of mifepristone. When the clinic tried to turn the post into an ad, its account was suspended. The clinic says that since it does not offer telehealth services, it was not attempting to sell the medication. The clinic appealed the decision and won a reversal, but the account was suspended again shortly after. Ultimately, the clinic was able to resolve the issue through a connection at Meta.

“We were not trying to sell drugs. We were just informing our followers about a service, a legal service that we offer. So that’s alarming that, you know, that was flagged as not fitting into their standards,” said clinic director Tammi Kromenaker. “To have a private company like Meta just go with the political winds and say, we don’t agree with this, so we’re going to flag these and we’re going to shut these down, is very alarming.”

Meta said its policies and enforcement regarding medication-related abortion content have not changed and were not impacted by the changes announced in January, which included the end of its fact-checking program.

“We allow posts and ads promoting health care services like abortion, as well as discussion and debate around them, as long as they follow our policies — and we give people the opportunity to appeal decisions if they think we’ve got it wrong,” the company said in a statement.

In late January, Emory University's Center for Reproductive Health Research in the Southeast, or RISE, put up an Instagram post about mifepristone that described what it is and why it matters. In March, its account was suspended. The organization then appealed the decision but the appeal was denied and its account was deleted permanently. This decision was later reversed after they were able to connect with someone at Meta. Once the account was restored, it became clear that the suspension was because it was flagged as trying to "buy, sell, promote or exchange illegal or restricted drugs.”

“Where I get concerned is (that) with the increased use of social media, we also have seen correspondingly an increased rise of misinformation and disinformation on social media platforms about many health topics,” said Sara Redd, Speaker director of research translation at RISE and an assistant professor at Emory University. “One of main goals through our communications and through our social media is to promote scientifically accurate evidence-based information about reproductive health care, including abortion.”

Laura Edelson, assistant professor of computer science at Northeastern University, said that at the end of the day, while people love to debate platforms' policies and what the policies should be, what matters is people's “experiences of sharing information and the information are able to get and they’re able to see.”

“This is just a policy that is not being implemented well. And that, in and of itself, is not all that surprising because we know that Meta has dramatically reduced spending on content moderation efforts,” Edelson said. “There are fewer people who are spending time maintaining automated models. And so content that is even vaguely close to borderline is at risk of being taken down.”