EXECUTIVE SUMMARY
Most people now receive health information over the internet through search engines, social media posts, and advertising. Because abortion is politicized, there is a great deal of information online that is misleading or inaccurate.
- Researchers investigated how people navigate online information, including both accurate and false information.
- Some sites claim abortion causes infertility or can kill women.
- After a web search, study participants tended to decide abortion was safer than they thought it was before the search.
Researchers have spent a few years trying to understand how abortion information is presented online and how it is understood by laypeople. This is one of those controversial healthcare issues in which internet information is more likely to be intentionally false than it is to be inaccurate due to ignorance or misinterpretation of data.
“The premise is recognizing that most people today are getting information from the internet,” says Leo Han, MD, MPH, study co-author and assistant professor with the Oregon Health & Science University department of obstetrics and gynecology. “If you want information on abortion, you can look it up first. Plus, Facebook and social media posts will feed you a lot of passive information about abortion through memes and people posting stuff. It’s a controversial and widely discussed topic.”
Information Intentionally Misleading
On other healthcare topics, such as prostate cancer, information online might vary. But the inaccurate information is not bad because of people trying to mislead information-seekers.
“But with abortion, because it’s politicized and there are camps of pro-choice and anti-choice out there, a lot of the internet stuff is wrong, incorrect, and misleading,” Han explains. “This information is what informs the public on how it perceives abortion.”
In a previous study, researchers had already shown the plethora of misinformation available online. For this investigation, they wanted to know how well people would navigate through both accurate and false information about abortion.
“We wanted to know if we took someone and asked them to look up abortion, what would they come away with from their knowledge and perception of abortion,” Han says. “A lot of the misinformation was making it seem like abortion was unsafe.”
The false information attempted to scare people about abortion. Some sites claimed that abortion would cause infertility or would kill women.
“They claimed to provide resources about abortion, and they masked themselves, a little bit, to not come off as being overtly anti-abortion, but they are,” Han says.
Han and colleagues asked participants whether abortion was safe and whether it caused infertility. The correct answers were “Yes, abortion is safe,” and “No, abortion does not cause infertility,” Han says.
After answering the questions, people were given web browsers that were clean of search history and asked to look for information online that would answer those two questions.
“One of the limitations was we conducted this study in Portland, OR, where our hospital and research center are based,” Han says. “We have a bias in terms of demographics.”
For instance, Portland participants tend to be more liberal than a participant pool that is based in a non-urban Midwestern or Southern area.
“In the real world, you could conduct the study in Ohio and capture people who are all over the place in political slant,” Han says. “In Portland, we tended to capture people who were more liberal.”
Investigators tried to enroll conservative participants and put up advertisements in churches, but they were unsuccessful in diversifying their pool of participants.
“What we found is that regardless of their leanings beforehand, after a web search, they tended to decide abortion was more safe than they thought it was before the search,” Han says.
The questions about safety and infertility were given a range of answers from participants not confident in abortion’s safety to extremely confident in its safety. The same range, scored 1 to 10, with 1 being “not confident,” also applied to their thoughts about whether abortion is likely to result in infertility.
After performing an internet search, participants were more likely to say they were extremely confident that abortions are safe and do not cause infertility.
“Despite the information on the web being of mixed quality, people seemed to see enough of the high-quality information or could tell what’s high-quality,” Han says. “They were more reassured by seeing it.”
The pre-search findings were surprising because even people who identified as pro-choice, educated, and liberal thought abortion was less safe.
“Initially, they thought it was unsafe, and after the search, they felt it was safer,” Han says. “The two takeaways are that after an unguided web search, where people looked at the internet for half an hour, they found abortion was more safe than before they did the internet search. Even people who you think knew abortion was very safe underrated its safety.”
Study participants also were asked about the safety of cesarean deliveries and connection to infertility. They believed cesarean deliveries were slightly less safe before they performed the internet search.
Susceptibility to Trap Laws
Inaccurate concerns about legal abortions and their safety might contribute to susceptibility to believing trap laws were passed for safety reasons.
“Trap laws are laws that are meant to reduce access under the pretense of increasing safety,” Han explains. “If the average person is not convinced that abortion is super safe, they might not see through these trap laws and see how these are really about being anti-abortion. I’ve come to appreciate that average people are being influenced by a lot of negative information on the internet.”
Han and colleagues found that the most common websites participants used for information were news sites, blogs, Wikipedia, and YouTube. Some people also found the websites of Planned Parenthood and other high-quality information sites.
“We asked, ‘Do you feel it was easy to find answers? Do you feel like information on the internet was efficient?’” Han says. “Eighty-six percent said it was easy to find information, and 55% said they thought the information was consistent from website to website.”
Almost 40% noted a lot of conflicting information online, and 7% thought there was a lot of mixed information, and they could not decide which information was accurate.
From a reproductive health provider’s perspective, knowing that patients might believe abortions are not as safe as data show, they could spend more time educating patients on the evidence of safety.
“Knowing that a lot of information online is low-quality and misleading, you could have websites in your brain to direct people toward,” Han says. “People want to look things up. If someone calls in on Tuesday to ask about abortion on Friday, they’ll Google it.”
Clinicians can steer them to websites with accurate information that is not designed to scare them.
“Cite facts on safety. People still need to work hard to spread information about abortion safety,” Han says. “Unfortunately, if you Google about abortion, which I do periodically, the vast majority of information, starting off, is pretty good, but it doesn’t take long before you get into a fake site, where people are talking about infertility and things like that.”
The goal should be to give patients information and websites that provide accurate information, combatting the world of false claims and misinformation, he adds.
REFERENCE
- Forbes M, Darney BG, Ramandathan S, et al. How do women interpret abortion information they find online? Contraception 2021 Apr;103:276-281. doi: 10.1016/j.contraception.2021.01.005. Epub 2021 Jan 14.
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