Abstract
BackgroundIn the United States, the internet is widely used to seek health information. Despite an estimated 18 million Google searches on abortion per year and the demonstrated importance of the abortion pill as an option for pregnancy termination, the top webpage search results for abortion pill searches, as well as the content and quality of those webpages, are not well understood.MethodsWe used Google’s Custom Search Application Programming Interface (API) to identify the top 10 webpages presented for “abortion pill” searches on August 06, 2018. We developed a comprehensive, evidence-based Family Planning Webpage Quality Assessment Tool (FPWQAT), which was used to assess webpage quality for the five top webpages presenting text-based educational content.ResultsOf the top webpages for “abortion pill” searches, a plannedparenthood.com page was the top result and scored highest on our assessment (81%), providing high-quality and useable information. The other four webpages, a Wikipedia.com page and three anti-abortion information webpages, scored much lower on our assessment (14%-43%). These four webpages had lower quality of information in less useable formats. The anti-abortion pages also presented a variety of disinformation about the abortion pill.ConclusionsBoth the lack of accurate clinical content on the majority of top webpages and the concerning disinformation they contained raise concerns about the quality of online abortion pill information, while underlining challenges posed by Google search results to informed choice for consumers. Healthcare providers and consumers must be informed of online abortion pill content that is not based in current clinical evidence, while advocates and policymakers should push for online information that is credible and useable. These changes are imperative given the importance of sound abortion pill information for reproductive decision-making at a time when in-person abortion services are further challenged in the US.
Highlights
Twenty-nine million women of reproductive age in the United States (US) live in states considered very hostile or hostile to abortion (43% of women of reproductive age as of 2018)
Evidence-based Family Planning Webpage Quality Assessment Tool (FPWQAT), which was used to assess webpage quality for the five top webpages presenting text-based educational content
Challenges to abortion access along with increases in use of the internet over the past 20 years, including its use as a resource for health information and services, could lead to growing reliance upon the internet to search for information and to locate abortion care resources [1, 4,5,6,7]
Summary
Twenty-nine million women of reproductive age in the United States (US) live in states considered very hostile or hostile to abortion (43% of women of reproductive age as of 2018). For these women, abortion care access is severely restricted by cutbacks in services, legal restrictions that inhibit access, abortion stigma, and fear of potential legal repercussions if a pregnancy were to be terminated [1]. Many individuals face real and perceived difficulties that shape their trajectory of seeking and potentially accessing abortion as a desired healthcare service. Despite an estimated 18 million Google searches on abortion per year and the demonstrated importance of the abortion pill as an option for pregnancy termination, the top webpage search results for abortion pill searches, as well as the content and quality of those webpages, are not well understood
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