Algorithmic Ad Blocking Limits Information about abortion in Colombia

As a doctor, María M. Vivas never wanted to become an expert in technology. Reproductive health is unfortunately much more politicized than other branches of medicine. “Information is something that is very blocked in abortion rights,” notes Vivas. “That’s one of the barriers to access.”

To keep up with the demand for online information about often stigmatized subjectsher organization – the Colombian network of sexual and reproductive health clinics Orient me – had to become well versed in search engine optimization, keywords and other aspects of website management.

Colombia is at the forefront of the bitter, decades-long fight in Latin America for greater access to abortion. Before 2006, abortion was illegal without exception in Colombia. In 2006, a limited set of exemptions was introduced. Pro-choice activism coalesced around the network Causa Justa, which included Oriéntame. The movement won a major victory in 2022 when Colombia’s Constitutional Court fully decriminalized abortions up to 24 weeks, with exceptions still in place after that.

“The decriminalization of abortion is a historic milestone for Oriéntame,” Vivas reflects. After the decision in February 2022, “the next day, the service of free, legal and safe abortion was available through Oriéntame for the first time in Colombia.”

However, “changing the law is not enough,” Vivas has learned. While it’s vital to tackle stigma and enshrine rights, “implementation is a huge challenge and that’s the challenge we’re going through right now.”

A key implementation challenge has been ensuring that people can access accurate information about their new rights. “One of the obstacles to the exercise of the right to abortion is the lack of objective, timely, adequate and sufficient information from health care providers and the authorities, which can make people believe that they are committing a crime when they decide to have an abortion,” explains Catalina Moreno Arocha, a former lawyer who coordinates his social integration project Fundación Karismaa digital non-profit organization and human rights in Colombia.

Online information is not the full story inequalities in internet access. “We have to provide information through many channels, including brochures,” Vivas explains. “But certainly the Internet is a very important channel.” It is critical to explain the basics, such as where the clinics are located and what services they provide.

This pipeline of information collapsed in September 2022, seven months after the decriminalization decision, when Google began blocking Oriéntame ads that mentioned abortion. As the most popular search engine in Colombia, this was devastating.

Restrictions also affected access to information about other sexual and reproductive health services. According to Vivas, after blocking ads, Oriéntame’s web traffic plummeted by 96% in just one month, for contraceptive, STD and gynecology services. Phone calls for her services immediately dropped.

No longer able to rely on ads to drive people in need to Oriéntame’s website, the team had to put in a lot of work to grow their web traffic organically, through content like blogs and podcasts. She also had to come up with a number of solutions, including changing keywords (from “abortion” to “legal termination of pregnancy”) and even creating a second website that didn’t mention abortion, to get past Google’s automatic bans. “It makes our lives doubly complicated,” not to mention adding to the cost of providing care information.

Essentially, this healthcare organization had to play whac-a-mole, creating complex strategies in an effort to stay one step ahead of the blocks. And these strategies worked only temporarily. Oriéntame is still not allowed to advertise its abortion services on Google.

The right to information about abortion “obliges other actors, such as search service platforms, to ensure the free flow of quality information in all countries,” comments Moreno Arocha. In August 2023, the organization and its partners sent a letter to Google requesting certification as a legitimate provider. It’s a type of maneuver that Colombian feminists and pro-choice activists have had to use in the past: when faced with obstacles, join forces.

Fundación Karisma was troubled by the certification gap for most countries in the world. “The inability to advertise legal abortion services is due to the fact that the clinic certification process is only available for the United States, the United Kingdom and Ireland,” according to Moreno Arocha. Karisma worked with Oriéntame and two other organizations working on abortion rights in Colombia, La Mesa por La Vida and La Salud de Las Mujeres and Female link worldwide, to raise the issue with Google. “Today we await Google’s response and look at other cases in which information about abortion has been unfairly moderated by social media platforms,” ​​explains Moreno Arocha.

On the clinical side, Vivas reflects, “I never thought I had to go to Google and say, ‘Please, I’m a legitimate provider, let me advertise myself.’ That was never in my public health training.” But this step is an example of how adaptable the pro-choice movement has had to be even with decriminalization, to ensure the law has teeth. “Every aspect of the implementation needs to be taken care of,” Vivas emphasizes.

This was a lesson from and other countries. In Spain, the website of the medical abortion provider Women on Web remains inaccessible even despite the Supreme Court ruling that this exclusion was illegal. Women on Web is also working to restore access to its website in South Korea and Turkey. In the USA, information on abortion is blocked on Facebook, Instagram, YouTube and Google, with the companies offering a series of inconsistent explanations if they do.

It’s unclear whether Google’s blocking of abortion ads in Colombia is a response to anti-choice pressure or the result of an overly sensitive algorithm. Either way, it seems abortion providers have to jump through hoops that other health professionals don’t. Moreno Arocha notes that social media platforms “should avoid removing informative content about safe abortion or suspending accounts that make such posts. They must do the same with regard to activist content that seeks to denounce setbacks in securing sexual and reproductive rights.”

Google and Meta did not respond to requests for comment. A spokesperson for TikTok commented that abortion is not a limited topic when discussed in a medical way. The company’s Colombia-specific policies on advertising do not mention abortion, but note that advertisers of health care products must actively work with a TikTok sales representative.

“Technology has always pushed medicine and healthcare forward,” Vivas acknowledges. With more transparency about how tech giants allow or block certain types of health content, medical professionals like her will be able to spend more time providing care.