Quality of Information Available Online for Abortion Self-Referral

Abstract

Objective: To assess the quality of information available online for abortion self-referral and to determine whether quality varies by region or distance to an abortion provider.

Methods: This was a cross-sectional study. We used a standard protocol to perform internet searches from August 2016 to June 2017 for abortion services in the 25 most populous U.S. cities and the 43 state capitals that were not one of the 25 most populous cities. We classified the first 10 webpage results and the first five map results and advertisements as facilitating abortion referral (local independent abortion provider, local Planned Parenthood facility, national abortion provider or organization, prochoice website, or abortion directory), not facilitating abortion referral (nonproviding physician office, nonmedical website, abortion provider greater than 50 miles from the location, news article, general directory, other), or hindering abortion referral (crisis pregnancy center or antichoice website). We used U.S. Census Bureau subregions to examine geographic differences. We made comparisons using a χ test.

Results: Overall, from 612 searches from 68 cities, 52.9% of webpage results, 67.3% of map results, and 34.4% of advertisements facilitated abortion referral, whereas 12.9%, 21.7%, and 29.9%, respectively, hindered abortion referral. The content of the searches differed significantly based on U.S. Census Bureau subregion (all P≤.001) and distance to an abortion provider (all P≤.02).

Conclusion: Two thirds of map results facilitated abortion self-referral, whereas only half of webpage results did so. Advertisements were the least likely to facilitate and the most likely to hinder self-referral. Quality was lowest in areas that were farthest from abortion providers.

Figure 1.

The proportion of webpage results facilitating, hindering, and not facilitating referral stratified by anonymous search engine (Google, Bing, or Yahoo), search strategy (1: “abortion” and location; 2: “abortion clinic” and location; 3: “where to get an abortion” and location), and Census Bureau subregion, and distance to an abortion provider.

Figure 2.

The proportion of location results facilitating, hindering, and not facilitating referral stratified by anonymous search engine (Google, Bing, or Yahoo), search strategy (1: “abortion” and location; 2: “abortion clinic” and location; 3: “where to get an abortion” and location), and Census Bureau subregion, and distance to an abortion provider.

Figure 3.

The proportion of advertisements facilitating, hindering, and not facilitating referral stratified by anonymous search engine (Google, Bing, or Yahoo), search strategy (1: “abortion” and location; 2: “abortion clinic” and location; 3: “where to get an abortion” and location), and Census Bureau subregion, and distance to an abortion provider.