Google Maps Regularly Misleads People Searching for Abortion Clinics

Chey was a 19-year-old college sophomore living near Orlando, Florida, when she discovered she was pregnant and decided to have an abortion. She didn’t have anyone she could ask for guidance, so she searched Google for a nearby clinic. “I wanted to find somewhere close to my partner, so I could tell him and bring him with me,” she said in a recent interview.

A Google Maps query for an abortion led her somewhere that offered the opposite: a so-called crisis pregnancy center—a type of non-medical organization with a mission to encourage women like Chey to go through with their unwanted pregnancies.

Google Maps routinely misleads people looking for abortion providers, a new analysis by Bloomberg News has found. When users type the words “abortion clinic” into the Maps search bar, crisis pregnancy centers account for about a quarter of the top 10 search results on average across all 50 US states, plus Washington D.C., according to data Bloomberg collected in July. In 13 states, including Arkansas, South Carolina and Idaho where the procedure is newly limited, five or more of the top 10 results were for CPCs, not abortion clinics.

Number of Crisis Pregnancy Centers in Top 10 Search Results

Note: Data as of August 11th, 2022.

Chey had no reason to mistrust the result; the Alphabet Inc.-owned search giant in recent years has worked to become a destination for accurate medical information. But CPCs, which are generally backed by religious groups, never provide abortions or refer patients to clinics that offer the procedure. Instead of the help she wanted, the center gave Chey a rubber fetus and a stack of pamphlets with false claims that abortions lead to mental health issues and a higher risk of breast cancer in women.

“When my partner left the room, I mentioned that I was in an abusive relationship,” said Chey, who asked that her full name be withheld for medical privacy reasons. The staff working at the CPC said that was all the more reason to have the baby. “They told me that carrying a pregnancy could help repair my relationship, that it would cause my partner to step up as a man, and that I would find purpose in life again.”

Since the US Supreme Court overturned Roe v. Wade, 10 states have criminalized abortion and 4 have put time limits on the procedure. In some states, including Texas, asking someone for help accessing an abortion could lead to legal liability for that person, making Google the safer resource. Still, the tech giant has failed to eliminate inaccurate results in Maps, cited as a problem by media organizations since at least 2018, when news outlets including Gizmodo asked the company to explain why searches were turning up CPCs.

The abortion search result problem, which has never before been publicly analyzed at this scale, is already the subject of political pressure and debate. In June, a handful of Democratic lawmakers urged the company to give accurate results to people seeking abortions. A month later, 17 Republican state attorneys general wrote a letter to Alphabet CEO Sundar Pichai, demanding that the company “not discriminate” against CPCs in search results for people looking for abortion services.

In this case, medical doctors and reproductive health advocates said, letting the problem fester while debates rage on could lead to real-world harm. “If Google is a pro-science organization, or even just neutral, they would not want to lead people to these places with false advertising that can be harmful to their lives,” said Allison Cowett, the medical director of Chicago-based Family Planning Associates. “These fake clinics are not on equal footing with folks that are practicing evidence-based medicine.”

The company in recent years has sought to become a one-stop shop for information on medical issues, by “making authoritative information more accessible.” Googling “concussion” or “broken bone,” for instance, provides a medical overview and a list of possible symptoms. Searching for “abortion” or “pregnancy” surfaces news links first, showing how reproductive health care has become politicized.

In a response to Bloomberg’s questions, Google said that it works hard to surface business results that are relevant, accurate and help users find what they’re looking for. A company spokesperson pointed to its policies against businesses that misrepresent themselves on Maps and Search, and said that when Google becomes aware of listings that violate its policies, it works to remove them as quickly as possible. People can also report misleading places for removal, the spokesperson said.

Google Maps is the dominant navigation service in the US, with over 118.4 million monthly users in the country and a 56% share of the market among mobile users, according to a recent report from Insider Intelligence. “Google is a verb. It’s just the default behavior for a lot of people to use Google,” said Yoram Wurmser, principal technology analyst at Insider Intelligence. In states where the procedure is more accessible, such as California and Maryland, Google Maps displayed mostly accurate results.

To understand the implications of Google Maps returning inaccurate results in much of the country, Bloomberg News spoke to 33 abortion care providers, reproductive justice and digital rights experts, as well as women who sought abortions using Google Maps who were then directed to CPCs. They alleged that CPCs engage in overtly deceptive practices, such as the use of imagery to signify medical expertise, including white lab coats and waiting room areas, despite having no medical licenses.

Their websites are difficult to distinguish from those of legitimate health clinics, offering free pregnancy tests, ultrasounds and appointment bookings, easily misleading those who are choosing between options in a Google Maps search. Once women are inside, according to the sources, the centers relay misinformation about the abortion procedure, including risk to life, risk of breast cancer, risk to mental health, risk to future fertility and fetal pain.

Quiz: Is This an Abortion Clinic? 👆

Decades of medical literature have debunked these claims. Long-term studies have found that abortion poses fewer health risks to the mother than childbirth, and there is no evidence of an association between abortion and breast cancer or a woman’s subsequent fertility. Scientific research has also shown it is not possible for a fetus to perceive pain before 24 weeks’ gestation, and psychological studies found that people who are denied abortions have poorer physical and mental health, as well as worse economic outcomes than those who seek and receive them.

Penny Young Nance, chief executive officer and president of Concerned Women for America, a conservative nonprofit women’s legislative action committee, said it was the abortion clinics that were misleading Google users by using keywords related to pregnancy. “I understand why they do that — at the end of the day, they are trying to reach an audience,” she said. But “Google’s responsibility is to be neutral. They have no business weighing in on the abortion debate.”

Cindy Cohn, the executive director of internet rights advocacy group Electronic Frontier Foundation, said Google can make decisions about search results based on politics if it wants to and that does not violate the law. “But I think it’s wrong to suggest that this is a question about politics,” she said. “It’s instead about whether Google should be ethically responsible to take steps to protect its customers against misleading search results. I think it should be.”

The number of abortion clinics is dwindling fast in the United States, making it difficult for Google to display one nearby in areas where they have become scarce. There are more than 2,500 crisis pregnancy centers compared to about 800 abortion providers in the US, according to research from the University of Georgia College of Public Health. But Maps doesn’t tell users when there are no options.

Google Maps did return a notice saying “No results found” while searching for an Ikea or Trader Joe’s in Alaska, according to Bloomberg tests. It would do the same if users searched for a specific organization, such as Planned Parenthood, and there were none, a Google spokesperson said. But searching for a category of business, such as abortion clinic, surfaces a range of other options that may be relevant, the company said – results Google is “actively” looking to improve.

On June 24, the day Roe was overturned, Alphabet Chief People Officer Fiona Cicconi sent a memo telling employees that the company would “keep working to make information on reproductive health care accessible across our products.” In July, the company announced it would automatically delete records of user visits to sensitive locations, including abortion clinics. That same month, the Google-owned video site YouTube said it would begin taking down content that promotes falsehoods about the safety of abortion and direct users to information from health authorities alongside videos and search results about abortion. That’s also how the site deals with false content related to Covid-19 and elections, and makes it the only social media company to apply similar policies to abortion.

Cowett, the Chicago doctor, told Bloomberg that there is “absolutely, in bold capital letters” a link between Google Maps providing misleading abortion clinic results and the quality of care women receive in the real world.

She said that in Illinois, which is surrounded by states that have placed limits on abortions, the clinic is booked up for weeks on end. Staff have increased their work hours and scrambled to manage the flood of new appointments booked by patients traveling from states the clinic had never seen on its roster before, including Alabama, Mississippi and Louisiana.

More calls to clinics in places like Illinois means it is much harder to get a staff member on the phone, Cowett said. “That means people looking on the internet, more commonly, and making these appointments online,” she said, including people traveling across state lines for care. “If people are driving 10 or 15 hours to see an abortion provider, it could be devastating for them to make an appointment somewhere which actually does not provide abortion.”

How to Spot a Crisis Pregnancy Center

The Services tab doesn’t show abortion services— only pregnancy testing, ultrasounds, etc.*

No pricing information for services. The page only emphasizes the need to come in for a “confidential” appointment.

The Services tab doesn’t show abortion services— only pregnancy testing, ultrasounds, etc. *

No pricing information for services. The page only emphasizes the need to come in for a “confidential” appointment.

The Services tab doesn’t show abortion services— only pregnancy testing, ultrasounds, etc. *

No pricing information for services. The page only emphasizes the need to come in for a “confidential” appointment.

The Services tab doesn’t show abortion services— only pregnancy testing, ultrasounds, etc. *

No pricing information for services. The page only emphasizes the need to come in for a “confidential” appointment.

*Note: Obstetricians told Bloomberg News that CPCs often give incorrect medical results for these tests.

There are indications in Bloomberg’s data set that Google knows enough about businesses to differentiate between abortion clinics and CPCs. In Bloomberg’s analysis, 124 of the 510 results — roughly a fourth of the data set — were CPCs. Of 149 Google Maps results that had at least one word referring to medical healthcare in its Google Maps description (such as “women’s health clinic,” “free clinic,” or “medical center”), a third were actually crisis pregnancy centers, not medical clinics that provided abortions. But the hundreds of Google Maps results described as “abortion clinic” on the service were indeed abortion providers.

A Google spokesperson confirmed that the company has “extra layers of verification in place” to help it confirm that places labeled as “abortion clinics” on Google Maps and Search actually offer abortions.

Google in 2019 announced a policy change requiring those who want to run ads using keywords related to getting an abortion to certify whether they do or do not provide one. It’s unclear whether Google would be able to apply that knowledge to its maps results.

In the meantime, real women are being fooled by the results on Google Maps. Megan Jeyifo, executive director of the Chicago Abortion Fund, which helps people who can’t afford abortions access one, said the confusion caused by Google was “rampant.” She recalled a woman in Tennessee who sought the group’s help in late June and got a referral to the Hope Clinic for Women in Granite City, Illinois, which performs abortions. The woman instead called Hope Clinic for Women in Nashville, Tennessee — a crisis pregnancy center — after Googling it. Both establishments appear in Bloomberg’s Google Maps data set.

“This is where it gets tricky, especially when you’re moving people around the country,” Jeyifo said.

Circumstances can become even more complicated when women are in particularly precarious conditions, like a domestic violence situation, said Roxanne Sutocky, community engagement director of The Women’s Centers, which operates abortion clinics in New Jersey, Connecticut, Pennsylvania and Georgia. “Sometimes, people are Googling for abortion care at a library or in a friend’s house, where they do not have the time and resources to really dig deep and get that information quickly, or might not have access to the device they’re using for very long,” she said. “That underlines the importance for why this information should be accurate.”

Chey, the young woman who sought an abortion in Florida, did eventually manage to get one. But the CPC had told her, falsely, that she wasn’t as far along in her pregnancy as she actually was. She got a surgical abortion in her second trimester because she was no longer eligible for the abortion pill; it took weeks of planning and saving money, and a lie told to her boyfriend’s family that they were going to the beach one day over Thanksgiving break.

Even though she never changed her mind about needing an abortion, the things the CPC told her left her sleepless and wracked with guilt. “I remember dealing with the physical aftermath and the stigma I immediately felt,” Chey said. She said never stopped researching abortion, including on Google, but she didn’t learn the truth about what happened to her until much later. Chey thought that CPCs simply presented “conflicting science and studies,” she said.

Sutocky often sees patients that visited CPCs first. One woman came to Sutocky’s Philadelphia clinic while already in her second trimester; like Chey, she had been fooled by a CPC with a similar-sounding name and got a false reading on her ultrasound.

Another patient was a tougher case. Sutocky could not convince her that the place she had gone first had provided false information.

“I tried to say, ‘This person, this place that you were talking to, was not a healthcare center. That was not a doctor,’” Sutocky said. “But the patient said, ‘No, I searched it, and I went there. That was what the computer said it was.’”