In 2018, Google was first confronted by media reports investigating why crisis pregnancy centers (CPCs)—often religious, non-medical organizations that do not provide abortion services or referrals for abortion services—frequently dominate Google Maps search results for “abortion clinics.” Now, four years later, the tech company seems to be making some moves to potentially change the quality of these sorts of search results.
In response to a Bloomberg report that “Google Maps routinely misleads people looking for abortion providers,” Google says it is “actively” seeking to improve the relevancy of search results of categories of businesses like “abortion clinics.” It seems that currently, search results based on business categories aren’t as relevant as the similar business results displayed following searches for specific business names.
The question being aimed at Google is whether its ongoing practice of displaying CPCs in results for abortion clinics qualifies as spreading health misinformation. Women claiming they were misled by Google Maps say the CPCs they visited went to extremes to dissuade them from seeking an abortion. That included relaying “misinformation about the abortion procedure, including risk to life, risk of breast cancer, risk to mental health, risk to future fertility, and fetal pain.”
On average, a quarter of results for anyone searching for US abortion clinics on Google Maps directs users instead to visit CPCs, and in about a quarter of the country, CPCs comprise more than half of search results.
This is surely a problem for those validly searching for safe and legal abortion services, as some states have banned abortion—shrinking the number of available US abortion clinics. It’s expected that people seeking services outside those states will plan to travel farther to find services in areas that are less familiar, many relying on Google Maps to find the closest nearby businesses.
Because Google Maps search results by category of business often display similar businesses instead of indicating when there are no relevant results nearby, experts say that as abortion access is restricted, CPCs could dominate results, leading more users to risk encountering abortion misinformation. Worse, some users may travel long distances to visit businesses that do not really provide abortion services. This problem isn’t necessarily just limited to the category of business searches, either. In some cases, the NARAL Pro-Choice America Foundation has shown that CPCs “deliberately” use similar or sometimes the exact same business names as existing abortion providers. This contributes additional confusion, even for Google Maps users who are searching for specific business names (not just conducting general “abortion clinic” searches).
Bloomberg says that their analysis of the “abortion search result problem” is the most extensive conducted publicly so far. They collected data from 50 states, interviewed women who were directed to CPCs by Google Maps after searching for “abortion clinics,” and fielded insights from “33 abortion care providers, reproductive justice, and digital rights experts.”
Responding, Google told Bloomberg that “it works hard to surface business results that are relevant, accurate, and help users find what they’re looking for,” claiming to swiftly remove any business that misrepresents itself once it learns of violations to its policies against such behavior. The company also says that it has added “extra layers of verification” to confirm that businesses marked as “abortion clinics” on both Google Search and Maps “actually offer abortions.” One example is a Google policy update where advertisers have to certify that they provide abortion services to run ads with keywords “related to getting an abortion,” but Bloomberg notes that “it’s unclear whether Google would be able to apply that knowledge to its maps results.”
Google’s abortion clinic search problem
It’s not just media outlets pressuring Google to explain how it displays results for abortion clinic searches. This summer, the tech company has been torn between demands from Democrats to improve the accuracy of abortion clinic search results, as well as from Republicans protesting supposed discrimination against CPCs that rely in part on Google Maps to connect them with their clientele: pregnant people who want an abortion.
Republicans alleged that “Google appears to have caved” to Democrats’ demands, but the Bloomberg report paints a different picture, showing that CPCs are displayed in top 10 search results on Google Maps in all but 17 states. Those states tended to have the fewest abortion restrictions, showing a pattern that Google Maps searches tended to display more accurate results in states where the procedure is most accessible. In 13 states, CPCs represent 50 percent or more of the top 10 search results for abortion clinics.
For users, it can be hard to tell the difference between a CPC and an abortion clinic at first glance. Experts allege that CPCs rely on “overtly deceptive practices,” designing their websites with medical imagery like waiting rooms or white coats to convince casual searchers that the CPC is a valid medical practice. Abortion care providers also reported that sometimes their clinics are so busy, they cannot always answer the phone, and thus it’s more likely that someone will book an appointment online without verifying the business, which is when they can become vulnerable to accidentally booking a CPC visit instead.
But Google doesn’t have as hard a time distinguishing between abortion clinics and CPCs. Bloomberg’s analysis of hundreds of Google Maps results showed that CPCs weren’t designated as “abortion clinics,” but rather “women’s health clinics,” “free clinics,” or “medical centers.” Because Google has taken steps to limit abortion misinformation by banning YouTube videos and verifying advertisers, some wonder if a Google Maps update should come next, establishing new priorities to verify every business overlooked by current verification practices and limit abortion misinformation for users actively seeking abortion services and information. The tech company also recently vowed to delete abortion clinic location data for all Google searches, suggesting a sophisticated ability to identify and label abortion clinics across Google Maps. Absent any policy update, Google Maps for now is likely to keep mixing up results to display both abortion clinics and CPCs in most states, ranked based on user reviews and feedback, not necessarily by relevance.
A Google spokesperson did not respond to questions about updating Google Maps’ policies. Instead, the spokesperson tells Ars that across Google products, the tech company works to “make high-quality information easily accessible, particularly on critical health topics.” That includes “when people search for places on Google Maps.” The navigation service aims to provide users “with a range of relevant options and context to determine which results will be most helpful.”
Back in 2018 when Gizmodo first reported on Google Maps’ abortion clinic search problem, there was also some criticism about users manipulating abortion clinic search results to limit their visibility. It’s alleged that anti-abortion users would leave low reviews for clinics, downgrading them on the search result as less popular or lower quality. More drastically, some abortion clinics claimed their business listings would be continually marked as permanently closed by dishonest users trying to delete clinics from search results entirely.
To actively find ways to “improve the presentation of the available results,” Google says it takes user feedback “seriously.” Users can flag reviews, inappropriate content, or misleading/fake businesses for removal, and the spokesperson says there’s also a complaint form to report multiple business profiles at once.
Since Roe v. Wade was overturned, the debate between states around abortion access has heated up, and it’s expected that many people will turn to Google Maps as the country’s top navigation service to find safe and legal services near them. Cindy Cohn, the executive director of Electronic Frontier Foundation, told Bloomberg that although Google isn’t legally bound to improve its search results on Google Maps, she thinks that perhaps “Google should be ethically responsible to take steps to protect its customers against misleading search results.”
