Profiting from Deceit

An intro from CCDH’s CEO Imran Ahmed

Google is betraying the trust of hundreds of thousands of Americans seeking reproductive healthcare and services. Instead of providing accurate results to people who search for “abortion clinics near me”, Google is directing them straight towards those who wish only to delay and prevent their care using deceptive practices.

This report demonstrates the scale of deceptive advertising by anti-choice groups, fake healthcare clinics and the marketing infrastructure that underpins the spread of their medical misinformation, in a post-Dobbs digital environment.

Fake reproductive health clinics – sometimes called Crisis Pregnancy Centers – appear to offer independent advice on reproductive healthcare but are actually run by ideological organizations who try to shame those seeking services such as abortions, and employ scare tactics based on medical misinformation and lies.

Although they purport to offer independent advice and genuine reproductive healthcare, in reality they aim to intercept people and prevent them from exercising their right to good advice and services.

They are the cornerstone of the anti-choice movement, which we have found spends four times as much on Google Search ads for deceptive fake clinics than it does on Google Search ads for their constitutionally-protected right to campaign to restrict abortion care.

This report reveals that fake clinics have spent a combined $10.2 million on search ads over the last two years. 71% of those clinics use deceptive means, such as advancing false claims that abortions are linked to cancer and other diseases. 38% of these clinics do not carry disclaimers on their homepage making it clear that they do not provide abortions.

Among fake clinics with Google Search ads, 40% promote so-called abortion pill “reversal” (APR) – an unproven and unsafe method for reversing a medical abortion.

Despite pledging to ban advertisements of this unproven and unsafe “treatment”, following CCDH’s September 2021 report, Endangering Women for Profit – Google has since taken $2.6 million in Search ad revenue from such fake clinic websites that promote it.

And by using new tools that open the black box of Google’s advertising business, we also show that fake clinics have targeted more than 15,000 different queries related to abortion, including “abortion pill”, “abortion clinic”, “abortion clinic near me” and “planned parenthood”.

These new findings reflect the digital environment that now exists in a post-Dobbs America, where search engines are lifelines for those seeking care and information about their options – which are increasingly scarce.

Google, as the dominant search engine, is therefore also the most effective way of intercepting those seeking reproductive healthcare advice and services. Studies show people have a high degree of trust in search engines, but they also struggle to differentiate organic results from paid-for ads. That’s why we’re seeing anti-choice groups investing so heavily in misleading digital advertising – and over twice as much in states where abortions are still legal.

Such is the anti-choice lobby’s focus on online marketing that an entire industry of specialist consultants has emerged. In the words of one such agency, their mission is to help fake clinics become “wise as serpents, harmless as doves”.

Every Google results page is as highly curated as a TV commercial break or a magazine’s ads page. The difference is that carefully designed algorithms determine who is featured most prominently, and who is overlooked. In the case of reproductive healthcare, Google is selling the virtual equivalent of prime real estate to the highest bidder, and the highest bidder is often a fake clinic.

Google is a willing participant and supporter of the fake clinic industry, profiting from – and even subsidizing – the anti-choice lobby’s campaigns. It is the lynchpin of a multi-million dollar fake clinic industry that works around the clock to deprive Americans of medical assistance by deceptive means.

Reform is urgently needed. In line with CCDH’s STAR Framework, legislators must demand a standard of safety by design, transparency, accountability and responsibility from Google’s monopolistic Search business.

This means holding Google to its promises on disclaimers that provide vital transparency information to those seeking healthcare, and empowering regulators to step in to prohibit misleading advertising on reproductive healthcare.

Google and the anti-choice movement must not be allowed to continue to betray Americans seeking reproductive healthcare advice and services. The first step is to dismantle the vast, powerful digital advertising architecture that has been so effectively weaponized to deprive them of their rights.