HeyJane, a telemedicine abortion provider, has had its TikTok account banned three times. Plan C, an organization that provides information about accessing abortion pills by mail, has had multiple posts across platforms taken down, along with an Instagram account suspension. Even Rewire News Group’s own TikTok account was banned, without notice or explanation.

These are just a few examples that highlight the widespread issue of social media platforms suppressing abortion and reproductive health-related speech. Activists, doctors, and organizations now fear having their engagement plummet, posts taken down, or accounts banned with even one mention of the word abortion.

Dr. Heather Irobunda, an OB-GYN with New York City Health and Hospitals who has around 80,000 followers on Instagram and nearly 43,000 on TikTok as of publication, attributes her role as a Black physician in the Bronx as a motivator for creating educational social media content, given that abortion bans disproportionately impact Black women and people of color. She said her posts being taken down or flagged “has been a widespread problem” on her accounts.

“The word ‘abortion’ gets flagged a lot, and even words related to reproductive health like ‘vagina’ or ‘vulva’ get flagged by Instagram and TikTok,” Irobunda said. “Sometimes you end up getting community guideline violations, you get your videos taken down, or your engagement goes down. I’ve had videos taken down, and I have decided not to post certain things because I was concerned about it being flagged or taken down.”

TikTok guidelines allow for “reproductive health and sex education content, such as the use of birth control and abortion discussed in a medical or scientific context related to procedures, surgeries, or examinations.” Meta, Facebook and Instagram’s parent company, has no specific mention of abortion, reproductive health, or sex education content in its community standards. Additionally, Instagram said earlier this year it would begin limiting “political content,” without defining whether it qualifies abortion and reproductive health-care content as political.

Though Meta censored abortion-related content even prior to the Supreme Court overturning abortion rights in 2022, as more states ban abortion or even restrict sex education, information access is increasingly vital. It can take weeks to have an account ban or content takedown decision reversed, which is frustrating for activists, health-care providers, and organizations that aim to get accurate and timely information out as quickly as possible.

Niharika Rao, a doula and National Institute for Reproductive Health political and legislative affairs associate, said that when doing work to get medication abortion on campuses, posts would constantly get flagged on Instagram.

“It shouldn’t feel like getting access to health-care [information] is equivalent to a Mission Impossible operation. It should feel as easy as Instagram-messaging a friend,” Rao said.

Social media platforms are flagging medically accurate words like “abortion,” “vulva,” and “vagina” that medical professionals use to communicate information, Irobunda said. To circumvent a platform’s algorithm, some users intentionally change the spelling of words with algospeak like “ab0rshun” or “aborti0n.” But Irobunda said that while these workarounds are clever, it can add to the stigma and make it more difficult to find accurate information.

“The people who are more likely to use the euphemisms are nonprofessionals, which is OK, but the problem is that there is an increasing likelihood of misinformation,” Irobunda said.

Under Section 230 of the Communications Decency Act, websites can host third-party content and moderate content without being held liable in most cases. In other words, social media companies have a right to choose which speech to host, making it difficult to single out suppression of abortion-related speech.

“There have been claims against a bunch of platforms for deplatforming people or for deprioritizing certain posts—and for the most part, those haven’t been successful.” Kendra Albert, a clinical instructor at Harvard Law School’s Cyberlaw Clinic, said. “Even though platforms are well within their First Amendment rights to decide what is said on their platform, that doesn’t mean there aren’t significant political consequences to suppressing particular forms of speech because they have concerns.”

The political consequences continue to unravel as abortion remains a top issue ahead of the November presidential election. Since Roe v. Wade’s overturn two years ago, several Republican-led states have introduced bills to punish organizations that share information about abortion or abortion medications online. Currently, 21 states ban or restrict abortion. Furthermore, there are open First Amendment questions moving through the courts that could further shape and inform how social media platforms might moderate speech and misinformation.

Social media, though often a breeding ground for mis- and disinformation, democratizes access to information, particularly in areas of the country where abortion is banned or comprehensive sex education is not taught in classrooms. In fact, young people in states where abortion is banned rely on TikTok as a resource, especially to hear from people who have had abortions.

For Abortion Care Tennessee, an organization that helps pregnant Tennesseans travel out of state for abortion care, an online presence is critical to raising awareness of its services. But the organization continues to face lower engagement and community guideline violations when it includes abortion-related hashtags or even donation links in its posts.

“For pro-abortion organizations trying to do reproductive justice work in ban states, oftentimes we won’t have a brick-and-mortar building where people can come in and see us, so our online presence is the only way that people can get plugged into our community, our services, and our education that we’re trying to offer,” Jules Edwards, Abortion Care Tennessee’s executive director, said.

“The South is in an access crisis, which means the South is also in need of more information, education, and resources than ever before, especially given how people find information about abortion services, which is primarily online or via word of mouth with trusted folks in their networks,” Edwards added.

Adding to the already tenuous relationship between abortion speech and social media platforms is the looming possibility of losing TikTok altogether. In April, President Joe Biden signed legislation that would force the sale of TikTok by January 19, 2025 or face a ban; a hearing before the U.S. Court of Appeals for the District of Columbia is scheduled for September 16.

“All anti-abortion policy and sentiment is about power and control,” Edwards said. “It makes perfect sense to me that opposition to abortion or conservative lawmakers would see the power behind people having access to free and accurate information, and so I don’t feel like the TikTok ban is coming out of nowhere.”

In the meantime, activists and organizations are calling on Meta and TikTok to be more transparent in how their content moderation practices apply to abortion-related content. A recent report from the human rights organization Amnesty International outlined recommendations for Meta and TikTok, specifically asking them to mitigate the spread of false abortion information, combat the harms from suppressing abortion-related speech, as well as increase transparency around the algorithm and bolster access to accurate abortion information.

“We shouldn’t have private companies’ interests dictate speech, because then you’re only going to have commercial, market-friendly, and advertiser-friendly speech prioritized,” Rao said. “I don’t want to be having to beg Meta to be able to post on what effectively functions like a public forum.”

Editor’s note: The author previously worked with Kendra Albert as a research assistant for the Initiative for a Representative First Amendment, but is not currently affiliated with the Harvard Cyberlaw Clinic.