Background: In the United States, the internet is widely used to seek health information. Despite an estimated 18 million Google searches on abortion per year and the demonstrated importance of the abortion pill as an option for pregnancy termination, the top webpage search results for abortion pill searches, as well as the content and quality of those webpages, are not well understood.
Methods: We used Google's Custom Search Application Programming Interface (API) to identify the top 10 webpages presented for "abortion pill" searches on August 06, 2018. We developed a comprehensive, evidence-based Family Planning Webpage Quality Assessment Tool (FPWQAT), which was used to assess webpage quality for the five top webpages presenting text-based educational content.
Results: Of the top webpages for "abortion pill" searches, a plannedparenthood.com page was the top result and scored highest on our assessment (81%), providing high-quality and useable information. The other four webpages, a Wikipedia.com page and three anti-abortion information webpages, scored much lower on our assessment (14%-43%). These four webpages had lower quality of information in less useable formats. The anti-abortion pages also presented a variety of disinformation about the abortion pill.
Conclusions: Both the lack of accurate clinical content on the majority of top webpages and the concerning disinformation they contained raise concerns about the quality of online abortion pill information, while underlining challenges posed by Google search results to informed choice for consumers. Healthcare providers and consumers must be informed of online abortion pill content that is not based in current clinical evidence, while advocates and policymakers should push for online information that is credible and useable. These changes are imperative given the importance of sound abortion pill information for reproductive decision-making at a time when in-person abortion services are further challenged in the US.