In a post-Roe landscape, pro-abortion advocates have been ringing alarm bells about digital abortion surveillance. As previous cases had shown, like when Meta turned over chats between a mother and daughter, digital communications can become evidence used in prosecutions against women obtaining abortions and those helping people access abortions. This can include messages between friends and family, internet searches, data shared with mobile apps and location data. In Texas, a man used text messages to file a wrongful death lawsuit against three women he alleged helped his ex-wife terminate a pregnancy.
The concern extends beyond messaging apps, too. Anti-abortion advocates have been pushing efforts to make abortion patients’ data publicly available despite confidentiality laws.
Sen. Tommy Tuberville (R-Ala.) introduced legislation this year that would require the Veterans Administration to provide quarterly reports on the number of abortions performed at VA hospitals and by affiliated providers. Sen. Katie Britt (R-Ala.) introduced the More Opportunities for Moms to Succeed (MOMS Act), a bill that would create a federal database for pregnant people nationwide. In Texas, one of the most restrictive abortion states in the country, lawsuits may be filed against “aiders and abettors,” which could include people who drive someone to obtain an abortion. In short, anti-abortion advocates are weaponizing technology to push an agenda eroding reproductive rights.
To protect oneself, those in the data privacy world recommend deleting period-tracking apps. Still, greater concern lies with apps like Facebook Messenger, or Google, which has been called a “uniquely dangerous tool.”
To combat this growing surveillance landscape, Tom Subak, former chief strategy officer at Planned Parenthood, teamed up with Cecile Richards, former president of Planned Parenthood, to create Charley, a private, secure chatbot that provides up-to-date, accurate information about abortion options in every zip code in the U.S. Salon connected with Subak about the current state of abortion surveillance and how pregnant people in the United States can keep themselves safe amid so much technology.
Can you tell me about the story behind Charley and how you and Cecile Richards created it?
When the first most serious restrictions started to get put in place, pre-Dobbs in Texas, Cecile gathered a small group of us together and said, “This is the beginning; it's going to get worse, and it's going to get worse not only for Texas, but for states all over the country, and let's see if there's something we can do.”
So what we looked for was, most importantly, what was the greatest need and the greatest need that we could contribute given our extensive experience and background. We had done a lot of online work together while we were at Planned Parenthood, and so what we looked at was whether or not abortion seekers' behavior was changing online so that we might be able to help abortion seekers.
In particular, [we focused on] the growing number of states that were either restricting or outright banning abortion, find the abortion care that they were looking for. And we found a couple of things, some surprising, some not surprising. But the short version is their behavior changed dramatically during and after the Dobbs decision, which was when people began to look for abortion pills in numbers we had never seen before. Actually, since Dobbs, there's been a 41 percent increase in searches for abortion pills. Abortion pills were the breakout search and cost was the other one. We found people were looking for answers to the following: How do I get abortion pills and can I afford them? That's really what we set out to do with Charley.
Can you elaborate on the privacy aspect and how it can be a secure platform for people seeking this information?
From the beginning, we said that this would be a privacy-focused, privacy-forward effort. And the privacy aspect of it was for the users. A lot of times you hear privacy and security, and sometimes that's all about the provider.
We went so far as to work with partners that were based in the EU so that the data, the small amounts of data that we collect, but don't retain, even the small amounts of data that we hold on to for a brief period were being held in Ireland and Germany and not in the United States.
We collect the absolute smallest amount of user data as we can, which is just location and last menstrual period, it's all we need to be able to provide the service that we're providing.
As I said earlier, we don't retain data for any purposes, and we don't do any tracking, even for analytics purposes. There's just a bunch of default practices these days in the digital space that they when intended or not, when you add them all up, it creates a trail of the user's behavior. And we wanted to put an end to that, and it was harder than we thought it would be because of this sort of default for tech these days. We want to know as little as we can.
I know surveillance is a huge concern right now. People often note the famous 2022 case in Nebraska when Meta turned over chats between a mother and her daughter in an investigation of an abortion. How, in your opinion has abortion surveillance changed since Dobbs?
How much abortion surveillance, the actual activity of surveillance, has changed? I don't think we know. How much is it a concern? We do know, and that is it’s something that everybody should be concerned about, I think, in a growing way.
We live in a landscape where, at one point, immediately after Dobbs, maybe we were concerned about if the state was going to sort of figure out that you were looking for an abortion. We now live in a time when states are criminalizing the actual possession of medication abortion, [such as] Louisiana. So I think there's more reason than ever for abortion seekers, abortion patients and abortion providers to be worried. But there are also things people can do to protect themselves as best they can be protected from that kind of surveillance.
In May, Sen. Katie Britt (R-Ala.) introduced the MOMS Act, a bill that would create a federal database for pregnant people nationwide. What concerns you the most about legislation like this, in which pregnancy-related data could be collected at the federal level?
We should all be concerned about data being collected by state and federal governments. And we should be concerned especially about health care data being collected.
There are all sorts of good reasons to collect health care data in an anonymized or aggregated way, so that we can run good public health programs at the federal level and the state level. We just learned this lesson in the starkest possible way during the COVID pandemic, but when it comes to requiring the collection, storing and ultimately handing over someone’s most personal health information, that just should be an absolute nonstarter. Legislation or not, bad actors at the state level and perhaps at the federal level, but certainly at the state level, are going to try to get individuals information to criminalize what should be absolutely permissible health care decisions and health care access by folks in all 50 states.
It’s a scary thought, and one that really just not only shouldn't be tolerated, but I think, is one that Americans of all stripes can agree on: the less data that the government is collecting about our health care decisions, the better.
What has surprised you the most about technology's role in the post-Dobbs landscape?
Search remains the primary way that abortion seekers go online to look for information. There is still a tremendous search volume for abortion generally and specifically different types of abortion access. That is still the case, and it is more so the case than ever.
And we've been heartened to see just how many tech startups have come forward to get into the provision explicitly of abortion care. And that’s a development that was almost unthinkable, even pre-Dobbs. Ineedana.com is terrific, and then PlanCPills.org is amazing.
Are you concerned about the rise in crisis pregnancy centers and the misinformation they spread?
Crisis pregnancy centers, or CPCs, have been a thorn in the side of abortion patients for a very, very long time, but I think more now than ever because they're funded better now than they were, with a tremendous influx of state funding that is going directly to them. There's more of them now than there ever were, close to 3,000 across the country.
They're there, and they're certainly online. They put a lot of effort into their online presence. But interestingly, the larger issue, and something we're working very hard on solving, is if you search for “abortion” or “abortion pill” or the variations, the top 10 search results that you're going to get — none of them provide an easy path or an obvious path to pills by mail — even if you're searching in Florida. You're not going to get an easy path to pills by mail.
What you are going to get is a lot of news stories, because abortion is in the news, and the news stories don't typically provide pathways to getting an abortion. And you're going to get a lot of information sites that have never-ending amounts of information from the CDC or Kaiser, great partners, right? But a lot of information, but also not pathways. What you're not necessarily going to see are CPCs.
You might see them in your local results, but we have a bigger fish to fry, and the bigger and those bigger fish are, we have got to make sure that resources like Charley, Ineedana.com and PlanCPills.org are front and center for the abortion seeker who is looking for information about abortion from a banned or restricted state, in particular if they choose and qualify for pills by mail.
