Thread by @DrSherryPagoto

HOT OFF THE PRESSES! In this piece we make the case that we are in an abortion infodemic and lay out an urgent research agenda.

This infodemic has unique features that make it challenging to address & this has implications for future infodemics. 🧵

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jmir.org/2023/1/e42582

First, let’s review why the loss of #reprorights puts women's health at risk. Here are the stats on maternal mortality in the US compared to other industrialized nations.

This is inexcusable.

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Digging deeper into the data reveals enormous inequities. Black women have 3 times the maternal mortality rate as white women. As do Native American women, women with diabetes, CVD, and obesity.

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What does this have to do with abortion bans?

Put simply, pregnancy is far riskier than abortion. And much riskier for some women.

A recent study showed that a national ban would increase maternal mortality by 24% with the highest increase among Black women (39%).

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Many women in the US no longer have the ability to weigh their options.

Cancer and pregnant? Tough luck.

Heart disease and pregnant? Tough luck.

Homeless and pregnant? Tough luck.

Pregnant by an abusive partner? Tough luck.

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Making matters worse, there is a coordinated effort to misinform women about the risks of pregnancy and abortion. It isn't new but it is intensifying rapidly.

This is officially an infodemic.

We need all hands on deck. This playbook will not stop at abortion.

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The @WHO defines an infodemic as when false or misleading information in digital and physical environments causes confusion, risky behaviors, and mistrust in health authorities.

We saw misinformation wreak havoc during the pandemic.

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Abortion misinformation has been circulating for decades. TX and FL funnel 100’s of millions of taxpayer $ into “crisis pregnancy centers” which are Christian-run centers that use disinformation to dissuade women from terminating unwanted pregnancies.
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nbcnews.com/politics/supre…

There are >2,500 crisis pregnancy centers across the US, they outnumber abortion clinics 3 to 1, a ratio that is only getting wider as abortion clinics are shuttering in more than half the US states.

These clinics are literally tax payer-funded disinformation engines.

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One study found that 80% of websites for crisis pregnancy centers contained misinformation, usually lies about risks of abortion.

Disinformation is the cornerstone of the antiabortion playbook.

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pubmed.ncbi.nlm.nih.gov/25091391/

What makes the abortion infodemic unique is it's coupled with legislative efforts that restrict access to accurate health information.

This poses significant obstacles to reaching women with accurate health information to inform their care decisions.

Some examples…

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Texas Republicans have introduced legislation that would force internet providers to block the entire state from websites that provide info on obtaining an abortion.

The bill also restricts people and companies from sharing abortion info online. 12/x
codastory.com/authoritarian-…

Texas docs feel silenced when a patient needs an abortion:

"I can't tell you anything further in Texas, but you need to get out of state."

Some even speak in code:

"The weather's really nice in New Mexico right now. You should go check it out."

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npr.org/sections/healt…

In Idaho, the attorney general says their ban prohibits doctors from even referring a woman across state lines to access abortion.

That’s right, doctors cannot legally tell patients where they can legally go to get the care they need.

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cnn.com/2023/04/05/pol…

In Mississippi, the attorney general is going after @HealthMayday a company that puts up billboards and TV ads informing women on how to obtain an abortion.

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theatlantic.com/ideas/archive/…

Banning abortion information is consistent w/ Republican lawmaker's efforts to ban books, silence teachers & restrict curriculums.

Their “free speech” branding is to distract from their efforts to control the narrative by banning any information they don’t like. 16/x

Well, many women insist on being heard. 👏

They’re sharing horror stories emanating from how abortion bans resulted in crucial care being withheld. A recent report by @DrDGrossman is tracking these cases. This is a must read.

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ansirh.org/sites/default/…

The architects of abortion bans are now taking advantage of the confusion they have sowed by blaming doctors for the harm brought upon patients by abortion bans.

They are actually advising women to sue their doctors.

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nytimes.com/2023/05/22/opi…

It is of paramount importance that we develop a playbook for mitigating infodemics that are accompanied by laws that restrict access to accurate health information.

The precedents being set here are alarming. What if it becomes illegal for doctors to recommend vaccines?

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The other unique and concerning feature of the abortion infodemic is what I would characterize as 'bystander apathy.'

This is the tendency of bystanders in stressful or life-threatening situations to not react or intervene.

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We hear the news. We hear the stories. We hear the lies. But the public’s reaction is surprisingly tepid.

3 factors facilitate bystander apathy:

First is diffusion of responsibility which is the tendency to think “I’m sure someone is doing something so I won’t bother.” 21/x

The second factor facilitating apathy is fear of unfavorable judgement. Have you noticed how uncomfortable it is for people to even say the word ‘abortion?'

The hostile environment has a silencing effect on people who could help. That's part of the antiabortion playbook.

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The third factor affecting bystander apathy is pluralistic ignorance which is the perception that because nobody is saying or doing much, the situation must not actually be that big of a deal.

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We’re in a huge mess and many lives will be lost.

Children will lose their mothers.

Spouses will lose their wives.

We have to decide if we are going to look away or act to prevent that from happening.

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What can we do?

Check out the research agenda we laid out: jmir.org/2023/1/e42582

Aside of research, here's 7 ways you can help reproductiverights.org/top-7-things-y…

And most importantly: Refuse to be silenced.

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THANK YOU TO MY CO-AUTHORS! @Dr_NateHW and @DrLindsayPalmer! 26/x

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