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My Twitter account was suspended after I tweeted the protocol for medication abortion. They said I was 'promoting self-harm.'

Nov 16, 2022, 21:50 IST
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  • The day after I tweeted the WHO's medication-abortion protocol, I was suspended from Twitter.
  • Twitter told me my account had violated a safety policy and was "encouraging self-harm."
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When my alarm sounded on the morning of the 2022 midterm elections, I rolled over and reached for my phone to start my usual wake-up ritual: scrolling through Twitter like it's the morning paper. I expected to see speculations about which races might see an upset. Instead, a bolded warning flashed when I opened my Twitter app: "We've temporarily limited some of your account features."

At first, I didn't think too much of it. My account had never been suspended in the 12 years since I joined Twitter, back when I was in ninth grade. I assumed the moderation system had probably just flagged some political critique with one too many expletives.

The message McMahon received from Twitter that her account features had been limited for 11 hours and 52 minutes.Courtesy Hayley McMahon

But then I got to the highlighted section and my stomach dropped: My account had "violated our rules against promoting or encouraging suicide or self-harm." I immediately knew why; I had experienced a similar situation with Instagram last year. Twitter had suspended my account for posting the World Health Organization's protocol for self-managed abortion, which refers to self-sourcing and safely using abortion pills without medical supervision.

The message McMahon received from Twitter that her tweet had violated its rules against promoting or encouraging suicide or self-harm.Courtesy Hayley McMahon

Sure enough, I scrolled down to find the "offending" tweet from a thread I posted on Halloween, in which I wrote: "For many people, self-managed abortion is a safe, effective, and acceptable option. For those who can access both mifepristone and misoprostol, WHO [the World Health Organization] recommends 1) Swallow 200mg of mifepristone 2) Wait 24-48 hours 3) Dissolve 800mcg (4 pills) misoprostol between cheek and gums."

I submitted an appeal and vented to a few friends over text, some of whom tweeted about the situation to warn others. As the news of my suspension from Twitter started to spread, I decided to do a little experiment to test the system, as any researcher would. I created a burner account on the app and reposted the tweet. A few hours later, the same suspension notice appeared. Disturbing — but not surprising.

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The censorship of critical information about abortion goes far beyond my tweet

Social-media companies censoring information about abortion pills is nothing new. Just days before Texas' infamous SB 8 abortion ban first went into effect in 2021, Instagram suspended Plan C's educational account and hid all uses of the hashtags #mifepristone and #misoprostol on the platform.

When the Supreme Court overturned the constitutional right to an abortion this summer, both Instagram and Facebook removed user posts about abortion pills. TikTok users, too, have reported being banned and suppressed for making content about abortion. Twitter had been one of the few major social-media sites that had not been caught censoring abortion-related content at some point. But Twitter is now under new management.

The email from Twitter stating that McMahon's account had been reinstated.Courtesy Hayley McMahon

Nearly two days after my 12-hour suspension had ended, I finally received a standard form email from Twitter Support stating that the suspension had been a mistake. Time and again, Facebook and Instagram have issued similar responses. It always just seems to be a technical error in the moderation process. I remain skeptical, to say the least.

What I do hope people understand, though, is that the impact of censoring evidence-based information about abortion pills goes far beyond my fairly brief Twitter suspension. Thousands of people have been denied abortion care since Roe v. Wade was overturned. Requests to Aid Access, an Austrian organization that bypasses US restrictions by mailing abortion pills from abroad, have skyrocketed.

As a public-health scientist who studies structural and social determinants of abortion access, I can tell you that the data clearly shows self-managed abortion is medically safe and effective (though there can be a legal risk). In fact, I can also say that it is self-care and not self-harm. In this sociopolitical moment, I am reminded that it is a fundamental principle of my field's code of ethics that people deserve to have the information they need to be able to make informed, autonomous decisions about their health — and I have a responsibility to make it easily accessible for their use. That is what I will continue to do.

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A Twitter representative could not be reached for comment.

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