The Markup presents a guide to keeping someone's plans private through every step of an abortion in any state, including Florida and South Dakota.
How do I protect my privacy if I'm seeking an abortion?
Updated
The reelection of former president Donald Trump is almost certain to disrupt the future of reproductive rights in the U.S. The president-elect has pledged to leave abortion up to states but could appoint anti-abortion leaders to federal positions or begin enforcing anachronistic laws that limit access. Meanwhile, measures to protect or expand abortion access on Election Day failed in Florida, Nebraska and South Dakota, and nearly 20 other states have banned or severely restricted abortion since the 2022 overturn of Roe v. Wade.
A national abortion ban is possible under the Trump administration without congressional action, said Amanda Barrow, an attorney with the UCLA Center on Reproductive Health, Law and Policy. "An unfortunate reality is any state gains or progress that have been made would be overshadowed by the harm that could be done at the federal level," she told The Markup.
Experts say people seeking an abortion can take meaningful measures to protect their safety and privacy as they research, order medication, make appointments, recover from the procedure, and figure out how they're going to pay for it all. They caution that everyone, including those living in a state without restrictions, may want to keep their health care decisions private.
Making decisions like this is part of creating what the Electronic Frontier Foundation, a nonprofit digital rights group, calls a security plan, and following their recommended process can help you decide what protective measures are best for you in different scenarios. Cooper Quintin, a senior staff technologist at the nonprofit, said that "there is no one-size-fits-all privacy and security" solution for any individual. "Think about your specific situation," he said, and then consider whether the advice you're reading applies to you.
The Biggest Threat To Your Privacy: The People You Tell
When people seeking abortions are scrutinized by law enforcement or the courts, it's often because they were reported by people, not technology. In a 2022 If/When/How study, a majority of abortion cases were reported to law enforcement by "healthcare providers and social workers" and "friends, parents, or intimate partners." Decide who you trust to involve in this process and limit the number of people you talk to.
Before you start planning your abortion, setting up a new email address and temporary phone number can protect your research and communications. You can use these to register throwaway accounts online, contact professionals, and message with trusted friends and family.
But digital communications still pose a risk. In one Texas case, a woman's ex-husband sued her friends for allegedly helping her get abortion medication after he read old text messages on her phone. If possible, have conversations about your research and plans in person. You can't leave a digital trail if you're not using digital tools to communicate.Â
"On the consumer privacy side I would advise people to be aware that seeking and obtaining care can create a vast digital trail … that prosecutors could use to criminalize health care," Barrow said.
Send and Receive Secure Messages
- Set up a new email on Gmail or Proton Mail using a unique, random password.
- Use Apple's paid Hide My Email service to create temporary addresses that forward email to you.
- Get a temporary Google Voice number or a burner phone if you're worried about someone seeing outgoing and incoming calls on a phone bill, or if you think that your phone might be compromised.
- Use Signal to send messages and make phone calls (and set messages to disappear after a short amount of time).
Find Accurate Information and Avoid Misinformation
Misinformation about abortion care, current laws, and available resources are commonly found online. People seeking abortions have used reliable websites like I Need An A to find health care providers in their state or the National Network of Abortion Funds for financial assistance.Â
Abortion rights advocates recommend you speak with health care professionals or the people at abortion funds for critical health information.
"When you talk directly to your local abortion fund, you're talking to someone who is a literal expert on what it means to access abortion in your community," Oriaku Njoku, executive director of the National Network of Abortion Funds, said.
Keep a couple of questions in mind when evaluating the truthfulness of something you've learned about abortion: Does the information come from a reliable source—an established news outlet or an established health or advocacy organization? If not, can you verify the information with one or more reliable sources?
Be Careful With Google Search Results
When you're searching online for information about abortion, do not automatically trust the links that appear, especially the top results, which are often sponsored ads. Search results might link to organizations that provide abortion services, such as Planned Parenthood or I Need An A, or they might link to crisis pregnancy centers run by anti-abortion groups.Â
When you're using Google, you may see an "AI Overview" at the top of your results or a "featured snippet" that surfaces information Google has determined to be relevant to your search. In our testing, these features sometimes gave biased, incorrect, and outdated information:
- When The Markup and CalMatters searched for how abortion affected personal relationships, the AI Overview summarized and linked to information exclusively from anti-abortion sources.
- In another search, Google featured a snippet with outdated information about Georgia's abortion ban. The information was correct at the source.
After The Markup and CalMatters reached out to Google for comment, spokesperson Colette Garcia said that the snippet had been updated. "Featured snippets are dynamic and evolve as content on the web does. It can take time for our systems to recrawl a site, but once it does, the featured snippet may update," she said. We confirmed that the featured snippet for the same search now shows the correct information about Georgia's abortion ban.
If you are reading the AI Overview, click through the link icons to go to the original information sources, and check what you learn against at least one other reliable source. For Google's "snippets," click through to the links to confirm that the information is up to date.
Don't Use AI Chatbots
Conversational AI chatbots like ChatGPT and Claude have given people authoritative-sounding information that's biased, harmful, or just wrong.
If you prefer a guided, conversational format, Charley is a non-AI chatbot supported by a coalition of organizations that advocate for abortion access. Charley responds with pre-written, vetted answers based on your responses.
Talk Anonymously to Humans
If you don't feel ready to call someone at a clinic or fund, you can anonymously call or text Reprocare for information or support.
You can also post questions to r/abortion on Reddit. To stay anonymous, post from a throwaway account. The subreddit is moderated full-time by an abortion access advocacy organization called the Online Abortion Resource Squad.
Validate or Fact-check Social Media
Social media is one of the only places where people are publicly sharing their own experiences with abortion procedures. However, social media is also a well-known source of misinformation. TikTok and Instagram, as well as other social media companies, have been accused of actively suppressing accurate information about abortion, including in the years before Roe was overturned.
How We Vetted a TikTok Account
The @drjenniferlincoln account shares reproductive health advice, including a pinned walk-through of ordering abortion pills from aidaccess.org. Can you trust that this person has the expertise she says she does?
- A Google search for "dr jennifer lincoln obgyn" turns up a link to this U.S. News profile, which has a profile photo that matches the person in the videos and says she's a doctor practicing in Oregon.
- A quick search of the Oregon Medical Board's license database (found by searching "medical license verification oregon") shows us an active license and a specialization in obstetrics and gynecology under that name in the state.
- It's also a good sign for her credibility that her second pinned video is an appearance with Barack Obama.
People trying to identify accurate information about any topic can first identify the organizations they trust to have reliable information. Then, they can look for those organizations' social media accounts to follow.Â
People who post about or hint that they're looking into an abortion have faced anything from support and encouragement to harassment and cruelty. Anyone looking to avoid online harassment can lock down their social media privacy settings with the free Block Party extension, and scrub their personal information from people-search sites. They may also want to refrain from broadcasting their location and sharing photos, videos or screenshots that might unintentionally reveal browser tabs or background items that could reveal their plans.
Tips on How to Browse Privately Online
- Turn off ad identifier tracking on your phone. This ID can track your identity, habits, and location.
- Not the only one using your computer or phone? Log out of accounts, close tabs, and regularly delete your browsing history.
- Use a privacy-focused search engine, like DuckDuckGo, that doesn't keep search logs. (Full disclosure: DuckDuckGo has donated to The Markup.)
- Browse the web in "private" or incognito mode.
- Use a browser that protects your privacy, like Brave or Firefox Focus.
- Use a public computer at a library, or ask someone you trust to find information for you.
- Beware parental control software and stalkerware on your devices, which allows someone else to monitor your internet use, phone calls, and location.
- If you find or suspect stalkerware, don't try to circumvent it as that could raise alarms.Â
Know Your State's Laws
Individual state laws vary significantly. Some states do not outlaw abortion and instead require waiting periods, medically unnecessary ultrasounds, or parental consent for minors.Â
Minors can petition a court for a judicial bypass of the parental notification or consent requirement. Some abortion funds can help manage the complexities around that process, said Njoku, the National Network of Abortion Funds' executive director.
Anti-abortion laws don't typically penalize the person who receives the abortion, but that won't necessarily protect you from accusations or arrest. Anyone who helps you could be in legal jeopardy, as well.
There are also misconceptions about what is and isn't legal. Despite lawmakers in several states attempting to outlaw traveling across state lines for an abortion, there's no law that meaningfully prevents you from traveling to another state for an abortion, as of November 2024.
If you live in a state where an abortion ban outlaws or severely limits access to the procedure, the greatest risks are to your health and freedom. Exceptions to bans—for the life or health of the pregnant person, for nonviable pregnancies, or for rape or incest—are common, but they are often denied. And, for years before Roe was overturned, states have been prosecuting pregnant people for using drugs or miscarrying, and encouraging private citizens to sue abortion providers and others who aid abortion patients.
Research Abortion Laws in Your State
- The New York Times' abortion ban tracker
- AbortionFinder's state-by-state guide
- The Guttmacher Institute's interactive map
- KFF's state health facts
Moving Forward on Your Decision
Avoid Crisis Pregnancy Centers
Crisis pregnancy centers are primarily faith-based anti-abortion groups that in many instances pose as medical clinics by offering ultrasounds and pregnancy tests as well as "abortion counseling." Some may even be licensed as medical facilities by state health departments and employ medical doctors and nurses but do not offer full-scope reproductive health care. Nationwide, there are between two and three times more crisis pregnancy centers than facilities that provide abortions.
Crisis pregnancy centers also advertise abortion support groups and retreats for people who are struggling with their decision. Since most centers are not medical clinics, they are not subject to medical privacy laws, so anyone visiting a center may be putting their private information at increased risk, especially in states where abortion is banned.
Abortion rights advocates and lawmakers have long accused these centers—also known as anti-abortion centers—of coercing vulnerable people into remaining pregnant by misleading them about abortion procedures and contraceptive methods.Â
While center supporters deny the accusations about misleading pregnant people, the centers have become a battleground for lawmakers bent on protecting abortion rights and offering services for people who live in states where abortion is banned.Â
How to Tell Crisis Pregnancy Centers Apart From Abortion Clinics
The California Department of Justice issued a consumer alert detailing ways to determine whether a place offering reproductive health care is a medical facility or a crisis pregnancy center. Some of the questions the department suggests consumers ask are:
- Is this a medically licensed facility?
- Are appointments and exams conducted by licensed providers, and if so, what kind of provider (nurse, doctor, etc.)?
- Does the facility perform abortions or provide referrals for abortions?
- How much does a visit cost, and do they take insurance?
- Will the facility keep your information confidential and not disclose your visit to anyone?
Other things the department recommends consumers look for is whether the facility offers birth control or if they try to delay scheduling appointments.
Crisis pregnancy centers are often affiliated with religious organizations like Care Net, Heartbeat International and Birthright International. Many also offer "abortion pill reversal," which is not supported by rigorous peer-reviewed scientific research.
Obtain and Take Abortion Pills Safely, In Person or Online
Most abortions in the U.S. are medication abortions done within the first 10 weeks of pregnancy using mifepristone and misoprostol. Clinical studies show these drugs are safer than many over-the-counter medications but must be prescribed by a clinician or doctor.
Some states only allow doctors to prescribe abortion medication, but in California, a variety of primary care providers can prescribe abortion pills, including doctors, physician assistants and nurse practitioners. Prescriptions can also be obtained at abortion clinics or through virtual consultations with a clinician.Â
In states where abortion is legal, CVS and Walgreens fill medication abortion prescriptions. Individual pharmacy workers have the right to opt out of dispensing the pills with personal belief exemptions; however, the store must make someone available to fill prescriptions in a timely manner. In San Diego, one woman managing a miscarriage accused CVS of inappropriately withholding abortion medication from her. It is also possible to mail-order abortion medication. Most organizations that mail abortion medication wrap it in packaging that does not reveal the contents, and will say so on their site.
In states where abortion is not legal, it is still possible to order the medication to be mailed from a state or country where providers are shielded from repercussions but there are legal risks. The Repro Legal Helpline can help with those legal questions.
Taking both mifepristone and misoprostol has been the recommended standard of care for decades, but as laws change throughout the U.S., some abortion providers are advising that patients alter the way they take the second pill, misoprostol, for increased privacy. Misoprostol can be taken by mouth or inserted into the vagina. If you live in an abortion-restricted state, some providers recommend only taking misoprostol by mouth because the pill may not fully dissolve in the vagina. Although it is impossible to tell the difference between bleeding and cramping caused by miscarriage or abortion symptomatically, a provider who conducts a vaginal examination may find the remains of the pill.
Find Financial Help and Make Payments Without Exposing Yourself
If you have health insurance, it may cover abortion, but if you're covered by someone else's plan, they may be notified when a claim is filed. In some states, there are ways to preserve your privacy. For example, in California, dependents on a health insurance plan can send a confidential communications request to the insurer to keep information private from the policyholder.
After you've chosen where and how you're going to get your abortion, the clinic will be able to give you payment options and, possibly, references to funds that can help you cover costs. If the provider doesn't have references on hand, the Women's Reproductive Rights Assistance Project and the National Network of Abortion Funds are trusted resources for finding financial assistance, though funds nationally are struggling to meet demand.
Payment Security
- Pay in cash or postal money orders if you can.
- If your bank statements aren't private, use a prepaid credit card after making sure your provider will accept it. You may need to confirm your identity to register and use the card.
- If you use payment apps like Venmo and Cash App, educate yourself on how they handle private information and turn off public sharing.
To pay for care, privacy experts recommend physical currencies. "Cash is king," said Cooper Quintin, a senior staff technologist at the Electronic Frontier Foundation. "But if not cash, money orders from the post office are the closest … in terms of anonymity."
"If you need to pay for something online, prepaid credit cards are probably a nice fit," he said. Especially if "you're in a situation where you have somebody who's looking at your credit card statements and is not going to be OK with that."
Minimize Surveillance While Traveling
Crossing state lines for reproductive health care is legal and constitutionally protected. But even if you don't need to visit another state for care, a travel burden can make getting an in-clinic abortion riskier.Â
Technology companies and law enforcement agencies have used phones and other mobile devices such as laptops and tablets to track people when they travel. Some states ban police from sharing surveillance data, but there are law enforcement agencies that continue to do so. Many states also participate in medical information exchanges that make many aspects of health care cheaper and more efficient, but that also means clinicians in states where abortion is criminalized could have access to medical records without a patient's knowledge, said Barrow, an attorney with UCLA's Center on Reproductive Health, Law and Policy.
California and Maryland are the only two states that have passed medical shield laws that prevent abortion-related care from being shared on health information exchanges.Â
Privacy experts say there are ways to minimize the risk of traveling. According to Edward Hasbrouck, travel expert and consultant to The Identity Project, "[There are] lots of reasons you could fly to Las Vegas for a weekend. Maybe somebody's getting married, maybe you're going gambling. The signal is going to get lost in the noise, even if they've got access to that reservation data."
"If you're traveling across state lines to get an abortion, you probably shouldn't bring your regular cell phone with you. Get a burner phone for the purpose if you can afford it," he said.
If leaving your phone behind is not an option, digital privacy experts recommend that anyone who does not want technology companies to use or sell their location should turn off location sharing on their devices. In 2021, The Markup identified a minimum of 47 companies that harvest, sell, or trade in mobile phone location data. This year, 404 Media reported on how U.S. law enforcement agencies purchased a tool that can track smartphone locations, including at abortion clinics and places of worship, around the world.
Digital Surveillance Protection
Don't travel if you don't have to. Instead, get abortion medication by mail. If you have to travel:
- Ask your contact at the clinic you've chosen for recommendations and resources.
- Leave your phone behind, or bring a borrowed or burner phone.
If you can't leave your phone behind:
- Stop your phone from sharing your location on Apple and Android.
- Turn off location history on Google, which applies to Google Maps.
- If you're taking a plane, train, or bus across state lines, have another reason for going to your destination.
If you have to drive:
- Be aware that newer cars can be tracked with apps.
- Check your car for AirTags and other tracking devices.
- Don't park near the abortion clinic when you arrive. Use public transportation or get a taxi and pay with cash. Do not use ride-sharing apps.
To lower risk from surveillance, Hasbrouck recommended that abortion-seekers avoid parking near the abortion clinic when they arrive. "It's the last mile that's most vulnerable" to automated license plate readers or cell-site simulators, Hasbrouck said.Â
He recommends parking elsewhere and taking public transportation, like "a metered taxi that you pay in cash," but not Uber or Lyft because their records are "name-associated and easier to find."
If you don't have access to a car, making the whole trip using public transportation may be your only option. That mitigates some of the pitfalls of driving a private vehicle, but it's not really possible to take public transportation anonymously.Â
Car companies do collect and sell location data for newer model cars, while making it difficult or inconvenient to opt out. That said, Hasbrouck believes that it's unlikely that law enforcement is getting broad access to car location data.Â
After Getting an Abortion
Get Treatment for Complications Without Revealing Compromising Information
Abortion, whether medication or procedural, is a common and safe procedure, but complications are possible, and the risk is higher the longer you've been pregnant. Pain, excessive bleeding, and infection are uncommon but possible complications of abortion procedures that could be dangerous if untreated, and exposes you to legal consequences if you seek treatment in a state with abortion restrictions. Even women who wanted pregnancies and miscarried have been charged with crimes, making disposal of fetal tissue with self-managed abortions even more challenging.Â
What to Say During Follow-up Care
- You don't have to say whether you got an abortion or took abortion medication.Â
- Tell your clinician that you believe you were pregnant and are now experiencing cramping and bleeding.
Other questions to prepare for:
- When did you start bleeding?
- How much are you bleeding (how many pads do you fill up in an hour)?
- When was the first day of your last period?
- Have you had an ultrasound before, and if so was the pregnancy inside the uterus or outside the uterus (ectopic)?
- If you had an ultrasound, how far along was the pregnancy?
- Are you feeling dizzy or lightheaded?
People do not need to disclose that they've had an abortion in order to receive follow-up care, said Jenn Karlin, MD, a primary care doctor who provides full-scope reproductive health care with the University of California San Francisco Health.
Providers will usually take your vital signs and conduct an ultrasound. They may also draw blood to confirm whether or not you're pregnant.
"If somebody is having vaginal bleeding, there is no way a clinician can tell whether or not you have taken pills or you're having a miscarriage without taking pills. Those two processes in your body look the same symptomatically," Karlin said.
If you're asked directly whether you took abortion medication, you don't have to answer that question, Karlin said. Instead, patients can tell their clinician that they believed they were pregnant and are now experiencing cramping and bleeding.Â
"The fact that they took pills or not if they are in a restrictive state doesn't affect medical decision making. I would treat somebody who is having a miscarriage and somebody who took [pills] similarly whether or not I knew," Karlin said.
Certain hotlines like the Miscarriage & Abortion Hotline are run by health professionals who can give recommendations on whether you need to be seen in person and how to prepare for in-person conversations.
Discard Messages, Receipts, and Paperwork Safely
If you share space or resources (like trash service) with people who you don't want knowing about your abortion, be careful how you discard physical receipts or paperwork you've collected. Shred it, or separate any portion of the paperwork that has your name or other identifying information on it from the rest and throw it in a public trash receptacle.
If another person may have access to your electronic devices, it's a good idea to delete emails and messages you've sent and received about your abortion.
Deleting an email may take two steps. In Gmail, for example, deleting an email moves it to the Trash folder where it's still accessible for 30 days. You can permanently delete it by going into the Trash folder, selecting the message and clicking Delete forever. Or you can click Empty Trash now to destroy all the messages in your trash.
Deleting a message you've sent or received is possible in most messaging services. In Apple Messages, for example, you can tap and hold on a message to get a menu, select "More" … then tap the trash can icon to delete it.
In most cases, this will delete the email or message from your devices but not from the devices of the people who sent them to you or received them from you. Some messaging services do offer "Delete for everyone" (Signal) or "Unsend for everyone" (Facebook Messenger) options, but it's not possible to guarantee that the message will be deleted from everyone else's devices.
Unless you're using an end-to-end encrypted messaging app like Signal, the company running the app may have copies of your messages in their databases that they could share with law enforcement.
Find Emotional Support
Most people who have had an abortion feel that it was the right decision even if it was a difficult one, researchers have repeatedly found. But just because someone has decided that an abortion is right for them, doesn't mean that they don't want or need emotional support.
Reproductive health advocacy groups have vetted a number of support groups for all pregnancy experiences, including miscarriage:
- Planned Parenthood recommends free and confidential support options for people who have had an abortion or miscarriage, including people who are seeking religious and spiritual guidance.
- The All-Options Talkline is a peer-run hotline that offers support for all pregnancy-related experiences, including, abortion, miscarriage, and parenting. They also serve partners and friends of people who are pregnant. Be advised that the volunteer-run line may go to voicemail and ask for a callback number.
This story was produced by The Markup and reviewed and distributed by Stacker.
Originally published on themarkup.org, part of the BLOX Digital Content Exchange.
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