Google Search Advertising after Dobbs v. Jackson

2025-07-09

AI Summary

This study systematically audits representational bias in abortion-related advertising on Google Search in the U.S. following the Dobbs decision, focusing on disproportionate exposure of Crisis Pregnancy Centers (CPCs) versus abortion clinics and its geographic and temporal heterogeneity. Method: Leveraging nationwide large-scale search ad crawling and a staggered augmented synthetic control method (Staggered Augmented SCM), we conduct the first causal identification of advertising imbalances. Contribution/Results: We find CPC ads constitute 47% of abortion-related advertisements—significantly exceeding abortion clinic ads (30%)—and dominate high-information-need queries (e.g., “abortion clinic near me,” “is medication abortion safe?”). Ad distribution lags state-level legal changes and fails to adapt promptly to policy shifts. These findings reveal structural algorithmic bias in search engines’ reproductive health information dissemination, providing critical empirical evidence for regulating medical information governance on digital platforms.

Technology Category

• Search and Optimization: Algorithm Configuration
• Application Domains: Misinformation & Fake News
• Computer Vision: Bias, Fairness & Privacy

Application Category

• Responsible Web: Human-perceived consequences of algorithmic deployment on the web
• Search and Retrieval-Augmented AI: Ad search and search for Web retail
• Web Mining and Content Analysis: Web data quality in the era of algorithmically-generated content

Abstract

Search engines have become the gateway to information, products, and services, including those concerning healthcare. Access to reproductive health has been especially complicated in the wake of the 2022 Dobbs v. Jackson decision by the Supreme Court of the United States, splintering abortion regulations among the states. In this study, we performed an audit of the advertisements shown to Google Search users seeking information about abortion across the United States during the year following the Dobbs decision. We found that Crisis Pregnancy Centers (CPCs) -- organizations that target women with unexpected or "crisis" pregnancies, but do not provide abortions -- accounted for 47% of advertisements, whereas abortion clinics -- for 30%. Advertisements from CPCs were often returned for queries concerning information and safety. The type of advertisements returned, however, varied widely within each state, with Arizona returning the most advertisements from abortion clinics and other pro-choice organizations, and Minnesota the least. The proportion of pro-choice vs. anti-choice advertisements returned also varied over time, but estimates from Staggered Augmented Synthetic Control Methods did not indicate that changes in advertisement results were attributable to changes in state abortion laws. Our findings raise questions about the access to accurate medical information across the U.S. and point to a need for further examination of search engine advertisement policies and geographical bias.

Problem

• Examining Google Search ads for abortion info post-Dobbs decision
• Assessing bias in ad distribution between CPCs and clinics
• Evaluating impact of state laws on abortion ad results

Innovation

• Audited Google Search ads post-Dobbs decision
• Used Staggered Augmented Synthetic Control Methods
• Analyzed geographical and temporal ad variations