Abortion and Censorship: A Slippery Slope

By Pablo Rodriguez, M.D. , RH Reality Check. Posted April 16, 2008.

Call it censored, call it buried, call it lost -- the search term "abortion" was all of the above for approximately a month on POPLINE -- a publicly-funded database that its administrators describe as "Your connection to the world's reproductive health literature."

Last week, researchers at the University of California, San Francisco, uncovered this ironic situation while trying to "connect" to "reproductive health literature." Health care providers, researchers, and advocates around the country were alarmed to learn that POPLINE (POPulation information onLINE), had rendered the search term "abortion" a stopword -- which directs the database to ignore the term when used in a search. UCSF librarians discovered this deliberate restriction when they were unable to find a single document containing the word "abortion" in POPLINE's database, and contacted the administrators at the Johns Hopkins Bloomberg School of Public Health to ask them why. Simply put, the UCSF librarians were told that "abortion" was eliminated as a search term by the POPLINE administrators so that the latter could examine the database for information "that might not have been consistent" with guidelines from a government agency that funds the project. And our UCSF colleagues were then given some mystifying, convoluted search term suggestions for finding medical literature on the subject, including "fertility control, post-conception" and "pregnancy, unwanted."

By Friday morning, news of the self-censorship had spread like a virus. Countless members of the medical, scientific, and advocacy communities responded and by early Friday evening, Hopkins Dean Michael J. Klag issued a statement unequivocally denouncing the administrators' decision to censor the word abortion and promising to get to the bottom of it. By Tuesday, he issued a follow up statement citing his opposition to the decision and his speedy response, while blaming "an overreaction on the part of POPLINE staff" to a search by USAID [United States Agency for International Development] officials who "found two items in the POPLINE database that advocated for abortion.”

So let's pause for a moment and review what happened: a vigilant literature search on the word "abortion" by unidentified Federal employees at USAID resulted in finding two abortion articles in the POPLINE database that they deemed to feature inappropriate advocacy. Once notified by the Feds, Hopkins administrators immediately made abortion a stopword -- an additional step not requested by USAID, but implemented to allow administrators to search for other material that might have been inconsistent with the agency's guidelines -- effectively ending access to abortion research to health professionals and the public on their 30-year-old database.

While giving credit to Dean Klag for his quick response to an untenable situation, there are two important questions that remain: Why are Federal employees at USAID so attentively monitoring scientific research articles on the POPLINE database for the word "abortion"? And why are Hopkins administrators so afraid of them? The Dean states that USAID is prohibited by law from funding any abortion activities or supplies. This is all the more reason for concern by researchers, civil libertarians, health care providers, and patients who deserve the best possible care. But the incident simply points to a larger problem: Federal policy regarding comprehensive reproductive health care is inadequate.

The Real Impact of Limiting Access to Information

The medical and scientific needs of the reproductive health professional community were impeded by POPLINE's decision to remove abortion as a search term on its publicly funded database. If this action had gone unchecked, the decision would have limited the medical and scientific community's ability to access information on a range of patient care scenarios, including women experiencing both wanted and unintended pregnancies.

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Dr. Pablo Rodriguez is associate chief of obstetrics and gynecology at Women and Infants' Hospital in Providence, medical director of Planned Parenthood of Rhode Island, and is a clinical assistant professor at Brown University's Program in Medicine. He is the Board Chair of the Association of Reproductive Health Professionals.

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