It’s been a long two years since the Dobbs decision to overturn Roe v. Wade. Between May 2022 when the Supreme Court accidentally leaked the draft memo and the following June when the case was decided, there was a mad scramble to figure out what the impacts would be. Besides the obvious perils of stripping away half the country’s right to reproductive healthcare, digital surveillance and mass data collection caused a flurry of concerns.

Although many activists fighting for reproductive justice had been operating under assumptions of little to no legal protections for some time, the Dobbs decision was for most a sudden and scary revelation. Everyone implicated in that moment somewhat understood the stark difference between pre-Roe 1973 and post-Roe 2022; living under the most sophisticated surveillance apparatus in human history presents a vastly different landscape of threats. Since 2022, some suspicions have been confirmed, new threats have emerged, and overall our risk assessment has grown smarter. Below, we cover the most pressing digital dangers facing people seeking reproductive care, and ways to combat them.

Digital Evidence in Abortion-Related Court Cases: Some Examples

Social Media Message Logs

A case in Nebraska resulted in a woman, Jessica Burgess, being sentenced to two years in prison for obtaining abortion pills for her teenage daughter. Prosecutors used a Facebook Messenger chat log between Jessica and her daughter as key evidence, bolstering the concerns many had raised about using such privacy-invasive tech products for sensitive communications. At the time, Facebook Messenger did not have end-to-end encryption.

In response to criticisms about Facebook’s cooperation with law enforcement that landed a mother in prison, a Meta spokesperson issued a frustratingly laconic tweet stating that “[n]othing in the valid warrants we received from local law enforcement in early June, prior to the Supreme Court decision, mentioned abortion.” They followed this up with a short statement reiterating that the warrants did not mention abortion at all. The lesson is clear: although companies do sometimes push back against data warrants, we have to prepare for the likelihood that they won’t.

Google: Search History & Warrants

Well before the Dobbs decision, prosecutors had already used Google Search history to indict a woman for her pregnancy outcome. In this case, it was keyword searches for misoprostol (a safe and effective abortion medication) that clinched the prosecutor’s evidence against her. Google acquiesced, as it so often has, to the warrant request.

Related to this is the ongoing and extremely complicated territory of reverse keyword and geolocation warrants. Google has promised that it would remove from user profiles all location data history related to abortion clinic sites. Researchers tested this claim and it was shown to be false, twice. Late in 2023, Google made a bigger promise: it would soon change how it stores location data to make it much more difficult–if not impossible–for Google to provide mass location data in response to a geofence warrant, a change we’ve been asking Google to implement for years. This would be a genuinely helpful measure, but we’ve been conditioned to approach such claims with caution. We’ll believe it when we see it (and refer to external testing for proof).

Other Dangers to Consider

Doxxing

Sites propped up for doxxing healthcare professionals that offer abortion services are about as old as the internet itself. Doxxing comes in a variety of forms, but a quick and loose definition of it is the weaponization of open source intelligence with the intention of escalating to other harms. There’s been a massive increase in hate groups abusing public records requests and data broker collections to publish personal information about healthcare workers. Doxxing websites hosting such material are updated frequently. Doxxing has led to steadily rising material dangers (targeted harassment, gun violence, arson, just to name a few) for the past few years.

There are some piecemeal attempts at data protection for healthcare workers in more protective states like California (one which we’ve covered). Other states may offer some form of an address confidentiality program that provides people with proxy addresses. Though these can be effective, they are not comprehensive. Since doxxing campaigns are typically coordinated through a combination of open source intelligence tactics, it presents a particularly difficult threat to protect against. This is especially true for government and medical industry workers whose information may be subjected to exposure through public records requests.

Data Brokers

Recently, Senator Wyden’s office released a statement about a long investigation into Near Intelligence, a data broker company that sold geolocation data to The Veritas Society, an anti-choice think tank. The Veritas Society then used the geolocation data to target individuals who had traveled near healthcare clinics that offered abortion services and delivered pro-life advertisements to their devices.

That alone is a stark example of the dangers of commercial surveillance, but it’s still unclear what other ways this type of dataset could be abused. Near Intelligence has filed for bankruptcy, but they are far from the only, or the most pernicious, data broker company out there. This situation bolsters what we’ve been saying for years: the data broker industry is a dangerously unregulated mess of privacy threats that needs to be addressed. It not only contributes to the doxxing campaigns described above, but essentially creates a backdoor for warrantless surveillance.

Domestic Terrorist Threat Designation by Federal Agencies

Midway through 2023, The Intercept published an article about a tenfold increase in federal designation of abortion-rights activist groups as domestic terrorist threats. This projects a massive shadow of risk for organizers and activists at work in the struggle for reproductive justice. The digital surveillance capabilities of federal law enforcement are more sophisticated than that of typical anti-choice zealots. Most people in the abortion access movement may not have to worry about being labeled a domestic terrorist threat, though for some that is a reality, and strategizing against it is vital.

Looming Threats

Legal Threats to Medication Abortion

Last month, the Supreme Court heard oral arguments challenging the FDA’s approval of and regulations governing mifepristone, a widely available and safe abortion pill. If the anti-abortion advocates who brought this case succeed, access to the most common medication abortion regimen used in the U.S. would end across the country—even in those states where abortion rights are protected.

Access to abortion medication might also be threatened by a 150 year old obscenity law. Many people now recognize the long dormant Comstock Act as a potential avenue to criminalize procurement of the abortion pill.

Although the outcomes of these legal challenges are yet-to-be determined, it’s reasonable to prepare for the worst: if there is no longer a way to access medication abortion legally, there will be even more surveillance of the digital footprints prescribers and patients leave behind. 

Electronic Health Records Systems

Electronic Health Records (EHRs) are digital transcripts of medical information meant to be easily stored and shared between medical facilities and providers. Since abortion restrictions are now dictated on a state-by-state basis, the sharing of these records across state lines present a serious matrix of concerns.

As some academics and privacy advocates have outlined, the interoperability of EHRs can jeopardize the safety of patients when reproductive healthcare data is shared across state lines. Although the Department of Health and Human Services has proposed a new rule to help protect sensitive EHR data, it’s currently possible that data shared between EHRs can lead to the prosecution of reproductive healthcare.

The Good Stuff: Protections You Can Take

Perhaps the most frustrating aspect of what we’ve covered thus far is how much is beyond individual control. It’s completely understandable to feel powerless against these monumental threats. That said, you aren’t powerless. Much can be done to protect your digital footprint, and thus, your safety. We don’t propose reinventing the wheel when it comes to digital security and data privacy. Instead, rely on the resources that already exist and re-tool them to fit your particular needs. Here are some good places to start:

Create a Security Plan

It’s impossible, and generally unnecessary, to implement every privacy and security tactic or tool out there. What’s more important is figuring out the specific risks you face and finding the right ways to protect against them. This process takes some brainstorming around potentially scary topics, so it’s best done well before you are in any kind of crisis. Pen and paper works best. Here's a handy guide.

After you’ve answered those questions and figured out your risks, it’s time to locate the best ways to protect against them. Don’t sweat it if you’re not a highly technical person; many of the strategies we recommend can be applied in non-tech ways.

Careful Communications

Secure communication is as much a frame of mind as it is a type of tech product. When you are able to identify which aspects of your life need to be spoken about more carefully, you can then make informed decisions about who to trust with what information, and when. It’s as much about creating ground rules with others about types of communication as it is about normalizing the use of privacy technologies.

Assuming you’ve already created a security plan and identified some risks you want to protect against, begin thinking about the communication you have with others involving those things. Set some rules for how you broach those topics, where they can be discussed, and with whom. Sometimes this might look like the careful development of codewords. Sometimes it’s as easy as saying “let’s move this conversation to Signal.” Now that Signal supports usernames (so you can keep your phone number private), as well as disappearing messages, it’s an obvious tech choice for secure communication.

Compartmentalize Your Digital Activity

As mentioned above, it’s important to know when to compartmentalize sensitive communications to more secure environments. You can expand this idea to other parts of your life. For example, you can designate different web browsers for different use cases, choosing those browsers for the privacy they offer. One might offer significant convenience for day-to-day casual activities (like Chrome), whereas another is best suited for activities that require utmost privacy (like Tor).

Now apply this thought process towards what payment processors you use, what registration information you give to social media sites, what profiles you keep public versus private, how you organize your data backups, and so on. The possibilities are endless, so it’s important that you prioritize only the aspects of your life that most need protection.

Security Culture and Community Care

Both tactics mentioned above incorporate a sense of community when it comes to our privacy and security. We’ve said it before and we’ll say it again: privacy is a team sport. People live in communities built on trust and care for one another; your digital life is imbricated with others in the same way.

If a node on a network is compromised, it will likely implicate others on the same network. This principle of computer network security is just as applicable to social networks. Although traditional information security often builds from a paradigm of “zero trust,” we are social creatures and must work against that idea. It’s more about incorporating elements of shared trust pushing for a culture of security.

Sometimes this looks like setting standards for how information is articulated and shared within a trusted group. Sometimes it looks like choosing privacy-focused technologies to serve a community’s computing needs. The point is to normalize these types of conversations, to let others know that you’re caring for them by attending to your own digital hygiene. For example, when you ask for consent to share images that include others from a protest, you are not only pushing for a culture of security, but normalizing the process of asking for consent. This relationship of community care through data privacy hygiene is reciprocal.

Help Prevent Doxxing

As somewhat touched on above in the other dangers to consider section, doxxing can be a frustratingly difficult thing to protect against, especially when it’s public records that are being used against you. It’s worth looking into your state level voter registration records, if that information is public, and how you can request for that information to be redacted (success may vary by state).

Similarly, although business registration records are publicly available, you can appeal to websites that mirror that information (like Bizapedia) to have your personal information taken down. This is of course only a concern if you have a business registration tied to your personal address.

If you work for a business that is susceptible to public records requests revealing personal sensitive information about you, there’s little to be done to prevent it. You can, however, apply for an address confidentiality program if your state has it. You can also do the somewhat tedious work of scrubbing your personal information from other places online (since doxxing is often a combination of information resources). Consider subscribing to a service like DeleteMe (or follow a free DIY guide) for a more thorough process of minimizing your digital footprint. Collaborating with trusted allies to monitor hate forums is a smart way to unburden yourself from having to look up your own information alone. Sharing that responsibility with others makes it easier to do, as well as group planning for what to do in ways of prevention and incident response.

Take a Deep Breath

It’s natural to feel bogged down by all the thought that has to be put towards privacy and security. Again, don’t beat yourself up for feeling powerless in the face of mass surveillance. You aren’t powerless. You can protect yourself, but it’s reasonable to feel frustrated when there is no comprehensive federal data privacy legislation that would alleviate so many of these concerns.

Take a deep breath. You’re not alone in this fight. There are guides for you to learn more about stepping up your privacy and security. We've even curated a special list of them. And there is Digital Defense Fund, a digital security organization for the abortion access movement, who we are grateful and proud to boost. And though it can often feel like privacy is getting harder to protect, in many ways it’s actually improving. With all that information, as well as continuing to trust your communities, and pushing for a culture of security within them, safety is much easier to attain. With a bit of privacy, you can go back to focusing on what matters, like healthcare.

Our concerns about the selling and misuse of location data for those seeking reproductive and gender healthcare are escalating amid a recent wave of cases and incidents demonstrating that the digital trail we leave is being used by anti-abortion activists.

The good news is some states and tech companies are taking steps to better protect location data privacy, including information that endangers people needing or seeking information about reproductive and gender-affirming healthcare. But we know more must be done—by pharmacies, our email providers, and lawmakers—to plug gaping holes in location data protection.

Location data is highly sensitive, as it paints a picture of our daily lives—where we go, who we visit, when we seek medical care, or what clinics we visit. That’s what makes it so attractive to data brokers and law enforcement in states outlawing abortion and gender-affirming healthcare and those seeking to exploit such data for ideological or commercial purposes.

What we’re seeing is deeply troubling. Sen. Ron Wyden recenty disclosed that vendor Near Intelligence allegedly gathered location data of people’s visits to nearly 600 Planned Parenthood locations across 48 states, without consent. It sold that data to an anti-abortion group, which used it in a massive anti-abortion ad campaign.The Wisconsin-based group used the geofenced data to send mobile ads to people who visited the clinics.

It’s hardly a leap to imagine that law enforcement and bounty hunters in anti-abortion states would gladly buy the same data to find out who is visiting Planned Parenthood clinics and try to charge and imprison women, their families, doctors, and caregivers. That’s the real danger of an unregulated data broker industry; anyone can buy what’s gathered from warrantless surveillance, for whatever nefarious purpose they choose.

For example, police in Idaho, where abortion is illegal, used cell phone data in an investigation against an Idaho woman and her son charged with kidnapping. The data showed that they had taken the son’s minor girlfriend to Oregon, where abortion is legal, to obtain an abortion.

The exploitation of location data is not the only problem. Information about prescription medicines we take is not protected against law enforcement requests. The nation’s eight largest pharmacy chains, including CVS, Walgreens, and Rite Aid, have routinely turned over prescription records of thousands of Americans to law enforcement agencies or other government entities secretly without a warrant, according to a congressional inquiry.

Many people may not know that their prescription records can be obtained by law enforcement without too much trouble. There’s not much standing between someone’s self-managed abortion medication and a law enforcement records demand. In April the U.S. Health and Human Services Department proposed a rule that would prevent healthcare providers and insurers from giving information to state officials trying to prosecute some seeking or providing a legal abortion. A final rule has not yet been published.

Exploitation of location and healthcare data to target communities could easily expand to other groups working to protect bodily autonomy, especially those most likely to suffer targeted harassment and bigotry. With states passing and proposing bills restricting gender-affirming care and state law enforcement officials pursuing medical records of transgender youth across state lines, it’s not hard to imagine them buying or using location data to find people to prosecute.

To better protect people against police access to sensitive health information, lawmakers in a few states have taken action. In 2022, California enacted two laws protecting abortion data privacy and preventing California companies from sharing abortion data with out-of-state entities.

Then, last September the state enacted a shield law prohibiting California-based companies, including social media and tech companies, from disclosing patients’ private communications regarding healthcare that is legally protected in the state.

Massachusetts lawmakers have proposed the Location Shield Act, which would prohibit the sale of cellphone location information to data brokers. The act would make it harder to trace the path of those traveling to Massachusetts for abortion services.

Of course, tech companies have a huge role to play in location data privacy. EFF was glad when Google said in 2022 it would delete users’ location history for visits to medical facilities, including abortion clinics and counseling and fertility centers. Google pledged that when the location history setting on a device was turned on, it would delete entries for particularly personal places like reproductive health clinics soon after such a visit.

But a study by AccountableTech testing Google’s pledge said the company wasn’t living up to its promises and continued to collect and retain location data from individuals visiting abortion clinics. Accountable Tech reran the study in late 2023 and the results were again troubling—Google still retained location search query data for some visits to Planned Parenthood clinics. It appears users will have to manually delete location search history to remove information about the routes they take to visiting sensitive locations. It doesn’t happen automatically.

Late last year, Google announced plans to move saved Timeline entries in Google Maps to users’ devices. Users who want to keep the entries could choose to back up the data to the cloud, where it would be automatically encrypted and out of reach even to Google.

These changes would appear to make it much more difficult—if not impossible—for Google to provide mass location data in response to a geofence warrant, a change we’ve been asking Google to implement for years. But when these features are coming is uncertain—though Google said in December they’re “coming soon.”

Google should implement the changes sooner as opposed to later. In the meantime, those seeking reproductive and gender information and healthcare can find tips on how to protect themselves in our Surveillance Self Defense guide. 

This post was written by Jack Beck, an EFF legal intern

In a recent letter to the FTC and SEC, Sen. Ron Wyden (OR) details new information on data broker Near, which sold the location data of people seeking reproductive healthcare to anti-abortion groups. Near enabled these groups to send targeted ads promoting anti-abortion content to people who had visited Planned Parenthood and similar clinics.

In May 2023, the Wall Street Journal reported that Near was selling location data to anti-abortion groups. Specifically, the Journal found that the Veritas Society, a non-profit established by Wisconsin Right to Life, had hired ad agency Recrue Media. That agency purchased location data from Near and used it to target anti-abortion messaging at people who had sought reproductive healthcare.

The Veritas Society detailed the operation on its website (on a page that was taken down but saved by the Internet Archive) and stated that it delivered over 14 million ads to people who visited reproductive healthcare clinics. These ads appeared on Facebook, Instagram, Snapchat, and other social media for people who had sought reproductive healthcare.

When contacted by Sen. Wyden’s investigative team, Recrue staff admitted that the agency used Near’s website to literally “draw a line” around areas their client wanted them to target. They drew these lines around reproductive health care facilities across the country, using location data purchased from Near to target visitors to 600 Planned Parenthood different locations. Sen. Wyden’s team also confirmed with Near that, until the summer of 2022, no safeguards were in place to protect the data privacy of people visiting sensitive places.

Moreover, as Sen. Wyden explains in his letter, Near was selling data to the government, though it claimed on its website to be doing no such thing. As of October 18, 2023, Sen. Wyden’s investigation found Near was still selling location data harvested from Americans without their informed consent.

Near’s invasion of our privacy shows why Congress and the states must enact privacy-first legislation that limits how corporations collect and monetize our data. We also need privacy statutes that prevent the government from sidestepping the Fourth Amendment by purchasing location information—as Sen. Wyden has proposed. Even the government admits this is a problem.  Furthermore, as Near’s misconduct illustrates, safeguards must be in place that protect people in sensitive locations from being tracked.

This isn’t the first time we’ve seen data brokers sell information that can reveal visits to abortion clinics. We need laws now to strengthen privacy protections for consumers. We thank Sen. Wyden for conducting this investigation. We also commend the FTC’s recent bar on a data broker selling sensitive location data. We hope this represents the start of a longstanding trend.