Changes in Reproductive Health Information-Seeking Behaviors After the Dobbs Decision: Systematic Search of the Wikimedia Database

Abstract

Background After the US Supreme Court overturned Roe v. Wade, confusion followed regarding the legality of abortion in different states across the country. Recent studies found increased Google searches for abortion-related terms in restricted states after the Dobbsv. Jackson Women’s Health Organization decision was leaked. As patients and providers use Wikipedia (Wikimedia Foundation) as a predominant medical information source, we hypothesized that changes in reproductive health information-seeking behavior could be better understood by examining Wikipedia article traffic. Objective This study aimed to examine trends in Wikipedia usage for abortion and contraception information before and after the Dobbs decision. Methods Page views of abortion- and contraception-related Wikipedia pages were scraped. Temporal changes in page views before and after the Dobbs decision were then analyzed to explore changes in baseline views, differences in views for abortion-related information in states with restrictive abortion laws versus nonrestrictive states, and viewer trends on contraception-related pages. Results Wikipedia articles related to abortion topics had significantly increased page views following the leaked and final Dobbs decision. There was a 103-fold increase in the page views for the Wikipedia article Roe v. Wade following the Dobbs decision leak (mean 372,654, SD 135,478 vs mean 3614, SD 248; P<.001) and a 67-fold increase in page views following the release of the final Dobbs decision (mean 8942, SD 402 vs mean 595,871, SD 178,649; P<.001). Articles about abortion in the most restrictive states had a greater increase in page views (mean 40.6, SD 12.7; 18/51, 35% states) than articles about abortion in states with some restrictions or protections (mean 26.8, SD 7.3; 24/51, 47% states; P<.001) and in the most protective states (mean 20.6, SD 5.7; 8/51, 16% states; P<.001). Finally, views to pages about common contraceptive methods significantly increased after the Dobbs decision. “Vasectomy” page views increased by 183% (P<.001), “IUD” (intrauterine device) page views increased by 80% (P<.001), “Combined oral contraceptive pill” page views increased by 24% (P<.001), “Emergency Contraception” page views increased by 224% (P<.001), and “Tubal ligation” page views increased by 92% (P<.001). Conclusions People sought information on Wikipedia about abortion and contraception at increased rates after the Dobbs decision. Increased traffic to abortion-related Wikipedia articles correlated to the restrictiveness of state abortion policies. Increased interest in contraception-related pages reflects the increased demand for contraceptives observed after the Dobbs decision. Our work positions Wikipedia as an important source of reproductive health information and demands increased attention to maintain and improve Wikipedia as a reliable source of health information after the Dobbs decision.