“Modern CPCs are plugged into the global anti-abortion movement’s sophisticated digital infrastructure, which facilitates expansion, client surveillance, and systemic, coordinated promotion of anti-abortion disinformation.”
—The Alliance, “Designed to Deceive”
While all eyes are on the Texas abortion ban and two Supreme Court cases poised to overturn Roe v. Wade, a new report shines light on the less visible side of the anti-abortion movement: “crisis pregnancy centers” preying on low-income women—and particularly Black women—with false promises, dangerous misinformation and stigmatizing judgment.
“Designed to Deceive: A Study of the Crisis Pregnancy Center Industry in Nine States” analyzes the websites of 607 crisis pregnancy centers (CPCs) between March 2020 and February 2021 in Alaska, California, Idaho, Minnesota, Montana, New Mexico, Oregon, Pennsylvania and Washington. The report is authored by The Alliance: State Advocates for Women’s Rights & Gender Equality, a collaboration among five regional women’s rights advocacy centers—Legal Voice, Gender Justice, Women’s Law Project, Southwest Women’s Law Center and California Women’s Law Center.
Placing a slice of the 2,500 CPCs across the country under a microscope, the report shows how the “modernized, proliferating, and mostly evangelical CPC industry” uses deceptive tactics and medically-inaccurate information to delay and obstruct access to abortion and prenatal care. CPCs today outnumber abortion providers by three to one nationally—and in some states, by as many as 11 to one.
The “modernized, proliferating, and mostly evangelical CPC industry” uses deceptive tactics and medically-inaccurate information to delay and obstruct access to abortion and prenatal care.
“The contemporary CPC industry is really a new beast,” said Tara Murtha, co-author and director of strategic communication at the Women’s Law Project. “This is not the CPCs of yesteryear. Now they are well-financed, well-coordinated and plugged into the global anti-abortion, anti-LGBTQ movement in ways that the public needs to understand, especially given they’re being increasingly funded with our tax dollars.”
CPCs Masquerade as Medical Clinics
The Alliance research found that CPCs portray themselves as offering medical services but in fact provide virtually no medical care or even referrals. CPCs’ primary services are self-administered urine stick pregnancy tests, anti-abortion “counseling” and material goods like diapers and maternity clothes, which are distributed in exchange for attending religious and ideologically-driven programs and counseling sessions.
“The three most common services offered by 80 percent of CPCs are absolutely not medical. They provide no medical value. They serve no medical purpose,” said Jenifer McKenna, report co-author and program director at the Alliance. “Yet CPCs are increasingly branding themselves as full, comprehensive medical clinics, or at least providers of medical care.”
Most CPCs are not licensed nor do they charge for their services so they can avoid state oversight and regulation required of healthcare facilities and businesses.
Fake clinics — including this RV outside of @PPSLR’s CWE health center — are funded with taxpayer $ but aren’t required to provide people with medically accurate info. In fact, many are on record providing false info about pregnancy & sex. #ExposeFakeClinics pic.twitter.com/DDPai2ytm2— Planned Parenthood Advocates in Missouri (@PPMO_Advocates) July 18, 2019
To make themselves look like medical clinics, CPCs plaster pictures of volunteers in lab coats across their websites and mobile vans, they mimic the names and language of reproductive health clinics, and they increasingly have ultrasound machines. The Alliance report found that more than half of CPCs today offer “nondiagnostic” ultrasounds—without making clear CPC staff are rarely medically trained to use them or that their use of ultrasounds is not intended to be medical in nature. It is solely meant to persuade women not to have an abortion.
CPCs are increasingly branding themselves as full, comprehensive medical clinics, or at least providers of medical care.
These deceptions have harrowing consequences. According to McKenna, one woman ended up in an emergency room with a ruptured fallopian tube after a CPC did an ultrasound but failed to detect her ectopic pregnancy. In another case, a CPC told a woman with a history of ectopic pregnancy she had to wait two weeks before getting an ultrasound.
“I have had patients who have obtained ultrasounds at CPCs who were unaware they were not receiving medical care from a real health care facility,” said Dr. Glenna Martin, a board-certified family medicine physician in Washington. “I am not aware of any other area of medicine in which these problems exist. There are no ‘crisis broken bone clinics’ that take an X-ray and assure you that you’ll be fine if you simply wear a sling. CPCs take advantage of that lack of knowledge to provide all of the form of a doctor’s office, but none of the function.”
While CPCs work to appear as if they are medical facilities, the three services they are least likely to offer are medical services—contraception, wellness care and prenatal care. In fact, 95 percent of CPCs offer no prenatal care and fewer than half even offer referrals for prenatal care.
“They engage in practices that are designed to delay people accessing real medical care,” said McKenna.
This impacts not only people seeking abortion, but also people who plan to carry their pregnancies to term—an estimated 80 percent of CPC clients, according to McKenna. The health consequences of CPCs delaying women from receiving prenatal care are unknown, although lack of prenatal care is a known cause of infant and maternal mortality and morbidity.
CPCs also obstruct access to contraception and accurate information about sexuality. Only one of the 607 CPCs studied provided contraceptive care. Meanwhile, 17 percent claimed to offer sexuality “education,” typically focused on abstinence, harmful stereotypes about LGBTQ+ youth and nontraditional families, and religious and shame-based messages. One CPC peer counselor training teaches that a boyfriend who “experiences homosexuality” can be a consequence of abortion.
Restrictions on abortion exist to exert control over the lives & bodies of people with uteruses. There’s never been any action to support the right-wing claim of being “pro-life”. We’re sick of it! #ExposeFakeClinics #ShoutYourAbortion #FakeClinicsLie pic.twitter.com/bv54SIn97l— Socialist Feminist Collective (@rocsocfem) October 28, 2021
Many CPCs falsely claim to provide full and unbiased information yet disguise the fact that they do not provide abortion. Some inflate miscarriage rates to encourage pregnant women to delay seeking medication abortion until too late. Many falsely claim abortion causes depression, a claim debunked by the American Psychological Association.
One crisis pregnancy center peer counselor training teaches that a boyfriend who “experiences homosexuality” can be a consequence of abortion.
While pretending to be medical clinics, CPCs collect confidential medical information. Murtha describes CPCs as “warehouses of digital information on people who give sensitive history about their reproductive and sexual health, perhaps under the impression that their information would be protected by HIPAA and the normal privacy protections at a medical facility when that’s not the case.”
Close to half of CPCs in the Alliance research were affiliated with large umbrella organizations like Heartbeat International, Birthright or Care Net. “The major organizations use local CPCs to distribute disinformation in a systematic fashion,” said Murtha. “They are then sharing client data with the major organizations, which is especially concerning.”
Public Funding of CPCs
A report released last June by Equity Forward revealed that lawmakers in many states are diverting significant amounts of taxpayer money earmarked for impoverished mothers and children to fund CPCs. According to the Alliance report, CPCs in 27 states operate with state funding, yet are subject to little or no legislative oversight.
“This is a system that has proliferated and grown in both number and power, mostly on taxpayer funds. It’s the quiet companion tactic to increasingly severe legislative restrictions,” said Murtha.
CPCs attract low-income people by advertising free pregnancy tests, ultrasounds and diapers.
“It’s the lack of resources, it’s poverty and the lack of connection to legitimate healthcare providers that CPCs exploit,” said Murtha. “While also helping manufacture poverty by taking those safety net funds in order to target low-income people.”
According to McKenna, one woman, desperate for resources and believing attending appointments at a CPC was important for the health of her pregnancy, reported losing her job because she missed work for a CPC appointment. She later lost her home.
One of the most surprising findings of the Alliance report is that state-funded CPCs are significantly less likely than non-state-funded CPCs to provide or offer referrals for prenatal care and are more likely to advocate “abortion pill reversal”—the idea that medication abortion is reversible by taking progesterone. More than one third (34.9 percent) of CPCs in the Alliance study advertise abortion pill reversal counseling, which McKenna describes “an unproven, potentially dangerous, experimental, hormonal intervention.” She also notes there is no evidence of demand for abortion pill reversal.
CPCs won’t tell you about abortion at all. If they do, they’ll often focus on it being some sort of negative experience in the lives of those who have one. The fact is, the most commonly reported feeling after an abortion is relief! Don’t believe CPC lies! #ExposeFakeClinics pic.twitter.com/pviVG6VClL— Socialist Feminist Collective (@rocsocfem) October 8, 2021
“It’s just the latest chapter in this country’s horrific history of experimental and coercive medical abuse perpetrated on people of color, and Black women in particular,” said Erin Maye Quade, advocacy and engagement director of Gender Justice in Minnesota.
CPCs are largely funded and run by white evangelicals who target communities of color, says McKenna. “It’s shameful that at the same time as maternal mortality and morbidity is worsening in this country, particularly during the pandemic and for Black women and other people of color, more and more public funding is going into the CPC industry that’s literally deceiving pregnant people, manipulating them, and undermining access to the health care they need.”
If Roe v. Wade were to fall, CPCs are positioned to enable the anti-abortion movement to surveille pregnant women and help states enforce abortion bans in the 26 states certain or likely to ban abortion.
The contrast between government regulation of abortion clinics compared to CPCs is stark, says McKenna.
“Abortion clinics that provide evidence-based reproductive health care services are subjected to relentless scrutiny, threats, over-regulation, and restrictive laws. By contrast, CPCs, which have a patently ideological agenda, use blatantly deceptive tactics, and systematically promote medical disinformation to pregnant people, are permitted to operate free of regulation, scrutiny, or accountability and have proliferated, increasingly on the public dime. What this says about how little pregnant people matter in this country is deeply disturbing.”
These policies have led to an inversion of the number of abortion clinics and CPCs over the last 50 years.
A Call for Action
The Alliance report is an important tool for feminists working to expose CPCs and persuade policymakers to hold them accountable for their deceptive and dangerous practices.
“There’s the perception that CPCs are benign, that they’re just providing information and resources to pregnant people,” said McKenna. “It’s been hard to get policymakers and particularly attorneys general to look seriously at them and understand that they’re engaging in deceptive practices that are harmful. So we decided what we needed to do was to map the harm, to collect facts on how they operate and what they are doing in order to make a case to take action.”
The Alliance recommends ending public funding of CPCs and instituting oversight and regulation of CPCs. Murtha says state governments should invest “resources into programs that would actually facilitate people accessing legitimate health care rather than funding obstacles to legitimate health care.”
Megan Peterson, executive director at Gender Justice in Minnesota, believes that implementing these recommendations at the state level is crucial.
“Regardless of what happens at the Supreme Court, our work will continue in our home states to make sure that everyone is able to access abortion care without fear of harassment, barriers, or interference from others—including from CPCs.”