The Threat of Crisis Pregnancy Centers Will Escalate in a Post-Roe U.S.

The proliferating web of “crisis pregnancy centers” (read: fake abortion clinics) is positioned to assist with state surveillance of pregnancy and enforcement of abortion bans once Roe v. Wade falls.

In August of 2017, ReproAction and SisterSong joined forces to protest fake abortion clinics in Atlanta. (Courtesy of ReproAction)

If you Google “abortion services near me,” chances are the top of your search will show an anti-abortion “crisis pregnancy center” (CPC). The ad will say something like, “Looking for abortion? We discuss all your options.” You may miss the small, pale words: “Does not provide abortions”—a warning required by Google after complaints about misleading CPC ads. The warning may not even appear.

In their ads and on their websites, crisis pregnancy centers mimic reproductive health clinics, using the language of choice and empowerment, support and compassion, wellness and patient-centered care. They often intentionally locate next to abortion clinics and use names like “Center for Pregnancy Choices” and “Your Options Medical.” Despite appearances, these organizations—often run by white evangelicals—use medically-inaccurate information and coercive tactics to obstruct women’s access to abortion, contraception and even prenatal care. 

With the Supreme Court poised to reverse Roe v. Wade and states racing to pass increasingly draconian abortion restrictions, many people are unaware that the CPCs now blanketing the country are an equal and escalating threat to abortion access, including as a tool for state surveillance of pregnant women and enforcement of abortion bans likely in more than half the states should Roe fall.

Most CPCs offered no prenatal care and only one provided contraception—but over half offered “nondiagnostic” ultrasounds to show images of the embryo to discourage women from abortion.  

According to The Alliance: State Advocates for Women’s Rights & Gender Equality, which has analyzed over 600 CPC websites in nine states, many CPCs portray themselves as medical clinics but in fact provide virtually no medical care. Primary CPC services were self-administered urine stick pregnancy tests, anti-abortion “counseling,” and material goods like diapers, distributed in exchange for joining ideological CPC activities. Most CPCs (95 percent) offered no prenatal care and only one provided contraception, but over half offered “nondiagnostic” ultrasounds to show images of the embryo to discourage women from abortion.  

The Alliance found CPCs aggressively promote the deceit that abortion is dangerous. Almost two-thirds made patently false or biased medical claims, including that abortion causes breast cancer and infertility, which is untrue according to the American College of Obstetricians and Gynecologists (ACOG).

Many claimed abortion causes depression, a claim debunked by the American Psychological Association.

Many inflated miscarriage rates to encourage women to delay care until it’s too late to use abortion pills or access abortion legally. Such delay tactics can be dangerous, especially for women with ectopic pregnancies and those who plan to continue their pregnancies and need prompt prenatal care. 

Moreover, one-third of CPCs in the Alliance Study promoted “abortion pill reversal”—giving pregnant women progesterone to counteract the first abortion pill, which ACOG calls “unproven and unethical” and “dangerous to women’s health.” CPCs systematically promoted a made-up “syndrome” about “post-abortion regret” instead of the truth: It is women who are denied abortion who regret it, and suffer long-term mental and physical health consequences.

roe-v-wade-overturned-crisis-pregnancy-centers
Police officers guard the U.S. Supreme Court at an anti-abortion march on Jan. 24, 2011. Many crisis pregnancy centers are part of large anti-abortion, anti-LGBTQ networks, such as Heartbeat International, Care Net and the National Institute of Family and Life Advocates. (Tim Sloan / AFP via Getty Images)

CPCs appear to be local, but many are part of large anti-abortion, anti-LGBTQ networks, such as Heartbeat International, Care Net and the National Institute of Family and Life Advocates (NIFLA). Under direction of these groups, CPCs are using sophisticated digital strategies including geo-fencing and menstrual apps to intercept those seeking abortion, and online data platforms to collect client information.

Privacy International has documented how CPCs use centralized platforms such as eKYROS and Next Level Center Management Solution to share and store client information. Heartbeat International boasts its software enables CPCs to share client information with the broader anti-abortion movement.

Pregnant women provide their personal and medical information to CPCs believing it will be kept confidential. They don’t know that most CPCs are not medical providers so not legally obligated to keep their information confidential. And they won’t know the CPC is sharing their private information with the anti-abortion movement.

CPCs systematically promoted a made-up “syndrome” about “post-abortion regret” instead of the truth: It is women who are denied abortion who regret it, and suffer long-term mental and physical health consequences.

According to the Alliance, a “modernized, proliferating and mostly evangelical CPC industry” is now collecting “massive amounts of client data including detailed sexual and reproductive histories through in-person ‘counseling,’ centralized chat platforms, and smartphone apps,” stored in a proprietary anti-abortion movement “mega-database.” The Alliance warns that the proliferating web of CPCs is now positioned to assist with state surveillance of pregnant women and enforcement of abortion bans once Roe falls. As abortion restrictions increase and more women turn to self-managed abortion, it remains to be seen how CPCs will succeed in blocking access.

Since most CPCs are unlicensed and do not charge for services, they avoid oversight and regulation. Now, despite documented proof of their deceptive strategies and unmonitored collection of client data, these unregulated groups are expanding on public funds. For decades CPCs have received federal “abstinence-only” grants. Now, according to the Alliance report, CPCs in 29 states also get state funding. A report by Equity Forward revealed how state lawmakers are diverting funds from safety net programs for pregnant women and children to CPCs.

A recent Associated Press tally found $89 million of state funding was allocated to CPCs in a dozen states this year, up from $17 million in eight states a decade ago. Texas alone has budgeted $100 million for CPCs, a 20-fold increase since 2005.

There are over 2,500 CPCs across the U.S., triple the number of abortion clinics. While CPCs have multiplied, health clinics providing abortion have diminished precipitously, from 2,749 in 1978 to under 780 today. In some states, CPCs outnumber abortion clinics 11 to one. CPCs operate in more than half of U.S. counties while whole states have only one abortion clinic. CPCs’ attempts to intercept women seeking reproductive health care may delay access until it’s too late to use medication abortion or access abortion care at all in the many states with bans on abortion after certain number of weeks.

While groups such as ReproAction and the Abortion Access Front work to expose CPCs, policymakers must address the rising public health and data privacy threats posed by the CPC industry. Last summer, Connecticut passed a law barring CPCs from using false, misleading or deceptive language about their services. Last month, the city of Somerville, MA passed a deceptive advertisement ordinance targeting “limited service pregnancy centers.”

Other states and cities should consider similar measures as well as data privacy protections and requiring CPCs to make mandatory referrals to medical professionals. The federal government should prohibit taxpayer money from supporting CPCs, to staunch the diversion of state funds to CPCs by anti-choice politicians. The Alliance offers a range of other actions states can take to regulate CPCs and address the deep gaps in maternal and reproductive health care that CPCs exploit.

CPCs practices endanger women’s health amid already high rates of maternal mortality and morbidity in the U.S. CPCs target Black women in particular, perpetuating a long history of medical racism. With the Court now poised to overrule or gut Roe, progressive states, cities and towns must act to ensure that deceptive CPCs are not more accessible to pregnant women than actual reproductive health care, and the CPC industry is not weaponized as a surveillance tool of the post-Roe state.

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About

Carrie N. Baker, J.D., Ph.D., is the Sylvia Dlugasch Bauman professor in the Program for the Study of Women and Gender at Smith College. She is a contributing editor at Ms. magazine. You can contact Dr. Baker at cbaker@msmagazine.com or follow her on Twitter @CarrieNBaker.