New state and local laws prohibit fake clinics’ deceptive advertising, protect patients’ privacy, and educate the public about crisis pregnancy centers’ dangerous practices.
In the wake of the Supreme Court’s elimination of federal constitutional abortion rights established over 50 years ago in Roe v. Wade, the anti-abortion movement is expanding its network of “crisis pregnancy centers” (CPCs) designed to interfere with women’s access to reproductive healthcare using deceptive advertising; disinformation about abortion, contraception and pregnancy; and non-medical ultrasounds to persuade women to carry to term and falsely signal medical legitimacy—while collecting their personal and health information, with no privacy protections.
In response, grassroots reproductive health advocates are taking action to counter CPC disinformation and abuse by advocating for state and local laws to prohibit deceptive advertising, protect health data privacy, advance public education about CPCs, and create avenues for consumer complaints about their deceitful and dangerous practices.
In 2022, advocates in several states won passage of local ordinances against CPC deceptive advertising, including in Los Angeles, Pittsburgh, Seattle and Somerville, Mass. New York City passed a law mandating a public education campaign about CPCs, and Columbus, Ohio, authorized “an examination into the activities of crisis pregnancy centers.”
At the state level, Connecticut passed a 2021 law prohibiting “limited services pregnancy centers” from making deceptive statements about pregnancy-related services. Following the June 2022 Dobbs ruling that overturned Roe, attorneys general and state agencies in multiple states issued CPC consumer advisories and established consumer complaint lines, including California, Massachusetts, Minnesota, Nevada and New Jersey.
In Massachusetts, which has the highest concentration of CPCs in New England, state health offices issued their own CPC warnings after Attorney General (now Governor) Maura Healey published her consumer advisory encouraging residents to file a civil rights complaint if they have concerns about a CPC experience. The state Department of Public Health now alerts consumers that CPCs are not reproductive healthcare clinics, as does the state public insurance program, MassHealth. And the state’s new attorney general has publicly pledged to protect consumers from CPCs.
“If we want Massachusetts to continue to lead the way for reproductive justice, we must directly address the unfair and deceptive practices used by crisis pregnancy centers,” said AG Andrea Joy Campbell. “My office is committed to protecting patients from these dangerous tactics and ensuring that people who need an abortion can access this essential healthcare without fear of intimidation, coercion or interference.”
Anti-abortion groups have loudly proclaimed CPC accountability measures violate their free speech and religious rights, but they recently withdrew a legal challenge to the Connecticut deceptive advertising law.
In October 2021, Care Net, an evangelical Christian network of CPCs headquartered in Virginia, filed a federal lawsuit challenging the Connecticut law. Care Net was represented by the Arizona-based conservative advocacy group, Alliance Defending Freedom (ADF).
Connecticut AG William Tong vigorously defended the law. “Women need accurate and timely information about their reproductive health choices,” said Tong at the time. “It’s indefensible to lie to women at a vulnerable time. I testified in support of Connecticut’s law and am fully prepared to defend it in court.”
On Jan. 12, 2023, Care Net and ADF withdrew the lawsuit.
“This outcome is a resounding victory for reproductive health in Connecticut,” said Stephanie Toti, senior counsel and project director at the Lawyering Project, an organization that works to improve access to reproductive healthcare.
“Last month, Care Net voluntarily dismissed its lawsuit against Connecticut Public Act 21-17 without securing any ruling in its favor or any concession from the state. The consumer protection law remains in full force and effect, and the Connecticut attorney general retains authority to take action against any facility that engages in deceptive advertising about pregnancy-related services.”
Meanwhile, in neighboring Massachusetts, activists have been pushing for local ordinances to hold CPCs accountable for truth-in-advertising, and their lawmakers are taking action. In March 2022, Somerville Councilor Kristen Strezo introduced an ordinance prohibiting deceptive CPC advertising, modeled on a 2017 Hartford ordinance, which the Somerville City Council passed unanimously on International Women’s Day.
“CPCs have gone under the radar for decades,” said Strezo. “I didn’t understand why more wasn’t being done about it at a municipal level. I was following what other communities were doing to find a way to regulate their deceptive behavior. What I saw in Connecticut was promising and thought that by introducing it in Somerville, we could really protect our constituents.”
The City of Salem adopted the Somerville model as Board of Health regulation in December 2022, and in January the Cambridge City Council voted 9-0 to pass an ordinance banning deceptive CPC advertising, with violations subject to a $300-a-day fine from the city’s licensing commission.
Other Massachusetts cities have taken up deceptive CPC advertising proposals including Easthampton, Boston, Worcester, Framingham and Newton. In Easthampton, Councilor Owen Zarat has proposed a “safe and fair access” ordinance requiring the city to inform residents about the deceptive practices of CPCs, assist with reporting complaints to the state, and provide information about full-spectrum reproductive healthcare clinics to help the public make informed choices.
“As a state where abortion, medical contraception and gender affirming care are all legal reproductive healthcare services, we are bound to see an influx of patients seeking care from states where such services are not legally available,” said Zarat. “Despite abortion being legal, CPCs exist in our commonwealth to dissuade patients from accessing clinics that offer a full array of choices in pregnancy. Worse, they act as Trojan Horses to lure patients under the guise of receiving certain care only to find out it is not offered or referred for.”
Women need accurate and timely information about their reproductive health choices. It’s indefensible to lie to women at a vulnerable time.
Connecticut AG William Tong
Abortion rights and constitutional lawyers have vetted the Easthampton ordinance to withstand legal challenge. A leading Massachusetts abortion rights advocacy group, Reproductive Equity Now, is now promoting it as a model in their new toolkit for municipal action to expand access to reproductive healthcare.
“City leaders are in a really unique position in their communities because they’re on the ground, they understand where people get their information, and they can reach more vulnerable populations in a different way than some other leaders can in the same space,” said Rebecca Hart Holder, executive director of Reproductive Equity Now. “They can really get at where are the knowledge gaps and how do we fill that on the municipal level. It has been really exciting to see the groundswell of people asking, what can we do at the municipal level?”
Councilor Strezo agrees. “Municipal leadership has been overlooked. There’s a lot that can be done at a municipal level, and residents can see the impact of municipal work faster. It doesn’t have to go through numerous bureaucracies to get change happening. And conversations that can happen at a municipal level are very valuable.”
Grassroots advocates are urging local officials to take action against deceptive CPC practices.
According to Kate Glynn, co-chair of the Abortion Rights Fund of Western Massachusetts,
“For folks trying to access abortion in the post-Dobbs landscape, there is so much changing information and misinformation. Even in Massachusetts, where we have some of the best protections in the country, people are confused. CPCs are absolutely exploiting that confusion. False CPC advertising is preying on pregnant people at a time where they need factual information very quickly.”
Glynn said local action is critical. “CPCs need to be held accountable for lying to pregnant people, whether they are abortion seekers or not. This is healthcare. We can actually protect people’s rights. We can actually protect people’s bodies.”
The new Healey-Driscoll administration in Massachusetts is also calling for municipal action.
In January, Lieutenant Governor Kim Driscoll partnered with Hart Holder of Reproductive Equity Now to publish a call for action by local lawmakers to “holistically advance reproductive equity, put an end to crisis pregnancy centers’ deceptive practices.”
“We cannot do this work at the state level without the partnership of all 351 cities and towns across the state,” said Driscoll and Holder. “Right now, as anti-abortion activists descend on municipalities, our cities have an opportunity to lead. We can show the rest of the country what reproductive equity at the city level looks like.”
But the pushback has been intense, even threatening. Easthampton Mayor Nicole LaChapelle has received intimidating letters from anti-abortion activists around the country—some blood soaked—condemning the proposed CPC ordinance.
I want to be aggressive, but I’m very afraid of the makeup of the Court and how they will use abortion exceptionalism to prevent us from regulating CPCs in a meaningful way.
Rebecca Hart Holder
LaChapelle also fears the city would be subject to lawsuits and further threats if she were to sign it into law. In 2018, the United States Supreme Court in NIFLA v. Becerra ruled that California could not require CPCs to post a sign saying they are not a medically licensed facility and that requiring that they do violates their First Amendment free speech rights.
“In the post-Dobbs world, crisis pregnancy centers are one of the next threats in the access to abortion landscape because of the Supreme Court’s outright refusal to allow states to fully regulate what crisis pregnancy centers are doing,” said Hart Holder. “I want to be aggressive, but I’m very afraid of the makeup of the Court and how they will use abortion exceptionalism to prevent us from regulating CPCs in a meaningful way.”
Despite these concerns, many Massachusetts lawmakers committed to aggressive state action in the post-Roe era are introducing new legislative proposals to hold CPCs accountable.
One bill introduced this year would protect consumers’ private health data by limiting the collection, sharing, and selling of health data not protected under HIPAA.
Another bill would mandate public education about crisis pregnancy centers, including about their “lack of medical services or licensed medical professionals,” and how they spread “medically inaccurate, medically unnecessary, or misleading” information. The bill would also require ultrasound services to occur “under the supervision of a…licensed healthcare professional.”
Last July, Republican Governor Charlie Baker vetoed $1 million in the state budget for public education about CPCs, and the Boston Globe editorial board excoriated the action noting, “Anti-abortion pregnancy centers are deceiving women. They need to know that.”
Now, with Democrat Maura Healey in the governor’s seat, advocates are pushing for reallocation of that funding in the next budget to support a statewide Department of Health campaign to raise awareness about the harms of CPCs, including on bus ads, billboards and the internet.
Massachusetts state Representative Lindsay Sabadosa, sponsor of the new health data privacy act, applauds the vigorous local movement to hold CPCs accountable, and is dedicated to advancing multiple state strategies.
“As a long-time abortion fund volunteer, I hear firsthand from women and girls who’ve gone to a CPC thinking it was a real health clinic, only to be lied to about their pregnancy,” said Sabadosa. “I’ve heard heartbreaking stories from pregnant people; CPC lies can be disastrous.”
Policymakers and advocates are also brainstorming new accountability strategies, such as requiring CPCs to do background checks on volunteers who serve minors.
“Crisis pregnancy centers are advertising for minors to come and get free pregnancy tests or a free ultrasound,” said Strezo. “Volunteers perform ultrasound tests, including transvaginal ultrasounds, and urine tests on them. We need to see if crisis pregnancy centers are doing background checks and sex offender checks on the volunteers they have staffing these pregnancy centers.”
Fake Clinics Put Patients at Risk
Health and safety standards at these fake anti-abortion clinics are also a serious concern.
The Center for Investigative Reporting recently published an expose about a Kentucky-based CPC’s use of expired disinfectant on a transvaginal ultrasound wand, which medical experts warn does not kill the human papillomavirus responsible for most cervical cancers. Advocates are sounding the alarm that this could be a health danger to pregnant people nationwide, since many CPCs are now performing ultrasounds and most are not licensed or subject to any inspection or oversight.
They are also concerned about CPCs promotion of “abortion pill reversal” and exploring ways to challenge it. Massachusetts advocates recently helped a concerned physician to file a complaint with the attorney general against a CPC claiming to provide this unproven and potentially dangerous anti-abortion “treatment.”
Advocates note that these harms fall most heavily on women who are young, financially insecure, and uninsured, and on women of color and immigrants needing healthcare. Studies show the CPC industry explicitly targets low-income women—especially low-income women seeking abortion information online—young women, and women of color, using deceptive ads to pose as medical clinics and obscure their anti-abortion mission.
“Everyone deserves access to medically-accurate, non-judgmental healthcare and anti-abortion crisis pregnancy centers jeopardize that care,’ said Dr. Nate Horwitz-Willis, executive director of the Planned Parenthood Advocacy Fund of Massachusetts. “To make reproductive healthcare equitably accessible, we need to address and prevent dangerous misinformation about abortion care.”
Despite these dangerous practices, a growing number of states funnel taxpayer dollars to CPCs without any oversight or accountability. Local advocates in several states are fighting back.
A new Minnesota bill would repurpose the state program funding CPCs, requiring grant recipients to provide medically-accurate information about abortion, and mandating funds for prenatal care, medical care and reproductive healthcare, including abortions. And in Pennsylvania, the first state to divert public funding to crisis pregnancy centers, advocates are working with lawmakers to expose their state-funded CPC network’s fiscal malfeasance and dangerous practices, and the legislature’s Women’s Health Caucus has called for defunding CPCs in the state.
“In the absence of a federal right to reproductive autonomy, it’s urgent that state and local governments step up to protect people from the predatory practices of fake clinics that deter, delay and deceive people seeking abortion or other reproductive healthcare,” said Amal Bass, interim executive co-director of the Women’s Law Project in Pennsylvania. “Deceptive crisis pregnancy centers threaten the health and privacy of women and all pregnant people and should be regulated to protect public health and held accountable when found to perpetuate harm.”
State and local advocacy groups raising awareness about CPCs are active in Colorado, Florida, Illinois, New Mexico, North Carolina, New York, Wisconsin and more states. National groups with campaigns against CPCs include ReproAction Hold Fake Clinics Accountable (fake clinic database, direct action toolkit, factsheets and webinars), Abortion Access Front’s Expose Fake Clinics and Reproductive Transparency Now, mobilizing CPC education and advocacy nationwide.
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