What are Crisis Pregnancy Centers?

Fake health centers, commonly called crisis pregnancy centers (CPCs), are organizations that seek to prevent or dissuade pregnant women from obtaining abortion care. Most CPCs provide medically inaccurate information and are not licensed medical facilities, though many CPCs go to great lengths to appear like medical facilities.

These fake health clinics often mimic the language and design of actual abortion care facilities to create confusion for women accessing abortion care. Many of these centers are religiously-affiliated or ascribe to anti-choice religious ideologies that govern their policies. They are subject to little or no regulatory oversight on the local, state, or federal level, meaning that they can distribute information to women that is not supported by scientific evidence or backed by medical consensus.

Fake health centers are a threat to public health and to women’s safety and well-being.

Tactics fake health centers use to dissuade women from obtaining abortion care

Misleading Language

Fake health centers frequently use the language of the pro-choice movement to confuse women into entering their spaces. Most of these centers use choice-centric terms in their names and materials; words like “pregnancy resource center”, “Choices Medical Clinic”, and “A Woman’s Choice.”

Gaming Search Results

Prior to 2014, CPCs actively used Google search results to attract women to their facilities. These fake clinics’ webpages would appear as paid advertisements when users searched for “abortion clinic.” In response to this discovery by reproductive rights advocates, Google ultimately agreed to remove CPCs’ paid ads.

Locating Close to Actual Clinics

Some fake health centers intentionally locate near or directly next to actual clinics that offer abortion care, in the hopes that women will enter their spaces instead. They even often use names that are almost the same as the real clinic they are next to in order to further confuse patients. Women report mistakenly entering fake health centers when attempting to visit the actual abortion care providers where they have an appointment.

Medically Inaccurate Information

Women who have entered fake health centers report being given false information regarding their own pregnancies, as well as medically inaccurate information regarding abortion care. Some CPCs will give women pregnancy tests and report incorrect or false results; provide ultrasounds that do not accurately depict fetal gestational age; and offer sensationalized, medically inaccurate information regarding abortion care. Many CPCs lie to women and tell them that abortion care causes breast cancer, infertility, or “post-abortion syndrome,” all claims that lack backing in scientific evidence.

Intimidation Tactics

While inside fake health centers, some women report being forced to watch anti-choice videos (that typically provide descriptions of abortion procedures that are graphic and wildly inaccurate), being prayed over by staff members, and being read verses from the bible¬–all with the goal of dissuading them from obtaining abortion care.

Delay Tactics

Many CPCs engage in delay tactics, telling women to put off making a decision about abortion care or other options by a month so that they will be too far along to obtain an abortion in their state. Other CPCs have told women explicitly that they can access abortion care through all nine months of pregnancy, which is false and misleading. Disturbingly, CPCs will also provide misinformation regarding rates of miscarriage, such as telling women that most pregnancies end in miscarriage so they don’t need to consider abortion care.

Follow-up Harassment

Even after they leave the fake health center, some women report being harassed and called by the center’s staff. One woman reported being called for three days by the staff of a Texas CPC after she left, with staff leaving her voicemails encouraging her to contact them.

Targeting Young People

These fake health centers target low-income women, communities of color, and young people. In 2017, a Mississippi branch of CareNet (a national chain of CPCs) advertised on the back of the tickets for a high school graduation ceremony. CPCs have also advertised in school newspapers, and have located close to colleges and universities, and offer free pregnancy tests to exploit their proximity to young women who may lack the resources or exposure to tell the difference between a CPC and a clinic offering abortion care.

Stories from Women who have visited CPCs:

One woman from the Florida Panhandle who called the NAF Hotline was unemployed, and her husband had just been laid off, when she found out that she was pregnant. She knew that having an abortion was the best option for their family at that time. She scheduled an appointment at the nearest clinic that could provide her care—over 250 miles away from her home—and worked to come up with the funds she would need to travel there and pay for her procedure. On the day of her appointment she drove hours to her provider, only to be lured into a CPC next door to the clinic, with a similar name and staff who assured her she was in the right place. They told her that they did not see her name in their system, and tried to get her to fill out extensive paperwork. Fortunately, before she supplied any of her personal information or details about her medical history, she asked if they provided abortion care, and when they admitted that they did not—and had misled her about where she was—she left the CPC and made it to the medical facility next door just in time for her appointment.

A single mother in Jacksonville, Florida, that called the NAF Hotline found out she was pregnant after she got a free pregnancy test from a CPC. After thoughtful consideration, she decided that an abortion was the right choice for her, and went back to the CPC for a free ultrasound. CPC staff falsely told the woman that she would have to wait for another two weeks before she could have an ultrasound; then, they talked to her about religion, forced her to hold a doll that they claimed was “what a baby would look like at six weeks,” and lied to her about her fetus’ development, saying that her baby already had a brain and would feel pain during an abortion procedure.

Latest Tactics used by Fake Health Centers

Medical Abortion Reversal

Some fake health centers claim that they can provide “medical abortion reversal.” Despite the claims of abortion opponents, there is no reliable research to prove that any treatment, including taking high doses of progesterone, can reverse a medical abortion and there isn’t any data on the safety of this experimental method. Leading medical groups like the American College of Obstetricians and Gynecologists (ACOG) have also expressed concerns that high doses of progesterone could have negative health effects on patients.[1]

Anti-abortion individuals have embraced this myth primarily based on one report, authored by anti-abortion individuals, documenting the experiences of only six women who had varying regimens of progesterone after taking mifepristone. These cases were not part of a controlled study, and they didn’t have oversight from an institutional review board or an ethical review committee as is standard for this kind of intervention. The anti-choice physician behind this myth claims to have created a national network of over 350 practitioners who are willing to attempt the unproven abortion reversal process with progesterone injections.[2] He also runs a CPC, in San Diego, California, where he advertises medical abortion reversal as a service.[3] Around 20 fake health centers in the United States now claim to offer medical abortion reversal.[4]

Medicalization

CPCs regularly attempt to legitimize their tactics by medicalizing their facilities. CPCs without medical professionals often use ultrasound machines and dress their staff in hospital scrubs or white coats to cultivate an appearance that they are actual medical providers.
Though CPCs remain focused on their anti-choice mission, many CPCs have begun to offer limited medical services in order to attract more women, hiring part-time anti-choice medical providers and purchasing medical equipment. The purpose behind the “medicalization” of CPCs is not to better serve women, but rather to use medical technology to attract and dissuade women who may be considering abortion care.

CPC Funding

Federal Funding

Multiple Congressional Representatives have introduced legislation attempting to federally fund “alternatives to abortion,” a term for services and programming that stigmatize abortion care, and encourage participants to consider adoption or parenting in lieu of abortion care, particularly via referrals to CPCs. Representatives have also introduced bills that directly fund CPCs. Though none of these bills have been enacted, federal funds still flow to crisis pregnancy centers through indirect means, such as the Temporary Assistance for Needy Families (TANF) program, Title V, and the U.S. Department of Health and Human Services.

State Funding

CPCs are also funded at the state level. At least 12 states fund CPCs directly through state grants and other programs. Examples of state funding include the following: 

  • Kansas funds CPCs through its Senator Clark Pregnancy Maintenance Initiative. The program awards grant money to Kansas organizations[1] that “provide case management services to women which enable them to carry their pregnancies to term”—however, these services may not include “performing, promoting, referring for, or educating in favor of abortion.”[2] The program received $338,846 in the 2016 budget, and the current appropriations bill maintains this funding.[3]
  • North Carolina funds CPCs through the Carolina Pregnancy Care Fellowship, which provides grant funding to “individuals and organizational partners impacting the state with the Culture of Life.”[4] North Carolina’s 2017 budget provides a total of $1 million in funding for the program, including $800,000 for purchasing “durable medical equipment,” $170,000 for medical equipment training, and $30,000 for administrative support.[5] The money for medical equipment will be used to buy ultrasound machines.[6]
  • North Carolina allocated $300,000 in 2017 to the Human Coalition’s Raleigh clinic for the creation of a pilot program to “provide a continuum of care and support to assist women experiencing crisis pregnancies to continue their pregnancies to full term.”[7] The Human Coalition is an explicitly anti-choice organization that works to “end the worst holocaust in human history” by making abortion “unthinkable and unavailable in our lifetime.”[8]
  • Minnesota funds CPCs through its Positive Alternatives to Abortion Program. This program will award a total of $10,247,952 in grants between 2016 and 2019, including $298,567 to the CPC Birthright of Alexandria.[9]

Privacy Issues

CPCs present significant concerns for patient privacy and facility regulation. CPCs often pose as medical facilities, but are not regulated as such, and therefore are not subject to the medical confidentiality rules under the Health Information Portability and Accountability Act (HIPAA) that govern licensed medical professionals.

Legitimate medical facilities must meet certain requirements under HIPAA. Because most CPCs are unlicensed, they are not bound by several requirements applying to comprehensive women’s health clinics that offer abortion care, including:
– Inspection by the State Department of Health and Human Services;
– Not revealing a patient’s identity without their consent; and
– Obtaining written permission from a patient before releasing health information for marketing purposes.

 

These fake health centers also appear to seek out patient information with the intention of misleading patients into thinking their storefronts are legitimate medical facilities. For example, reproductive health advocates found that in 2016 and 2017, multiple CPCs in Washington state requested private information from undercover investigators, including a medical intake questionnaire, the last four digits of a SSN, marital status, and a driver’s license. When one investigator said she was uncomfortable completing consent forms to grant the facility use of her information for fundraising and for storing photographs of her and refused to sign a “purported HIPAA consent form,” staff at the CPC filled out the forms for her and asked her to sign them.