Rise of crisis pregnancy centers highlights shift in anti-abortion movement

Key Concepts

• Crisis Pregnancy Centers (CPCs): Faith-based, non-profit organizations that offer resources to pregnant women with the stated goal of steering them away from abortion.
• Anti-abortion Movement: A social and political movement advocating for the prohibition of abortion.
• Post-Roe America: The period following the U.S. Supreme Court's decision in Dobbs v. Jackson Women's Health Organization, which overturned Roe v. Wade and eliminated the federal constitutional right to abortion.
• Deceptive Practices: Allegations that CPCs use misleading information or tactics to dissuade women from seeking abortions.
• Unsafe Practices: Concerns about the medical advice and services provided by CPCs, particularly when they are not licensed medical facilities.
• Data Collection and Surveillance: Worries that CPCs may collect sensitive patient information for purposes beyond healthcare, potentially for surveillance or prosecution.
• Government Funding and Tax Credits: The increasing involvement of state and federal funds in supporting CPCs through grants, programs, and tax incentives.
• First Amendment Rights: The legal arguments surrounding free speech and the ability of states to regulate CPCs without infringing on these rights.
• Ectopic Pregnancy: A dangerous condition where a fertilized egg implants outside the uterus.

Case of Faith-Based Pregnancy Centers in New Jersey and Supreme Court Arguments

Tomorrow, the U.S. Supreme Court will hear arguments in a case concerning faith-based pregnancy centers in New Jersey. The organization is seeking to prevent the state's attorney general from investigating allegations that these centers misled women into believing they offered abortions. This case is indicative of a broader effort to regulate "crisis pregnancy centers" (CPCs), which are described as a growing component of the anti-abortion movement in the post-Roe era.

Personal Experience: Hana Miller's Encounter with a CPC

Hana Miller, a freshman at Brandeis University, recounted her experience four years prior when she became pregnant. After searching online for abortion care, she contacted a clinic that appeared high in the search results. She described the clinic as "really trying to beat around the bush, really trying to just get me there." Upon entering, the facility resembled a typical doctor's office, complete with staff in scrubs. However, she soon realized she was at a crisis pregnancy center, not an abortion clinic. CPCs, primarily faith-based non-profits, aim to provide resources to pregnant women to discourage them from having abortions. Reproductive rights advocates and the medical community have raised concerns about CPCs employing deceptive and potentially unsafe practices. Miller stated that the center misinformed her about her pregnancy duration, stating she was eight weeks pregnant when she was actually six. While this misinformation did not change her decision, it instilled a sense of shame and embarrassment about her pregnancy.

CPCs as a Strategic Component of the Anti-Abortion Movement

Carrie Baker, a professor of gender, law, and public policy at Smith College, explains that CPCs represent a significant "ground game" for the anti-abortion movement, distinct from the more visible efforts to make abortion illegal. Following the overturning of Roe v. Wade, which led to the closure of many abortion clinics, the conservative Christian movement has focused on establishing CPCs as replacements. As of the previous year, there were over 2,600 CPCs in the U.S. compared to only 765 abortion clinics. These centers often provide free services such as diapers, pregnancy tests, and anti-abortion counseling. A significant concern is that many CPCs offer healthcare services and medical advice without being licensed medical facilities.

Concerns Regarding Medical Practices and Data Privacy

Baker highlights instances where patients at CPCs have allegedly been misdiagnosed, leading to delays in necessary medical care, or have been provided with misinformation about the safety of abortion. A critical issue is that most CPCs are not licensed medical clinics and are therefore not subject to federal healthcare privacy laws (like HIPAA). This lack of regulation raises concerns about how patient information is handled. Baker expressed worry that CPCs might be collecting data on individuals, creating databases of young pregnant women or those who might become pregnant, potentially for the purpose of surveillance and criminal prosecution.

Financial Landscape of CPCs

The CPC industry is projected to generate over $2.5 billion this year. Between 2017 and 2023, these centers received nearly $430 million in federal funds through programs related to teen pregnancy prevention, welfare, and other initiatives. While the majority of CPC funding comes from churches and private donors, there is a growing trend of state taxpayer dollars being allocated to these organizations.

CPCs in Missouri: A Case Study

Missouri is home to over 90 CPCs. Brian Westbrook, executive director of Coalition Life, an anti-abortion group operating a CPC in the St. Louis suburbs, discussed their approach. Coalition Life also engages in "sidewalk counseling" outside abortion clinics. Westbrook stated that they believe women do not typically desire abortions and aim to "coach them" to pause and reconsider their decision. His center reportedly served around 1,100 women last year, assisting an average of four to five individuals daily. The center offers pregnancy and STI testing, ultrasounds, and pregnancy coaching, with the ultimate goal of supporting the creation of a stable family unit.

Funding Mechanisms and Tax Incentives

Westbrook attributes their operations to private donors. In Missouri, residents can receive a 70% tax credit for donations to groups like Coalition Life. Last year, the state approved $11 million in these tax credits. This is in addition to the state's "Alternatives to Abortion" program, which received over $8 million in 2024. Westbrook acknowledged the benefit of tax credits for donors but expressed a preference for minimizing government funding due to potential "strings attached" and a desire for operational independence.

State-Level Funding and Accountability Challenges

Missouri is not an isolated case. From 2021 to 2024, anti-abortion centers in at least 21 states have received funding through grants, state programs, budget allocations, or tax credits. Carrie Baker notes that even in states where abortion is legal, holding CPCs accountable is challenging. She likens their operational model to that of churches, asserting that they can state whatever they wish without regulation because they do not charge for services.

Massachusetts: Legal Challenges and Regulatory Efforts

Massachusetts has seen legal action and regulatory efforts concerning CPCs. Last year, a CPC in Worcester settled a lawsuit alleging a nurse failed to diagnose an ectopic pregnancy, a condition that required emergency surgery for the patient. In response, Governor Maura Healey launched a $1 million education campaign to discourage residents from visiting CPCs. The challenge, as noted by Governor Healey, is to address the "real problem and threat to the health and safety of a lot of people" without violating the First Amendment.

State Senator Becca Rausch authored a bill, now law, requiring a licensed healthcare professional to supervise any ultrasound related to a pregnancy. This measure aims to prevent CPCs, which often lack the necessary licenses and training, from providing ultrasounds, thereby mitigating the risk of inaccurate or unsafe services. The rationale is that search engines and algorithms often direct individuals to CPCs first, and by restricting their ability to perform ultrasounds, this initial point of contact can be altered.

However, some groups are pushing back. Your Options Medical, which operates centers in eastern Massachusetts, is suing the state, arguing that the education campaign infringes on their free speech and equal protection rights.

Hana Miller's Continued Advocacy

Weeks after her experience at the CPC, Hana Miller successfully obtained abortion care at a licensed clinic. Her ordeal inspired her to pursue a degree in public health, focusing on reproductive health and policy. Upon graduating, she reflected on the shame and guilt she initially felt, concluding that "They should feel that," referring to the CPCs. Hana hopes that by sharing her story, she can help others avoid similar negative experiences.