Since the Supreme Court overturned Roe v. Wade, 13 states have started enforcing bans or restrictions on abortion, a number that is expected to increase. But even in states where the procedure remains legal, people seeking to end a pregnancy can face unexpected obstacles.
These obstacles include organizations known as crisis pregnancy centers (CPCs), which, lawmakers, advocates, and public health experts warn, can interrupt the process of seeking abortion care and provide misleading information about pregnant people’s options. In June, four senators introduced the Stop Anti-Abortion Disinformation Act to “crack down on false advertising that crisis pregnancy centers (CPCs) employ to dissuade patients from getting the reproductive care they need.”
CPCs are nonprofit, often faith-based organizations. They are not medical centers and do not provide abortion care or referrals. Their primary objective is to dissuade pregnant people from getting abortions and instead encourage parenthood or adoption.
The issue is that there’s a “high level of misconception” around CPCs among the public, and even among health care workers, says Andrea Swartzendruber, associate professor at the University of Georgia College of Public Health who has been researching these centers since 2015. The lack of awareness around what services CPCs do and don’t provide can delay access to abortion care.
“There is a need for growing awareness about what the centers are, what they do, how they operate, and resources that can help people [differentiate] crisis pregnancy centers from safe, evidence-based care,” Swartzendruber says.
What are CPCs and what services do they provide?
CPCs—also known as pregnancy resource centers, pregnancy support centers, anti-abortion clinics, or fake abortion clinics, typically depending on someone’s stance on abortion—have been around for decades in the U.S. There are more than 2,500 CPCs across the nation, outnumbering abortion clinics by 3 to 1. This ratio is likely to widen as abortion clinics shut down in states where the procedure is banned.
Most CPCs are religiously affiliated and operate under a CPC network, such as Birthright International, Care Net, and Heartbeat International. They are supported financially not only by their parent organizations, but in some cases also by the states in which they are located. According to the Associated Press, nearly $89 million in tax dollars has been allocated to CPCs across about a dozen states in the 2021-2022 fiscal year—a fivefold increase from a decade ago.
The centers often advertise free pregnancy tests, abortion counseling, pre-abortion screenings, abortion education, or post-abortion care. But they do not help people get an abortion. They also often oppose birth control pills, condoms, and premarital sex. Some CPCs will offer ultrasounds, STD testing, parenting classes, or material resources like diapers and infant clothing.
Swartzendruber says that CPCs will “only grow in prominence” now that the Supreme Court has overturned Roe. In states that ban abortion, CPCs may shift their strategy to focus on promoting sexual abstinence before marriage. In states where abortion remains legal, the centers will likely double down on their efforts to prevent abortions, which will affect both in-state residents as well as people from out of state who travel to seek care.
Alice Cartwright, a doctoral candidate at the University of North Carolina at Chapel Hill specializing in abortion and contraception access, says people need to be aware that CPCs are not medical providers. They are exempt from the regulatory oversight that applies to health care facilities and are free to mislead and misinform pregnant people about their options for seeking care. They are also known to spread misinformation about abortion. Patient privacy is another concern, as HIPAA, a federal law that prevents the disclosure of patient information, can’t protect some patient information gathered by CPCs.
“People have this idea that health care providers have your best interest at heart and give you all of your options in a way that’s best for you and for your well-being,” Cartwright says. “CPCs are not health care providers. They may provide limited health care services, but, overwhelmingly, the people who work there are not trained medical providers—they’re volunteers.”
How to identify CPCs
CPCs can be hard to identify because they often use misleading tactics. Swartzendruber says that CPCs have increasingly presented themselves as medical facilities in recent years. The centers are more frequently using words like “health,” “medical,” or “clinic” in their names and are advertising services like “pre-abortion screenings” and “advanced termination consultations” on their websites, she says. Some also have staff wearing white coats.
It doesn’t help that search engines have a hard time excluding CPCs from search results for “abortion clinic near me” and “abortion pill.” The Center for Countering Digital Hate found that 11 percent of abortion search results in “trigger law” states—those that had laws in place to effectively ban abortion when Roe was overturned—lead to CPC websites. The problem was particularly acute with Google Maps results, with 37 percent of such results presenting CPCs as abortion clinics local to the user.
It’s not uncommon for pregnant people to have visited a CPC, according to Cartwright’s research. In a study conducted between August 2017 and May 2018, she found that among 857 pregnant people searching for abortion services online, 13 percent visited a confirmed CPC. Those who had visited a CPC were significantly less likely to have had an abortion. They were also more likely to be still seeking abortion or continuing the pregnancy.
“[For] the people who decided to continue their pregnancy, it’s possible that they were already leaning toward that option and going to a CPC further supported their decision,” Cartwright says. “But for people who were still trying to get an abortion, they may have been potentially misled or delayed by going to a CPC.”
She notes, however, that more research is needed to understand what people who visited these centers were actually looking for.
The best way to avoid mistakenly visiting a CPC is to do your research and check that the site offers the services you’re looking for. There are no “telltale” signs for spotting a CPC, Swartzendruber says, but there are hints: If all services are free or if the organization’s website mentions unproven services like abortion reversal, the facility may be a CPC.
The University of Georgia College of Public Health’s Crisis Pregnancy Center Map, led by Swartzendruber and Danielle Lambert, serves as one of the most comprehensive resources identifying CPCs across the nation. Checking if the site you’re about to visit is listed on this map can reduce the risk of ending up at a CPC unintentionally.
The role of CPCs in a post-Roe America
States where abortion remains legal have started to pay more attention to CPCs.
Massachusetts’s attorney general issued a warning in July, informing patients that “CPCs may appear to be reproductive health care clinics, but do NOT provide abortion care or abortion referrals, contraception or other reproductive health care, despite what they may advertise.” New York state, meanwhile, is funding an investigation into whether CPCs are sharing false medical information about abortion.
But CPCs and their parent organizations are also upping their efforts. Heartbeat International, a leading anti-abortion organization, said in a statement that it is “anticipating an expansion of efforts to reach and serve the women who are traveling into New York and New York City and may be experiencing doubt about whether abortion is the answer they want.”
In states where abortion is now banned or soon to be banned, many CPCs remain in operation, shifting their focus to providing services people need to get through unplanned pregnancy, childbirth, and parenting. These services could include basics like diapers, formula, and help with food and rent.
“I do think it’s important for people who work in reproductive and maternal health to think about what services we are not providing in our health care and social system that people are seeking out at a CPC,” Cartwright says.