Beware of crisis pregnancy centers in post-roe era
Awoman seeking help with an unintended pregnancy made an appointment at a crisis pregnancy center hoping to understand her options. The center had advertised as helping women in situations like hers, so she shared her personal information.
She had been sexually assaulted. She was pregnant. She was unsure what to do.
With the pregnancy confirmed, a worker at the center told the woman she should view the pregnancy (and presumably the assault) as a blessing.
This is just one story that Andrea Swartzendruber, an associate professor in the College of Public Health at the University of Georgia, shared with me when we talked about her extensive research on crisis pregnancy centers (CPCS).
To understand how the centers fit into the landscape of reproductive care, Swartzendruber and a team of researchers interviewed 50 people about their experiences at Georgia CPCS.
There was also the story of a woman who was misdiagnosed with an ectopic pregnancy. According to Swartzendruber’s findings, 77% of CPCS advertise pregnancy ultrasounds but these are not the same ultrasounds that a prenatal caregiver would use to examine fetal health. They are used solely as a tool to influence pregnancy decisions, Swartzendruber said.
The woman ended up in a hospital emergency room where she learned that she did not have an ectopic pregnancy.
Just as concerning are the more common experiences at CPCS.
“There were high levels of misconception about what crisis pregnancy centers are and the services they provide,” Swartzendruber said. “We had people telling us they felt very stigmatized, shamed or guilted.”
Crisis pregnancy centers first evolved in the 1960s as faith-based, pro-life facilities that counseled women with unwanted pregnancies to avoid abortions. The centers have since grown into a national network of about 3,000 facilities that operate under a range of names and employ questionable tactics to draw women seeking abortions into their doors.
Other than promoting abstinence and dissuading people from having abortions or using contraceptives, the role of CPCS in the sexual and reproductive health care space is unclear.
In 2022, state officials allocated $2 million in taxpayer dollars to fund these facilities throughout the state, according to data from the Charlotte Lozier Institute, an anti-abortion research institute linked to Susan B. Anthony Pro-life America.
Over the years, many CPCS have changed their names to include words like “medical” or “clinic” as part of a strategy to buttress claims of offering medical services, but the centers are not health facilities and are not subject to the Health Insurance Portability and Accountability Act (HIPPA), creating a host of safety and privacy concerns.
“None of their medical services are done in accordance with national standards, nor are they regulated,” Swartzendruber said.
Though national guidelines suggest that a person at risk for pregnancy is also at risk for sexually transmitted infections (STIS), only about 22% of CPCS offer STI testing and only 8% offer HIV testing, according to Swartzendruber’s findings.
Some centers that offer STI treatment do not have a longer-term strategy. If someone goes to a CPC and is tested for chlamydia but not HIV, and they leave without being counseled about contraceptive use in the future, they are further at risk, Swartzendruber noted.
With the CDC reporting all-time STD infection-rate highs, that approach to treatment can be life-threatening.
The centers have also employed tactics to connect with a broader swath of women. One CPC now offers sports physicals to girls as a way to engage early with a population that might become pregnant and consider abortion.
CPCS have become repositories of information about women who are pregnant by gathering data through several points of contact including phone calls, online queries and in-person visits. Some CPCS have policies on their websites indicating that personal data is kept confidential except in certain circumstances.
One of those circumstances, Swartzendruber said, is when a person is considered to be a danger to themselves or others. But the majority of CPC’S staff (75%) and volunteers (88%) are not licensed medical professionals, according to Lozier Institute data, so those assessments are likely being made by a lay person who may decide that a woman seeking an abortion qualifies as someone endangering another person, she said.
Swartzendruber said the centers will continue expanding nationally and will likely try to capitalize on abortion bans by pushing their limited services as a viable option for reproductive health care.
The government has a responsibility to help ensure pregnant people have access to quality, regulated health services and to rein in unregulated centers that engage in misinformation and misrepresentation while providing non-comprehensive health services that could physically or emotionally harm pregnant people.
Unfortunately, in states across the country, lawmakers have left it up to unsuspecting women to figure it out on their own.