This is an op-ed that I originally wrote in late spring 2019. After shopping it around to a few publications and never hearing back, I ultimately FORGOT ABOUT IT(???) until almost 3 years later, when the opportunity arose to discuss Crisis Pregnancy Centers (CPCs), also known as Fake Clinics, on a podcast interview. The op-ed isn't current, so some stats may no longer be exactly correct (e.g. the number of fake clinics, though that's verifiable if you wanna do some Googling), but the most important thing remains unchanged: state and federal governments are still funding these clinics, using YOUR taxpayer dollars to deceive and harm vulnerable people seeking healthcare.
How the Trump Administration Helps Fake Women's Health Centers
In 2016, leaving my office located steps from the University of Colorado at Boulder campus, I was handed a “back to school” bag by a group of sidewalk volunteers. The bag contained advertising from local businesses catering to college students, with the requisite coupons for pizzas, sub shops, and school supplies. Also in the bag was a pamphlet for a "women’s health center" in nearby Lafayette, Colorado. In pretty pastel tones and Instagram-worthy design, Marisol Health advertised free pregnancy and STI testing, and counseling on “what options are available” for those who are or think they may be pregnant. It sent just the kind of welcoming, nonjudgmental message a college-aged woman navigating her newfound sexual freedom, and perhaps sexual crises, may find appealing. It gave every impression of being a clinic that would offer patients their full range of reproductive options, including contraception and abortion. To the untrained eye, it was essentially a Planned Parenthood with different branding.
But as someone very familiar with the fraught landscape of reproductive healthcare access in America, my hackles were immediately raised. A scroll to the very bottom of the organization’s homepage told me all I needed to know: in small font, next to the “privacy policy” text, were the words “Archdiocese of Denver.” I knew what I was dealing with.
This is one of the approximately 2,800 anti-abortion crisis pregnancy centers (CPCs) in the United States. Known by opponents as a fake health centers, there are about 75% more CPCs in the US than there are abortion clinics. And they are often the only pregnancy centers in rural areas. But if you’ve never noticed a CPC in your town, it’s because they don’t want you to.
Crisis pregnancy centers, like Marisol, hide in plain sight by operating under the guise of offering comprehensive reproductive healthcare. Instead, they are religiously-affiliated, anti-abortion, and often unlicensed “medical” centers that, as stated by the California legislature, dissuade pregnant people from abortion through “intentionally deceptive advertising and counseling practices that often confuse, misinform and even intimidate” mostly low-income clients from making informed choices. Eighty-three percent are affiliated with evangelical Christianity, and nearly all are tax-exempt. Their deceptive practices are well documented, and range from including words like “choices” in their names and locating themselves next to abortion clinics to trick pregnant people into walking through their doors, to wearing medical scrubs and giving ultrasounds even when they are not licensed medical facilities (and operate outside of privacy laws like HIPPA), to lying to patients about how far along their pregnancies are. A scroll to the “We Can Help You” tab on Marisol’s website plainly reveals its commitment to scientifically dubious advice common to CPCs, including information on “Abortion Pill Reversal,” a process the American College of Obstetricians and Gynecologists has publicly declared is unsupported by science.
A close look at the news on CPCs would leave one to believe that there’s not much we can do in our current political environment to stop them. In 2018, 14 states directly funded CPCs, channeling an estimated $40 million in taxpayer dollars. The clinics are already eligible for federal grants, and the Trump administration has continued its history of funding anti-abortion groups through recent changes to the federal Title X family planning program. These changes will make it harder for clinics that offer abortions, like Planned Parenthood, to qualify for funds and much easier for religiously-affiliated CPCs that oppose abortion and certain types of contraception to obtain them. Perhaps even more dejecting, in the June 2018 Supreme Court decision in National Institutes of Family and Life Advocates v. Becerra (NIFLA), an ideologically-split 5-4 court struck down a California law designed to protect people from CPCs’ deceptive practices through mandated disclosures to patients about the availability of state-subsidized reproductive healthcare and, for the approximately 30% of clinics which are unlicensed, a disclosure of this status.
But while the political tide is currently buoying anti-abortion CPCs, the pro-choice movement does have options (no pun intended).
The NIFLA ruling appears to leave open the possibility for laws that specifically ban deceptive practices. Prior to the ruling, the city of Hartford, Connecticut, passed an ordinance requiring anti-abortion CPCS to clearly state their staff’s medical qualifications (or lack thereof), and forbids them from using false or deceptive advertising. This law is likely to pass Constitutional muster, as intentional deceptions are not Constitutionally protected speech. The ruling also would allow states or organizations to create public awareness campaigns to educate on the difference between CPCs and truly comprehensive reproductive health clinics. Laws and campaigns such as these can be enacted at the state or local level, even in predominantly conservative states which themselves fund CPCs. State legislatures can be lobbied to stop funding CPCs with taxpayer dollars. The new Title X rules are being challenged by state attorneys general, and voters can pressure their own AGs to join in so that federal funds do not go towards clinics that are driven more by ideology than ethical medical practice.
Of course, crisis pregnancy centers have a legal right to their religious convictions. They cannot be compelled, as in the California law, to give patients information that conflicts with their religious beliefs. But they do not have a legal right to trick people into believing they are receiving medical care when they are not. They do not have the right to operate under the guise of medical science while putting real people’s lives at risk through abject lack of informed consent. The American Medical Association confirms this, stating that “CPCs violate principles of medical ethics, despite purporting to dispense medical advice.”
Especially given the abundance of CPCs relative to actual reproductive healthcare clinics, it is imperative that they be held to a higher standard when it comes to serving already vulnerable individuals during one of the most critical healthcare decisions of their lives. While the situation at the federal level is grim, state and local politicians can place meaningful limits on CPCs’ power to deceive patients, especially while receiving taxpayer funds.
In no other realm of medicine, such as cancer care, would we accept policies that allow people seeking healthcare to receive inaccurate and incomplete information on their options. So why should we settle for them when it comes to reproductive health?
FURTHER LINKS:
- Must-watch video: Crisis Pregnancy Centers: Last Week Tonight with John Oliver (HBO)
- Further info on the dubious practice of "abortion pill reversal" and how the American College of Obstetricians and Gynecologists says it is "not supported by science"
- Unmasking Fake Clinics: An Investigation into California's Crisis Pregnancy Centers (NARAL Pro-Choice California Foundation, 2015) - "secret shoppers" went into California CPCs. One told a client that her IUD was her "baby")
- Check out the National Network of Abortion Funds; they can tell you whether a clinic is a real clinic. You should also donate to them, as abortion funds will be tasked with providing even more critical access to abortion care as states pass more restrictive anti-abortion laws (or ban abortion altogether should Roe fall).
- Abortion Care Network: Independent abortion providers care for the majority of people seeking abortion care in the United States. Founded in 2008, Abortion Care Network (ACN) is the national association for independent community-based, abortion care providers and their allies. They work to ensure the rights of all people to experience respectful, dignified abortion care. Donate to them.
- In February 2022, The Alliance: State Advocates for Women’s Rights & Gender Equality partners released an urgent warning about the role the crisis pregnancy center (CPC) industry is poised to play in a post-Roe United States – as a surveillance tool for the anti-abortion movement: The CPC Industry as a Surveillance Tool of the Post-Roe State
- Why Crisis Pregnancy Centers Are Legal but Unethical (American Medical Association Journal of Ethics, 2018)
- Crisis Pregnancy Centers Lie: The Insidious Threat to Reproductive Freedom (Report by NARAL Pro-Choice America, 2015)
- Experts Say Crisis Pregnancy Centers Could Spy On And Report Women Seeking An Abortion (Buzzfeed News, January 2022)
- More on NIFLA v. Becerra: Supreme Court Sides With California Anti-Abortion Pregnancy Centers (NPR, June 2018)