This Week in Abortion, Crisis Pregnancy Centers
This Week in Abortion, Crisis Pregnancy Centers
A collection of good reads, events from the week, and policy insights.
Welcome to your weekly roundup of abortion news, articles, and general hot takes. This week, in addition to the news, we are digging into crisis pregnancy centers. If you curl up with a cup of tea this morning, we hope you’ll find it as useful as we did!
Good Reads
Opinion column from a retired pediatrician in Tennessee argues for more common sense exceptions and getting the government out of the healthcare game.
Anti-access laws have created a culture of fear and a whole new lexicon for patients and doctors, who are afraid to say the word “abortion.” This forces patients to pick up on hints and do their own research to figure out what to do next. Listen HERE.
Activists in some towns are pushing to keep abortion clinics out as part of a battle along the border between pro and anti-access states.
Events of the Week
Walgreens caved to political pressure and said it won’t sell abortion pills by mail in 20 conservative-led states. While the AGs in those states indicated Walgreens (and many other pharmacies) could face legal consequences, these types of threats have not stopped Rx companies in the past. Legally, the discrepancy between state and federal laws does make it hard for companies to navigate, but in a time where many corporations are making policies supporting access options for their female employees, it’s a disappointing move. It’s not clear what other pharmacies are planning to do.
Utah’s Senate passed a law limiting abortions to hospitals, essentially eliminating the four remaining abortion clinics in the state. We anticipate it will swiftly pass the House vote and be signed into law by the governor.
In a case of folks doing their jobs instead of playing political games, Ohio’s anti-access AG approved language to enshrine abortion rights in the state constitution, saying “In this matter, I am constrained by my duty to rule upon a narrow question, not use the authority of my office to effect a good policy or to impede a bad one.”
Over 200 international organizations signed a letter to the UN urging immediate action against the human rights crisis in the USA due to the severe abortion bans. The US is typically a signatory to these types of letters, and while somewhat posturing, the letter is well-researched and is a good thought piece!
Tennessee legislators tanked two bills in committee and passed a third that signals worrying trends. First, legislators voted down a bill that simply clarified that the term abortion does not include the use of contraceptives. Then, a Republican legislator pulled his bill creating exemptions after facing pressure from Tennessee Right to Life. Finally, the same committee passed a bill that prohibits local governments from “assisting with abortions, such as paying for women to travel to other states for the procedure.” In TN, the few republicans that are trying to push the envelope, even just a little, are getting hung out to dry and cities that want to at least make their jurisdiction a bit better are getting quashed. Watch the blatant display of political intimidation below.
Legal Updates
Another woman was charged for having an abortion, this time for a self-managed abortion that took place in 2021 and was illegal at the time. It’s unclear why she was only charged now, but across the country cases are slowly adding up.
An anti-abortion clinic in New York can proceed with its lawsuit “alleging that a state law prohibiting employers from firing or disciplining employees”, who have had an abortion violates the organization's constitutional rights.
Twelve Democratic state attorneys general are suing the FDA in an effort to loosen the restrictions on the distribution of mifepristone. As we mentioned last week, we’ve all been waiting for the Texas US District Judge’s decision on whether the FDA approval process was followed. This is a creative countermeasure to a negative outcome that basically argues the FDA should drop all remaining restrictions due to the 20+ year safety record of the drug.
Feature - What is the deal with crisis pregnancy centers?
You are likely hearing a lot of stories about crisis pregnancy centers in the news (or in this newsletter). We were curious and started with the assumption, “Maybe they aren’t all that bad.” After all, when you’re pregnant it’s nice to know there is a place to go to find out what’s “normal” and pick up clothes. And, there is a clear need for more reproductive support in this country. Well, we searched. And tried. And failed to find a silver lining from a policy standpoint.
The first thing to know is that “crisis pregnancy center” has become a catch-all term for faith-based, anti-abortion centers.
These are outfits that are non-governmental, non-medical practices. Not all of them are faith-based and anti-abortion, but most of them are, and often they make it intentionally difficult for patients to know whether they are anti-abortion, or even whether they are a true medical practice. Both varieties get hundreds of millions in federal and state aid. So, for now, the harm caused by the rash of bad centers outweighs whatever little good some might be doing.
The physical care these centers give is tertiary and generally not accountable to any regulatory oversight. It’s possible, for example, that their staff/volunteers might be able to identify an ectopic pregnancy. But, it’s also possible they will miss such things and leave women thinking they are safe when they aren’t, particularly if their mission is primarily to keep women pregnant. It’s happened. Because most of them are unregulated, they may directly harm their patients by exposing them to viruses. It’s happened. Some also provide incorrect medical advice on basic things like condoms, or give women ultrasound images that aren’t of their uterus. Some might even use a patient's visit against them, reporting their information to the authorities in states that ban abortion or subjecting them to harassment. Unregulated and non-medical staff are not subject to HIPPA laws. It’s happening right now.
Ok, but what if these are all small one-off stories meant to scare us? In most states, you can’t become a hairdresser without obtaining a license. In most instances, the worst that happens might be that someone gets lice from unclean brushes. But that risk exists and a license is required.
The idea of unlicensed, unregulated, (commonly) state-sponsored non-medical “clinics” that can prey on vulnerable pregnant women just seems a bit absurd.
It’s true that many of these centers provide access to services and goods that potential mothers’ need like pregnancy tests, social service counseling, and diapers. But, those services typically come with requirements like attending classes or even bible sessions. While government services are often tit-for-tat (think work requirements for benefits eligibility), it is NOT typical for the requirements to be religious, or for the information to be intentionally misleading. Giving out diapers to your church women’s club after bible study is not the same as providing counsel to vulnerable women who need healthcare, but this is what they are getting public money for.
You are left with dangerous outcomes from bad actors with deceptive practices and often proselytizing, if beneficial, outcomes from good actors.
But, there are policies and programs that can address the problem both in pro-access and anti-access states. And, there are things you can do to help.
First the problems:
Misleading and False Messaging. These centers are made to look like medical facilities when they aren’t, and they engage in deceptive practices online and in physical spaces - advertising on billboards and even opening next to real medical clinics. Some states tried to address this by requiring that centers disclose when they have no licensed medical providers, but in 2018 the Supreme Court flagged such efforts as likely unconstitutional.
Promises of services and donations with strings attached. A few years ago the NYTimes profiled one of the more responsible, transparent centers. They offer pregnant women a chance to earn “baby bucks” by taking parent classes and bible study. Requiring classes for benefits is a common tactic used by social service agencies to incentivize forward progress. But in this case it’s tied to religious learning and potentially anti-abortion propaganda, potentially using federal dollars that could otherwise be given directly to those parents.
Little Regulation. Even in states that are general pro-access, crisis pregnancy centers face little regulation even though they often provide a physical service. Some states do appear to require licenses and some jurisdiction require them to post a notice on a board that they do not provide or refer people to abortions. However, attempts to require these centers provide full and accurate information or be crystal clear they aren’t medical facilities have generally failed.
Stealing resources. According to one account, at least 18 states have directly funded CPCs through Alternatives to Abortion programs. 10 states have used federal funds. Thats hundreds of millions of your tax dollars being wasted, even if you live in a responsible state. The federal programs that provide funding for these centers are not allowed to provide money for abortion procedures and were particularly difficult to for medical clinics to access for any services under the Trump administration. Talk about a double standard!
Now, things you can do:
Support Online Transparency. Several websites (here, here, and here) crowdsource information on crisis pregnancy centers.
You can review and tag Centers you are aware of on these sites and flag them in comments on google maps.
Be aware of the big players in the space - Care Net, Heartbeat International, Birthright International, and the National Institute of Family and Life Advocates.
You can share with your friends to make sure folks in your circles do not fall victim to these types of institutions.
Share your opinion with your local constituent affairs offices.
We know politicians want to hear from their constituents and do listen to ideas (Mollie was in a Republican governor’s office when they signed legislation allowing medical marijuana in schools for youth…constituents can make a difference!).
Let your elected leaders know that you’re aware of these centers in your area and concerned about their deceptive and unregulated practices. You can find them here.
Be an informed resident and voter. Check if any organizations supporting crisis pregnancy centers have donated to local political campaigns.
Finally, some things we’d like to see the pro-access community work towards:
Providing Alternatives: Deceptive as they may be, crisis pregnancy centers are clearly filling a need. The anti-access community has always been good at rallying and coordinating resources to take advantage of weaknesses in our systems. The pro-access community could provide a balance by creating more clinics that aren’t full service, but are truthful and provide full, caring counsel and referral. Responsible, comprehensive help networks and centers may even be a necessity in anti-access states.
Advancing Legislation:
Though it may not be available for a number of years, the most impactful strategy would be to push for federal legislation (ideally tying some portion of state budgets to oversight of these entities).
Last summer, senators introduced the Stop Anti-Abortion Disinformation Act to address false advertising, but it never moved.
Other options could include requirements for certain types of organizations to provide warnings about crisis pregnancy centers, akin to “the more you know” public messaging campaigns. Some companies, like Yelp, have already started doing this.
There are also options in pro-access states:
Create requirements for government funding. Even local jurisdictions can do this by restricting their reproductive health programs to full service, licensed clinics and making sure no other social service programs are unknowingly working with a center.
Truth in advertising laws. Connecticut passed a law in 2021 that fines pregnancy centers that disseminate deceptive advertising. Illinois has a bill in the current session to require pregnancy centers to disseminate notice that they are unlicensed in all on-site and advertising materials.
Like always, there are fewer actionable options in anti-access states. But there is still opportunity for improvement.
Local jurisdictions can put in place zoning rules and restrictions on government funding, though it’s likely state legislatures will preempt this.
Concerned residents can push for basic licensing of these facilities. Call us crazy, but it seems like a facility should receive a visit from a health inspector once in a while if it’s the kind of place where big metal objects are regularly stuck inside someone’s body.
Filing Lawsuits: There are some options for those who have been victimized by a center including raising a complaint of consumer fraud or even making a battery claim. Proving these claims can be difficult, and most people visiting these organizations don’t have the time or resources to sue. Still, given the current role of courts in abortion policy, it’s a tactic we would expect to see more of.