How crisis pregnancy centers get millions in tax dollars to perpetuate lies
Nationwide, they outnumber actual abortion clinics three to one.
🚨 WE’RE OFFERING FREE TRIALS FOR ALL NEW PUBLIC NOTICE SIGNUPS 🚨 Click the button to support this work and unlock full access to everything we publish.
ALSO IN THIS EDITION: Scroll to the bottom for a programming note from Aaron.
By Lisa Needham
Over the last few decades, crisis pregnancy centers (CPCs) have played a significant role in the war over abortion rights. That’s starting to change — in some states at least.
At first glance, CPCs appear to provide information and assistance to pregnant people, but their real purpose is to target people seeking abortion care and try to stop them from having an abortion. Now, some blue states are taking steps to limit the reach and funding of these centers. Red states, meanwhile, continue to shovel money at these misinformation-driven organizations.
Crisis pregnancy centers, briefly explained
CPCs fall into two broad categories. Some offer only counseling and pregnancy tests, while others offer limited medical services like ultrasounds. No matter the offerings, CPCs are not usually medical clinics and are often completely unregulated, staffed by non-medical personnel, and unbound by confidentiality regulations such as HIPAA. Many of them are affiliated with national anti-choice organizations, and, across the country, they outnumber actual abortion clinics three to one. In several states, CPCs enjoy generous taxpayer funding. The Associated Press found that, between 2010 and 2022, 13 states gave CPCs roughly $495 million.
CPCs use that money in highly sophisticated efforts to block people from getting abortions. CPCs spent $10 million on Google ads from March 2021 to March 2023, pushing the fake clinics to the top of search results when people search for terms like “abortion clinic near me.” They use vague language such as “Looking for abortion? We discuss all your options,” and sometimes even set up shop near real abortion clinics to try to physically intercept people going to those clinics.
CPCs also got a huge assist from the Supreme Court a few years back. In 2015, California passed a law that required CPCs to provide two notices, one requiring unlicensed clinics to say they were not licensed to provide medical services. Two CPCs sued, saying delivering those notices violated their free speech rights. In 2018, the Court’s conservative majority sided with the CPCs, saying providing that information forced them to express a message with which they disagreed.
In Illinois, a Trump-appointed federal judge just blocked the state’s attempt to restrict CPCs from lying about abortion. As with the Supreme Court case, anti-abortion groups said being unable to deceive people seeking abortions violated their First Amendment rights.
Because of court decisions like these, CPCs know that they can operate with relative impunity, as laws that mandate they tell the truth will be struck down. That’s helpful for them, given that much of the information CPCs give is outright false. A study of the websites for 607 CPCs found that nearly two-thirds made false or biased medical claims regarding abortion and reproductive health.
Many CPCs tell people abortion can cause breast cancer and infertility even though both notions have been repeatedly debunked. Over one-third of the CPC websites advertise “abortion pill reversal,” which does not actually exist. Conservatives say medication abortion can be “reversed” by taking progesterone after taking an initial dose of mifepristone, one of the drugs used for medication abortions. Doing that is so dicey that a 2020 study to evaluate the claim was stopped early because of safety concerns for the patients.
A note from Aaron: Working with brilliant contributors like Lisa requires resources. To support this work, please click the button below and take advantage of my special offer — free trials for all new signups.
As much as CPCs try to mimic healthcare clinics, often by having employees and volunteers wear white coats and seeing people in exam-style rooms, they provide little to no healthcare, particularly reproductive healthcare. They discourage people from using condoms, saying they are not effective, and push abstinence-only views. Of the 607 CPC websites examined by The Alliance, only one offered any contraceptive care.
The so-called “medical” services most CPCs offer are pregnancy tests and ultrasounds. The pregnancy tests are often the same types of urine stick tests available at drugstores. The ultrasounds typically are “non-diagnostic” ultrasounds, which can’t detect fetal abnormalities or other potential dangers. Those ultrasounds are also sometimes used to deceive people into thinking they are earlier in their pregnancy. Then, people can end up missing the cutoff for when abortions are legal to obtain in their state. And in the worst-case scenario, they can miss pregnancy issues that are literally deadly.
RELATED FROM PN: Ohio's Issue 1 rejection shows how toxic abortion is for the GOP
According to a lawsuit filed in Massachusetts earlier this year, a CPC in that state failed to catch that the plaintiff had an ectopic pregnancy. Ectopic pregnancies occur when the egg implants outside the uterus. They are never viable and, if they rupture, can be fatal. The nurse at a CPC in Worcester told the plaintiff her pregnancy was viable and within the uterus. The plaintiff’s fallopian tube ruptured roughly a month later, causing internal hemorrhaging and requiring emergency surgery to remove her fallopian tube. As Jezebel explains, an actual medical provider would have seen the ectopic pregnancy on a diagnostic ultrasound and the patient could have safely ended the pregnancy with medication.
This free edition of Public Notice is made possible by paid subscribers. If you aren’t one already, please sign up to support our work. We’re currently offering free trials for all new signups. Just click the button below.
Misinformation is no substitute for healthcare
Having taxpayers pick up the bill for these organizations hasn’t been limited to conservative states. Minnesota gave $37 million to CPCs between 2010 and 2022, while Pennsylvania doled out $86 million in that same span. But CPCs in those states can no longer rely on a steady flow of public money. Earlier this year, Minnesota passed a law that will redirect state grant funding from CPCs to groups that “increase access to and availability of medically accurate sexual and reproductive health services.” This should help decrease CPCs in a state where they have outnumbered abortion clinics 11 to 1.
Pennsylvania recently took a stand against these fake clinics as well. For three decades, the state contracted with Real Alternatives, an umbrella organization that gave money to a network of 27 CPCs. The organization received $134 million in public money in that time, of which $21 million was supposed to be for children and pregnant people living in poverty. Democratic Gov. Josh Shapiro just terminated the last contract Real Alternatives had with the state, and, as in Minnesota, Pennsylvania will begin shifting state funding to actual health providers.
Unsurprisingly, the situation is much more grim in red states. Red states already spent millions on CPCs prior to the fall of Roe, with Florida, Georgia, Louisiana, North Carolina, and Texas giving CPCs $282 million since 2010. Several states diverted millions from the Temporary Assistance to Needy Families (TANF) program, shifting much-needed dollars for low-income families to the business of lying about abortion. For eight years, from 2011 to 2019, Florida took money from its rape crisis program fund and gave it to CPCs.
Now, red state legislators are even more emboldened. As conservatives in Ohio keep trying to pass abortion bans, the state gives millions to pregnancy centers rather than organizations like Planned Parenthood, which actually provide medical services. The state legislature in Kansas recently overrode the Democratic governor’s line-item veto and approved $2 million for an “alternatives to abortion” program.
Texas allotted $100 million in funding for 2022-2023 to its “Alternatives to Abortion” program, which funds CPCs like Pregnancy Center of the Coastal Bend, profiled last year in the Washington Post. Although that CPC received $776,000 in taxpayer dollars in 2022 alone, the executive director said she cannot afford to hire any doctors. Instead, if one of the center’s staff thinks they see something like an ectopic pregnancy, they text a photo of the ultrasound to two local volunteer OB/GYNs, who then weigh in via FaceTime.
This is not pregnancy care. It’s a dangerous substitute, one that can make people believe they’ve received medical attention and information when they haven’t at all. At the same time, Texas is fighting to block doctors from providing abortions even when patients face serious pregnancy complications. Misinformation is no substitute for healthcare, but only the former is getting millions of taxpayer dollars.
Public Notice programming news
By Aaron Rupar
I have some good news and some less great news. Let’s start with the good news, cool?
Public Notice is now being published four times a week! This has recently been my schedule most weeks anyway, but now I’m making it official. Barring breaking news or special editions of the newsletter, the normal publication schedule going forward will be Monday-Wednesday-Thursday-Friday. Some weeks — like this one — I’ll have four newsletters of all-original reporting, commentary, and analysis. But at least once a month I’ll mix in subscriber threads where readers can interact directly with me (and each other) by asking questions, suggesting story topics, and so forth. In short, subscribers are going to get more content and more chances to chat with me. I’m excited about it.
Now for the less great news: I’m putting my podcast on indefinite hiatus. To make a long story short, this summer — which began with my father’s passing and ended with me having to cancel a purchase agreement for a house because of a deadbeat builder — has been extremely taxing. I’ve been spread thin and need to simplify things. With Congress back in session and promising to be a clown show of epic proportions, I want to make sure I’m available during the day to cover hearings. So I’ve made the tough choice to stop recording new episodes for now.
I provided a bit more detail in a quick episode I record yesterday announcing the news, which you can check out below.
I know this news will be disappointing to some subscribers. But I want to get back to writing more regularly — Monday’s extremely well-received newsletter is an example of the type of work I want to do more of — and spending large chunks of Tuesday and Wednesday on the show has made it difficult. I hope to be in a position before too long where I’ll again have the bandwidth to podcast — both figuratively and literally, since we have poor internet in the condo we’re currently squatting in. But for now, I think this decision will make Public Notice a better product, and put me in the best position to thrive personally and professionally.
Thanks for understanding. Onward we go.
That’s it for today
We’ll be back with more tomorrow.
Thank you for talking about CPC’s today. I’d love more articles like this. Especially if you can interview folks who work in repro like Imani Gandy, Jess Pieklo, & Jessica Valenti.
I was 19, pregnant, & didn’t want to be. It was the late 90’s. I went to a cpc without knowing what it was. They showed me fake fetal development dolls. They tried to coerce me into staying pregnant. They took joy in telling me the local planned parenthood didn’t perform abortion. Then sneered at me when I insisted on getting an abortion. These places aren’t about helping women. Their “help” can come with a lot of strings attached. Like mandatory church attendance to get freaking diapers. These places do not care about women or their health care needs.
As both an RN and malpractice attorney, that misdiagnosed ectopic scared the hell out of me! Maybe it will take a few crushing malpractice claims to shut down the fake clinics. And yes, if they hold themselves out to be a medical practice - white coats and all - they can be sued for malpractice and practicing medicine without a license. Yikes.