The Crisis Pregnancy Center Conundrum

Crisis pregnancy centers (CPCs) are non-profit organizations that provide free counseling and prenatal care to pregnant individuals. Many of these centers—which usually have an explicit pro-birth mission—have ties to religious groups and anti-abortion organizations. CPCs frequently market themselves as full-service medical clinics and promise to provide free pregnancy tests, ultrasounds, and comprehensive counseling on all pregnancy-related options. In reality, most CPCs lack medical facility licensing, offer limited medical and social services, and present pregnant people with only two options: parenthood or adoption. Because CPCs generally lack medical licenses and offer their services free of charge, they are often exempt from federal and state regulations governing medical ethics and patient privacy, such as the Health Insurance Portability and Accountability Act (HIPAA). In addition, although some staff at CPCs dress in scrubs or white coats, they are typically volunteers without formal medical training who may fail to disclose if the CPC is not a licensed medical facility. Communities of color—which frequently face a shortage of health care providers, socioeconomic barriers, and difficulties accessing health insurance—are particularly vulnerable to the risks CPCs pose. Individuals in these areas are confronted with higher rates of unintended pregnancies, and in some communities of color, CPCs often become the only accessible provider of prenatal and reproductive health services. Critics claim that CPCs use deceptive tactics to attract patients and encourage them to remain pregnant. They also argue that CPCs prevent patients from making informed decisions about their reproductive health. For example, CPCs often make factually inaccurate claims about contraception and abortion to dissuade pregnant people from considering abortion. Attempts to regulate CPCs’ controversial practices have fallen short. For example, in 2015, California enacted the Reproductive Freedom, Accountability, Comprehensive Care, and Transparency Act (FACT), which mandated disclosures about whether CPCs were medically licensed facilities. The statute also required CPCs to tell patients about the availability of free and low-cost family planning services elsewhere in the state. Three years later, however, the U.S. Supreme Court struck down the FACT Act in National Institute of Family and Life Advocates (NIFLA) v. Becerra. The Court vindicated CPCs’ complaints, finding that the Act infringed on the centers’ First Amendment rights. After NIFLA, CPCs continue to proliferate. Today, more than a dozen states fund crisis pregnancy centers using taxpayer dollars, with some contributing as much as $38 million. This week’s Saturday Seminar highlights expert research on CPCs’ impacts on free speech and access to health care