NU Sexual Health, Advocacy, Resources, and Education (NU SHARE) works on Northeastern’s campus to protect bodily autonomy and to provide students with accurate information regarding all aspects of sexual and reproductive health. As NU SHARE, we stand firmly against CPCs and their direct challenge to the right of individuals to make informed medical choices about critical aspects of their reproductive health.
Author’s note: Although women are the primary group seeking and receiving abortions, gender nonconforming individuals also fall into this group. Gender-neutral language is used throughout, where possible and appropriate.
“Abortion causes breast cancer.” “Abortion causes women permanent psychological damage.” “Your baby can already feel pain.”[1] These are just a few of the falsehoods told under the false pretenses of medical accuracy and reproductive choice to patients seeking abortions at Crisis Pregnancy Centers (CPCs). These pseudo-medical facilities are a growing threat to reproductive health and freedom in all corners of the United States, and perhaps the most heinous tactic in the anti-abortion movement’s arsenal against Roe v. Wade.
CPCs are organizations disguised as legitimate health clinics, providing people with medical misinformation about the risks of abortion. The actual mission of CPCs is the opposite of their advertised purpose, as they do not provide real reproductive health services. These centers target people who are searching for legitimate services by advertising free pregnancy tests and ultrasounds, and commonly use false advertising in highly public spaces to portray the centers as well-founded and accessible health clinics.[2] Many patients’ experiences have been detailed through investigative reports, most commonly exposing the centers’ misleading and inaccurate information to people with genuine questions and concerns about their unintended pregnancy.[3] These centers falsely claim to support those in need, but don’t provide accurate information about abortion or any abortion services, posing a huge threat to reproductive education in the US.
While Roe v. Wade protects a woman’s right to abortion under the First, Fourth, Ninth, and Fourteenth Amendments, some state legislatures wiggle through the loopholes of Roe v. Wade in their regulations. Anti-abortion legislators in states such as Texas have passed statutes mandating ultrasounds for people seeking abortions, despite the fact that the procedure is not medically necessary for first trimester abortions, and constitutes little more than an additional burden and cause of emotional distress.[4] Some states have policies that require physicians to provide to those seeking abortion specified information and counseling that is often misleading, out-of-date, biased, or even medically false.[5]
CPCs thrive by distributing this medically inaccurate information. The misinformation generally fall into several categories; firstly, claims of what abortion will cause: increased risk for breast cancer, future fertility issues, and increased issues of mental health.[6] Though the idea that abortion will increase the risk of breast cancer was refuted by the National Cancer Institute in 2003, CPCs continue to misinform pregnant individuals of this perceived health concern.[6] Many CPCs also attempt to frighten patients by claiming their abortion will make it difficult to conceive in the future, that they will have heightened risk of miscarriage, and that the procedure will cause permanent damage to the uterus. There is some risk in second-trimester abortions compared to first-trimester abortions — which constitute about 92% of all abortions performed and have much lower risk profiles.[6] However, CPCs do not differentiate between these situations, and don’t recognize studies disproving the myth that abortions cause mental health concerns. In fact, a study published in the Archives of General Psychiatry in 2000 found that the best predictor of an individual’s mental health after an abortion is their mental health status before the procedure.[5] Moreover, according to literature produced by the American Psychological Association in 1989, patients feel the most emotional distress before the procedure.[5]
In addition to lying about the effects of abortion, many CPCs also overemphasize the risk associated with the procedure. As NARAL found in their 2011 study of twenty-four Massachusetts CPCs, one in three mischaracterize abortion risks, making it seem more dangerous than it is.[7] In actuality, the death rate for abortion is just 0.0006%, and less than 0.3% of abortions result in complications serious enough to warrant hospitalization.[8] This is roughly ten times lower than the fatality risk associated with carrying a pregnancy to term and giving birth, a fact many CPCs ignore.[7]
Accompanying these scare tactics is often a significant dose of guilt and shame. Individuals have reported CPC volunteers berating them for their decision to have premarital sex or for their sexual orientation.[9] Statements such as “if you didn’t want to get pregnant, then you shouldn’t be having sex” are common and are supported by the abstinence-only contraceptive approach many CPCs promote.[7]
Other shaming tactics are less explicit. CPCs rely on the anti-abortion rhetoric of fetal personhood — which defines fetuses as people and thus abortion as murder — to shame people for their choices. For example, over 80% of CPCs in Massachusetts discussing fetal development rely on intentionally misleading information, including portraying fetuses as mini-babies.[7] Through this misleading discussion, CPCs attempt to use false medical information to create a mental linkage between personhood and fetuses, and a false narrative of the abortion procedure.
However, these tactics do not prevent abortions, contrary to CPCs’ stated goals. As Mark Gius, a professor of economics at Quinnipiac University, shows in his analyses of anti-abortion laws, restrictions such as mandatory counseling and waiting periods have little to no effect on abortion rates.[10][11] Rather, the majority of people who choose to have an abortion are sure of their decision. So what purpose do these maneuvers employed by CPCs serve?
The goal of these tactics — promoting abstinence only education, employing fetal personhood rhetoric, and more — is to shame individuals for their choices. It adds to the already immense social stigma that surrounds abortion by implying that those who choose to have the procedure are immoral murderers. The tactics employed by CPCs only add to the already difficult decision people must make. It is a costly procedure: four to nine hundred dollars for a first-trimester abortion in Massachusetts, even more expensive if performed in a hospital.[12] This is particularly difficult for those who want to carry pregnancies to term, but may be unable to do so due to a multitude of factors —unstable economic circumstances, abusive partners, or medical complications, to name a few.
The danger of CPCs and their actions becomes apparent when misleading CPC counseling is combined with restrictive legislation that limits access to abortion. As Professor Gius’ studies show, a person’s decision to have an abortion is affected by provider availability.[10][11] If abortion access is already impeded by laws such as mandatory waiting periods — that require people to make multiple visits to clinics — or laws like those seen in Texas which drastically reduce the number of clinics, the delaying tactics of CPCs further limit access. The tactics may delay individuals beyond the trimester deadline at which abortion is legal, or might result in such high costs (in terms of the procedure itself, travel, childcare, time off work, etc.) that the procedure is unfeasible. These hostile CPCs do not support Americans by providing them with more options, but instead limit their access to safe and constitutionally-protected services.
But how are people deceived into thinking they are going to a reputable clinic? CPCs often falsely present themselves as abortion providers using billboards and signs bearing slogans such as, “Pregnant and scared?” that direct individuals facing an unintended pregnancy to call national hotlines, which in turn direct callers to local CPCs. More recently, CPCs have begun investing in online advertising. When someone searching for abortion providers in their area in online phonebooks enters keywords like “abortion services,” they will see information for crisis pregnancy centers, even though CPCs do not provide abortions.[7] Fortunately, Google began removing these misleading results in April of this year with updated AdWord policies that specifically prohibit “misrepresentation of self, product, or service.”[13] Previously, CPCs were able to pay for their ads to appear at the top of search results for terms such as “abortion clinic.”[14]
The deception does not end once a CPC has a potential patient on the phone, or even in the center itself. A 2014 VICE documentary showed that patients are deliberately mislead at every stage of their visit, even the initial call. When one patient featured in the documentary explicitly asked about pricing for abortion services at a Texas CPC, the receptionist simply told her “we don’t discuss pricing over the phone.”[15] Once the patient arrived, she remained under the impression that she would be receiving abortion services until the strange behavior of the staff disturbed her so much that she left. The patient in the VICE documentary was also told over the phone that she qualified for a free ultrasound. The presence of an ultrasound machine and technician is one way to lure patients into the clinics and feign medical legitimacy. However, no medical training is required to purchase or operate an ultrasound machine, and professional models are available online for anyone with the funds and desire to purchase one.[16]
Given their deceitful tactics and lack of medical accuracy or services, it is surprising that CPCs receive massive government subsidies for their operations, due to their classification as 501(c)(3) non-profits. CPCs use federal and state funding, sometimes obtained through grants from other organizations, to proliferate CPCs nationwide, as well to maintain their internal operations.[17] Partnering with anti-abortion government lobbyists is critical for their growing legal support and financial backing. According to NARAL, twenty-three states currently provide state taxpayer dollars to these organizations.[18] Texas alone has allocated $5.15 million of its budget to CPCs and even the much smaller, politically moderate state of Pennsylvania provides up to $4 million annually to CPCs.[19][17]
Consequently, many questions of constitutionality result from government funding of non-profits with religious and political agendas. President Bush’s 2001 faith-based non-profit initiative, which established the White House Office of Faith-Based and Neighborhood Partnerships, allowed for government subsidies to be provided to religion-based non-profits.[20] It did not, however, sanction funding of organizations that provide misinformation and utilize manipulative tactics to impose an ideology on unassuming individuals.
Another disturbing example of CPC tactics is the location choice for a CPC. CPCs are often strategically located in low-income, disadvantaged neighborhoods in an attempt to target low-income women, especially women of color. CareNet, which is one of the largest operators of CPCs nationwide, started a program called Urban Initiative in 2003 which established fifteen new centers in thirteen cities. This program has since been renamed the Underserved Outreach Initiative. In its internal documentation, CareNet has acknowledged that it operates this program in underprivileged areas to provide abortion alternatives to those who are more prone to get an abortion.[21] A volunteer for another CPC network has said, “We’re going straight to the ‘hood, straight into urban areas…to reach more abortion minded and vulnerable women.”[21] The people who seek care at CPCs, and the people that CPCs target, are often young, poorly educated, or impoverished.[6] These populations are lured to the free services CPCs offer through advertisements that are placed in the neighborhoods where these people live.[6]
It is true that people of color are more likely to seek abortions, but CPCs misunderstand the reasons why. For example, black women are twice as likely as white women to obtain an abortion. This is not because abortion providers are targeting black women, but because traditionally minority groups face disproportionate difficulties in accessing comprehensive family planning services and struggle with adherence to birth control.[22] CPCs target disadvantaged women because they see an opportunity to promote their mission in areas where they see the greatest opportunity for success.
The availability and provision of medically accurate, relevant information is crucial to an individual’s ability and right to make a decision based on informed consent for any treatment or procedure, and abortion is no exception. The premise of informed consent provides that an individual’s decision ought to be voluntary, not manipulated or coerced, and should be founded on accurate information.[23] If this is not the case, then patients are fundamentally unable to exercise their right to make their own decisions. The practices of many CPCs are not in line with the foundation of informed consent and they violate basic medical ethics. These practices are not only a legal concern, but a public health concern as well. The interference of CPCs and the misleading information that they provide patients can result in a variety of health issues, including an increased likelihood of delay in prenatal care for individuals with unintended pregnancies, or even no prenatal care at all.[6]
While freedom of speech allows Crisis Pregnancy Centers and anti-abortion activists to voice their opinions, they must be held accountable for misleading and harmful tactics. CPCs should not be able to present themselves as legitimate medical facilities when they do not have trained medical staff and distribute false information. CPCs intentionally target those with little access to legitimate reproductive healthcare, and shame patients into changing their minds. CPCs should not receive state or federal funding for their biased and inaccurate counseling and deceptive advertisements. Rather, they should be forced to identify themselves as what they are: anti-abortion advocates seeking to mislead people in need of compassion and care and deny them their constitutional right to safe abortions. Protecting reproductive freedom means ensuring access to safe, honest, and compassionate care, services Crisis Pregnancy Centers cannot possibly provide.
Authored by NU SHARE with contributions by:
Roxanne Anderson, Human Services, 2018
Garrett Bollinger, International Affairs, 2015
Maya Bur, International Affairs and Human Services, 2018
Katherine Frisher, International Affairs, 2015
Taylor Grenga, Political Science and Sociology, 2018
Berit Lindell, Biology and Sociology, 2016
Emily Pearson, History, 2015
Grace Shin, Political Science, 2016
Works Cited
[1] “Common lies told by crisis pregnancy centers,” NARAL Pro-Choice Virginia, http://www.naralva.org/what-is-choice/cpc/common-lies.shtml.
[2] “Crisis pregnancy centers,” in NARAL Pro-Choice Massachusetts, http://www.prochoicemass.org/get-the-facts/cpcs/.
[3] “Crisis pregnancy centers,” Planned Parenthood, http://www.prochoicemass.org/get-the-facts/cpcs/.
[4] State policies in brief: Requirements for ultrasound. 2014. Guttmacher Institute.
[5] Richardson, Chinue, and Elizabeth Nash. “Misinformed consent: The medical accuracy of state-developed abortion counseling materials,” Guttmacher Policy Review 9 (4) (2009).
[6] Rosen, Joanne. “The public health risks of crisis pregnancy centers,” Perspectives on Sexual and Reproductive Health 44 (3) (2012).
[7] “Just because you’re pregnant…”: Lies half-truths, and manipulation at crisis pregnancy centers in Massachusetts. 2011. NARAL Pro-Choice Massachusetts.
[8] Raymond, E., and D. Grimes. “The comparative safety of legal induced abortion and childbirth in the United States,” American College of Obstetrics and Gynecology 119 (2)(2012): 215-219.
[9] 12th and Delaware. Film. Directed by Heidi Ewing and Rachel Grady. New York City: Loki Films, 2010.
[10] Gius, M. “The impact of provider availability and legal restrictions on the demand for abortions by young women.” The Social Science Journal 44 (2007): 495-506.
[11] Gius, M. “The impact of ultrasound laws on the demand for abortions by young women,” Journal of Applied Business and Economics 12(5) (2011): 54-65.
[12] “Abortion care in Massachusetts – cost of an abortion,” NARAL Pro-Choice Massachusetts, http://www.prochoicemass.org/media/abortioncarecost.shtml.
[13] “Prohibited content,” Google, https://support-google-com.ezproxy.neu.edu/adwordspolicy/answer/6008942#con
[14] Tsukayama, Hayley. “Google removes deceptive pregnancy center ads.” The Washington Post, April 28, 2014.
[15] “The Fake Abortion Clinics of America: Misconception,” YouTube video, 18:03, posted by “VICE News,” September 2014, https://www.youtube.com/watch?v=g-ex4Q-z-is.
[16] “Ultrasound Buyer’s Guide,” Providian Medical Equipment, http://providianmedical.com/wp-content/uploads/2012/07/providian-medical-ultrasound-machine-buyers-guide.pdf.
[17] Pennsylvania crisis pregnancy center materials 2005-2007: History of pregnancy centers in Pennsylvania. 2008. University of Pennsylvania Law School.
[18] “Support for crisis pregnancy centers.” NARAL Pro-Choice America, http://www.prochoiceamerica.org/what-is-choice/fast-facts/support-for-cpcs.html.
[19] Beyer, Clara. “State-funded misinformation: The problem with crisis pregnancy centers,” Brown Political Review. November 19. 2013.
[20] “Partnering with the federal government: Some do’s and don’ts for faith-based organizations,” The White House, http://georgewbush-whitehouse.archives.gov/government/fbci/guidance/partnering.html.
[21] “The truth about crisis pregnancy centers,” NARAL Pro-Choice America, http://www.naral.org/media/fact-sheets/abortion-cpcs.pdf.
[22] Cohen, Susan. “Abortion and Women of Color: The Bigger Picture,” Guttmacher Policy Review 11 (3) (2008).
[23] Gold, Rachel and Elizabeth Nash. “State abortion counseling policies and the fundamental principles of informed consent,” Guttmacher Policy Review 10 (4) (2007).
