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Second Opinions
— And why you and your patients need to know what they really are
by
Jennifer Lincoln, MD
May 2, 2023
I had just finished presenting my ob/gyn chief Grand Rounds on adolescent pregnancy when I saw a raised hand from an audience participant.
“You know the resources slide you listed? A few of those clinics aren’t clinics at all — they actually try to talk people out of abortion.”
I thanked her for her clarification and voiced my apologies. How was it that I — a very well-trained ob/gyn resident just a few weeks from graduation — was not able to discern a real medical clinic from an anti-abortion center parading as a “crisis pregnancy center”? If it was hard for me to tell the difference, how could I expect my patients to be able to do so?
This confusion is intentional. But now I know what I’m looking for, and I use my extensive social media reach to call out these facilities and prevent others — patients and healthcare providers alike — from falling into the same trap I did many years ago. Here are my top tips.
What Are Anti-Abortion ‘Crisis Pregnancy’ Centers?
These centers go by many names such as pregnancy resource center, pregnancy counseling center, or crisis pregnancy center (CPC). Recently, the AP recommended we abandon these terms and call them what they are: anti-abortion centers (AACs). This way, people will understand that their true aim is to talk pregnant people out of having an abortion. With over 2,500 of such centers in the U.S., they all share the overarching goal of convincing people not to have an abortion — and how they do this is astonishingly deceptive.
What Are Their Tactics?
These centers can be best described by the tactics they use. And yes, this is really what’s happening out there (specific tactics vary by center):
Their websites appear unbiased. They will often co-opt medical language and commonly employ phrases related to choice and autonomy. Nowhere on their sites do they disclose their religious affiliations or funding sources.They always offer free pregnancy tests, and often claim they are “medical grade” to make them seem more accurate than a standard home urine pregnancy test (they are not).Free ultrasounds are often advertised with the goal of “showing life.”They offer free services such as parenting classes and assistance with goods like diapers and maternity clothes.The website will include abortion information, lending to the confusion that they may actually provide these services (they don’t).They are almost always located in economically depressed locations and are often co-located near actual abortion clinics, sometimes adopting similar signage to try to trick patients into coming to their building instead.What’s the Real Story Behind These Tactics?
In case you haven’t figured it out, it’s all about confusion, coercion, and control. AACs actively provide misinformation regarding abortion and falsified side effects with the goal of scaring people out of this option, and oftentimes trying to push adoption in unethical ways.
Multiple examples of this exist, including a recent undercover exposé of five AACs in Indiana. Many AACs are religion-based and heavily promote prayer and Christianity within the exam room — regardless of their patient’s religious background. Ultrasounds are not always performed by trained staff, leading to inaccurate dating (sometimes this is done on purpose to trick the pregnant patient into waiting too long to seek an abortion). Recent coverage in Kentucky showed that transvaginal probes were not being sanitized correctly and thus can contribute to the spread of sexually transmitted infections. The free services advertised by these centers are often tied to the attendance of faith-based classes. Basically, it’s the opposite of medically accurate, unbiased healthcare.
Who Funds the Centers?
AACs are often funded by religious organizations, private donors, and yes, government funding. According to Equity Forward, as of 2022, 17 states have state-funded programs that give state or federal tax dollars to these centers, with more trying to pass legislation to do the same. At least 10 states have used federal funds meant for Temporary Assistance to Needy Families to instead fund these coercive centers. And that 6-week ban Florida Gov. Ron DeSantis (R) recently signed into law? It earmarks $25 million annually to fund anti-abortion centers.
It’s important to note you won’t find this information on the public-facing websites meant for patients. Instead, separate back-end sites meant for donors are where the true goals of faith-based (as opposed to medically-based) counseling exist and their overall mission can be seen. A perfect example of this duality is this AAC in Tallahassee, Florida, located essentially on the Florida State University campus. This is their other website where they clearly state their core value is “We desire to glorify, be obedient to, and serve God in everything we do.” That is a far cry from providing medical care.
What Can We Do As Healthcare Providers?
As I stood there after my Grand Rounds presentation years ago, wondering how I missed the reality of these centers, I learned that knowing that these coercive institutions exist is half the battle. Despite AACs getting more media attention now, the average American has no idea what they are and most assume they are legitimate medical clinics filling a need for early pregnancy care.
If you refer patients to these clinics for early pregnancy confirmation ultrasounds, stop. Even better is going a step further, and if you have access to ultrasonography in your office, offer free pregnancy ultrasounds as an alternative to patients seeking this out at AACs. Use your voice to educate your community, and get involved with legislation that aims to prohibit state funding from being given to these organizations, mandates employee background checks, and prohibits deceptive advertising. Call these centers what they really are to make their goals clear.
You can find some phenomenal resources here if you want to get involved and fight back. Even sharing the occasional social media post about this can go farther than you think — every little bit helps and makes a difference.
Jennifer Lincoln, MD, is a board-certified ob/gyn practicing in Portland, Oregon. She is also an author, social media educator, and executive director of the health education nonprofit Mayday Health.