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Pregnancy centers in the US, which discourage women from getting abortions, are adding more medical services – and may be poised to expand even further.
The expansion – from testing and treating sexually transmitted infections to providing primary medical care – has continued over the years. It accelerated after Supreme Court Overturned Roe v. Wade three years ago, clearing the way for states to ban abortion.
The push may gain more momentum Planned Parenthood Some clinics are closing and others are being considered for closure following the change MedicaidPlanned Parenthood is not only the nation’s largest abortion provider, but also provides cancer screenings, STI testing and treatment, and other reproductive health services.
“We want to ultimately replace Planned Parenthood with the services that we provide,” said Heather Lawless, founder and director of the Reliance Center in Lewiston. idahoShe said about 40% of patients at the anti-abortion center come for reasons unrelated to pregnancy, including some who use a nurse practitioner as their primary caregiver.
The changes have disappointed abortion-rights groups, who, in addition to opposing the centers’ anti-abortion message, say they lack accountability; refusal to provide birth control; And most offer only limited ultrasounds that can’t be used to diagnose fetal anomalies because the people conducting them don’t have that training. A growing number also offer unproven abortion-pill reversal treatments.
Because most centers do not accept insurance, the federal law prohibiting the release of medical information does not apply to them, although some say they follow it anyway. They also are not required to adhere to the standards required by Medicaid or private insurers, although those providing some services typically must have medical directors who comply with state licensing requirements.
“There are really fundamental questions,” said Jennifer McKenna, senior adviser at Reproductive Health and Freedom Watch, a project funded by liberal policy organizations that researches pregnancy centers, “about whether this industry has the clinical infrastructure to provide the medical services it is currently advertising.”
Post-Roe world opens up new opportunities
Perhaps better known as “crisis pregnancy centers”, these mostly privately funded and religiously affiliated centers were expanding services such as diaper banks before the Supreme Court’s 2022 Dobbs v. Jackson Women’s Health Organization decision.
As soon as abortion was banned, centers expanded medical, educational and other programs, said Moira Gaul, a scholar at the Charlotte Lozier Institute, the research arm of SBA Pro-Life America. “They are ready to serve their communities for a long time,” he said in a statement.
For example, in Sacramento, California, the Alternative Pregnancy Center over the past two years has added nurses and medical assistants as well as family practice doctors, a radiologist and a specialist in high-risk pregnancies. Alternatives – an affiliate of Heartbeat International, one of the largest associations of pregnancy centers in the US – is the sole health provider for some patients.
When The Associated Press asked to interview a patient who had received only non-pregnancy services, the clinic provided Jessica Rose, a 31-year-old woman who took the rare step of transitioning after spending seven years as a man, during which she received hormone therapy and a double mastectomy.
For the past two years, she has received all medical care at Alternatives, which has an OB-GYN who specializes in hormone therapy. Few, if any, pregnancy centers advertise that they provide assistance with contraception. Director Heidi Matzke said Alternatives has treated four similar patients in the past year, although that is not its main mission.
Rose said, “APC provided me with a position that was consistent with my beliefs as well as who I saw as a woman.” She said other clinics were “making me think that change was not what I wanted to do.”
Pregnancy centers are expanding as health clinics decline
By 2024, there were more than 2,600 anti-abortion pregnancy centers operating in the U.S., an increase of 87 from 2023, according to the Crisis Pregnancy Center Map, a project led by University of Georgia public health researchers who are concerned about aspects of the centers. According to the Guttmacher Institute, 765 clinics offered abortions last year, more than 40 fewer than in 2023.
Over the past few years, pregnancy centers have received a boost in taxpayer funding. About 20 states, largely Republican-led, now give millions of public dollars to these organizations. Texas alone has sent $70 million to pregnancy centers this fiscal year Florida Devoted over $29 million to its “Pregnancy Support Services Program”
This increase in resources is coming as Republicans have blocked Planned Parenthood from receiving Medicaid funds under the tax and spending law signed in July by President Donald Trump. While federal law already blocked the use of taxpayer funds for most abortions, Medicaid reimbursements for other health services were a large portion of Planned Parenthood’s revenues.
Planned Parenthood said its affiliates could be forced to close 200 clinics.
Some had already closed or been reorganized. He has cut abortion in Wisconsin and eliminated Medicaid services in Arizona. An independent group of clinics in Maine closed primary care for the same reason. The uncertainty is further heightened by pending Medicaid changes, which are expected to result in more uninsured Americans.
Some abortion-rights supporters worry that this will mean more health care deserts where pregnancy centers are the only option for more women.
Caitlin Joshua, founder of the abortion-rights group Abortion in America, lives in Louisiana, where Planned Parenthood closed its clinics in September.
They are concerned that women seeking health services at pregnancy centers will not get what they need as a result of the closures. “Those centers should be regulated. They should be providing information that is accurate,” he said, “instead of just getting a sermon they didn’t ask for.”
Thomas Glessner, founder and president of the National Institute of Family and Life Advocates, a network of 1,800 centers, said the centers have government oversight through their medical directors. “His criticism comes from a political agenda,” he said.
In recent years, five Democratic state attorneys general have issued warnings that centers that advertise to people seeking abortions should not perform abortions and should not refer patients to such clinics. And the Supreme Court has agreed to consider whether a state investigation of an organization that runs a center in New Jersey impedes free expression.
Pregnancy centers don’t provide exactly the same services as Planned Parenthood
Choices Medical Services in Joplin, Missouri, where a Planned Parenthood clinic closed last year, moved from focusing solely on discouraging abortion to a broader sexual health mission about 20 years ago when it began offering STI treatment, said Carolyn Schrage, its executive director.
According to Arkansas State Police and Schrage, the donor-funded center works with law enforcement at locations where officers may find pregnant adults.
They estimate that more than two-thirds of this work is unrelated to pregnancy.
Hayley Kelly first met Choices volunteers in 2019 at a regular weekly dinner they brought to the dancers at the strip club where she worked. Over the years, she went to the center for STI testing. Then in 2023, when she didn’t have insurance and was struggling with medications, she wanted to confirm the pregnancy.
She guessed the staff wouldn’t like that she was leaning toward abortion, but she says they just answered questions. Ultimately she had that child and later another child.
“It’s an amazing place,” Kelly said. “I tell everyone I know, ‘You can go there.'”
The center, like others, does not provide contraception — a standard offering in sexual health clinics that experts say are best practices for public health.
“Our focus is on sexual risk elimination, not just reduction,” Schrage said.