Anti-Abortion Pregnancy Centers Expand Medical Services Beyond Ultrasounds and Diapers

Pregnancy centers in the U.S. that discourage women from getting abortions have been adding more medical services — and could be poised to expand further. The expansion — ranging from testing and treatment for sexually transmitted infections to even providing primary medical care — has been unfolding for years. It gained steam after the Supreme Court overturned Roe v. Wade three years ago, clearing the way for states to ban abortion.

The Expansion of Services in a Post-Roe World

The push could get more momentum with Planned Parenthood closing some clinics and considering shuttering others following changes to Medicaid. Planned Parenthood is not just the nation's largest abortion provider, but also offers cancer screenings, STI testing and treatment, and other reproductive health services. “We ultimately want to replace Planned Parenthood with the services we offer,” said Heather Lawless, founder and director of Reliance Center in Lewiston, Idaho. She said about 40% of patients at the anti-abortion center are there for reasons unrelated to pregnancy, including some who use the nurse practitioner as a primary caregiver.

Perhaps best known as “crisis pregnancy centers,” these mostly privately funded and religiously affiliated centers were expanding services such as diaper banks ahead of the Supreme Court's 2022 Dobbs v. Jackson Women's Health Organization ruling. As abortion bans kicked in, the centers expanded medical, educational and other programs, said Moira Gaul, a scholar at the Charlotte Lozier Institute. “They are prepared to serve their communities for the long-term,” she said in a statement.

Case Study: Alternatives Pregnancy Center

In Sacramento, California, for instance, Alternatives Pregnancy Center in the last two years has added family practice doctors, a radiologist and a specialist in high-risk pregnancies, along with nurses and medical assistants. Alternatives — an affiliate of Heartbeat International, one of the largest associations of pregnancy centers in the U.S — is some patients' only health provider. For example, 31-year-old Jessica Rose has received all medical care at Alternatives for the last two years, which has an OB-GYN who specializes in hormone therapy.

Accountability and Clinical Concerns

The changes have frustrated abortion-rights groups, who, in addition to opposing the centers' anti-abortion messaging, say they lack accountability. They refuse to provide birth control; and most offer only limited ultrasounds that cannot be used for diagnosing fetal anomalies because the people conducting them don't have that training. A growing number also offer unproven abortion-pill reversal treatments. “There are really bedrock questions,” said Jennifer McKenna, a senior adviser for Reproductive Health and Freedom Watch, “about whether this industry has the clinical infrastructure to provide the medical services it’s currently advertising.”

Because most of the centers don't accept insurance, the federal law restricting release of medical information doesn't apply to them, though some say they follow it anyway. They also don't have to follow standards required by Medicaid or private insurers, though those offering certain services generally must have medical directors who comply with state licensing requirements.

Comparison of Available Services and Reported Limitations