Sarah Wasko / Media Matters

UPDATE: On June 26, the Supreme Court decided NIFLA v. Becerra, ruling against the California law regulating fake health clinics. The court “held that part of California's crisis pregnancy center disclosure law is unconstitutional and that another part is likely unconstitutional.” [Supreme Court, accessed June 2018; BuzzFeed News, 5/26/18]

The Supreme Court heard oral arguments in a case involving anti-abortion fake health clinics

Supreme Court heard oral arguments on March 20 in a case dealing with the deceptive nature of fake health clinics. On March 20, the Supreme Court heard oral arguments in National Institute of Family and Life Advocates (NIFLA) v. Becerra, which involves California’s Reproductive Freedom, Accountability, Comprehensive Care and Transparency (FACT) Act. Under the act, licensed clinics are required to display a notice at their facilities and in their advertising materials stating that California provides “immediate free or low-cost” reproductive services, which include abortion. Unlicensed clinics are required to post a notice stating that they are not medical facilities and do not have medical professionals doing on-site supervision. NIFLA, which represents both licensed and unlicensed fake health clinics in California, challenged the law as a violation of its facilities’ free speech rights to not promote abortion or contraceptives. [BuzzFeed, 3/20/18; Media Matters, 3/16/18; California legislature, accessed March 2018; Vice News, 11/14/17]

Fake health clinics are known to engage in deception and manipulation in their advertising and interactions with clients. Anti-abortion clinics use multiple deceptive tactics to pose as comprehensive reproductive health providers in order to dissuade individuals from obtaining abortions. A yearlong investigation by Cosmopolitan found that these fake health clinics (also called crisis pregnancy centers or “CPCs”) “increasingly look just like doctor’s offices with ultrasound rooms and staff in scrubs. Yet they do not provide or refer for contraception or abortion. Many pregnancy-center counselors, even those who provide medical information, are not licensed.” As Teen Vogue reported, some fake clinics also lie about state restrictions that may prohibit abortion past a certain week of pregnancy and about the risks of abortion procedures -- including making inaccurate claims that abortion makes a person infertile or causes breast cancer. Some fake clinics even mislead potential clients before people even get in the door -- posing as comprehensive reproductive care clinics or suggesting in their advertising that they offer abortion services or contraceptives, when in reality many fake clinics provide neither. Some fake clinics also receive direct funding from states. As Lizz Winstead explained for HuffPost: “CPCs are NOT health care centers, yet many states divert Medicaid, TANF (Temporary Assistance for Needy Families), and other government funding designed to help low income people into these fake clinics.” [Media Matters, 11/20/17, 12/28/17; Cosmopolitan, 7/14/15; Teen Vogue, 6/21/17; Broadly, 5/30/17; Slate, 1/5/16, 4/29/14; National Institute for Reproductive Health, accessed March 2018; National Women’s Law Center, accessed March 2018; Truth In Advertising, 10/15/15; Salon, 7/14/15; HuffPost, 7/31/17]

Constitutional law scholar Erwin Chemerinsky: NIFLA v. Becerra “should be an easy issue to decide.” Constitutional law scholar and professor Erwin Chemerinsky wrote for the Los Angeles Times that NIFLA v. Becerra “should be an easy issue to decide — in favor of the California law — but it is not because it arises in the context of abortion.” Chemerinsky explained that the California law “was enacted so that women would receive accurate information about the existence of state healthcare programs,” and it does not require the clinics or anyone working there “to say anything. Nor is there any requirement to provide additional information; for instance, specifics about contraception or a referral to a clinic that performs abortions.” He stated that “under traditional legal principles, the Supreme Court would acknowledge that there is an important state interest in letting women know of programs available to them” and that the First Amendment “burden” on these clinics “is extremely minimal.” Chemerinsky also noted, “It's quite possible, however, that with four justices who have in the past voted to uphold any restriction on abortion, and a fifth who often joins them, the FACT Act will be condemned as compelled speech and declared unconstitutional.” [Los Angeles Times, 3/20/18]

Six outlets published must-read pieces on the negative impact of anti-abortion fake health clinics

NARAL Pro-Choice America President Ilyse Hogue wrote in Cosmopolitan: Fake health clinics’ “singular ideology” is to make a person “give birth, no matter the consequences for her life.” Ilyse Hogue, president of NARAL Pro-Choice America, wrote about the NIFLA case for Cosmopolitan, explaining that fake health clinics attempt to use a variety of tactics to achieve their goal of preventing abortions, such as “performing intrusive and unnecessary ultrasounds by untrained individuals, threatening to reveal pregnancy to family members, or even giving fake due dates so that women think they're too far along to abort.” These tactics result in delays and inadequate care that could lead to serious health consequences. From Cosmopolitan:

A network of over 2,700 “crisis pregnancy centers,” or CPCs, around the country pose as abortion clinics with the goal of luring women in and deceiving, shaming, and cajoling them into deciding against abortion. This is their singular ideology — making a woman give birth, no matter the consequences for her life.

We at NARAL have documented their willingness to use almost any means necessary to get that done: performing intrusive and unnecessary ultrasounds by untrained individuals, threatening to reveal pregnancy to family members, or even giving fake due dates so that women think they're too far along to abort. And the deception is almost airtight; from Google search results to the waiting rooms built to look medically official, the CIA couldn’t create a more convincing fake scene if they were trying to lure a spy.

In fact, the deceit is so detailed that one crisis pregnancy center in West Virginia even fooled anti-abortion activists, who accidentally vandalized the fake clinic instead of the real clinic down the street.

[...]

Because these fake clinics only serve the goals of their anti-abortion ideology, and don’t actually serve the life or health of women, someone like Jessica won’t be screened for any of the common health conditions that could complicate a pregnancy. And if a pregnant woman has made her decision to have an abortion, we know that the delay in access intentionally caused by these fake clinics significantly increases the chance of medical complications for the women. [Cosmopolitan, 3/20/18]

Writer for Romper chronicled her visit to a fake health clinic, where she was “lied to, deceived, and shamed.” Grace Powers, a reproductive health activist, wrote for Romper about her experience visiting an anti-abortion fake health clinic when she learned she was pregnant at 21 years old. Powers wrote that the clinic staff harassed and shamed her in an attempt to stop her from getting an abortion. From Romper:

I was 21 years old when I found out I was pregnant. I didn’t know what I was going to do, but I knew that before I made a decision about my pregnancy, I wanted to get information from a medical professional — information that I could use to make the right choice for me and my partner. I remembered that there was a place I had passed dozens of times, right near my college in a working-class town that said it offered help to pregnant women looking for information. The women's health center had a very generic name — “The Pregnancy Center” — the kind you’d expect to see at any health clinic. So, I made an appointment, hoping they could provide me with the help and information I needed without requiring me to take extra time out of my college classes.

[...]

It wasn’t until after I was directed to a patient room that I realized something was wrong. The staff kept calling me “mommy,” and my boyfriend “daddy,” while pressuring me not to have an abortion, and I wasn’t given any information about my healthcare options — just lies. They told me abortion was an unsafe option, something I know isn’t based on evidence or science. Their lie was meant to scare me out of my options. I left the center feeling angry, manipulated, and ashamed.

The possibility that I wouldn’t get the care I needed never crossed my mind. Nothing that I had seen about this clinic would have led me to believe otherwise. I was vulnerable in that moment and scared. I thought I would get the information I needed to make the best possible decision for myself. Instead, I was lied to, deceived, and shamed.

It didn’t stop after I left the center. The staff there — the same people that tried to shame me and make me feel uncomfortable — kept calling and calling, asking if I had an abortion or not. They kept trying to pressure me to commit that I wouldn’t have one. They continued to harass me, and the only way I felt I could get them to stop calling was to tell them that yes, I chose to have an abortion. [Romper, 3/20/18]

The St. Louis American published an account explaining that “black women and other women of color are often the target population” for fake health clinics. Jessica Estes, a statewide organizer for NARAL Pro-Choice Missouri, wrote in The St. Louis American of fake health clinics that she had “experienced their deception firsthand” when she was 16 and that the facility targeted women of color. From The St. Louis American:

These fake clinics have a well-documented history of intentionally misleading women, particularly black women, and deceiving them. I know, because I experienced their deception firsthand.

At 16 years old, I was concerned I may be pregnant. My aunt suggested I go to Birthright, a clinic that offered free pregnancy tests and other services. After providing a urine sample, I was taken to a small room without my aunt. Soon an older white woman came in and sat her chair directly across from mine. She promptly began to lecture me. I cannot recall everything that was said, but I will never forget the way it made me feel – full of shame and judgment.

I was afraid, and I was alone. I wanted more than anything to simply know the results of my test and leave, but the power dynamics at play said otherwise, with her being an older white woman and I a young black teenage girl. I was trapped. I felt powerless. I was at an incredibly vulnerable moment in my life, looking for someone to help. I thought I could trust them. Eventually, she told me my pregnancy test was negative.

Fourteen years later I learned that Birthright was not a healthcare clinic and it is highly likely that there were no actual healthcare professionals on staff. Like many other women and girls before me, I had been deceived and manipulated to believe the lie.

[...]

Fake women’s health centers are strategically located in close proximity to real healthcare clinics. Black women and other women of color are often the target population. Both of these strategies are clearly exhibited locally.

Drive down Forest Park Parkway on any day of the week and you will see a Thrive Bus (another fake clinic) just across the street from Planned Parenthood. This fake clinic is plastered with large pictures of black women, attempting to draw us in. A few streets over on Lindell, Thrive and Birthright have individual offices. Again, you will find large pictures of black women on the entry doors to Thrive. This marketing approach clearly communicates that fake women’s health centers subscribe to stereotypes about women of color, while simultaneously benefiting from the reality that women of color are disproportionately negatively impacted by our faulty healthcare system. [The St. Louis American, 3/19/18]

Rewire.News: “Women of color are paying the steep price” for the practices of fake health clinics. In a post for Rewire.News, Sung Yeon Choimorrow, executive director for the National Asian Pacific American Women’s Forum, wrote, “We need to expose the truth about these fake centers before their lies endanger the health and safety of any more pregnant women—especially low-income people, people of color, and immigrants.” Choimorrow explained that fake health clinics are “frequently targeting young women and communities of color—including Asian American and Pacific Islander (AAPI) women,” who “are already a medically underserved community.” From Rewire.News:

We need to expose the truth about these fake centers before their lies endanger the health and safety of any more pregnant women—especially low-income people, people of color, and immigrants.

[...]

Many of these centers are also deliberately located in low-income neighborhoods, neighborhoods of color, urban centers, and counties with higher than average rates of segregation. These operations advertise heavily, frequently targeting young women and communities of color—including Asian American and Pacific Islander (AAPI) women. Due to lack of information and culturally or linguistically competent resources, AAPI women are already a medically underserved community—and fake health centers create additional barriers to the care we need. It’s shameful.

[...]

When AAPI women and women in general are confronted with false choices—or, even worse, not given agency over the conditions under which we become parents—the outcome can be devastating. Allowing fake health centers to spread their misinformation in our communities does real harm to low-income communities and women of color by reducing a woman’s chance at having honest conversations about her reproductive decisions.

[...]

For me, this landmark case is another reminder that women, especially low-income and women of color, must deal with threats from coercive laws and fight for agency over our bodies. Whether it is not being able to make our own reproductive decisions, dealing with horrible and unsafe working conditions, or having to worry about our documentation status, women of color in this country are constantly faced with false choices. Many of us do not get to have a say in what happens to our bodies, our families, and our communities.

Fake health centers are just one more way that our society continues to fail women, and women of color are paying the steep price. We, as a nation, set a dangerous precedent if we allow falsehoods and lies to override women’s fundamental right to decide if, when, and how we become parents. [Rewire.News, 3/19/18]

The Texas Tribune’s TribTalk: “Texas women will likely face the worst treatment” if the Supreme Court strikes down the California law. On The Texas Tribune’s opinion site TribTalk, Maggie Jo Buchanan, a women’s health policy consultant, discussed the negative practices of anti-abortion clinics, including the specific impact these deceptive centers have in Texas. Buchanan speculated that if the court ultimately strikes down the California law, “Texas women will likely face the worst treatment.” From TribTalk:

These centers enjoy the backing of powerful national organizations and politicians alike. Texas alone provides tens of millions of dollars in taxpayer funds to support the political agenda of CPCs. In fact, they outnumber comprehensive clinics approximately 1 to 9 in our state.

[...]

CPC staff have been documented making wildly inaccurate claims about abortion and birth control that have been discredited by the American College of Obstetricians and Gynecology. They emotionally manipulate women while targeting low-income women and communities of color. Some provide ultrasounds in order to benefit from state laws that require women to undergo one before ending a pregnancy. The skills of some that provide such “services” aren’t necessarily reliable — one volunteer at a center performing an ultrasound mistook a woman’s IUD for a pregnancy.

[...]

This risks not only women’s reproductive rights but also their health and, as our state’s tragically high maternal mortality rate demonstrates, their very lives.

[...]

In Texas, these centers already operate largely unchecked. If, however, the Court were to sanction such a sweeping legal right, CPCs are sure to push the envelope further and further in attempts to secure their political goals. And, as so often is the case when it comes to women’s health care, Texas women will likely face the worst treatment. [The Texas Tribune, 3/14/18]

Damn Joan published an anonymous account of one person’s experience going to a anti-abortion clinic. Online publication Damn Joan published an anonymous (at the author’s request) account of an experience visiting an anti-abortion clinic in Tennessee. The author also explained that someone seeking an abortion could be easily misled into going to an anti-abortion clinic when searching for assistance online. From Damn Joan:

“If you are pregnant, what options are you considering?” she asked kindly.

I told her that I would probably be seeking an abortion. After all, the sign on this low-slung brick building across from a massive Kroger grocery store in Oak Ridge, Tennessee, said that we were in the Choices Resource Center.

Linda’s face tightened. “That’s not a decision to make lightly. It could have serious mental consequences,” she said, lifting her hands to her temples, as if to show me exactly where my remorse would take up permanent residence. “And there can be physical complications too.”

“God put this baby in your belly. He knows what he’s doing; he wants you to have this baby,” Karen added, nodding emphatically, her wrinkled eyes earnest.

“You’re 33,” said Linda. “Maybe this is your chance to become a mother.”

I placed a hand over my long-empty uterus.

“We’re here for you. We help so many girls like you,” Karen continued.

Here’s the thing: I knew I wasn’t pregnant. I adhere piously to the church of Taking My Birth Control Every Damn Day. But as a woman living in Tennessee, in a rural notch of the Bible Belt where access to abortion care is severely restricted, I wanted to know what would happen if I ever needed to exercise my right to terminate a pregnancy. And as a journalist, I planned to write about what I discovered.

[...]

Then I searched for “abortion nearby” on Google Maps. This was a more fruitful endeavor—most of the results were at least an hour away, but there were a lot to choose from: AA Women’s Services, Hope Resource Center, Pregnancy Care Center, and, of course, Choices Resource Center.

The number of results should have been a clue. In Tennessee, 96% of counties lack an abortion provider; there are only 11 in the state. According to the Abortion Care Network, there is exactly one independent abortion provider; the nearest Planned Parenthood to me is in Knoxville, 100 miles away. So what were all these clinics popping up when I was searching for an abortion?

[...]

When I clicked through to some of the sites in my results, it was often hard to tell if they were CPCs or places that could really help. The generically named Hope Resource Center site notes that “Every woman facing an unplanned pregnancy has three options: parenting, adoption, or abortion,” but “does not perform or refer for abortion.” AA Women’s Services made its end goal pretty clear from the logo and slogan at the top: an infant’s footprints and, in huge cursive font, “every life deserves a lifetime.” I put myself in the shoes of someone in search of real help and cringed.

The abortion FAQ page on the Pregnancy Care Center site had a lot of misleading science, details cherry-picked from seemingly reliable sources and presented without context. There were claims like “Abortion carries the potential for physical complications, which are significant if they happen to you,” and that “Surgical and later-term abortions are also associated with an increased risk of emotional/psychological complications such as depression, anxiety, and relationship difficulties.” Quick fact-check: Women who had abortions didn’t experience more depression, anxiety, low self-esteem, or dissatisfaction with life than those who were denied it, and a first-trimester abortion is one of the safest medical procedures out there. Pregnancy Care Center’s site was set up to pressure and gaslight visitors whether they actually went to the physical center or not—and it wasn’t going to let facts get in the way.

Then I came to the Choices Resource Center. Despite the name, it seemed clear to me that it was a CPC, but I decided to find out for myself. I made an appointment for a pregnancy test the next day.

[...]

That’s where the two pressed me on my “options” before the test results were even in. They evoked pseudoscience and God; they kept referring to me, a woman in her mid-30s, as a girl. Just as I was preparing to respond to Karen, the woman in pink scrubs returned to inform us that my test was negative. “Oh, thank God,” I exhaled. Karen and Linda seemed almost disappointed. They’d psyched themselves up for a fight, but there was nothing to fight for. They didn’t care about me or my health—just the contents of my womb. [Damn Joan, 2/8/18]

John Oliver explains how crisis pregnancy centers manipulate people. During the April 8 edition of HBO’s Last Week Tonight with John Oliver, host John Oliver delved into the numerous deceptive tactics of fake health clinics -- also known as crisis pregnancy centers (CPCs) -- that erroneously represent themselves as comprehensive reproductive care clinics in order to manipulate people into not having abortions.

Samantha Bee: “Crisis pregnancy centers may look sweet and helpful, but they're really full of toxic bullshit.” Full Frontal's Samantha Bee detailed how “crisis pregnancy centers are an illusion” and “a complete hustle.”

This post has been updated following the Court's ruling.