Pregnancy centers in the U.S. that discourage women from getting abortions have been adding more medical services \u2014 and could be poised to expand further.<\/p>\n
The expansion \u2014 ranging from testing and treatment for sexually transmitted infections to even providing primary medical care \u2014 has been unfolding for years. It gained steam after the Supreme Court overturned Roe v. Wade<\/a> three years ago, clearing the way for states to ban abortion<\/a>.<\/p>\n The push could get more momentum with Planned Parenthood closing some clinics<\/a> and considering shuttering others following changes to Medicaid. Planned Parenthood is not just the nation\u2019s largest abortion provider, but also offers cancer screenings, STI testing and treatment, and other reproductive health services.<\/p>\n \u201cWe ultimately want to replace Planned Parenthood with the services we offer,\u201d 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.<\/p>\n The changes have frustrated abortion-rights groups, who, in addition to opposing the centers\u2019 anti-abortion messaging,<\/a> say they lack accountability; 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\u2019t have that training. A growing number also offer unproven<\/a> abortion-pill reversal treatments.<\/p>\n Because most of the centers don\u2019t accept insurance, the federal law restricting release of medical information doesn\u2019t apply to them, though some say they follow it anyway. They also don\u2019t 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.<\/p>\n \u201cThere are really bedrock questions,\u201d said Jennifer McKenna, a senior adviser for Reproductive Health and Freedom Watch, a project funded by liberal policy organizations that researches the pregnancy centers, \u201cabout whether this industry has the clinical infrastructure to provide the medical services it\u2019s currently advertising.\u201d<\/p>\n Post-Roe world opened new opportunities<\/p>\n Perhaps best known as \u201ccrisis pregnancy centers,\u201d these mostly privately funded and religiously affiliated centers were expanding services such as diaper banks ahead of the Supreme Court\u2019s 2022 Dobbs v. Jackson Women\u2019s Health Organization ruling. <\/p>\n As abortion bans kicked in, the 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. \u201cThey are prepared to serve their communities for the long-term,\u201d she said in a statement.<\/p>\n 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 \u2014 an affiliate of Heartbeat International, one of the largest associations of pregnancy centers in the U.S \u2014 is some patients\u2019 only health provider.<\/p>\n 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 detransitioning after spending seven years living as a man, during which she received hormone therapy and a double mastectomy.<\/p>\n For the last two years, she\u2019s 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 help with detransitioning. Alternatives has treated four similar patients over the past year, though that\u2019s not its main mission, director Heidi Matzke said.<\/p>\n \u201cAPC provided me a space that aligned with my beliefs as well as seeing me as a woman,\u201d Rose said. She said other clinics \u201cwere trying to make me think that detransitioning wasn\u2019t what I wanted to do.\u201d<\/p>\n Pregnancy centers expand as health clinics decline<\/p>\n As of 2024, more than 2,600 anti-abortion pregnancy centers operated in the U.S., up 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, down more than 40 from 2023.<\/p>\n Over the years, pregnancy centers have received a boost in taxpayer funds. Nearly 20 states, largely Republican-led, now funnel millions of public dollars to these organizations. Texas alone sent $70 million to pregnancy centers this fiscal year, while Florida dedicated more than $29 million for its \u201cPregnancy Support Services Program\u201d <\/p>\n This boost in resources is unfolding as Republicans have barred Planned Parenthood<\/a> from receiving Medicaid funds under the tax and spending law<\/a> President Donald Trump signed in July. While federal law already blocked the use of taxpayer funds for most abortions, Medicaid reimbursements for other health services were a big part of Planned Parenthood\u2019s revenue.<\/a><\/p>\n Planned Parenthood said its affiliates could be forced to close up to 200 clinics. <\/p>\n Some already had closed or reorganized. They have cut abortion in Wisconsin<\/a> and eliminated Medicaid services in Arizona. An independent group of clinics in Maine stopped primary care<\/a> for the same reason. The uncertainty is compounded by pending Medicaid changes<\/a> expected to result in more uninsured Americans.<\/p>\n Some abortion-rights advocates worry that will mean more health care deserts where the pregnancy centers are the only option for more women.<\/p>\n Kaitlyn Joshua, a founder of abortion-rights group Abortion in America, lives in Louisiana, where Planned Parenthood closed its clinics in September.<\/p>\n She\u2019s concerned that women seeking health services at pregnancy centers as a result of those closures won\u2019t get what they need. \u201cThose centers should be regulated. They should be providing information which is accurate,\u201d she said, \u201crather than just getting a sermon that they didn\u2019t ask for.\u201d<\/p>\n Thomas Glessner, founder and president of the National Institute of Family and Life Advocates, a network of 1,800 centers, said the centers do have government oversight through their medical directors. \u201cTheir criticism,\u201d he said, \u201ccomes from a political agenda.\u201d<\/p>\n