Welcome to Bustle's Abortion AMA column, where reproductive rights advocate and Romper editor Danielle Campoamor will speak to experts and medical professionals to answer people's questions about abortion in a way that is educational, unvarnished, and judgement free. Ask us anything.
Thanks to the politicalization of a common medical procedure, it's become increasingly difficult to find accurate information — particularly online — about abortion and the places that offer them. So if you've asked yourself, "Can I get an abortion at a crisis pregnancy center?" please know that you're not the only one asking that question. There are between 2,500 and 4,000 crisis pregnancy centers in the United States, compared to just 1,500 abortion providers, so women seeking abortions are more likely to encounter the former — online or IRL — than the latter.
The American Medical Association (AMA), the largest physician group in the U.S., defines crisis pregnancy centers as "organizations that seek to intercept women with unintended or 'crisis' pregnancies who might be considering abortion." The intent of these organizations, according to the AMA, is to prevent abortions by persuading women that adoption or parenting is a better option. Most are religiously affiliated, funded via state governments, special grants, and federal funding, and are unlicensed facilities posing as medical practices. And according to a Feb. 2018 report by Gizmodo, these facilities are successfully targeting women seeking abortions via search optimization — using ad placements and keywords to show up online when someone searches for a nearby clinic that provides abortion services. "On so many levels they've been very strategic at blending in," Dr. Jennifer Conti, an abortion provider and clinical assistant professor at Stanford University and a fellow with Physicians for Reproductive Health, a group of doctors who advocate for reproductive rights, tells Bustle. "On Google they're some of the first hits that come up, they label themselves with 'choice' or 'options' so they seem all inclusive, and if you call them, they're scripted to answer any questions with, 'Well, just come in and let's talk about it.'"
"When I walked in, I knew almost immediately that I’d been wrong," Katie Stack, a woman who visited a crisis pregnancy center when she had an unwanted pregnancy, wrote in The New York Times in 2011. "Though the volunteers wore scrubs, none of them were medical professionals. They insisted on calling my pregnancy my 'baby' and my 'child.' The intake questions included, 'What is your relationship to Jesus Christ?'" According to Conti, once a woman is in the facility, the staff will often keep them in a room to look at an ultrasound until they're convinced the embryo or fetus is a baby, not allowing them to leave until they've decided to continue with their unplanned, previously unwanted pregnancy. "They just really shame the woman and make her feel like she doesn't have any options."
According to a March 2018 article in the AMA Journal of Ethics, "Lay volunteers who are not licensed clinicians at CPCs often wear white coats and see women in exam rooms." But, again, they are not licensed medical physicians working in a licensed medical facility. "None of the medical policies and best practices that doctors go by and medical professionals go by, like the Hippocratic Oath, apply to an unlicensed medical center," Heather Shumaker, Senior Counsel for Reproductive Rights and Health at the National Women’s Law Center, tells Bustle. "They're not medical providers, so they're not subject to the type of laws that medical providers are subject to." These laws include the Health Insurance Portability and Accountability Act (HIPPA), which protects patients' personal information. So not only are CPC staff members untethered to the Hippocratic Oath — a vow physicians take that promises they will "respect hard-won scientific gains" and will "consider the benefit of patients and abstain from whatever is deleterious and mischievous" — but they're under no legal obligation to protect personal medical information provided to them by those who walk inside their clinics.
"It's practicing medicine without a license, essentially, which is illegal, unethical, and shocking," Conti says. "But they get around that by saying that they’re not medical clinics and they’re non-profits and non-government organizations." According to Conti, that's why they're able to use deceptive practices — like misdiagnosing gestational ages and adding messages to ultrasound pictures. According to the website of the National Institute of Family and Life Advocates (NIFLA), a charitable organization that is a member of the National Pro-Life Religious Council, more than 860 crisis pregnancy centers — what it calls "pregnancy solution centers" — currently provide ultrasounds and other medical services. NIFLA claims all services are supervised by a "a licensed physician," who is the "medical director" of the "clinic," but according to an article in Cardozo Law Review, "CPCs are generally staffed by volunteers committed to Christian beliefs but who lack medical training." They have also been found to give false information about abortion procedures — without facing any legal ramifications. (Bustle reached out to NIFLA for comment but has not yet heard back.)
A March 2018 study published by the U.S. National Library of Medicine and National Institutes of Health, which studied the prevalence and impacts of crisis pregnancy center visits among pregnant women, found that CPCs offer unhelpful services and inaccurate information to pregnant women — especially women who have already determined they want an abortion — that create additional barriers to accessing reproductive health care. Conti says clinics often tell patients they aren't as far along as they truly are, so they're more likely to delay their decision until they are past the gestational age where abortion is legal in most states.
"Reproductive health care is so time sensitive and it's so important that women get that information right away, especially pregnant women," says Schumaker. Forty-three states in the U.S. prohibit abortions after a certain point in pregnancy, 17 of which ban abortion at about 20 weeks post-fertilization, according to the Guttmacher Institute, which means inaccurate information can have long-lasting and potentially dangerous ramifications.
Thankfully, policy makers are taking note. In October 2015 The California Fact Act passed — a state law that, according to a report from NPR, required crisis pregnancy centers to be more forthcoming about additional reproductive services offered to women living in the state as a way to let women seeking abortion services know the full scope of their legal options. A network of crisis pregnancy centers, including NIFLA, sued in response, and the case, NIFLA v. Becerra, is currently being heard in the Supreme Court. "Those who are opposed to anti-abortion counseling centers are not opposed to the existence of a center that is anti-abortion and seeks to encourage women to continue their pregnancies," Shumaker says. "The part that reproductive rights advocates are concerned about is that these centers use deceptive practices to lure women into these facilities, and deception is not protected by the first amendment."
So, how can you tell the difference between a Crisis Pregnancy Center and a health care center that provides abortions? Conti says it's difficult, but familiarizing yourself with their reported practices is a good start. For example, if a clinic is telling you an abortion will cause breast cancer, infertility, and psychiatric disorders, you are not at a legitimate medical clinic. And, of course, the best thing you can do, according to Conti, is be an advocate for yourself and ask up front, and often, if the center provides abortions. "If you're getting the run-around and you're not getting clearance and your gut is telling you something wrong," she says, "walk out." You can also find an abortion provider online via the National Abortion Federation, a professional association of abortion providers that includes private and non-profit clinics, Planned Parenthood affiliates, trusted women's health centers, hospitals, and physicians' offices. Additionally, Planned Parenthood provides an online service that makes it easy to book an appointment with one of their clinics or affiliates by simply entering in your zip code on their website or calling 1-800-230-7526.
Searching for adequate information about your reproductive health and medical choices can be daunting, especially in this complicated political climate. Vigilance is, for better or worse, a necessary part of obtaining abortion care. But it's not impossible to find a provider that will present scientific, fact-based, unbiased information so you can make the best possible decision for your body, your family, and your future. Do your research, reach out to trusted, affiliated providers, and trust your instincts.
Have questions about abortion? You can email them safely and anonymously to Abortion AMA at email@example.com, and we'll answer them. Together.