Pregnancy centers in the United States, which discourage women from getting abortions, have begun adding more medical services — and could be poised for further expansion.
The expansion — from testing and treating sexually transmitted diseases to providing primary medical care — has been unfolding for years. It gained momentum after the abolition of the Supreme Court Roe v. Wade three years ago, This paves the way for states to ban abortion.
This push could get more momentum with Planned Parenthood Some clinics closed And thinking about closing others after changes to Medicaid. Planned Parenthood is not only the nation’s largest abortion provider, but also offers cancer screenings, testing and treatment for sexually transmitted diseases, and other reproductive health services.
“We ultimately want to replace Planned Parenthood with the services we provide,” said Heather Lawless, founder and director of the Reliance Center in Lewiston, Idaho. About 40% of patients at the anti-abortion center are there for reasons unrelated to pregnancy, including some patients who use the nurse practitioner as their primary caregiver, she said.
These changes have frustrated abortion rights groups, which in addition oppose the centers’ plans. anti abortion messages, They say they lack accountability; Refusal to provide contraception; Most offer only limited ultrasounds that cannot be used to diagnose fetal abnormalities because the people who do them do not have this training. It also offers an increasing number Not installed Reversal treatments for abortion pills.
Because most centers do not accept insurance, the federal law restricting the disclosure of medical information does not apply to them, although some say they follow it anyway. They also do not have to follow standards required by Medicaid or private insurance companies, although those who provide certain services generally must have medical directors who comply with state licensing requirements.
“There are really fundamental questions about whether this industry has the clinical infrastructure to provide the medical services that it currently advertises,” said Jennifer McKenna, a senior adviser at Reproductive Health and Freedom Watch, a project funded by liberal political organizations that researches pregnancy centers.
These privately funded, religiously affiliated centers, known as “crisis pregnancy centers,” may have been expanding services like diaper banks before the 2022 Supreme Court ruling in Dobbs v. Women’s Health of Jackson.
As the abortion ban began, the centers expanded medical, educational and other programs, said Moira Goll, a researcher at the Charlotte Lozier Institute, the research arm of SBA Pro-Life America. “They are prepared to serve their communities for the long term,” she said in a statement.
In Sacramento, Calif., for example, the Surrogate Pregnancy Center in the past two years has added family medicine physicians, 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 United States — is the sole health provider for some patients.
When the Associated Press asked to interview a patient who received only non-pregnancy services, the clinic introduced 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.
For the past two years, she has received all her medical care at Alternatives, which has an obstetrician-gynecologist who specializes in hormone therapy. Few, if any, pregnancy centers advertise that they offer help with the detransition process. Heidi Matzke, the center’s director, said Alternatives has treated four similar patients over the past year, although that is not its main mission.
“APC has provided me with a space that aligns with my beliefs as well as my vision as a woman,” Rose said. Other clinics “were trying to make me think the transfer wasn’t what I wanted to do,” she said.
As of 2024, there were more than 2,600 anti-abortion pregnancy centers operating in the United States, 87 more than in 2023, according to the Crisis Pregnancy Center Map, a project led by University of Georgia public health researchers interested in aspects of the centers. According to the Guttmacher Institute, 765 clinics provided abortions last year, down more than 40 from 2023.
Over the years, pregnancy centers have received increased taxpayer dollars. Nearly 20 states, largely led by Republicans, now funnel millions of public dollars to these organizations. Texas alone sent $70 million to pregnancy centers this fiscal year, while Florida allocated more than $29 million to the Pregnancy Support Services Program.
This increase in resources is evident, as Republicans have done Preventing family planning Of receiving Medicaid funds under Tax and spending law President Donald Trump signed in July. While federal law already prohibits the use of taxpayer funds for most abortions, Medicaid reimbursements for other health services have been a large part of Family planning revenues.
Planned Parenthood said its affiliates may have to close up to 200 clinics.
Some have already been closed or reorganized. They have Abortion cut in Wisconsin It eliminated Medicaid services in Arizona. An independent group of clinics in Maine I stopped primary care For the same reason. Uncertainty is exacerbated by Pending Medicaid changes It is expected to lead to more uninsured Americans.
Some abortion rights advocates worry that it will mean more health care situations where pregnancy centers are the only option for more women.
Caitlin Joshua, founder of the abortion rights group Abortion for America, lives in Louisiana, where Planned Parenthood closed its clinics in September.
She is concerned that women seeking health services at pregnancy centers as a result of these closures will not get what they need. “These centers need to be regulated,” she said. “They need to provide accurate information, rather than just getting a speech that they didn’t ask for.”
The centers are subject to government oversight through their medical directors, said Thomas Glessner, founder and president of the National Institute for Family and Life Advocates, a network of 1,800 centers. “Their criticism comes from a political agenda,” he said.
In recent years, five Democratic state attorneys general have issued warnings that the centers, which advertise to people seeking abortions, do not provide them or refer patients to clinics that do. And the Supreme Court He agreed to look into it Whether the state’s investigation into an organization running centers in New Jersey stifles free speech.
Medical Services in Joplin, Missouri, where it closed its Planned Parenthood clinic last year, moved from focusing solely on discouraging abortion to a broader sexual health mission about 20 years ago when it began offering STD treatment, said its executive director, Carolyn Schrage.
The center, funded by donors, works with law enforcement in places where authorities may find pregnant adults, according to Arkansas State Police and Schrage.
She estimates that more than two-thirds of her work is not pregnancy-related.
Hayley Kelly first met Choices volunteers in 2019 at a regular weekly dinner they brought for dancers at the strip club where she worked. Over the years, I’ve gone to a center for STD testing. Then in 2023, when she was uninsured and struggling with drugs, she wanted to confirm the pregnancy.
She expected the staff wouldn’t like her tendency toward abortion, but she says they just answered questions. She ended up having this child, and then another.
“It’s a great place,” Kelly said. “I tell everyone I know, ‘You can go there.’”
The center, like others, does not provide contraception — standard offerings at sexual health clinics that experts say are public health best practices.
“Our focus is on eliminating sexual risks, not just reducing them,” Schrage said.