AUSTIN, TEXAS — Savanah Low — a staunch pro-choice advocate who works with Jane’s Due Process, volunteers at Planned Parenthood, and protested at the Texas state legislature last session in a Handmaid’s Tale red robe and white bonnet — once accidentally volunteered at a “crisis pregnancy center.”
The True Options Pregnancy Center, a business in Sherman, Texas where Low volunteered years ago, presents as a family planning clinic, but has no obstetrician or gynecologist on site. On its website, the center says it offers abortion information, but it doesn’t actually refer anyone to abortion if they come in and ask about it.
Even when people don’t want an abortion, the clinic isn’t very helpful. “Women come in asking to use [the ultrasound machine] to see if their baby is healthy and find out the sex. She turns them down because the only purpose of that ultrasound machine is to convince people not to have an abortion. They provide no medical service,” Low said. True Options staff told ThinkProgress that their nurses aren’t trained to determine a baby’s sex, and are only able to identify if a person is pregnant.
Low isn’t the only one who has been misled. It’s easy to get tripped up, as these anti-choice centers masquerade as family planning clinics that offer comprehensive medical services and advice. They do not inform visitors upfront that their clinics don’t provide abortions. And the result could be hours of wasted time for pregnant people seeking abortions — at perhaps the most time-sensitive moment in their lives. The later an abortion is obtained, the more risky and expensive it becomes.
“They would shut themselves down if they actually give information to people. That would change the whole game.”
These types of clinics are everywhere, and advertisements for them are riddled along highways across the country. These centers try to intercept people who might be considering abortion and persuade them that adoption or parenting is a better option. And in Texas, the clinics take advantage of restrictive laws — such as mandatory ultrasounds — and the abortion provider shortage, which makes access especially difficult for low-income people and people of color already. This is intentional. Lawmakers have siphoned public funds from family planning providers like Planned Parenthood to dozens of these crisis pregnancy centers because abortion — although legal — is taboo in conservative circles.
There are roughly 2,500 of these clinics nationwide. By comparison, there are only about 1,800 abortion clinics. Some crisis pregnancy centers are exempt from regulatory or credentialing oversight that apply to other health care facilities because they just provide non-medical services like self-administered pregnancy tests or parenting training. Oversight is virtually nonexistent — especially compared to abortion clinics, where regulations are so unnecessarily onerous that sites have been forced to closed down. This is especially concerning because pregnant people go to these centers seeking out medical advice.
People in rural pockets like Kerrville are especially “screwed over” by these centers, said Marcia Fox of the Bridge Collective, an Austin-based practical support group that offers, for example, to drive people — many who are low-income and people of color — to their abortion appointments. She says half the people who call the Bridge Collective hotline struggle to find an abortion clinic at first and often run into crisis pregnancy centers. Roughly 20 people called the hotline last month.
“If [crisis pregnancy centers] had to say [they] don’t provide abortions… that would save a lot of women a lot of time,” said Fox. In Texas — where abortion is illegal after 20 weeks or more postfertilization — time is especially critical. “They would shut themselves down if they actually give information to people. That would change the whole game.”
A 2015 California law requires clinics to tell clients exactly what kind of care they’re in for at any given reproductive health center. That law is currently being challenged by a group representing crisis pregnancy centers, with Supreme Court oral arguments beginning Tuesday. It requires all family planning centers with a licensed doctor to tell patients what services are available statewide, like contraception or abortion, and a phone number for further information. And unlicensed clinics need to disclose the following on site or in their advertisements: “This facility is not licensed as a medical facility by the State of California and has no licensed medical provider who provides or directly supervises the provision of services.” The Supreme Court will decide whether this law is constitutional no later than this summer.
“[P]eople are entering these fake centers… thinking that they’re actually going into an abortion clinic or a women’s health center.”
Many in Texas will be monitoring this Supreme Court hearing, as local lawmakers have tried to pass similar laws. In 2012, the Austin city council passed an ordinance requiring clinics to disclose whether they were licensed medical centers. But a federal judge struck it down in 2014 on the grounds that the ordinance was unconstitutionally vague and violated crisis pregnancy centers’ due process. Former Council Member Bill Spelman (D), who introduced the ordinance, told ThinkProgress he could imagine the Supreme Court writing its decision in such a way where the ordinance becomes enforceable — as it was never repealed but deemed unenforceable.
“We are not compelling — that’s a sticking point for [crisis pregnancy centers] — clinics to list places where abortion is offered,” Spelman said in reference to the argument that California law requires crisis pregnancy centers to connect pregnant people with abortion providers. “All we are saying is say if you have a doctor on the other side of the door.” He could foresee the Supreme Court upholding this portion of California’s law. If the Supreme Court does, Austin’s law could be enforceable and other Texas cities may pass similar ordinances, as many expressed interest years prior, he said.
California’s case is likely to have national ramifications for crisis pregnancy centers, particularly in states like Texas where courts invalidated similar laws, but in the meantime, the clinics continue deceiving patients. In Texas, NARAL Pro-Choice Texas has identified at least 200 crisis pregnancy centers, which the organization defines as clinics that say they offer abortion counseling but instead try to dissuade people from terminating their pregnancy. NARAL has been researching crisis pregnancy centers for years but wasn’t able to give ThinkProgress a precise count at this time perhaps because the centers are difficult to spot and often masquerade as abortion clinics. Texans have far fewer abortion provider options; there are only 22 abortion clinics statewide and most are along the Interstate 35 corridor, leaving coverage gaps in West and South Texas.
“Because of the large knowledge gap around abortion care in Texas with the many restrictions that have been passed over the last decade or more, people are entering these fake centers — fake women’s health centers — thinking that they’re actually going into an abortion clinic or a women’s health center and they’re getting, you know, lies and fake medicine instead of actual health care,” said Emily Martin, program director at NARAL Pro-Choice Texas.
Of the more than 200 crisis pregnancy centers, dozens are funded by taxpayer dollars. Federal welfare dollars fund “Alternatives to Abortion,” a Texas program — with a total operating budget of more than $38 million — designed for low-income pregnant people. Lawmakers also voted last legislative session to move millions from a clean air program to these clinics. The state health department contracts with “Texas Pregnancy Care Network” and this group subcontracts with 51 crisis pregnancy centers. A Rewire analysis of Alternatives to Abortion in 2016 discovered that Texas doesn’t actually measure the program’s success based on health indicators, and that most taxpayer funds went to “counseling” — a term the state doesn’t define — and $739,000 went to advertisements.
Pro-choice advocates have long been critical of the program’s lack of government oversight, and state Democratic lawmakers tried but failed to defund the program last session, just as state Republican lawmakers successfully blocked some public funds to organizations associated with abortion. A legislative staffer for a Democratic lawmaker told ThinkProgress her office has repeatedly asked Texas Health & Human Services Commission (HHSC) for information, like if each clinic is a medically licensed facility or has at least one licensed physician on site, but the inquiries have gone unanswered.
“That’s a big pot of money that those folks are getting,” the staffer said. “My office — my boss — has opinions on those particular clinics and would love to be proved wrong.”
When ThinkProgress reached out to HHSC inquiring about government oversight, a press officer said, “HHSC reviews TPCN’s performance and conducts inspections as necessary.” When asked in a follow-up email if all 51 pregnancy centers are medically-licensed clinics, the press officer said, “The sites are not medical clinics.”
Misinformation about abortion is everywhere, and crisis pregnancy centers further complicate this. Texas state laws already exaggerate the risk of abortion. Doctors have to tell patients about misleading risks associated with abortion during state-mandated counseling, even though abortion is a safe procedure. In fact, it’s medically safer than getting your wisdom teeth removed or childbirth.
“It’s kind of crazy that abortion providers are forced to tell their patients things about potential risks of the procedure … that are untrue. Yet the crisis pregnancy centers don’t even have to tell women that there aren’t medical professionals in the provision of services,” said Dr. Daniel Grossman, director of Advancing New Standards in Reproductive Health.
Even before people enter the clinic for an abortion, they have to find ways to pay for the procedure that costs upwards of $550 ( Texas has one of the most restrictive insurance laws), set time aside for it (Texas also requires a minimum of two appointments with 24-hours in between), and now — with the growing number of crisis pregnancy centers — find a clinic that will actually facilitate this care.