Traducido en español por El Planeta Media.
Little-known nonprofit organizations called "crisis pregnancy centers" are finding themselves in the spotlight in the renewed fight over abortion rights.
The centers, many of which advertise "free pregnancy services," offer pregnancy testing and ultrasounds with no health insurance required. They do not offer abortion services and are supported by anti-abortion rights groups.
Critics accuse them of hiding an anti-abortion agenda, providing inaccurate information and working to lure pregnant people to their facilities, so they can encourage them not to terminate pregnancies.
Since the U.S. Supreme Court overturned the constitutional right to an abortion in June, the work of these centers has become the subject of national, state and local debate.
Massachusetts Sen. Elizabeth Warren testified in the U.S. Senate this month about legislation she co-sponsored that seeks to prohibit the centers from using deceptive or misleading advertising. Warren said crisis pregnancy centers, or CPCs, claim to provide reproductive health care, but their goal is to prevent abortions.
"CPCs often lure women seeking legitimate reproductive care, including abortions, into their facilities by advertising themselves as comprehensive health care providers, but this is flatly untrue," Warren said.
Warren cited a study that shows there are about 30 such centers in Massachusetts and thousands across the nation. She pointed to another study that found three quarters of the centers do not have a registered nurse, and 84% do not have a physician on staff.
Leaders and staff at some of the centers defend their work, and say they've been mischaracterized by abortion rights advocates and politicians.
"One of things that was really disturbing about what Sen. Warren said is that she said, 'pregnancy centers deceive,' " said Teresa Larkin, executive director of Your Options Medical in Revere. "Maybe there are some centers that do that, but it was a blanket statement that looped all of us into this pot that nobody wanted to be in. We didn't pick this battle, and we want people to know the truth."
Several crisis pregnancy centers declined to speak with WBUR, but Larkin says she wants to address the criticisms.
Larkin says Your Options is different from other crisis pregnancy centers in that it is licensed as a clinic by the Massachusetts Department of Public Health. She says there are medical professionals on staff, and clients' medical information is kept private. She says both her center's website and its client forms indicate that Your Options does not provide abortions and does not refer clients to abortion clinics.
Although Your Options calls itself a Christian ministry in documents filed with the state, Larkin says the center's main objective is to help people with unplanned pregnancies.
"I can't speak to what [other centers] do," Larkin said. "I can only say what we do and that is help women."
The small waiting room at Your Options is decorated with a sofa and two upholstered chairs. It's where clients fill out a short form with basic contact information.
"We have neutral decor, we don't have baby pictures up, we don't have religious things all around," Larkin said. "It's meant to be calming, safe."
Clients are brought into a smaller counseling room to meet with the center's patient advocate. Larkin says they are asked questions about their pregnancy status and plans.
"We ask if they know if they're pregnant, if they've made a decision yet, what are some of the stressors they're looking at, and what they're considering," Larkin said. "It's pretty brief, maybe five minutes and then she would bring them back to meet with the nurse."
The nurse sees clients in a medical exam room with an ultrasound machine. Nancy, who didn't want her last name used because of threats against the center, said she is a registered nurse who is certified to do ultrasounds. She conducts tests to confirm a pregnancy and does an ultrasound to determine how far along the pregnancy is. She says about 60% of those who come to Your Options tell her they plan to continue their pregnancies.
"I say, 'OK, if that's the case, do you need vitamins, do you need resources, what is it that you would like from us?' " Nancy said. She added that the center may provide information about housing resources, food stamps or adoption.
"I can't speak to what [other centers] do. I can only say what we do and that is help women."Teresa Larkin, Your Options Medical
If a client wants information about abortion, Nancy says she may discuss whether a medication abortion is an option.
"Maybe you are 13 weeks, so you are not able to do the pill. Here in Massachusetts the pill you can take up to 11 weeks," Nancy explained. "So I just give her that kind of medical piece of information and then I tell her what kind of abortion she would have."
Nancy says she may explain how a medication abortion works or walk the client through the process of a surgical abortion. She says she does not exaggerate the risks of an abortion or encourage one pregnancy option over another, as critics have claimed.
An information sheet the center gives clients describes a medication abortion, which is estimated to be used in more than half of all abortions nationally. The sheet refers clients to a website about the medication risks and describes the procedure as "causing the fetus to die."
Many medical experts call this language "loaded" and misleading. Dr. Tara Kumaraswami, assistant professor of obstetrics and gynecology at UMass Chan Medical School, reviewed the Your Options abortion information sheet and said it is "not entirely accurate."
"This is a sprinkling of facts with misinformation," Kumaraswami said.
Larkin maintains that Your Options does not try to force anyone's decision, but she does acknowledge she has a viewpoint.
"We can't influence someone in such a way. We see them for one hour — and none of us has that power," Larkin said. "But individually? Yes, we've seen so many ultrasounds that it's very difficult to argue with the fact that that is life, a separate life. You can't see that baby on a screen and deny its personhood."
Abortion rights advocates argue centers like Your Options should not be allowed to advertise as clinics. They accuse the centers of providing an incomplete picture of reproductive health options and misleading women about how far along they are in their pregnancies. They say Your Options uses inflammatory language to describe abortion, which creates fear among people who are already vulnerable.
When people go to a crisis pregnancy center, abortion rights advocates point out, it can delay their decision to seek an abortion, which can lead to riskier and more expensive procedures.
Leaders at the group Reproductive Equity Now say the abortion information Your Options provides to clients overstates the risks of an abortion and is not objective health care advice.
"When someone is facing an unintended pregnancy, they deserve the facts. And you simply can't get that at a crisis pregnancy center," said Rebecca Hart Holder, the executive director of the group. "The goal of a crisis pregnancy center is to prevent you from deciding that abortion care is the right option for you."
"When someone is facing an unintended pregnancy, they deserve the facts. And you simply can't get that at a crisis pregnancy center."Rebecca Hart Holder, Reproductive Equity Now
Larkin points out that her center has been licensed as a clinic by the state Department of Public Health since 1999. The license is reviewed every two years. A DPH spokesperson said the state does not track how many crisis pregnancy centers are licensed, and has not received any complaints against Your Options.
The center's budget is "less than one million dollars," Larkin says, almost all of it from private donations. Financial documents indicate Your Options has 14 employees and most work part-time. Larkin says Your Options serves about 300 people a year at its four Massachusetts locations.
Since the Supreme Court ruling overturning Roe v. Wade, the impact on Your Options has been mixed, Larkin says. She has seen a slight increase in donations. At the same time, Larkin has installed security cameras because of vandalism, protests and threats.
"We've had to meet with the police. We're on a first name basis with two FBI agents that are checking in with us weekly," Larkin said. "So the FBI is really, you know, concerned."
About a half dozen Massachusetts communities are considering ordinances to regulate crisis pregnancy centers. During a Worcester city council meeting last month, Marcy Ostrow, with the Jane Fund of Central Massachusetts, an abortion rights group, called the centers "fake health clinics" and said they should have more oversight.
"It is time to reveal their true intent, which is to restrict reproductive options through misinformation and deception," Ostrow testified during the meeting.
The ongoing debate over the centers prompted state Attorney General Maura Healey to issue an advisory warning about crisis pregnancy centers. Healey's office says it has received four complaints since 2014, involving two crisis pregnancy centers. Your Options was not among them.
One complaint accused a center of harassing clients: "This website offers abortion and when you get there to the facility they harass and intimidate you," the complaint said. "There is a bait and switch happening here. It is deceiving to people when they are desperate."
Some legal experts believe state attorneys general could play key roles in future court battles over crisis pregnancy centers. Boston University Health Law Professor Emerita Wendy Mariner says because the U.S. Supreme Court ruled in 2018 that the centers are protected on free speech grounds, consumer actions may become the next avenue for critics to challenge the centers and seek monetary compensation for their clients.
"If attorneys general crack down on these organizations under the consumer protection laws, they could get triple damages," Mariner said. "You get hit with a lot of damages, that's one way to stop bad actors."
Mariner expects the fight over crisis pregnancy centers will continue as more people in states where abortion is restricted look for abortion services in states like Massachusetts where it remains legal.
This segment aired on August 18, 2022.