The Biden-Harris administration needs to end fake abortion clinics

In the aftermath of the Supreme Court’s decision to overturn Roe v. Wade, President Biden signed an executive order directing federal agencies to consider ways to protect abortion access. Three weeks later, at the first meeting of the new Interagency Task Force on Reproductive Healthcare Access, he announced another executive order aimed at assisting patients who travel out of state to obtain abortions. That same week, Kansas soundly defeated an effort to remove abortion protections from its state constitution.

For those who support access to abortion care, these are positive steps. But they ignore an important threat: the thousands of fake abortion clinics, also known as crisis pregnancy centers (CPCs), that are operating across the country. These centers divert, delay, and deceive people seeking abortion care, exploiting their personal information while accepting millions of dollars in public funding.

Although crisis pregnancy centers have been in operation for decades, they are now a particular threat to the work currently underway to ensure abortion access post-Dobbs.

A comprehensive study by The Alliance: State Advocates for Women’s Rights and Gender Equality, organizations I work with, showed that crisis pregnancy centers are often connected to national or global anti-abortion organizations and many share a playbook: They pretend to be an abortion or women’s health clinic, often establishing themselves right next door to real clinics, and frequently use confusing names. But they do not provide abortion services, or referrals to abortion services, or even accurate information. These fake clinics aim to reach low-income people facing unintended pregnancies by advertising free services. The targeting is particularly troubling as research shows that individuals who are denied abortion care — and their families — experience worse health and socioeconomic outcomes than those who access the care they need.

Although crisis pregnancy centers say they provide medical information, they are not covered by the privacy and security rules of HIPAA. That’s because, despite what they pretend to be, they are not considered to be health care facilities.

In the post-Dobbs era, crisis pregnancy centers — and their websites and hotlines — aim to mislead people trying to find their way to abortion care, particularly those traveling from restrictive states who may make arrangements online or over the phone. For example, as abortion providers are forced to move to less restrictive states like New Mexico, patients from surrounding states will need to travel there; thus CPCs are rapidly expanding their New Mexico presence as well. Most of these fake abortion clinics collect personal and contact information of every caller or online or in-person visitor, information that can be shared with their anti-abortion parent networks and used for surveillance, harassment, and prosecution, including in the would-be patient’s home state.

Workers in these centers tell people seeking abortion that there’s no need to hurry or worry because they have plenty of time and will likely miscarry anyway. They may provide fake or confusing ultrasound results, spout false information about abortion, and provide substandard “care.” Staff with no medical training may offer drugstore pregnancy tests, non-medical ultrasounds, and a fake and dangerous “cure” for medication abortion. They rarely provide prenatal care or even offer referrals for it, delaying what may be critical care if the pregnancy goes to term. They promise to provide baby supplies such as diapers and formula but require clients to attend religious indoctrination videos or classes before they receive even minimal supplies.

And the more states restrict abortion, the more people CPCs will deceive.

In many states, these fake clinics have received public funds diverted from safety-net programs that individuals facing unplanned pregnancies actually need. The fake clinics now claim they will provide maternal health care and parenting support to more people in the post-Dobbs era. National anti-abortion organizations recently approached 22 governors about increasing state funds to crisis pregnancy centers. Such funding is often through the federal Temporary Assistance to Needy Families program.

Here’s what the Biden-Harris administration should do next to counter the impact of crisis pregnancy centers:

Educate the public. Every federal effort to blunt the damage done by the Dobbs decision should explicitly warn people about crisis pregnancy centers. The administration has a powerful tool in the public-facing website reproductiverights.gov. That website should include links to the privately created maps and databases designed to warn consumers about the CPCs in their communities.

State attorneys general in California and Massachusetts already have issued consumer warnings about the limited and misleading nature of the services provided by crisis pregnancy centers; the federal government could and should do the same. If the FBI and the Department of Justice can warn consumers about Covid-19 scams, they and other agencies can do the same for fake health clinics.

Close the CPC loopholes. Federal powers should be deployed to prevent crisis pregnancy centers from impersonating medical providers, deceiving consumers, and using personal information for surveillance, harassment, and prosecution. Fake health clinics should not be able to share and exploit the personal health information of people who contact them. The federal Department of Health and Human Service’s Office of Civil Rights, which enforces the privacy and security provisions of HIPAA, understands why this is essential, having recently issued guidance for consumers on how to protect health information on a cellphone or tablet.

Federal agencies should explore other possible avenues as part of protecting abortion access. For example, recently introduced legislation would direct the Federal Trade Commission to prescribe rules prohibiting disinformation in the advertising of abortion services. Laws on the books protect the personal information of people receiving benefits through public programs: those protections could be strengthened to prevent CPCs from abusing taxpayer funds.

Provide the actual support that CPCs only pretend to deliver. It is not enough for policymakers to simply defend practical access to abortion. As reproductive justice leaders say, every human being deserves “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.” That human right feels increasingly elusive to many Americans. Black, Latinx, and Indigenous people in the U.S. experience disproportionate harms and death related to pregnancy because of societal and health system failures. Crisis pregnancy centers add to both the systemic failures and the harms.

The Biden-Harris administration, through federal agencies and funding mechanisms, must pursue every policy avenue to expand access to genuine reproductive and pregnancy care, as well as parenting support and supplies. At the local level, real reproductive health providers, food pantries, diaper banks, and other community organizations are genuinely committed to helping people make their own reproductive choices. Many already work to provide access to free or low-cost care and baby supplies — delivered without constraints or harassment. Addressing the huge gap between needs and reality in low-income communities is a heavy, long-term lift that must include bold action at the local, state, and national level, such as this proposal from the Biden-Harris administration to address the ongoing maternal health crisis.

CPCs are a direct threat to efforts to protect access to abortion, improve reproductive and maternal health care, and support underserved communities. The Biden-Harris administration should act to help Americans recognize and avoid fake abortion clinics, to close the legal loopholes that protect them from scrutiny and accountability, and to ensure that government funds support needed services, not deceptive practices.

Susannah Baruch is an attorney and consultant who works with reproductive rights, reproductive health, and reproductive justice organizations, including organizations in The Alliance.