Researchers expose practices of crisis pregnancy centers across the U.S.
A new study from scientists at the University of California San Diego introduces a powerful new approach to understanding the operation of crisis pregnancy centers, non-profit organizations dedicated to an anti-abortion agenda. The study published in JAMA Internal Medicine provides the first account of the practices of crisis pregnancy centers (CPC) operating in the United States.
“While our study shows crisis pregnancy centers provide valuable community services, like parenting classes, there is a clear need for consumer safety measures to prevent the promotion and use of their questionable medical services,” said John W. Ayers, Ph.D., who is deputy director of informatics at the UC San Diego Altman Clinical and Translational Research Institute, in addition to scientist at UC San Diego’s Qualcomm Institute, co-creator of ChoiceWatch.org and study coauthor.
ChoiceWatch.org: A new window into crisis pregnancy center operations
The study utilized ChoiceWatch.org, an innovative analysis engine that archived and analyzed more than 470,000 webpages from 1,825 crisis pregnancy center websites between September 2023 and March 2024.
Crisis pregnancy centers have largely avoided scrutiny. For example, there are no databases of CPCs or reporting of CPC practices collected by government health agencies.”
Karan Desai, medical student at University of Michigan Ann Arbor Medical School, co-creator of ChoiceWatch, and study’s first author
“By maintaining this public database, we’re creating transparency around CPC practices and providing evidence that can inform both healthcare providers and policymakers,” noted Mark Dredze, Ph.D., the John C Malone Professor of Computer Science at Johns Hopkins University, study co-author and co-creator of ChoiceWatch.org. “This transparency is essential for ensuring public health.”
To demonstrate how these data can be used, the research team selected a subset of 1,825 CPC websites archived between September 2, 2023, and March 14, 2024, and used the content of these pages to describe where they operate and what services they advertised.
Crisis pregnancy centers: A national presence
The research revealed a nationwide network of crisis pregnancy centers, with Texas leading with 143 locations, followed by California (126) and Florida (98). When adjusted for population, Montana and Wyoming showed the highest concentration, with 7.45 and 6.48 crisis pregnancy centers per 100,000 women of reproductive age, respectively. Utah, Hawaii and Washington D.C., had the lowest concentrations.
“While some might assume crisis pregnancy centers operate primarily in states with restrictive abortion policies, our data shows they maintain a strong presence across all 50 states,” said Hollie Keene, a student research fellow at the Qualcomm Institute at UC San Diego and study coauthor, noting that progressive states have similar numbers of crisis pregnancy centers as states that heavily restrict abortion.
The team found that 90% of crisis pregnancy center websites advertised social services, including adoption (83%), parenting (62%), post-abortion social support (39%) and men’s social support (14%).
The team also found that 91% of CPCs advertised medical services, including pregnancy tests (85%), ultrasounds (77%), STI testing (54%) and abortion education (52%). Most concerning, 30% of CPC websites promoted “abortion pill reversal,” with some centers directly targeting women who might regret starting a medication abortion.
“CPCs are offering an unproven and potentially dangerous intervention in the form of abortion pill reversal treatments,” added Davey Smith, M.D., professor at the UC San Diego School of Medicine, director of the Altman Clinical and Translational Research Institute at UC San Diego and study co-author. “This treatment lacks FDA approval, but, more worryingly, could increase the risk of serious complications like sepsis, especially in cases where it interferes with the completion of a medication abortion.”
A call for crisis pregnancy center regulation
In discussing their findings, the authors suggest the need for greater scrutiny of crisis pregnancy centers to inform regulation that ensures their services conform with medical best practices.
“Healthcare providers should proactively address misinformation about abortion pill reversal during medication abortion counseling,” said Smith. “Patients should understand that ‘reversal’ treatments are neither proven nor recommended, and, if complications or concerns arise, they should return to their healthcare team, not a crisis pregnancy center.”
“Even benign services, such as STI testing, should be provided within a healthcare ecosystem that prioritizes safety and meets regulatory approvals,” said Desai. “It is unclear if trained professionals are providing these medical services, if the diagnostics or treatments meet acceptable standards, or what safety protocols are in place.”
ChoiceWatch.org will continue to archive and analyze crisis pregnancy center websites, allowing researchers and policymakers to track crisis pregnancy centers over time, monitor how policies impact crisis pregnancy center practices, evaluate compliance with regulations and identify emerging trends in CPC marketing strategies.
Desai, K. S., et al. (2024). Characterizing Services Advertised on Crisis Pregnancy Center Websites. JAMA Internal Medicine. doi.org/10.1001/jamainternmed.2024.6440.
