In brief
In the wake of the Supreme Court's decision to overturn Roe v. Wade, pregnancy centers in the U.S. are expanding their range of services, from STI testing to primary medical care. As Planned Parenthood considers closing clinics due to funding constraints, these centers aim to fill gaps in healthcare access, despite criticism regarding their methods and accountability. With increasing government support, the landscape of reproductive health is evolving as pregnancy centers position themselves as key providers in a changing environment.
Pregnancy centers in the U.S. that discourage women from getting abortions have been adding more medical services — and could be poised to expand further.
The expansion — ranging from testing and treatment for sexually transmitted infections to even providing primary medical care — has been unfolding for years. It gained steam after the Supreme Court overturned Roe v. Wade three years ago, clearing the way for states to ban abortion.
The push could get more momentum with Planned Parenthood closing some clinics and considering shuttering others following changes to Medicaid. Planned Parenthood is not just the nation’s largest abortion provider, but also offers cancer screenings, STI testing and treatment, and other reproductive health services.
“We ultimately want to replace Planned Parenthood with the services we offer,” said Heather Lawless, founder and director of Reliance Center in Lewiston, Idaho. She said about 40% of patients at the anti-abortion center are there for reasons unrelated to pregnancy, including some who use the nurse practitioner as a primary caregiver.
The changes have frustrated abortion-rights groups, who, in addition to opposing the centers’ anti-abortion messaging, say they lack accountability; refuse to provide birth control; and most offer only limited ultrasounds that cannot be used for diagnosing fetal anomalies because the people conducting them don’t have that training. A growing number also offer unproven abortion-pill reversal treatments.
Because most of the centers don’t accept insurance, the federal law restricting release of medical information doesn’t apply to them, though some say they follow it anyway. They also don’t have to follow standards required by Medicaid or private insurers, though those offering certain services generally must have medical directors who comply with state licensing requirements.
“There are really bedrock questions,” said Jennifer McKenna, a senior adviser for Reproductive Health and Freedom Watch, a project funded by liberal policy organizations that researches the pregnancy centers, “about whether this industry has the clinical infrastructure to provide the medical services it’s currently advertising.”
Perhaps best known as “crisis pregnancy centers,” these mostly privately funded and religiously affiliated centers were expanding services such as diaper banks ahead of the Supreme Court’s 2022 Dobbs v. Jackson Women’s Health Organization ruling.
As abortion bans kicked in, the centers expanded medical, educational and other programs, said Moira Gaul, a scholar 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, California, for instance, Alternatives Pregnancy Center in the last two years has added family practice doctors, 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 U.S — is some patients’ only health provider.
When The Associated Press asked to interview a patient who had received only non-pregnancy services, the clinic provided 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 last two years, she’s received all medical care at Alternatives, which has an OB-GYN who specializes in hormone therapy. Few, if any, pregnancy centers advertise that they provide help with detransitioning. Alternatives has treated four similar patients over the past year, though that’s not its main mission, director Heidi Matzke said.
“APC provided me a space that aligned with my beliefs as well as seeing me as a woman,” Rose said. She said other clinics “were trying to make me think that detransitioning wasn’t what I wanted to do.”
The center, like others, does not provide contraceptives — standard offerings at sexual health clinics that experts say are best practices for public health.
