United States (JR) – Crisis pregnancy centers (CPCs) are pro-life organizations that often offer women incorrect, incomplete or misleading information about their reproductive options.
In response, some localities have passed legislation requiring CPCs to make disclosures to their clients. California, for example, passed the Reproductive FACT Act in 2015. Under this law, CPCs must notify clients of public resources available to prevent or terminate pregnancies. It also mandates that CPCs inform their patients if they are not licensed as a medical facility.
Anti-choice advocates have taken issue with these requirements. The National Institute of Family and Life Advocates has sued California’s attorney general on behalf of CPCs. In November 2017, the U.S. Supreme Court decided it would hear the case.
Two law review articles provide context. While papers published in law journals often promote a particular interpretation of the law, these sources offer background on CPCs and relevant legal precedent. A 2016 article in the American Journal of Law & Medicine looks specifically at the First Amendment and reproductive freedom. An article published in 2017 in the Northwestern Journal of Law & Social Policy, “Have Crisis Pregnancy Centers Finally Met Their Match: California’s Reproductive FACT Act,” suggests the California law will be held constitutional and represents a first step to regulating CPCs.
The upcoming Supreme Court case, National Institute of Family and Life Advocates v. Becerra, No. 16-1140, will evaluate whether requiring CPCs to disclose information that counters their beliefs is a violation of First Amendment rights to free speech.
But what, exactly, do these centers believe, and what information do they promote?
A number of academics have explored this topic, scouring the websites of CPCs. A 2016 paper published in the Journal of Pediatric and Adolescent Gynecology found that nearly half of the 85 websites surveyed promoted abstinence-only sexual education. Over 60 percent of these websites provided negative facts about condoms, including minimizing their efficacy and suggesting they break often, and less than 10 percent encouraged the use of condoms to prevent sexually transmitted infections.
A larger examination of 254 CPC websites, published in Contraception in 2014, found that 80 percent provided at least one item of false or misleading information — most commonly, claiming links between abortion and mental health concerns.
A study published in 2017 in Women’s Health Issues focused on the websites of crisis pregnancy centers in Georgia. It reviewed all of the accessible websites of the CPCs in the state and found that more than half had “false or misleading statements regarding the need to make a decision about abortion or links between abortion and mental health problems or breast cancer.” Eighty-nine percent of sites did not indicate that their centers do not offer contraceptives or direct patients to resources where they might find them.
Researchers from the University of North Carolina who visited 19 CPCs in the state from March to June of 2011 found that nearly half “provide counseling on abortion and its risks,” and over half provided at least one piece of information that was misleading or false, ranging from the efficacy of condoms to links between abortion and infertility, breast cancer and mental health problems.
In fact, research on the associations between abortion and mental health indicates that women who are denied abortions might have a higher risk of adverse psychological outcomes in the short term compared with women who received abortions. A 2017 study in JAMA Psychiatry found that eight days after seeking an abortion, women who were denied one reported more anxiety symptoms, lower self esteem and similar levels of depression as women who received abortions. In the longer term — 4 to 5 years after the abortion — women who terminated pregnancies were not at a higher risk of post-traumatic stress disorder, depression, or anxiety than those denied abortions.
Though research from the 1990s suggested a link between abortion and increased risk of breast cancer, these studies have come under scrutiny. More recent research indicates that abortions do not cause an increased risk of breast cancer.
While CPCs tend to provide inaccurate information about abortion, a study published in 2016 in Contraception suggests that many who visit these centers in-person are not seeking pregnancy counseling. The researchers looked at the reasons why 273 first-time clients went to a secular pregnancy resource center in Indiana and found that only 6 percent discussed pregnancy options during their visit. Most said they went to the center for parenting-related support, including free diapers and baby clothes.
For those seeking information about pregnancy options, even disclosure requirements like California’s disputed Reproductive FACT Act have their limits. Research suggests that publicly funded family planning clinics do not always offer women the full range of reproductive health care options.
A study published in Perspectives on Sexual and Reproductive Health in 2016 looked at survey data from 567 publicly funded family planning facilities across the country and found that a smaller proportion made abortion referrals compared to adoption referrals (84 percent versus 97 percent). Moreover, they found issues relating to access — less than 3 percent of rural facilities had a first-trimester abortion provider located within 20 miles.
Limited access and barriers to abortion care have consequences. A study published in 2017 in Perspectives on Sexual and Reproductive Health found that most women who had to travel across state lines or over 100 miles within their state to receive an abortion reported “delays in care, negative mental health impacts and consider[ed] self-induction.”