Comparing Website Identification for Crisis Pregnancy Centers and Abortion Clinics

"It Wasn't Very Public-Clinicy": Client Experiences at Faith-Based Pregnancy Centers

Faith-based pregnancy centers strive to offer "alternatives to abortion" that supporters claim aid women and critics assert manipulate pregnant people, stigmatize abortion, and potentially delay clients from obtaining medical care. However, scholars know little about the exchanges within appointments and how clients make sense of these experiences. Drawing on ethnographic observations of client appointments in two pregnancy centers in the West and 29 in-depth interviews with clients, this article uses an intersectional framework to analyze client experiences. Clients favorably compared centers to clinical health care providers, emphasizing the unexpectedly attentive emotional care they received. These evaluations stem from clients' reproductive histories, which are shaped by gender, racism, and economic inequalities that configure their access to and interactions within the health system. Emotional care serves to create and maintain pregnancy centers' impression of legitimacy among clients.

Early pregnancy confirmation availability at crisis pregnancy centers and abortion facilities in the United States

OBJECTIVES

Crisis pregnancy centers (CPCs) seek to dissuade people from having abortions. Twenty-five states have policies supporting CPCs. We aimed: (1) to characterize access to early pregnancy confirmation at CPCs compared to abortion facilities nationwide and (2) to understand the role of state CPC policy in service access.

STUDY DESIGN

We conducted a national mystery caller study of 445 CPCs and geographically paired abortion facilities, posing as patients seeking pregnancy confirmation. Facility type (CPC vs abortion facility) was the primary exposure in Aim 1. Wait time to first available early pregnancy appointment was the primary outcome. In Aim 2, state-level CPC policy designation (supportive vs not supportive of CPCs) was the primary exposure. Difference in wait time ≥7 days to first available appointment between CPCs and paired abortion facilities was the primary outcome.

RESULTS

CPCs were more likely than abortion facilities to provide same-day appointments (68.5% vs 37.2%, p < 0.0001), and free pregnancy testing (98.0% vs 16.6%, p < 0.0001). The median wait to first available appointment at a CPC was 0 days (IQR 0,1), compared to 1 day at abortion facilities (IQR 0, 5), p < 0.0001. In states with supportive CPC policy environments, abortion facilities were less likely to have wait times exceeding their paired CPC by a week or more, compared to paired facilities in states with non-supportive CPC policy environments (p = 0.033). This remained true after adjusting for state abortion policy environment (p = 0.011).

CONCLUSIONS

Pregnancy confirmation is more accessible at CPCs compared to abortion facilities. Factors other than state-level CPC policies likely influence service accessibility. There is a need for improved access to pregnancy confirmation in medical settings.

IMPLICATIONS

Our findings demonstrating that pregnancy confirmation is more accessible at crisis pregnancy centers than at abortion facilities are predicted to be exacerbated in the wake of abortion clinic closures following the Dobbs v Jackson Women's Health Organization Supreme Court decision. This highlights the need for improved funding and support for pregnancy confirmation service delivery in medical settings, including abortion facilities.

Pregnancy options counseling

PURPOSE OF REVIEW

This article reviews key aspects of pregnancy options counseling, and highlights how inappropriate counseling can create barriers to timely and safe abortion care.

RECENT FINDINGS

Access to safe abortion services in the United States is increasingly constrained. One way to combat this hostile environment is to ensure that individuals presenting for care early in pregnancy have access to comprehensive and unbiased pregnancy options counseling. There are unfortunately many barriers to individuals receiving adequate pregnancy options counseling, and marginalized groups experience disproportionate effects of inappropriate counseling. Research shows that individuals desire appropriate pregnancy options counseling when seeking early pregnancy care, and that providers often serve as a barrier to this care. Provider miseducation and opposition to pregnancy options counseling, particularly as it concerns abortion care, creates challenges and delays for people seeking abortion services. Crisis Pregnancy Centers use misinformation to further these barriers to appropriate care.

SUMMARY

Nondirective and patient-centered pregnancy options counseling is standard of care. People seeking pregnancy options counseling desire and deserve comprehensive and accurate information. Providers must not serve as barriers to safe and appropriate care. Increasing nondirective pregnancy options counseling research, education, and training is crucial to ensuring access to safe and appropriate abortion care.

The Problems with Crisis Pregnancy Centers: Reviewing the Literature and Identifying New Directions for Future Research

Crisis pregnancy centers (CPCs) are nonprofit organizations that present themselves as healthcare clinics while providing counseling explicitly intended to discourage and limit access to abortion. These facilities engage in purposefully manipulative and deceptive practices that spread misinformation on sexual health and abortion. CPCs have also been shown to delay access to medically legitimate prenatal and abortion care, which negatively impacts maternal health. Along with increasing anti-abortion legislation, the proliferation of CPCs paired with the closure of abortion clinics exacerbates the ongoing harmful impact these centers have on the reproductive healthcare landscape; however, despite their growing influence, there is still limited research on patients’ understanding of and experiences with CPCs. This article provides a review of academic literature on CPCs and suggests future directions for research. Ongoing scholarship may aid in improving patient awareness and education regarding CPCs, an important step toward protecting reproductive autonomy.