Crisis pregnancy centers outnumber abortion clinics in the US.
Doctors warn that CPCs could prevent women from getting the medical care they need.
Insider spoke to one woman who was misled into thinking she was getting an abortion at a CPC.
Estefanía thought she was making an appointment to get an abortion.
Fearing she might be pregnant after a missed period, she typed "abortion pill near me" into Google and went to the first clinic that came up on the web page. When she got to The Keim Center in Virginia Beach, it didn't look or smell like a medical clinic — it was too nice, too inviting.
After speaking with an employee who asked what search phrase she used to find the clinic, she was placed in a consultation room and advised not to use her phone. The room didn't have any medical equipment, not even an ultrasound machine — something she was sure she'd be having.
"It looked like they were sitting me down for tea," said Estefanía, who asked Insider to only be identified by her first name.
Unbeknownst to her, Estefanía had walked into one of the more than 2,500 crisis pregnancy centers, or CPCs, in the US.
Their goal? To deter women who want abortions from obtaining them.
A woman who wasn't a medical professional then entered the room and began asking Estefanía personal questions about her relationship, like whether or not she planned to marry her boyfriend. She then advised Estefanía to make a pros and cons list about having an abortion.
Any time the 26-year-old told the employee her reasoning for not wanting a child, she was met with pushback. Those counter arguments became stronger when Estefanía's boyfriend entered the room.
"She kept referring to it as a baby," she said. "I think at that point it didn't do anything but make me feel a little worse about myself."
After the back-and-forth, a nurse walked in and confirmed Estefanía was pregnant after reviewing her urine sample. It was too early for her to have an ultrasound, the nurse explained to her, and the clinic would not provide an abortion or make referrals.
"I remember immediately being like, what is this then?" she said. "If you're not telling me how to get an abortion, then what am I doing here? What can you give me?"
The history of CPCs — and why they're so widespread in the US
There are more than three CPCs for every abortion clinic in the US. Many of them are supported by national anti-abortion organizations, like CareNet and the National Institute of Family and Life Advocates, that provide CPCs with everything from client materials to legal advice.
Anti-abortion activist Robert Pearson is credited as the reason why CPCs are so widespread. Pearson opened one of the first CPCs in the 1980s and wrote a manual on how pro-life groups could start their own centers.
The manual contains scripted answers to questions like "do you do abortions there?" and arguments to use against women who say "they have the [right] to control their own body."
Pearson also suggested CPCs establish themselves near abortion clinics. Some CPCs in the US will even use nearly identical names and building signs as clinics nearby to create confusion.
Some centers also identify by two names, following Pearson's advice.
The Keim Centers, which Estefanía went to, is run by a nonprofit called the Crisis Pregnancy Center of Tidewater whose website is upfront about the organization's anti-abortion and religious views — unlike the one Estefanía found, which makes no religious references. The Keim Centers did not respond to Insider's request for comment.
To get women to come to a center, Pearson advised placing ads in newspapers for free pregnancy tests that looked exactly like ads for abortion clinics. These days, CPCs use digital ads that show up in searches for things like "abortion pill" or "abortion information" in order to appear like clinics.
Attempts have been made for decades to regulate CPCs' tactics to get women to unwittingly enter their doors.
In 2014, Google began removing deceptive ads under abortion search results and later added labels to centers that did not provide abortions. California tried to get CPCs to disclose whether or not they were medically licensed, but the Supreme Court struck down that law.
Despite these efforts, hundreds of women like Estefanía still find themselves tricked into making appointments at these CPCs.
'Our mission statement: To decrease abortion in our area'
The Pregnancy Resource Center of the Poconos is one of 156 CPCs in the state of Pennsylvania, where crisis centers outnumber clinics 9-to-1. Similar to The Keim Centers, the PRC does not provide abortions or refer patients to abortion providers.
"We want every woman coming in here in that difficult situation to choose life and that is our mission statement: To decrease abortion in our area," Alice Marchesani, the executive director of PRCP, told Insider.
Marchesani said the resource center provides free ultrasounds, free pregnancy tests, and parenting programs where attendees earn points that can then be redeemed at their on-site baby boutique.
In the last year, Marchesani said about 30% of women who visited the center were seeking an abortion. When Insider's Katie Nixdorf asked what the center's intention was for having abortion as one of their SEO words, Marchesani answered that it's imperative for women to know they have other options.
"We're very upfront. We don't feel like that's deceptive at all," said Marchesani.
The executive director reiterated that the center's purpose isn't to deceive women, but instead to offer them alternatives to abortion.
"We don't feel like there's any kind of bait and switch," she said.
In Pennsylvania, abortion is legal up to 24 weeks of pregnancy, and beyond then if the pregnant person's life is at risk. That could change next year as Pennsylvanians prepare to vote on a measure about the state's abortion laws, according to The Philadelphia Inquirer.
Marchesani said if the laws change in Pennsylvania to allow for greater abortion access, it would serve as a sobering wake-up call for pro-life people.
"This is really the biggest civil rights issue since the sixties. We're here to advocate for pre-born children and we need to be bold," Marchesani said.
CPCs create 'barriers' for women seeking abortions
Although the goals of CPCs seem to be supportive, experts say that interacting with CPCs when a person's goal is to get an abortion can prove to be a taxing experience.
Dr. Lisa Perriera, the chief medical director of The Women's Centers, told Insider that CPC staff members often share misleading and non-medically accurate information about abortions to scare women out of abortions.
Many people who work at CPCs do not have medical degrees or experience, she said.
"They don't have the capability to do truly anything medical," Perriera said. "Most of the folks that work in crisis pregnancy centers are people that are on a mission to end abortion."
Estefanía experienced this at her appointment at The Keim Centers, which she said "scared" her. She was given a pamphlet that falsely claimed abortions could cause breast cancer. Her counselor also told her that if she had a medical abortion, she might see little hands or little feet during the process — another false claim, as Estefanía was only 4 weeks pregnant at the time.
Additionally, Perriera said CPCs will try to delay abortions by keeping women at their centers for hours or scheduling follow-up appointments. By the time women manage to make an appointment at a real clinic, the procedure could be more costly or difficult.
"This is a stressful situation people are going through and those centers are creating barriers to them that makes it even more stressful," Perriera said.
Despite not being real medical centers, CPCs receive substantial state and federal funding. Since 2010, nearly half a billion in tax-payer dollars have funded CPCs in 13 states, the Associated Press reported.
Many of the states that receive the most funds for CPCs also have some of the harshest abortion restrictions.
The future of CPCs, and what that means for privacy concerns
In a post-Roe world where abortion rights are not guaranteed for many women, CPCs have regained new attention for the role that they play in the anti-abortion movement.
Researchers from Middlebury College have estimated that the extinction of national abortion rights means the number of people living closer to CPCs than abortion clinics will double, and CPCs will outnumber abortion clinics 1-to-5.
And states that have banned abortions are seeking to expand CPCs. In Texas, plans to build a $10 million mega-crisis pregnancy center are underway.
Tara Murtha, the director of strategic communications at the Women's Law Project in Pennsylvania, said in a post-Roe world, CPCs could assist law enforcement attempts to locate and prosecute women who seek out abortions.
Many CPCs, not bound by laws that protect medical privacy, can turn in personal information obtained by their staff to national anti-abortion organizations like Heartbeat International.
Heartbeat International also created a chatbot that requires users to disclose their identity and location, maintaining they can use the information collected for any purpose.
"If you interact with a CPC on a chatbot that pops up online or an app, or call one of the hotlines not knowing it's a CPC hotline, any of those avenues are ways that your medical, sexual reproductive health, addiction, or relationship history can wind up in an anti-abortion database that does not have to adhere to privacy protections," Murtha told Insider.
Murtha said CPCs need to be defunded by states that support these centers and allow the money to go to actual medical services and services that help families without the obstacles of CPCs.
She also recommended that governments should require CPCs to be more transparent about what they do. Currently, CPCs are not required to be licensed or answer to any state or federal regulatory bodies.
'I just was not ready'
Estefanía ultimately ended her pregnancy, but the experience she had at The Keim Centers is something she has yet to overcome.
Every time she looks at the sonogram image she received before her abortion, she remembers the voice of one of the CPC workers saying: "We're all individuals, you will never have this baby again."
"We shouldn't allow anyone to push their agenda like that, especially to women that are so vulnerable ... because at the end of the day, they couldn't control the fact that I didn't have the money, the space, the time," Estefanía said.
"I just was not ready, and words can't make you ready for that."
Correction: December 5, 2022 — An earlier version of this story misstated that Estefanía was six weeks pregnant at the time of her appointment at The Keim Centers. She was 4 weeks pregnant.
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