By Lizzy Miller*

Introduction

In 2022, the federal constitutional right to abortion previously found in Roe v. Wade was overturned by Dobbs v. Jackson Women’s Health Organization.^[1] Crucially, Dobbs found that “the  state has an ‘important and legitimate interest’ in protecting fetuses that it does not have in preventing contraception.”^[2] While abortion remains constitutionally protected in Minnesota,^[3] pregnant people searching for care throughout the state may be targeted by anti-abortion organizations posing as medical clinics.^[4] These non-profit organizations are referred to as Crisis Pregnancy Centers (CPCs), and aim to prevent pregnant people from obtaining abortions.^[5] In addition, CPCs promote misinformation regarding abortion, reproductive health, contraception, and sexually-transmitted infections.^[6]

Legal Background

            CPCs are not regulated by laws affecting medical centers, and as organizations that provide services free of charge, are also unregulated by the Federal Trade Commission or state ordinances regarding commercial businesses.^[7]As non-medical centers, CPCs and their staff are not bound by the Health Insurance Portability and Accountability Act, or HIPAA.^[8] The main challenges to CPC’s messaging occur through local ordinances.^[9] The Reproductive FACT Act in California, passed in 2015, required CPCs to disclose their unlicensed medical status, state that they do not refer clients for abortions, and provide information to clients regarding free or reduced cost reproductive health services.^[10]The U.S. Supreme Court addressed the constitutionality of this Act in National Institute of Family and Life Advocates v. Becerra in 2018 and found that CPCs’ messaging was protected as free speech under the First Amendment.^[11]

            In August of 2022, the Minnesota State Attorney General published a consumer alert in regard to “the limited services and potentially deceptive nature of certain claims” promoted by CPCs.^[12]

CPCs Practices

            CPCs spread misinformation to clients seeking reproductive services. CPCs often promote“abortion pill reversal,” a practice encouraging pregnant people to take progesterone to “reverse” the effects of the first of two abortion pills.^[13] One 2019 study intended to study “abortion pill reversal” ended after three women were hospitalized due to severe vaginal bleeding after taking progesterone.^[14] CPCs also use fear- and shame-based tactics to dissuade clients from terminating their pregnancies. In reference to the aftermath of taking the abortion pill, one CPC staff member stated to a pregnant woman “you never get over seeing that baby.”^[15] Despite studies that show abortion is a safer procedure than childbirth,^[16] CPCs falsely claim that abortion results in infertility, breast cancer, and mental health problems.^[17]

            Many CPCs advertise free services, but may not provide clients with such services.^[18] Because of this, CPCs often target vulnerable populations who are more likely to seek abortions, such as low-income people and people of color, despite their actual varied purposes in seeking reproductive services.^[19] CPCs targeted advertising is pervasive. Further, CPCs may offer “free” resources such as diapers and baby clothes to clients if they engage in counseling.^[20]This counseling is usually in the form of ‘informative videos,’ which provide additional misinformation surrounding reproductive health and abortions.^[21] These resources are intended to promote parenting rather than abortion. A reproductive justice advocate working with the Texas Equal Access Fund for low-income people obtaining abortions stated that an internet search for “abortion near me” will return results for CPCs rather than abortion clinics.^[22]Additionally, people seeking information about the CPCs before visiting will often be encouraged to visit the centers in person.^[23] Once clients arrive, CPC staff are able to convey misinformation more effectively. Finally, CPCs will not direct clients to other providers that may inform or assist people in seeking abortions.^[24]

A recent study conducted by The Alliance: State Advocates for Women’s Rights and Gender Equality found over 95% of Minnesota’s CPCs do not provide pregnant clients with pre-natal or wellness care.^[25] Gender Justice, a Minnesotan advocacy organization, found that none of Minnesota’s CPCs provide contraception to clients.^[26] CPCs, including almost half of Minnesota’s CPCs, provide non-diagnostic ultrasounds, which provide no medical benefit.^[27]Perhaps most egregiously, CPCs may tell pregnant people they are earlier or further along in pregnancy than is true, complicating their access to abortion if there is a gestational age cut-off.^[28]

Looking Forward – The Positive Pregnancies Bill

            The Associated Press found that CPCs have received almost half a billion dollars in public funding since 2010,^[29] while CPCs in Minnesota receive about 3.5 million dollars in public funding each 5-year grant cycle.^[30] In January, the Minnesota Democratic-Farmer-Labor Party introduced a “Positive Pregnancies” bill which “would require state grant recipients to provide medically accurate information about abortion and allocate funds to health care to assist pregnant people and young parents with prenatal care, medical care and reproductive health care, including abortions.”^[31] Specifically, the bill amends Minnesota Statute § 145.4235, “Positive Abortion Alternatives” to remove the requirement that state grant recipients encourage people to carry their pregnancies to term and inform pregnant people on the “developmental characteristics of . . . unborn children.”^[32] Further, the bill would require grant recipients to provide services without requiring preconditions such as counseling, ultrasounds, or viewing media.^[33] The amended bill keeps language that recipients must provide information on adoption services and assistance with childcare.^[34]Finally, the Positive Pregnancies bill does not allow any release of records without written informed consent from the person in question or their representative.^[35]

H.F. 289 provides necessary changes to Minnesota Statute § 145.4235 to support pregnant people. If passed, CPCs would have to change their practices to comply or stop accepting state grants altogether. Until then, pregnant people seeking reproductive services should have all the necessary and correct information about CPCs to make choices about their health and future.

[1] No. 19-1392, 597 U.S. ___ (2022).

[2] Stephen Gilles, Dobbs, Obergefell, and “the Critical Moral Question Posed by Abortion”, SCOTUSblog (July 6, 2022),https://www.scotusblog.com/2022/07/dobbs-obergefell-and-the-critical-moral-question-posed-by-abortion/.

[3] Attorney General Ellison Issues Consumer Alert About Crisis Pregnancy Centers, Off. Of Minn. Att’y Gen. (Aug. 22, 2022),https://www.ag.state.mn.us/Office/Communications/2022/08/23_CrisisPregnancyCenters.asp.

[4] Id.

[5] Id.

[6]  Amy G. Bryant & Jonas J. Swartz, Why Crisis Pregnancy Centers are Legal but Unethical, 20 AMA J. of Ethics 269 (2018).

[7] Id. at 271.

[8] What are Crisis Pregnancy Centers?, Planned Parenthood (Nov. 4, 2021), https://www.plannedparenthood.org/blog/what-are-crisis-pregnancy-centers (stating no HIPAA regulation could pose issues for clients in states where anti-abortion laws operate).

[9] Amy G. Bryant & Jonas J. Swartz, Why Crisis Pregnancy Centers are Legal but Unethical, 20 AMA J. of Ethics 269, 271 (2018).

[10] Id. at 272.

[11] 585 U.S. ___ (2018).

[12] Attorney General Ellison Issues Consumer Alert About Crisis Pregnancy Centers, Off. Of Minn. Att’y Gen. (Aug. 22, 2022),https://www.ag.state.mn.us/Office/Communications/2022/08/23_CrisisPregnancyCenters.asp.

[13] Mara Gordon, Safety Problems Lead to Early End for Study of ‘Abortion Pill Reversal’, NPR: MPR News (Dec. 5, 2019), https://www.npr.org/sections/health-shots/2019/12/05/785262221/safety-problems-lead-to-early-end-for-study-of-abortion-pill-reversal.

[14] Id.

[15] Cynthia McFadden, Maite Amorebieta, & Didi Martinez, In Texas, State-Funded Crisis Pregnancy Centers Gave Medical Misinformation to NBC News Producers Seeking Counseling, NBC News (June 29, 2022), https://www.nbcnews.com/politics/supreme-court/texas-state-funded-crisis-pregnancy-centers-gave-medical-misinformatio-rcna34883 (demonstrating the CPC staff member was claiming that blood clots or tissue expelled from the uterus after taking the abortion pill will resemble a baby). NOTE: This statemetn made by a CPC staff member is WILDLY untrue and harmful. Include this statement as an example in the text rather than in a footnote.

[16] Amy G. Bryant & Jonas J. Swartz, Why Crisis Pregnancy Centers are Legal but Unethical, 20 AMA J. of Ethics 269, 271 (2018).

[17] What are Crisis Pregnancy Centers?, Planned Parenthood (Nov. 4, 2021), https://www.plannedparenthood.org/blog/what-are-crisis-pregnancy-centers.

[18] Id.

[19] Bryant & Swartz, supra note 6 at 270.

[20] Id.

[21] Id.; Sam Stroozas, Minnesota, Seen as Abortion Haven, Still Funds ‘Crisis Pregnancy Centers’, MPR News (Jan. 23, 2023),https://www.mprnews.org/story/2023/01/23/minnesota-seen-as-abortion-haven-still-funds-crisis-pregnancy-centers.

[22] Cynthia McFadden, Maite Amorebieta, & Didi Martinez, In Texas, State-Funded Crisis Pregnancy Centers Gave Medical Misinformation to NBC News Producers Seeking Counseling, NBC News (June 29, 2022), https://www.nbcnews.com/politics/supreme-court/texas-state-funded-crisis-pregnancy-centers-gave-medical-misinformatio-rcna34883.

[23] What are Crisis Pregnancy Centers?, Planned Parenthood (Nov. 4, 2021), https://www.plannedparenthood.org/blog/what-are-crisis-pregnancy-centers.

[24] Id.

[25] Attorney General Ellison Issues Consumer Alert About Crisis Pregnancy Centers, Off. Of Minn. Att’y Gen. (Aug. 22, 2022),https://www.ag.state.mn.us/Office/Communications/2022/08/23_CrisisPregnancyCenters.asp.

[26] Sam Stroozas, Minnesota, Seen as Abortion Haven, Still Funds ‘Crisis Pregnancy Centers’, MPR News (Jan. 23, 2023),https://www.mprnews.org/story/2023/01/23/minnesota-seen-as-abortion-haven-still-funds-crisis-pregnancy-centers.

[27] Attorney General Ellison Issues Consumer Alert About Crisis Pregnancy Centers, Off. Of Minn. Att’y Gen. (Aug. 22, 2022),https://www.ag.state.mn.us/Office/Communications/2022/08/23_CrisisPregnancyCenters.asp.

[28] Amy G. Bryant & Jonas J. Swartz, Why Crisis Pregnancy Centers are Legal but Unethical, 20 AMA J. of Ethics 269, 273 (2018); What are Crisis Pregnancy Centers?, Planned Parenthood (Nov. 4, 2021), https://www.plannedparenthood.org/blog/what-are-crisis-pregnancy-centers.

[29] Cynthia McFadden, Maite Amorebieta, & Didi Martinez, In Texas, State-Funded Crisis Pregnancy Centers Gave Medical Misinformation to NBC News Producers Seeking Counseling, NBC News (June 29, 2022), https://www.nbcnews.com/politics/supreme-court/texas-state-funded-crisis-pregnancy-centers-gave-medical-misinformatio-rcna34883.

[30] Cathy Wurzer, Sam Stroozas, & Alanna Elder, Abortion Rights Advocates Push to End State Funding for ‘Crisis Pregnancy Centers’, MPR News: Minn. Now (Jan. 23, 2023), https://www.mprnews.org/episode/2023/01/23/abortion-rights-advocates-push-to-end-state-funding-for-crisis-pregnancy-centers.

[31] Sam Stroozas, Minnesota, Seen as Abortion Haven, Still Funds ‘Crisis Pregnancy Centers’, MPR News (Jan. 23, 2023),https://www.mprnews.org/story/2023/01/23/minnesota-seen-as-abortion-haven-still-funds-crisis-pregnancy-centers.

[32] See Positive Pregnancies, H.F. 289, 2023 Minn. Leg. §145.4235(2)(b)–(c)  (Minn. 2023) (as introduced).

[33] Positive Pregnancies, H.F. 289, 2023 Minn. Leg. §145.4235(1)(a) (Minn. 2023) (as introduced).

[34] Positive Pregnancies, H.F. 289, 2023 Minn. Leg. §145.4235(1)(c)(4) (Minn. 2023) (as introduced).

[35]  Positive Pregnancies, H.F. 289, 2023 Minn. Leg. §145.4235(3)(a)(3)  (Minn. 2023) (as introduced).

 

*Lizzy Miller is a staffer for JLI Vol. 41.