Crisis pregnancy centers told to avoid ultrasounds for suspected ectopic pregnancies

In the United States, one of the largest support groups in the pregnancy center for the crisis pregnancy is to tell its members’ clinics to avoid prenatal ultrasounds on women they suspect to have ultimate pregnancies, according to recordings obtained by NBC News of a recent presentation of a legal group which advises non-flags. The guidelines are involved in the wake of a trial against a center of the Massachusetts which did not diagnose an extra-uterine pregnancy.

The National Institute of Family and Life Advocates (NIFLA), a group that provides legal support and medical training to crisis pregnancy centers, advised members of a meeting earlier this year to be cautious during the ultrasound service to a woman they suspect can have an extra-uterine pregnancy, calling for the condition “the greatest medical and legal risk for clinics” NBC News obtained via the conference.

“I do not want to see on a website where advertising is:” Come to us and exclude us an ectopic, “said a representative of Nifla.” It is impossible to exclude an ectopic unless you do HCG, “they added, referring to a blood test that measures hormones to confirm a pregnancy.

In the Massachusetts trial brought in 2023, a crisis pregnancy center was accused of not having diagnosed an ectopic pregnancy and of causing a deadly emergency for a client. The complaint allegedly alleged that the Clearway Clinic engaged in a misleading advertisement, aimed at persuading women to give up abortions rather than “providing them with the range of medically appropriate options”.

The plaintiff, a resident of Worcester who was kept anonymous in the trial, allegedly alleged that the nurse who had ultrasound in the center “had not undertaken sufficient medical measures” to ensure that the pregnancy was viable. The pursuit alleys that the woman’s fallopian tube broke about a month after ultrasound, “causing massive internal bleeding and requiring emergency surgery”.

After a favorable lower justice decision for the applicant, the crisis pregnancy center paid the case in June 2024 without admitting responsibility.

The crisis pregnancy centers operate through the United States in order to persuade pregnant women to continue their pregnancies. Many open near abortion clinics, promoting family planning services and limited health care services such as pregnancy tests and ultrasounds. Many generally do not offer regular prenatal exams or gynecological services, and they do not offer abortion procedures, abortion drugs or women’s care.

According to Andrea Swartzendruber, an epidemiologist of reproductive health at the University of Georgia College of Public Health who studies pregnancy centers in the event of a crisis, many centers have announced free ultrasounds such as diagnosing an extra-uterine pregnancy and passing their wives.

“They talk about extra-uterine pregnancies in their advertising and on their websites,” said Swartzendruber. “They use it to commit and try to motivate people to come for an ultrasound.”

Extra-uterine pregnancy occurs when a fertilized egg implies and grows outside the uterus. Although the condition is rare, affecting only 1% to 2% of pregnancies, it can be fatal. At the start of a pregnancy, symptoms may include vaginal bleeding or pain or light cramps, but women may not realize that they are undergoing extra-uterine pregnancy at this stage. The condition is diagnosed by an ultrasound, a pelvic examination or a blood test.

Some of the Nifla cases represented clinics made their way to the Supreme Court, including a 2018 case which gave a major victory to the first amendment to the crisis pregnancy centers in California. Although Nifla does not represent the Clearway clinic in the case of Massachusetts, the center was listed as a member in 2023.

“Just when I walk here, I had a call for a center,” said one of the recording lawyers, telling a story of a clinic suspected of a client had an extra-uterine pregnancy. “They brought in a woman who cracked, and she said on a scale of 1 to 10, it was just below a 6. And I am like, yes, as, I would not scan it.”

The lawyer acknowledged that the right decision would be to send the customer to the emergency room.

Nifla has published advice similar to its member centers in the past. A 2018 document entitled “Policy and medical procedures” advises centers that “if a patient has symptoms of pregnancy or extraordinary miscarriage, it will not be proposed an ultrasound examination and is advised, verbally and in writing, to immediately obtain medical care.”

According to Swartzendruber, these advice is not always considered by industry.

“It seems to be a very marked change, especially since so many CPCs use fear around extra-uterine pregnancy as a reason to come and be scanned,” she said.

Nifla did not respond to several requests for comments.

The NIFLA training documents presented in Reunion and obtained by NBC News say that these health services create “access points” to “help prevent unwanted pregnancies and intervene in the lives of people who are most vulnerable abortion”.

According to the American College of Obstetricians and Gynecologists, the crisis pregnancy centers “represented as legitimate genesic health care clinics providing care for pregnant people, but in fact aim to dissuade people from accessing certain types of reproductive health care, including abortion care and even contraceptive options.”

“Because the religious ideology of the owners and employees of these centers has priority on the health and well-being of women who seek care in these centers, women do not receive complete clinical information, precise and based on evidence on all available options,” explains an article published in the American Medical Association of Ethics.

During the Nifla panel, lawyers and a participating doctor advised the centers to scan women they suspect of having extraordinary pregnancies.

After being questioned by a member of the public to scan a woman with low levels of HCG, the hormone produced by the placenta during pregnancy, a doctor urged this member of the public to divert women and to be seen by his medical supplier.

Human chorionic gonadotrophin, or HCG, is familiarly known as pregnancy hormone. According to the Cleveland Clinic, HCG levels increase after design and continue to increase up to about 10 weeks in pregnancy. Low or decreased HCG levels may indicate a miscarriage or extra-uterine pregnancy.

“I do not scan. If you have a low level like that, it could be an early pregnancy, but it is one of the cardinal signs of ectopic and one of the cardinal signs of miscarriage, rising slowly HCG. Please don’t,” said the doctor. “She already has a supplier. Throw it on them. “

“She should return to her supplier,” added a legal representative.

Another bridge bridge from the summit, entitled “Bondage: the impact of prenatal ultrasound”, advised participants on “the words to be avoided for the reduction of legal risks” during an ultrasound. The words listed are “good”, “very”, “ok”, “normal” and “perfect”.

Concerns concerning federal laws on privacy

During the panel, a lawyer addressed another controversy facing the centers: federal laws on privacy. Although some crisis pregnancy centers offer limited prenatal care or gynecological services, they are generally equipped with volunteers and are not bound by federal laws on the confidentiality of health. However, many of them declare in their privacy policies that they comply with the Federal Health Insurance Portability and Accountability Act, known as Hipaa. NBC News previously brought back letters to the general prosecutors of states on potential confidentiality problems around the centers announcing their services as “in accordance with the HIPAA”.

During the Nifla meeting, the representatives recognized confidentiality problems.

“There is this movement not to say HiPAA, and I finally made sure that everyone has put things right. So I am a little upset,” said one of the lawyers of the panel. “We want you to respect these policies, but do not announce yourself as a compliance with the HIPAA.”

Debra Rosen, executive director of the reproductive advocacy group Health and Freedom Watch, said that this approach can be misleading.

“Unregulated pregnancy clinics have masked as a medical establishment, are not covered entities under the HIPAA and, for decades, have vigorously rejected the most basic forms of responsibility,” said Rosen. “Women at the national level face real damage, because these marginal clinics trap them between confidentiality illusions and the real legal protections they receive. This dangerous gap requires legislative action. “

State requirements for ultrasounds

While the seminar guided the participants to be cautious around extraordinary pregnancies to avoid legal responsibility, Nifla representatives also described the opposition of the organization to legislative efforts in certain states to strengthen license requirements around ultrasound, mentioning the invoices introduced in Indiana and New Jersey which would require ultrason licensees. While pregnancy centers employ a little medical staff, a large part of the work done is via volunteers, some without medical history.

“Some might be damaging to the centers,” said a representative. “So we want to make sure that if you hear bills in your states, we want to know and we want to help you.”

A representative of the State of Indiana, Democrat Maureen Bauer, said that she had presented the bill in response to an extra-uterine pregnancy that had been missed in a crisis pregnancy center.

“This is why I filed HB 1094 to demand a license for anyone who exploits an ultrasound machine in Indiana,” she wrote in an article on Facebook, “to make sure that we no longer have tragic stories like the young Iusb student who lost his child and his ability to have children in the future due to a required hysterectomy, because the person who provided him with a pregnancy center Crisis did not identify his prejudice.