More anti-abortion pregnancy centers offer medical services as Planned Parenthood clinics close

Pregnancy centers in the United States that discourage women from having abortions have added more medical services — and may be poised to expand further.

This expansion – from screening and treatment for sexually transmitted infections to providing primary medical care – has been happening for years. It gained momentum after the Supreme Court overturned Roe v. Wade three years ago, paving the way for states to ban abortion.

The push could gain momentum with Planned Parenthood closing some clinics and considering closing others following changes to Medicaid. Planned Parenthood is not only the nation’s largest abortion provider, but also offers cancer screenings, STI testing and treatment, and other reproductive health services.

“We ultimately want to replace Planned Parenthood with the services we provide,” said Heather Lawless, founder and director of the Reliance Center in Lewiston, Idaho. She said about 40 percent of the anti-abortion center’s patients are there for reasons unrelated to pregnancy, including some who use the nurse practitioner as their primary caregiver.

The changes have frustrated abortion rights groups who, in addition to opposing the centers’ anti-abortion messages, say they lack accountability; refuse to provide contraception; and most offer only limited ultrasounds that cannot be used to diagnose fetal abnormalities because the people performing them do not have this training. A growing number of people are also offering unproven treatments to reverse the abortion pill.

Because most centers do not accept insurance, the federal law restricting the release of medical information does not apply to them, although some say they follow it anyway. They are also not required to follow standards required by Medicaid or private insurers, although those that offer certain services generally must have medical directors who comply with state licensing requirements.

“There are really fundamental questions,” said Jennifer McKenna, senior advisor for Reproductive Health and Freedom Watch, a project funded by liberal policy organizations that studies pregnancy centers, “about whether this industry has the clinical infrastructure to provide the medical services that it is currently advertising.”

Perhaps better known as “crisis pregnancy centers,” these centers, most of them privately funded and religiously affiliated, were expanding services such as diaper banks before the 2022 Supreme Court decision Dobbs v. Jackson Women’s Health Organization.

As the abortion ban took effect, centers expanded their medical, educational and other programs, said Moira Gaul, a researcher at the Charlotte Lozier Institute, the research arm of SBA Pro-Life America. “They are ready to serve their communities for the long term,” she said in a statement.

In Sacramento, California, for example, the Alternatives Pregnancy Center has recruited family doctors, a radiologist and a high-risk pregnancy specialist, as well as nurses and physician assistants, over the past two years. Alternatives – a subsidiary of Heartbeat International, one of the largest associations of pregnancy centers in the United States – is the sole health care provider for some patients.

When The Associated Press asked to interview a patient who had only received non-pregnancy-related services, the clinic provided Jessica Rose, a 31-year-old woman who took the rare step of detransitioning after spending seven years as a man, during which she received hormone treatment and a double mastectomy.

For the past two years, she has received all medical care at Alternatives, which has an obstetrician-gynecologist who specializes in hormone therapy. Few, if any, pregnancy centers advertise that they provide detransition assistance. Alternatives has treated four similar patients in the past year, even though that’s not its primary mission, Director Heidi Matzke said.

“APC offered me a space that aligned with my beliefs and embraced me as a woman,” Rose said. She said other clinics “tried to make me believe that detransitioning wasn’t what I wanted to do.”

In 2024, more than 2,600 anti-abortion pregnancy centers were operating in the United States, 87 more than in 2023, according to the Crisis Pregnancy Center Map, a project led by public health researchers at the University of Georgia concerned about aspects of these centers. According to the Guttmacher Institute, 765 clinics offered abortions last year, a drop of more than 40 compared to 2023.

Over the years, pregnancy centers have received an increase in taxpayer dollars. Nearly 20 states, largely led by Republicans, now devote millions of public dollars to these organizations. Texas alone sent $70 million to pregnancy centers this fiscal year, while Florida dedicated more than $29 million to its “Pregnancy Support Services Program.”

This increase in resources comes as Republicans have barred Planned Parenthood from receiving Medicaid funds under the tax and spending law signed by President Donald Trump in July. While federal law already blocked the use of taxpayer dollars for most abortions, Medicaid reimbursements for other health services accounted for a large portion of Planned Parenthood’s revenue.

Planned Parenthood said its affiliates could be forced to close up to 200 clinics.

Some had already closed or reorganized. They abolished abortion in Wisconsin and eliminated Medicaid services in Arizona. An independent group of clinics in Maine stopped primary care for the same reason. The uncertainty is compounded by impending changes to Medicaid that are expected to lead to an increase in the number of uninsured Americans.

Some abortion rights advocates fear it will lead to more health care deserts, with pregnancy centers being the only option for more women.

Kaitlyn Joshua, founder of the abortion rights group Abortion in America, lives in Louisiana, where Planned Parenthood closed its clinics in September.

She fears that women seeking health services at pregnancy centers following these closures will not get what they need. “These centers should be regulated. They should provide accurate information,” she said, “rather than just getting a lecture they didn’t ask for.”

Thomas Glessner, founder and president of the National Institute of Family and Life Advocates, a network of 1,800 centers, said the centers are overseen by the government through their medical directors. “Their criticism,” he said, “comes from a political agenda.”

In recent years, five Democratic attorneys general have issued warnings that the centers, which advertise to people seeking abortions, are not providing them and are not referring patients to clinics that do. And the Supreme Court agreed to consider whether a state investigation into an organization that runs centers in New Jersey is stifling its free speech.

Choices Medical Services in Joplin, Mo., where the Planned Parenthood clinic closed last year, shifted from a mission focused solely on discouraging abortion to a broader sexual health mission about 20 years ago when it began offering treatment for STIs, said its executive director, Karolyn Schrage.

The center, funded by donors, works with law enforcement in locations where authorities may find pregnant adults, according to Arkansas State Police and Schrage.

She estimates that more than two-thirds of her work is not pregnancy-related.

Hayley Kelly first met Choices volunteers in 2019 at a regular weekly dinner they brought to dancers at the strip club where she worked. Over the years, she went to the center for STI testing. Then, in 2023, while uninsured and struggling with drugs, she wanted to confirm a pregnancy.

She thought the staff wouldn’t like her leaning toward an abortion, but she says they just answered the questions. She ended up having that baby and, later, another.

“It’s an amazing place,” Kelly said. “I tell everyone I know, ‘You can go.'”

The center, like others, does not provide contraceptives — a standard offering at sexual health clinics that experts say is best public health practice.

“We are focused on eliminating sexual risks,” Schrage said, “not just reducing.”