‘Crisis pregnancy’ clinics suddenly at center of abortion debate

Municipalities look to crack down on what they say is deceptive advertising

THE ORGANIZATION HAS operated quietly for three decades, headquartered today in a nondescript brick storefront along Revere’s main street. “Your Options Medical” advertises the sign on the clinic, a faith-based nonprofit that operates four centers in Massachusetts focused on counseling pregnant women.

While the clinic’s staff say they discuss the range of choices women have, there’s little doubt that continuing the pregnancy and giving birth is the option they hope women will exercise. The organization, described by its director as “life-affirming,” is one of several groups operating “crisis pregnancy centers” in Massachusetts that suddenly find themselves at the center of the debate over abortion unleashed by the Supreme Court’s ruling in June that overturned the landmark 1973 Roe v Wade case that established a constitutional right to abortion.

As the battle over abortion quickly shifted to become a state-based debate, these clinics run by pro-life advocates are suddenly drawing attention, even in a state that has some of the nation’s strongest laws protecting the right to an abortion. State and municipal leaders in Massachusetts who support abortion rights are discussing ways to regulate these clinics, often through bans on deceptive advertising practices. Part of their concern is that as more women come to Massachusetts from states where abortion is illegal seeking abortion care, they could be deceived into visiting a crisis pregnancy center instead.

Sen. Elizabeth Warren held a public event in Boston with abortion rights groups after the Supreme Court decision where she called crisis pregnancy centers “deceptive outfits that front for groups that are trying to harass or otherwise frighten people who are pregnant to keep them from seeking an abortion.”

But the effort to regulate clinics is colliding with the First Amendment rights of abortion opponents to speak freely. Courts have already ruled that government cannot compel a crisis pregnancy center to speak in a particular way. Municipal regulations are bumping up against uncertainty over what counts as a crisis pregnancy center and what practices are deceptive. So far, deceptive advertising ordinances are being considered mainly in communities that do not have a crisis pregnancy center. If that changes, attorneys who oppose abortion rights are almost certain to challenge them.

It is hardly the first time in Massachusetts that abortion rights and free speech issues have collided. The US Supreme Court in 2014 struck down on free speech grounds a state law that established a 35-foot buffer zone around abortion clinics from which pro-life protesters were banned.

Teresa Larkin, executive director of Your Options Medical, who has worked there since 1999, said she is uninterested in political advocacy, and she is disheartened by the animosity directed at her clinic. The Revere building was recently spray painted with graffiti that read, “If abortions are not safe, neither are you.”

“It’s sad because there’s such a misperception of who we are,” Larkin said.

Larkin said she was disappointed to hear the rhetoric of Warren and Attorney General Maura Healey, who published a consumer advisory warning people about crisis pregnancy centers. “I wish they really knew what we did, why we exist, who we’re here to help,” Larkin said.

While there are a range of crisis pregnancy centers, which provide different services, Larkin describes the services her clinic provides as “pregnancy confirmation.” The women who visit are pregnant but generally unsure if they want to keep the pregnancy. They might be young women frightened to tell their parents or women without health insurance. The clinic provides a pregnancy test, an ultrasound, and a counseling session where women discuss their options. If a woman chooses to keep her baby, they offer a welcome basket with clothing, diapers, wipes, and other goods. Services are free, covered by private fundraising.

Speaking to a reporter at the company’s Revere clinic, Larkin is open about the fact that the staff are Christian abortion opponents. “We’re an organization that does believe that life begins at conception,” Larkin said.

Larkin said counselors explain the abortion procedure and its risks. They offer the woman the opportunity to see the fetus on an ultrasound, if she chooses, and provide information like how far along a pregnancy is and whether a heartbeat is detected. They refer women to services that can help them obtain insurance, housing, or food.

The clinic looks like a standard medical office, with a counseling room, an exam room, and offices. It is licensed by the Department of Public Health as a medical clinic. Ultrasounds are performed by a registered nurse certified in sonography. A doctor who works at South Shore Hospital volunteers as the clinic’s medical director, and that physician and a radiologist are available remotely to review ultrasounds and write reports.

An exam room with an ultrasound machine at Your Options Medical in Revere. August 3, 2022. (Photo by Shira Schoenberg)

When a pregnant woman walks into the clinic, she is handed a form that states, “We do not provide or refer for abortion or adoption, nor do we provide pre-natal care.” Their website makes a similar statement in bold.

“We’ve never in 30 years faced any kind of disciplinary action as a result of false or deceptive advertising,” Larkin said. “We’re not a ‘fake clinic.’”

But Your Options Medical is more transparent than some other crisis pregnancy centers. In explaining their concerns, abortion rights supporters point to a report conducted by a progressive women’s rights group, which examined crisis pregnancy centers operating in nine states, though not Massachusetts. The report by The Alliance: State Advocates for Women’s Rights and Gender Equality says that crisis pregnancy centers are anti-abortion facilities designed to prevent low-income people from accessing abortion and contraception through “deceptive and coercive tactics and medical disinformation, and misleadingly presenting themselves as medical facilities.”

It says these centers provide false information about abortion; offer non-medical services like a self-administered urine pregnancy test while pretending to be a medical clinic; and promote the use of a hormone to “reverse” abortion after someone took the first of two abortion pills, a practice that is likely medically harmful. The report says the centers use misleading advertising to draw in patients who are considering abortion, without making clear that they are anti-abortion. Only a small percentage of centers even have a doctor affiliated with the clinic, it says, despite medical-related messaging like staff wearing white coats.

The lead author of the report, Jenifer McKenna, who lives in Leeds and has worked on several Western Massachusetts ordinances to regulate crisis pregnancy centers, said while she has not studied Massachusetts centers, it became clear from doing the study that the nine states were emblematic of broader practices. “It became clear based on what we found that there’s systemic practices, deceptive disinformation practices that individual [crisis pregnancy centers] use, not because they come up with the ideas themselves, but they’re part of a strategic movement,” she said.

Warren, at the Boston event, charged that the centers are grounded in deception. “People walk into crisis pregnancy centers believing they’re about to get an abortion,” Warren said.

Somerville became the first Massachusetts community to impose local regulations on crisis pregnancy centers when it passed an ordinance in March. City Councilor Kristen Strezo, who introduced the ordinance, said Somerville does not have any crisis pregnancy centers. But in a city populated with lots of college students, “I wanted to make sure my constituents were protected should a crisis pregnancy center ever try to establish in our city,” Strezo said. “It does not shut them down. It assures constituents they will be acting with integrity, and they are not lying or presenting inaccurate medical information.”

The Somerville ordinance covers limited service pregnancy centers, defined as those that do not provide abortion. It prohibits centers from advertising publicly any statement related to pregnancy services “that is deceptive, whether by statement or omission” and that the center knows is deceptive. Violations are punishable by a $300 fine.

Strezo said she wants to avoid situations where a person does an internet search for “abortion providers near me” and unintentionally ends up at a crisis pregnancy center.

The Somerville ordinance is modeled after a similar measure in Connecticut, which was passed statewide in 2021, after having been in place as a city ordinance in Hartford since 2017. The Connecticut law is being challenged in court.

Other Massachusetts communities that are considering similar ordinances include Cambridge, Northampton, Easthampton, and Worcester.

“The concern is that they should be honest about what they’re doing and up front about the fact that they’re religiously based anti-abortion centers, which most of them are, rather than trying to pretend they’re neutral health care,” said Carrie Baker, a Northampton resident and magazine journalist who helped craft ordinances in Northampton and Easthampton.

But crafting a legal ordinance and figuring out who it applies to is not straightforward.

The Worcester City Council instructed the city manager and city solicitor to craft an ordinance that is modeled after Cambridge and Somerville’s and ensures that any organization providing pregnancy services “must either directly provide or provide referrals for abortions or emergency contraception.” That is not what Cambridge and Somerville’s ordinances do, however, and those involved in drafting other ordinances say they do not believe they can legally regulate what information is provided inside a clinic. The sponsor of Worcester’s resolution, City Councilor Thu Nguyen, did not respond to a request for comment, and no ordinance has yet been drafted.

In 2018, the Supreme Court struck down a California law that required crisis pregnancy centers to post certain notices, making clear that any kind of “compelled speech” at a center would likely be illegal.

In Easthampton, opponents of the ordinance, including the conservative Massachusetts Family Institute, expressed concerns about the impact it will have on Bethlehem House, a faith-based nonprofit supported by the Catholic Church that offers free baby supplies and pregnancy resources.

But City Councilor Owen Zaret, who sponsored the ordinance, said the proposal is about regulating deceptive advertising when a clinic falsely suggests or implies it provides abortion care – and it would not apply to Bethlehem House, which is focused on providing diapers, clothes, and other goods. “I don’t see anywhere, nor have I heard from within the community that they offer medical or quasi medical services to people who may be pregnant,” Zaret said. “And on top of that they’re pretty clear about what they do.”

Andrew Beckwith, president of the Massachusetts Family Institute, said he believes the deceptive advertising ordinances are legally dubious under the First Amendment. “They’re trying to restrict the speech that happens at parental resource centers,” Beckwith said. Beckwith said the ordinances should not be allowed to target only crisis pregnancy centers, but not cover Planned Parenthood. He said none of the ordinances define deceptive practices, making them overly broad, so centers will not know if they are violating the rules.

“Folks who are passionate about abortion are lashing out at the most public-facing pro-life organizations in the Commonwealth,” Beckwith said. “It’s disheartening. It’s also disturbing from a legal perspective.”

Beckwith said it will be up to crisis pregnancy centers whether they want to litigate, but he anticipates a legal challenge to a local ordinance. “A lot of pro-life lawyers are talking about this in Massachusetts the last few weeks,” Beckwith said.

So far, the ordinances are being considered primarily in liberal-leaning communities that do not actually have a crisis pregnancy center, like Somerville, Cambridge, and Northampton. Advocates say they are planning in case a center should open or in case a mobile clinic tries to travel there. One exception would be if Worcester moves forward with an ordinance.

Clearway Clinic, with locations in Worcester and Springfield, advertises that it provides “clarity and control to women considering abortion.” It offers pregnancy tests, STD testing, ultrasounds, a nurse consultation, and “medical diagnosis” of a pregnancy. Its website says it will provide information about abortion, and information about abortion procedures and risks is published on the site. Only in an out-of-the-way link in its FAQ section does the site say Clearway does not provide abortion. On its patient registration form, the clinic does make clear that it “does not perform, prescribe or refer for abortion.”

Kelly Wilcox, executive director of Clearway Clinic, cited that form in testifying against Worcester’s proposed ordinance. “Our organization is committed to 100 percent transparency in all marketing practices and patient interactions,” Wilcox said, according to her written testimony. “We do not provide or refer for abortions and we are careful to disclose this fact before setting up any appointments.” While the tagline on their digital ads says, “Thinking about abortion?” Wilcox noted that Google requires a disclaimer that says “Does not provide abortions.”

Wilcox said in testimony that her clinic provides free baby goods, referrals for services like adoption and job training, pregnancy tests, post-abortion care, pre-natal classes, and other services, and helped more than 600 women and children last year. The clinic uses the word abortion in ads because it provides abortion-related services, like post-abortion care, she said, but every woman who contacts Clearway Clinic is told it does not perform or refer for abortion.

Massachusetts, with among the strongest abortion rights laws in the country, may seem like an unlikely battleground over the issue. But reproductive rights groups say they worry that as more women from states where abortion is illegal come to Massachusetts seeking care, more crisis pregnancy centers will open and more women will be deceived. Currently, Reproductive Equity Now, which advocates for abortion rights, maintains a list of around 30 crisis pregnancy centers in Massachusetts compared to 10 abortion clinics.

Nate Horwitz-Willis, executive director of the Planned Parenthood Advocacy Fund of Massachusetts, said centers cater to low-income people and people of color, which exacerbates the inequities around health care that are “spurred from mis- and disinformation.” Horwitz-Willis said crisis pregnancy centers are not required to function as health care entities, because they are not licensed to provide health care. When someone is going there seeking care, “these facilities will…violate all medical standards when they’re talking about medical information and skew it to where they’re trying to force people into unwanted pregnancies,” he said.

Rebecca Hart Holder, executive director of Reproductive Equity Now, said crisis pregnancy centers often intentionally locate near an abortion provider and create websites that are searchable for people seeking abortion care. “A person facing pregnancy wants unbiased information,” Hart Holder said. “If they stumble upon a crisis pregnancy center, they’re not going to find the kind of counseling they’d expect that would help them dive into their options and make an informed decision about what they might choose to do about an unintended pregnancy.” She said they are also not required to adhere to medical privacy laws for protecting personal information.

But Hart Holder said legally, “They’re extremely difficult to regulate.”

All three Democrats running for attorney general – Shannon Liss-Riordan, Quentin Palfrey, and Andrea Campbell – have said they would use state consumer protection and deceptive advertising laws to crack down on crisis pregnancy centers that try to intentionally mislead consumers.

In the consumer warning issued by Healey, the current AG and presumed Democratic nominee for governor, she said crisis pregnancy centers do not provide abortion care, are not licensed medical facilities, and often provide “inaccurate and misleading information about abortion.” Karissa Hand, a spokesperson for Healey’s gubernatorial campaign, said as governor, Healey “will be committed to increasing public education efforts to ensure that people know their rights and can recognize the warning signs of a fake woman’s health clinic.”

State Sen. Becca Rausch, a Needham Democrat, secured funding in last year’s budget to require the Department of Public Health to maintain a list of abortion clinics, so consumers have a source of accurate information about where to obtain abortion care. (Abortion clinics must opt in to be included on the list, since some may want anonymity due to security concerns.) Rausch said there are potential avenues for regulating crisis pregnancy centers through deceptive advertising laws or by defining who can describe themselves as a health clinic, but the First Amendment makes it challenging to regulate.

Concerns around deception even extend to complaints by abortion rights advocates that some pregnancy crisis centers set up near a Planned Parenthood facility and paint their buildings the same shade of pink, to trick women into entering. “There’s nothing legally that we can do to say you can’t use this particular shade of pink,” Rausch said.

Some of those working in pregnancy centers say Healey, Warren, and those concerned about deception are lobbing charges too broadly. Kerry Pound is on the board of the Pregnancy Care Center of Merrimack Valley, a Christian organization with centers in Haverhill, Lowell, and Lawrence that helps women who have unplanned pregnancies. It provides free maternity clothing, baby clothes, baby supplies, community referrals, parenting classes, and “post-abortion support.” It does not provide any medical services, and its website does not imply that it does.

“Warren and Healey are painting with a broad brush and smearing every single pregnancy center, therefore they put all pregnancy centers at risk,” Pound said.

Meet the Author

Shira Schoenberg

Reporter, CommonWealth

About Shira Schoenberg

Shira Schoenberg is a reporter at CommonWealth magazine. Shira previously worked for more than seven years at the Springfield Republican/MassLive.com where she covered state politics and elections, covering topics as diverse as the launch of the legal marijuana industry, problems with the state's foster care system and the elections of U.S. Sen. Elizabeth Warren and Gov. Charlie Baker. Shira won the Massachusetts Bar Association's 2018 award for Excellence in Legal Journalism and has had several stories win awards from the New England Newspaper and Press Association. Shira covered the 2012 New Hampshire presidential primary for the Boston Globe. Before that, she worked for the Concord (N.H.) Monitor, where she wrote about state government, City Hall and Barack Obama's 2008 New Hampshire primary campaign. Shira holds a master's degree from Columbia University's Graduate School of Journalism.

About Shira Schoenberg

Shira Schoenberg is a reporter at CommonWealth magazine. Shira previously worked for more than seven years at the Springfield Republican/MassLive.com where she covered state politics and elections, covering topics as diverse as the launch of the legal marijuana industry, problems with the state's foster care system and the elections of U.S. Sen. Elizabeth Warren and Gov. Charlie Baker. Shira won the Massachusetts Bar Association's 2018 award for Excellence in Legal Journalism and has had several stories win awards from the New England Newspaper and Press Association. Shira covered the 2012 New Hampshire presidential primary for the Boston Globe. Before that, she worked for the Concord (N.H.) Monitor, where she wrote about state government, City Hall and Barack Obama's 2008 New Hampshire primary campaign. Shira holds a master's degree from Columbia University's Graduate School of Journalism.

Pound said she “never in a million years” thought pregnancy care centers would be attacked if Roe v. Wade were overturned. “It breaks my heart and it’s so bizarre to me that you’re attacking the places that help women,” she said.