A crowd gathered in front of the Massachusetts State House on May 3 to protest the leaked Supreme Court decision to overturn Roe v. Wade. (Olivia Deng)
The “industry is a sophisticated global network led by anti-abortion organizations.” In Mass, they outnumber actual abortion clinics 3 to 1
Kaylee started suffering from severe migraines and cramps in January 2021. She initially thought she was just about to get her period, but the symptoms continued until she wasn’t able to go to work. When her period didn’t come, she took a pregnancy test that came back positive. Immediately, Kaylee started googling to find abortion referrals near her, and the first result that came up was First Concern Pregnancy Resource Center in Marlborough, Massachusetts.
“In the window they had a Planned Parenthood sign, which I thought was kind of strange,” Kaylee recalls. “So I go in, the whole place is really empty, they have me fill out a form. I think my first red flag was they asked me if I had any church affiliations.”
Inside, Kaylee said she couldn’t see contraceptives or signs pointing to First Concern being a reproductive health center, though there were plenty of diapers and baby toys. She spoke with a woman who introduced herself as a counselor who led pregnancy support groups. There was no evidence of medical credentials in view.
“Within the first 15 minutes of me being there, she also did tell me that they don’t refer for any medical services, any medical treatment, including abortion,” Kaylee said. “They only refer for ultrasounds.”
First Concern is one of an estimated 30 crisis pregnancy centers in Massachusetts, where CPCs outnumber abortion clinics 3 to 1. The centers, which are not licensed medical facilities, pose as legitimate abortion clinics but mislead people about reproductive health and attempt to steer them away from an actual clinic. Usually offering free services, CPCs are not staffed with licensed doctors or nurses. First Concern could not be reached for comment.
According to Taylor St. Germain, director of communications at reproductive health advocacy organization Reproductive Equity Now, CPCs pose a serious threat to people seeking unbiased reproductive health care, especially in the wake of the Supreme Court overturning Roe v. Wade on June 24.
“[Crisis pregnancy centers] present themselves as resources for people facing unplanned pregnancy, when in reality, they are intended to manipulate and dissuade pregnant people from accessing abortion care,” St. Germain said. “These centers are oftentimes funded by anti-abortion organizations.”
Research by the Alliance, which advocates for reproductive health rights and gender equality, found that CPCs may seem like “small, local, and independent facilities,” but the “crisis pregnancy center industry is a sophisticated global network led by international, national, and regional anti-abortion organizations.” The study notes that most of these organizations are a part of wider evangelical, Catholic, and Christian nationalist movements that provide extensive services for CPCs: digital strategy, infrastructure and content; marketing and public relations; and training and technical support. Pregnancy Help in Brighton, for example, is a ministry sponsored by the Pro Life Office of the Archdiocese of Boston. Deacon Robert Connor has served as president on First Concern’s board of directors, and the CPC has also fundraised through Ministry Sync, a Kickstarter for faith-based projects now called FundEasy. As scrutiny on these centers increases, they try harder to conceal their religious affiliations.
“These centers are definitely at the forefront of the anti-abortion movement,” St. Germain said. “We are really focused on ensuring that people have access to information to know where they can access legitimate unbiased reproductive health care, especially in this ever changing abortion landscape. … They use deceptive advertising practices to lure people into their clinics who are looking for their full options while not providing such.”
Web of lies
Leveraging search engine optimization (SEO) and pay-per-click (PPC) strategies, CPCs create websites that appear in online searches for legitimate abortion clinics, advertise online and in print, and deliberately choose locations near reproductive health clinics. CPCs may even game the press—First Concern garnered uncritical coverage from Worcester’s Telegram & Gazette last October. A study by the Alliance found that CPCs spend a significant amount of money on advertising and use marketing firms that cater to the anti-abortion movement. The study states: “As one anti-abortion marketing firm advised, ‘How do pregnancy centers reach the abortionminded woman before these abortion pill providers do? … Through marketing strategies like SEO and PPC, you can rank on top of Google and reach women before abortion providers do.’”
Despite Google’s ad policy implemented in 2019 requiring CPCs to be transparent about not providing abortion care or referrals, CPCs find loopholes. “As a result, a person seeking full options counseling or abortion referrals ends up in the wrong hands,” St. Germain said.
Kaylee said she felt misled by First Concern’s website.
“I remember feeling like this might be a safe place to go … I was under the impression that by the wording that they were using, they were pro-choice. They continue to use the [words] ‘choice,’ ‘your decision,’ ‘your choice,’ ‘just here to help support you.’”
When Kaylee called First Concern telling them she thought she might need medical treatment for her abortion, they didn’t give her any information. But since she felt assured by the website, she went in for an appointment the same day she called.
Kaylee took another pregnancy test at First Concern, which came back positive. They scheduled an ultrasound in two weeks. She said she was there for about two hours and the counselor made it difficult for her to leave.
“I left super uncomfortable and she also gave me a care package with a book in it that was full of stories about women who chose to keep their babies and see through the pregnancy and decided against abortion,” Kaylee recalled. “And also some stories about families who adopted kids from women who were considering abortion. It was a very, very manipulative book…It painted abortion as something that is never necessary.”
The big “P”
When Abby was a teenager, they felt like it was safe to go to Birthright, a CPC with locations all across the US including Massachusetts, for birth control and condoms. After all, they’d heard of the place, recognizable with a big ‘P’ sign, and driven past it. So Abby went to the Clinton, Connecticut location seeking help.
As they sat down and waited, Abby started picking up things to read. “It was all about Christian adoption pamphlets. And then there were a bunch of Christian magazines. And then I left,” they said. “I got kind of shocked, because I realized [if] I actually had a pregnancy scare, I probably would have gone there and needed help and not received the kind of help that I was looking for, which was pretty scary. And I was thinking about how this was not a secret place, people talked about it. A lot of my friends were newly sexually active. So we’d say things like, What if I got pregnant, and we were all like, Just go to that place in Clinton with that big ‘P’ sign on it.”
Birthright could not be reached for comment.
The Office of Attorney General Maura Healey has an online warning and information page about CPCs, explaining that “CPCs do NOT provide comprehensive reproductive healthcare” and that “CPCs are organizations that seek to prevent people from accessing abortion care,” among other relevant facts. On the NGO side, the Beyond Roe Coalition, a Massachusetts coalition made up of REN, Planned Parenthood, and the ACLU, has laid out a proposal for a post-Roe America that includes boosting public education about the centers: “We must increase our public education efforts on the danger of CPCs and highlight where they exist in our communities.”
On June 23, US Sen. Elizabeth Warren, Congresswomen Carolyn B. Maloney and Suzanne Bonamici, and Sen. Bob Menendez introduced the Stop Anti-Abortion Disinformation Act to address false CPC advertising. Locally, in March, the Somerville City Council passed an ordinance that bans CPCs from using deceptive language. Failure to comply will result in a $300 fine, even though CPCs are generally funded by national anti-abortion organizations like Heartbeat International, with plenty of donations plus millions in taxpayer-subsidized funding some have managed to leverage nationally.
How about banning CPCs entirely? Cambridge city councilors have introduced an ordinance to prohibit permits or licenses for CPCs, even though there are currently zero in that city.
Supporting abortions with mutual aid
As advocates apply pressure on lawmakers, mutual aid groups in the form of abortion funds have been helping ameliorate the harm of the anti-abortion movement.
“The advantage of working through a mutual aid lens is that we try to eliminate any barriers to receiving aid,” said Margaret Batten, a board member of the Eastern Massachusetts Abortion Fund. “If someone calls and tells us that they have an appointment for an abortion and they have a need, we will fund it. And we’re unencumbered by a lot of hierarchy or bureaucracy.”
Patients often have cost concerns about accessing care. For example, Kaylee considered First Concern because they advertised free services. Kaylee’s still on her family’s California-based insurance plan and she’s had issues with her insurance not being accepted in doctor’s offices and emergency rooms.
Abortion funds ensure people can afford their abortion and accommodation, which can include travel, a place to stay, and childcare. There are four in Massachusetts: the Jane Fund, the Eastern Massachusetts Abortion Fund, Tides for Reproductive Freedom, and the Abortion Rights Fund of Western Massachusetts. In 2021, EMAF dispersed $161,000 for abortion funding and supported 374 people, according to Batten. While the majority of people EMAF supported were in state, they have helped people from Texas and neighboring states like Rhode Island where Medicaid doesn’t cover abortion as well as New Hampshire, which has an earlier cutoff for abortion than Massachusetts.
How can people tell the difference between a CPC and a legitimate abortion clinic? St. Germain advised to check the website for statements about whether or not the facility provides abortion referrals, which is often not obvious on their websites. Basically, reading the fine print is critical. She added that people can directly ask the center if they offer full options counseling, abortion referrals and abortion care, and assess if the facility is hesitant to give abortion referrals. Lastly, the Reproductive Equity Now director of communications recommended the New England Abortion Care Guide REN released in April. It’s a resource for people to find accurate, up-to-date information on where they can access abortion care.
“It’s going to be really important as more people start to travel to Massachusetts for care, as hostile state legislatures implement these bans,” St. Germain said.
Kaylee never showed up for her ultrasound appointment at First Concern, but she was bombarded by emails from them reminding her about her appointment and asking her for donations. Instead, she called Planned Parenthood and scheduled an abortion service two days after she reached out to them.
“When I got there, they did an exam and found that the pregnancy wasn’t viable and my body wasn’t able to pass it and get rid of it. They told me that I was lucky that I got it sorted out when I did, because if I waited too long I could have developed an infection, it could have gone septic, there could have been so many other complications that could have happened,” Kaylee said. “When I told them about the crisis pregnancy center, and how they scheduled me for an ultrasound two weeks after I saw them, they told me that would have probably been too long. And I probably would have been really sick and in need of emergency services if I waited that long.”
After narrowly avoiding a situation in which her health could have been severely compromised, Kaylee sees CPCs as a trap for vulnerable people seeking reproductive health care to get misinformation about their bodies.
“It’s scary that [CPCs are] still in the state because even though abortion is legal, these places can still kill people, they can still do a lot of damage,” she said. “It’s not really about the people like me and the people who are alive and getting pregnant. It’s about the agenda they have. It’s not about helping people.”