A new reality for pro-life pregnancy centers

The doors of the Mosaic Virginia pregnancy resource center in Herndon, Va., are locked. Clients must press a buzzer before the front desk staffer checks the cameras and opens the door. Inside, the cool gray lobby is welcoming, filled with comfortable seats and portraits of landscapes and flowers. The complicated entry process has been in place for nearly all the clinic’s short history—because Mosaic’s Herndon location opened just before last June.

In the 12 months since the Supreme Court struck down Roe v. Wade, leaving abortion regulation to individual states, pregnancy resource centers (PRCs) have had to navigate a rapidly changing legal landscape, increased scrutiny, and the fierce wrath of abortion activists.

Whether they’re located in majority pro-life or pro-abortion states, nearly all pregnancy centers are struggling with obstruction online. In June 2022, as the Dobbs decision loomed, congressional Democrats sent Google CEO Sundar Pichai a letter asking for the company’s ubiquitous search engine to flag PRCs in searches for pregnancy services with a notification saying they do not provide abortions.

“Directing women towards fake clinics that traffic in misinformation and don’t provide comprehensive health services is dangerous to women’s health and undermines the integrity of Google’s search results,” the letter read.

Google began implementing their requests a month later. The company also deprioritized PRC websites in search results related to abortion, making them harder to find, and started flagging and deprioritizing PRCs’ ad campaigns if they contained abortion-related language. Yelp followed suit. It added a label saying PRCs “provide limited medical services and may not have licensed medical professionals onsite.”

PRC directors are frustrated by the “fake clinic” allegations. Most do include abortion-related language in their marketing, encouraging women considering an abortion to come for information about all available choices—including abortion, adoption, and parenting. But they are typically certified or trained by networks like Care Net or the National Institute of Family and Life Advocates (NIFLA) to provide accurate medical information, tell clients up front that they do not provide abortions, and refrain from pressuring clients or judging their decisions.

Sherry Sherwood, director of the Living Alternatives family of clinics located across Illinois and Indiana, said that in her 19 years of experience, she’s never seen a clinic use deceptive practices: “It’s very clear that if you want to be affiliated with any of these national organizations, that you have to use ethical standards, that you have to operate with integrity—you have to use best practices.”

Abortion advocates have long used the “fake clinic” narrative as a tactic to keep women away from pregnancy centers. A 1990 article in the Women & Health research journal used the term to accuse PRCs of deceiving women with “intense anti-abortion propaganda.” In 2005, Susanne Martinez, Planned Parenthood’s vice president of public policy at the time, told The New York Times that PRCs lure women with “coercive” practices. Reproaction’s Fake Clinic Database and its sister initiative #ExposeFakeClinics have maintained lists of almost 3,000 PRCs since 2015. But pro-abortion activists’ accusations have intensified since the fall of Roe.

Google’s crackdown on PRCs is having a noticeable effect. Clinics that rely on Google to reach people have seen a drop in clients since last August. The Living Alternatives clinics pulled out of most online ad campaigns because leaders felt the cost wasn’t worth the diminished results. Niki Mattson, director of the Mosaic clinics, hired a good marketing agency that finds less restricted terms to use. But overcoming Google’s hurdles means marketing now takes a larger share of her group’s budget. Other clinic directors said they had flown under Google’s radar for now but anticipated overhauls to their ad campaigns any day. Nearly every clinic interviewed for this story had to increase its marketing budget.

As part of an effort to regain lost ground online, some pregnancy centers are adding telehealth services. Mosaic Virginia, Horizon Pregnancy Clinic in California, and Raffa Clinic in Texas are all currently developing telehealth platforms either individually or in conjunction with other PRCs.

Debra Tous, Horizon’s director, said a new chatbot on the clinic’s website will give visitors more interaction and connect them to a hotline of nurses who can take live calls. Now that women can easily order abortion pills online in most states, bypassing even a doctor’s visit, Tous recognizes a need for pro-life centers to provide easy access to professional help.

“If there’s somebody to talk to, it might help draw them in,” she said. “It’s too easy for them to take a pill or find an abortion clinic.”

Many PRCs also have allocated a larger share of their budgets to security in the last year. Immediately after the Dobbs decision, extreme pro-abortion activist groups like Jane’s Revenge vandalized several clinics, smashed windows, and even firebombed a few. None of the PRC directors I interviewed had endured anything on that scale, but they still felt pressure. Several centers received death threats and had their voicemails spammed with angry callers. Threesa Sadler, director of the Raffa Clinic, said abortion activists filled online appointment slots with fake details, leading to a month of frequent no-shows. Several centers also experienced protests outside or reported minor incidents of vandalism. Most installed new cameras and security systems and hired private security for at least a month—significant costs for nonprofits.

Though the initial furor surrounding Roe’s defeat has died down, PRCs still face hostility in many state legislatures. California’s assembly recently considered a bill, AB 315, that specifically targets pregnancy centers. The bill, currently postponed in committee, would encourage people to sue PRCs if they feel misled by abortion-related terms in their marketing. A similar ordinance is already in place in the city of Los Angeles. The Illinois legislature passed a bill, SB 1909, that would impose fines of up to $50,000 for “unfair methods of competition or unfair or deceptive acts or practices” by PRCs.

But several PRC directors in majority pro-abortion states say getting involved in their local communities has improved their centers’ ability to provide needed services and extended their reach. The Living Alternatives clinics were able to pull back on their online marketing because over 50 percent of their clients come from referrals. Their client numbers have increased since Dobbs.

Erin Rogers, director of Bakersfield Pregnancy Center in Bakersfield, Calif., has also seen more clients, partially due to the cordial relationships she’s built with public health officials in Kern County. They often refer clients to her for everything from maternal help to testing for sexually transmitted infections.

“I want us to be the one that they turn to as a trusted partner,” she said. “And so I think in the end, as we build those relationships locally, we build our own protection against unfair legislation that’s happening in Sacramento against pregnancy centers.”