Online strategies

Pro-life pregnancy centers have long worked hard to reach women with life-affirming alternatives to abortion. One of their latest tools: artificial intelligence.

Last spring, Choose Life Marketing launched Olive, an AI chatbot that allows women to make an appointment at a center even when staff members are not available. Unlike ChatGPT, Olive sticks to a few basic conversations. “Olive is an AI scheduler. … [But] it’s just more conversational,” said Choose Life CEO Nelly Roach. “Olive does not minister to anybody. Olive does not do consultations. Olive schedules.”

Choose Life Marketing works with pregnancy centers that want to market their services through online tools. Roach said Olive allows pro-lifers to go toe-to-toe with the pro-abortion movement that has already started using AI. Planned Parenthood launched its chatbot Roo in 2019, and four years later, abortion advocates created Charley, a chatbot designed to tell women how and where to get an abortion or abortion drugs.

After Olive debuted, abortion supporters raised concerns about data breach vulnerabilities, technology replacing human consultations, and the tool’s likelihood of influencing women not to have abortions. Roach said Olive complies with health data safety requirements, and she said detractors object to the group’s pro-life stance. “If we launched it in the secular world without the current opposition, it’s just one of those tools,” Roach said. “We do what everyone else does, it’s just that we have a movement that has fierce opposition.”

As more women turn to the internet to buy abortion pills without ever speaking to someone in person, chatbots are just one way pro-life pregnancy centers are ramping up their online presence. While some prioritize advertising on Google, others are considering ways to incorporate AI and 24/7 chat lines into their work. Pro-abortion groups and companies claim the efforts are deceptive and accuse the centers of spreading misinformation, while undertaking the same strategies themselves.

Gatekeeping chatbots

The pro-abortion watchdog group Campaign for Accountability released a report in November blaming pro-life groups for what it called “mistruths” in chatbot responses to abortion-related questions. In the report, researchers asked five popular AI chatbots whether it was possible to reverse the effects of an abortion pill and whether a woman could change her mind after taking the abortion drug mifepristone. All five chatbots gave information about abortion pill reversal (APR), in which a physician prescribes progesterone to counteract the effects of the first drug used in chemical abortions. The chatbots gave varying disclaimers that the treatment is not always effective and has not been approved by some mainstream medical organizations.

According to the report, ChatGPT and Google’s AI Mode provided information about the treatment and links to relevant news and medical reports, and they encouraged users to speak with a doctor immediately about their options. Grok, Perplexity AI, and Meta AI gave the phone number for Heartbeat International’s Abortion Pill Reversal Helpline.

Andrea Trudden, the vice president of communications and marketing for Heartbeat International, said the AI programs likely gathered information from the hundreds of pregnancy organizations that either offer APR or link to the 24-hour hotline. Google in 2021 began blocking Heartbeat from advertising the phone number on the search engine’s website. According to the organization, more than 7,000 babies have been saved through APR, but abortion advocates deride the treatment as unproven and claim that advertising it is deceptive.

“Anytime that there have been lawsuits against pregnancy centers for one reason or another where there are claims of deception, the pregnancy center wins,” Trudden said. In August, a federal court permanently blocked the state of Colorado from penalizing medical professionals at a pro-life health clinic for prescribing APR. Heartbeat and local pregnancy centers in New York and California are currently embroiled in legal battles over their promotion of the treatment.

This week WORLD repeated the researchers’ questions to the same five chatbots. Only Google’s AI feature provided the APR hotline in its response. Most of the chatbots said there is no formally approved method to stop an abortion after taking mifepristone. Meta’s program refused to give an answer at all.

Trudden believes the companies altered their bots’ responses as a result of public pressure. “This is suppressing First Amendment rights,” she said. “It’s forcing the AI companies to fall in line to certain ideologies, and it actually takes away information and shows the influence that these AI personal assistants actually do have.”

None of the three tech companies whose bots previously shared the hotline number responded to a request for comment about the changed responses.

Going where the clients are

While the younger generation is increasingly utilizing AI programs, Google is still the first place many women turn to when they have questions. “If you want to reach that at-risk client, you have to purchase Google ads,” said Rachel Metzger, executive director of A Door of Hope pregnancy center in Delaware. “Since I started doing it in 2023, I have seen a 156% increase in our at-risk clientele.”

Now the ministry serves four or five women who are considering abortion each week, as many as it used to see on a monthly or bimonthly basis, Metzger said. She added that more than two-thirds of the women coming to the center find it through Google, and the rest primarily come on the recommendation of someone they know.

Metzger said her organization spends about $60,000 per year on Google ads alone. Part of that budget goes to paying marketing companies to continually optimize her ads based on local search terms and trends. “I’m competing with the abortion clinics that are surrounding me,” she said. “The more competition you have, the key words get more expensive.”

A 2023 Center for Countering Digital Hate report found that pregnancy resource centers spent about $10.2 million in Google Search ads over a two-year period. Abortion advocates claim the ads deceive women searching for abortions by offering things like pre-abortion consultations that are intended to persuade a woman not to kill her unborn baby.

Google now includes a disclaimer with ads for pregnancy centers and abortion groups to clarify whether or not they offer abortions, though Metzger said the women calling her center often do not read them. “We get phone calls all the time [from women] thinking that we’re an abortion clinic, and the first words out of our mouth [are], ‘We do not offer that service here, but here are the services that we do offer,’ and I’d say 90% of the time, the client still makes an appointment,” she said.

Heather Lawless, founder and CEO of Reliance Ministries in Idaho, said it is critical that pro-life groups appear at the top of web searches because women often spend just minutes looking through the results before moving on. “We have to be creative when we want to show up first in that Google search,” said Lawless, who also chairs the Pro-Life Marketing Ethics Council. “We knew that the typical pregnancy center lingo wasn’t doing it because she’s searching for answers right now.”

After abortion advocates unveiled the website justthepill.com to sell abortion pills to women across the country, Lawless and her colleagues created itsthepill.com to connect women to local pregnancy centers for ultrasounds and more information. “[The website] has information about the abortion pill and what it does to your body. It’s all medical truth,” she said.

Pro-life pregnancy centers in eight states pooled their marketing resources to promote the website and outspend Planned Parenthood on Google, Lawless said. According to her, the effort has so far successfully put the website at the top of Google searches about abortion in the areas where participating centers operate. “We can’t just sit back and wait for them to walk into our clinics, because they’re not,” she said. “They’re sitting at home on their couch, on their phone, ordering the abortion pills. So we have to be able to reach them at home, on their couch.”

Anytime, anywhere

Many organizations are looking for ways to reach women who are searching for answers after hours. In New Jersey, Lighthouse Pregnancy Resource Center contracted an external around-the-clock service staffed by nurses to chat with women in the evening. “We’re used to instant answers, and so [women] want to be answered,” said Executive Director Debbie Provencher. “But to have our own staff covering 24/7 is not as cost-effective.”

Provencher said an important reason they chose the service is because her staff could train the nurses who would be responding to messages to ensure they respond in a way that aligns with the ministry’s standards. In Delaware, Metzger said she decided not to work with an after-hours service or with an AI chatbot because she wants to protect the culture and client engagement methods that A Door of Hope has established.

Rachel Owens used to serve as director of a group of pro-life medical clinics that offered a 24/7 nurse call line in Iowa. She saw how the service gave women who were up in the middle of the night searching for help an opportunity to connect with a real, knowledgeable medical provider who could answer her questions. “This generation has grown up with abortion as healthcare their whole lives. They see it as healthcare, and so they want to talk to a healthcare professional,” she said.

In 2008, the state became a testing ground as Planned Parenthood of the Heartland piloted its first telehealth service. Now about 70% of abortions in Iowa are chemical abortions.

After the overturning of Roe v. Wade in 2022, Owen founded the nonprofit Infinite Worth, which provides live chat and text services for more than 600 pregnancy resource centers across the country. The organization now employs 40 nurses who engage with about 17,000 women per month and help educate them about the realities of what happens in an abortion and connect them with local resources. Infinite Worth also produced educational content that women can access anyplace and anytime.

Once, one of Owen’s nurses spoke to a woman in Florida who was living in her car and wanted an abortion. She was unwilling to go to a pregnancy center, but she agreed to let the nurse check in on her via text and eventually met her in person.

“It went on for two weeks,” Owen said. “Every day, they just brought resources to her, loving her, gently caring for her.” Eventually the woman agreed to move into a maternity home, received medical care, and continued with her pregnancy.

Infinite Worth shares all conversations with a local pregnancy center so that when an expectant mother does visit, she doesn’t have to reintroduce herself or repeat her story. Owen said the chat allows a woman to engage with someone before she ever visits a center in-person, a step Owen said is more difficult for those who grew up in the digital age.

“We need to start a relationship with them where they’re comfortable, and they’re comfortable on their phones,” Owen said. “If we’re not there, someone else is going to be.”