Intake forms at unregulated pregnancy clinics (UPCs) are often very intrusive, asking personal questions that have nothing to do with the limited “services” they provide. And they use the answers, not to help their clients but, to promote their ideology.
The main objective of UPCs is to prevent clients, either by persuasion or delay, from having an abortion. Although these organizations have the right to oppose abortion, most UPC advertisements, signs and websites present these facilities as conventional medical clinics, even as abortion providers. Inside, they also look like medical offices, with waiting rooms, exam rooms outfitted with medical equipment, and staff wearing lab coats and scrubs.
Clients are required to fill out intake forms that often ask deeply personal questions. Even though they are not conventional medical providers and have no legitimate need for the information, UPCs often ask clients for a list of the prescription drugs they take, a list of their current or past illnesses, and a list of medical conditions including those which are not relevant to the services that UPCs provide.
Some ask for the name or age of the potential baby’s father, whether the client is living with a man to whom she is not married, the client’s age when she first became sexually active, whether the client is currently sexually active with more than one partner, and whether the client engages in same-sex relationships. Further, even though the information is irrelevant because they don’t bill insurance, UPCs often ask for the client’s government identification documents, insurance information, income, employer, or eligibility for public assistance.
Certainly, the staff at nonprofit facilities have a right to ask questions; that is not the issue here. The issue is that, by masquerading as a medical clinics, many UPCs are tricking clients into believing that they must divulge very sensitive information in order to obtain medical services. It’s like a phishing scheme.
But, at least (you wonder), isn’t this information kept confidential? Often the answer is no.
Conventional medical clinics must follow the privacy, confidentiality and records security requirements of the Health Insurance Portability and Accountability Act (HIPAA). UPCs are not subject to HIPAA and, therefore, are not required to protect clients’ health information, a fact that national UPC umbrella organizations concede. Nevertheless, many UPCs give clients a sense of security by deceptively claiming they are subject to HIPAA or “HIPAA compliant.”
In fact, UPCs generally maintain client records in online databases that are accessible by third parties outside of the UPC. A digital system called eKYROS feeds personal client information into a central database linked with the national UPC umbrella groups Heartbeat International and Care Net. Other central databases used by UPCs include Next Level and CoolFocus.
As a brief by the Alliance reports: “the CPC industry is now functioning as surveillance infrastructure for the anti-abortion movement, amassing data that could be used in pregnancy- and abortion-related prosecutions….” The global anti-abortion group Heartbeat International, for example, stores “digital dossiers” on clients, stating ‘Big data is revolutionizing all sorts of industries. Why shouldn’t it do the same for a critical ministry like ours?’”
The American Medical Association “urges the development of effective oversight for entities offering pregnancy-related health services and counseling.” The American College of Obstetricians and Gynecologists says that policymakers should hold UPCs “accountable for deceptive practices by, for example, enforcing and strengthening consumer protection laws against false and misleading advertising, investigating the pervasiveness and impact of deceptive practices on patients, and partnering across the public and private sector to ensure transparency.” They are right and this requires state legislation like our model Right to Dignified Care Act.