IdeaLog

States need to address UPCs’ lack of ethics

Posted on October 27, 2025

State boards of medicine and nursing are ignoring ethical violations by doctors and nurses who are associated with UPCs. Essentially, these licensed professionals are helping UPCs impersonate medical clinics, which is defrauding clients.

Anyone who is licensed in health care is subject to discipline, from a reprimand to a loss of license. Every state regulates its medical professionals with a Board of Medicine (also called a Board of Physicians or other names) and a Board of Nursing. These boards issue licenses and, also, if a doctor or nurse is accused of violating laws, regulations or ethical rules, conduct investigations and impose disciplinary measures.

According to the anti-abortion movement, there are more than 10,000 licensed medical staff members at UPCs (4,779 paid staff and 5,396 volunteers). Since there are about 2,600 UPCs nationwide, there are, on average, about four licensed medical professionals associated with each clinic.

The problem is, most UPCs present themselves as conventional medical clinics, but they’re not. UPC advertisements, signs and websites make them look like medical clinics, and inside, they also look like medical offices, with staff wearing lab coats and scrubs. Examination rooms look like doctors’ offices with a medical examination table and ultrasound machine, and often dressed up with items like otoscopes, blood pressure gauges, a handwashing station, a biohazard waste container, and anatomical posters or plastic models.

About 75 percent of UPCs use ultrasound machines for non-medical purposes. UPCs do not perform diagnostic ultrasounds from which medical conclusions can be drawn. They call them “limited” ultrasounds, which is little more than showing pictures of the womb in the hope that, once seen, clients will bond with the fetus and not seek an abortion. UPCs are using medical equipment unethically and even one of the three major UPC umbrella groups, Care Net, truthfully answered the question “Can we just do ultrasounds without becoming a medical clinic?” with the answer “Absolutely not. The use of ultrasound energy in any form is considered the practice of medicine.”

Even though they are not 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 homosexual relationships. None of these are ethical questions for a UPC to ask because their services are limited to off-the-shelf pregnancy and STD/STI tests, counseling and providing material services like diapers and wipes.

Because UPCs are not regulated medical clinics, they can and do violate clients’ privacy. Conventional medical clinics must follow the privacy, confidentiality and records security requirements of the Health Insurance Portability and Accountability Act (HIPAA) and/or state laws and regulations. UPCs are not subject to HIPAA and not legally required to protect clients’ health information, a fact that the national UPC umbrella organizations concede. Nevertheless, many UPCs give clients a sense of security by falsely claiming that they are subject to HIPAA or “HIPAA compliant.”

Some UPCs have been documented misleading clients about their medical conditions. For example, clients may be given false information as part of their ultrasound or the fetus’ gestation age may be willfully miscalculated to deter clients from seeking an abortion.

States need to ensure that medical and ethical practice standards are enforced. A Joint Position Statement of the Society for Adolescent Health and Medicine and the North American Society for Pediatric and Adolescent Gynecology states that the groups would: “Urge all governmental, regulatory (e.g., medical and nursing boards), and accrediting bodies with responsibility for enforcing medical and ethical practice standards to ensure that health care professionals providing services at CPCs and services delivered at CPCs adhere to established standards of care.” Similarly, the American Medical Association “urges the development of effective oversight for entities offering pregnancy-related health services and counseling.”

These are extremely modest recommendations which states can and should follow.