Issue Overview
The Unregulated Pregnancy Clinic (UPC) industry is large and widespread. More than 2,600 pregnancy centers operate in all 50 states,195 most of which affiliate with one or more of three national organizations: Care Net, Heartbeat International, and National Institute of Family and Life Advocates (NIFLA).
Over the past three years, [State] has granted $XXXX to pregnancy centers. XX pregnancy centers operate in [State], and XX has received funding from the state.
Pregnancy centers [use your state’s term] present themselves as free medical clinics to mislead clients seeking abortion. Their primary goal is to prevent clients, through persuasion, misinformation, or delay, from having an abortion.196 While these organizations have the right to oppose abortion, most use misleading tactics, including ads, signs, and websites presenting their facilities as conventional medical clinics, even, at times, as abortion providers.197,198 Inside, they often resemble medical offices, with waiting rooms and exam rooms outfitted with medical equipment, and staff in lab coats and scrubs.199 Clients must often fill out intake forms that ask for private health information.200
The vast majority of pregnancy centers [use your state’s term] advertise medical or quasi-medical services. Nearly all offer free pregnancy tests201 readily available at any pharmacy. Between one-quarter202 and one-half203 advertise free STD/STI tests, and approximately three-quarters advertise free ultrasounds, 204 typically performed by someone presenting as a medical professional.
Pregnancy centers [use your state’s term] use of ultrasound machines is unethical. UPCs do not perform diagnostic ultrasounds that address medical issues. Instead, they offer so called “limited” or “non-diagnostic” ultrasounds, intended to show pictures of the uterus they hope will dissuade clients from seeking an abortion. This is a misuse of medical equipment;205 even one of the three major UPC umbrella groups, Care Net, admits as much when it truthfully answers, “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.”206
Mobile pregnancy centers [use your state’s term] are intentionally designed to look like conventional medical facilities.207 As ICU Mobile, “A Ministry Division of Care Net,” concedes: “ICU Mobile units are neutrally branded and medically designed. By having this independent brand, we break down the barriers that may prevent abortion-minded women from coming on board…”208 Another set of mobile UPC trucks, from Save the Storks, have painted on the sides: “Women’s Choice Center,” “Pregnancy Testing & Ultrasound,” and “mobile medical unit.”209
Clients seeking pregnancy services need factual medical advice. The American Medical Association “advocates that any entity offering crisis pregnancy services…truthfully describe the services they offer or for which they refer—including prenatal care, family planning, termination, or adoption services—in communications on site and in their advertising, and before any services are provided to an individual patient.”210
Pregnancy centers commonly tell these five medical lies:
1) That having an abortion raises the risk of developing breast cancer. However, the American Cancer Society,211 the National Cancer Institute,212 and the American College of Obstetricians and Gynecologists213 have flatly refuted this claim.
2) That having an abortion raises the risk of infertility. A study published by the National Institutes of Health found that “there is no association between abortion and secondary infertility.”214 A Guttmacher Institute survey of scientific studies found that abortion poses “virtually no long-term risks of future fertility-related problems such as infertility…”215 The American College of Obstetricians and Gynecologists also shares that position.216
3) That having an abortion raises the risk of negative emotional or mental health problems or increases the risk of suicidal ideation. An American Psychological Association Task Force217 and a comprehensive New England Journal of Medicine study218 found no such evidence. A study published by the National Institutes of Health concluded that abortion is “not a statistically significant predictor of subsequent anxiety, mood, impulse-control, and eating disorders or suicidal ideation.”219
4) That medication abortion poses greater risks than other common prescription drugs or than childbirth. In fact, an analysis of U.S. Food and Drug Administration data found that mifepristone is four times safer than penicillin, ten times safer than Viagra, and more than four times safer than childbirth. Further, a two-drug medication abortion using both mifepristone and misoprostol is even safer.220
5) That an abortion procedure poses greater health risks than other common medical procedures or than childbirth. In fact, “the risk of complication or mortality from abortion is less than the same risk from common procedures like wisdom tooth removal, cancer-screening colonoscopy, and plastic surgery,” according to the American College of Obstetricians and Gynecologists.221 A study based on data from the Centers for Disease Control found that the “risk of death associated with childbirth is approximately 14 times higher than that with abortion.” 222
SECTION 1. SHORT TITLE
This Act shall be called the “Truth in Reproductive Health Act.”
SECTION 2. FINDINGS
The legislature finds that:
1. Individuals and organizations have the right to lie about abortion; they are welcome to say whatever they like.
2. However, if organizations receive state funding and represent themselves as medical providers, it is necessary and appropriate to require them to refrain from asserting medically inaccurate information that could harm the health of [State] residents.
3. False or misleading information about the effects of abortion hinders a resident’s ability to make an informed decision and may delay appropriate medical care when time is an important factor.
4. The American Medical Association (AMA) insists that: “any entity that represents itself as offering health-related services should uphold the standards of truthfulness, transparency, and confidentiality that govern health care professionals.” The AMA further urges that: “public funding only support programs that provide complete, non-directive, medically accurate health information to support patients’ informed, voluntary decisions.”223
5. The American College of Obstetricians and Gynecologists (ACOG) states that: “People seeking reproductive health care must have access to comprehensive, evidence-based, nonjudgmental health care and information from qualified professionals, regardless of whether they decide to continue a pregnancy or seek abortion care.”224
6. It is unconscionable for the government to use taxpayer funds to support the expression of health care information that is demonstrably false and potentially damaging to clients.
SECTION 3. TRUTH IN REPRODUCTIVE HEALTH CARE
After section XXX, the following new section XXX shall be inserted:
MEDICALLY ACCURATE INFORMATION FROM HEALTH CARE FACILITIES THAT RECEIVE GOVERNMENT FUNDING
(A) No organization shall be eligible for any type of grant or subsidy from the state if, while presenting itself as providing health care services, its staff or volunteers disseminate oral or written information asserting any of the following:
1. That having an abortion raises the risk of developing breast cancer;
2. That having an abortion raises the risk of infertility;
3. That having an abortion raises the risk of negative emotional or mental health problems or increases the risk of suicide ideation;
4. That medication abortion poses greater health risks than other common prescription drugs or than childbirth; or
5. That an abortion procedure poses greater health risks than other common medical procedures or than childbirth.
(B) A facility presents itself as providing health care services if it does any of the following:
1. Advertises itself, including on the Internet or on signage, as if it provides medical services, or uses medical imagery in promotional materials, including but not limited to websites, social media, and printed materials.
2. Is made to look like a medical office with medical examination tables or equipment not generally found in a nonmedical counseling center.
3. Has staff providing medical services or medical counseling who are not licensed medical providers.
4. Claims to comply with the requirements of the Health Insurance Portability and Accountability Act (HIPAA).
5. Claims that clients are able to file complaints against the facility with a particular federal or state health agency, if those agencies do not accept complaints for the type of facility being run.
6. Lists in advertising or on-site a medical director who is not licensed under [cite code] as a physician, [and if appropriate, licensed as a physician assistant or nurse practitioner] or lists a medical director who is licensed but does not directly supervise, in person, the provision of all medical services provided at the facility. [NOTE: Many states have laws or regulations that define “direct supervision.” Ask your in-state advocates and bill drafters to ensure that the legislation uses language that fits your state.]
7. Requires clients to fill out an intake form before receiving services which asks for personal health information, such as a listing of prescriptions the client is taking or a listing of medical conditions that are unrelated to establishing a client’s pregnancy.
SECTION 4. EFFECTIVE DATE
This law shall become effective on July 1, 20XX.
