Issue Overview

The Unregulated Pregnancy Clinic (UPC) industry is large and widespread. More than 2,600 pregnancy centers operate in all 50 states,⁹² 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). Between 2019 and 2022 alone, the UPC industry reported over $5.6 billion in revenue, more than $4.9 billion in expenses, and $2.3 billion in assets.⁹³

UPCs often 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.⁹⁴ 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.^95,96 Inside, they often resemble medical offices, with waiting rooms and exam rooms outfitted with medical equipment, and staff in lab coats and scrubs. Clients must often fill out intake forms that ask for private health information.⁹⁷

UPC clients have reported that they believed they were at an actual medical clinic,^98,99 where staff made false claims about reproductive health care under the guise of medical authority. UPCs often target people who are young, have lower incomes, and may not be familiar with the difference between a traditional medical clinic and a UPC. These clients are vulnerable; many may be afraid. This vulnerability is exploited when someone who may or may not be an appropriately licensed medical professional makes alarming medical claims to someone in a state of stress. That’s routinely the UPC strategy: use medical impersonation to push falsehoods about the safety of standard reproductive health care.¹⁰⁰

Residents of [State] are being inundated with ads for UPCs. Online ads, billboards, and signs frequently make UPCs appear to be standard medical clinics staffed by licensed medical practitioners, when, overwhelmingly, they are not.

The best way to diminish the negative impact of UPCs is to promote fact-based reproductive health care. Between 2021 and 2024, state legislatures allocated over half a billion in taxpayer dollars ($513 million) to the UPC industry.¹⁰¹ It is time to counterprogram against the UPCs’ ubiquitous “Pregnant? Need Help?” style ads.

We also need to promote more accessible, trustworthy resources. UPCs operate and advertise several centralized hotlines and online directories to direct clients their way, such as Heartbeat International’s Option Line¹⁰² and Directory of Pregnancy Health Centers,¹⁰³ Care Net’s National Hotline¹⁰⁴ and directory of UPCs,¹⁰⁵ the Pregnancy Decision Line,¹⁰⁶ and the “Pregnant, Need Help” Hotline.¹⁰⁷ While similar resources exist for all-options clinics, they must be easier to use, more widely promoted, and better known.