Limited health services, misinformation: A look at crisis pregnancy centers amid tax break bill

A bill that would give up to $5 million in tax breaks for donations to anti-abortion crisis pregnancy centers could soon pass the Louisiana legislature, after being touted as a way to address the maternal and infant health crisis in a state with one of the strictest abortion bans.

The bill has already passed the Senate and the House Ways and Means Committee with overwhelming Republican support. It moves now to the House floor, and then the governor’s desk.

Author Sen. Beth Mizell (R-Franklinton) said the bill was designed to improve maternal health.

“We’ve talked for years about how low the rankings are in Louisiana on maternal wellness and health,” Mizell said in a Senate committee, referencing Louisiana’s status as among the worst in maternal and infant mortality and health outcomes in the country, especially for Black and Native women.

Half the state’s parishes are “maternity care deserts,” meaning they contain no maternal health care, and Black women face significantly elevated rates of maternal mortality in those parishes and across the state.

“We all know what happened with Roe v. Wade,” Mizell continued, “and that in tandem with the rankings of the state, something had to be done to address it.”

Mizell’s bill would rename qualifying crisis pregnancy centers that meet minimal standards as “Maternal Wellness Centers,” incentivizing donations to these centers and listing them on the Louisiana Department of Health website. No organization that in any way supports, promotes or refers for abortion would be eligible for the tax breaks.

Though Mizell argued these centers would help improve maternal health, crisis pregnancy centers are not medical clinics, nor would the bill require them to become health care providers.

A WWNO/WRKF review of 33 crisis pregnancy websites and the services they advertise found that the majority offer nearly no maternal health care, nearly no reproductive health care, and some provide health misinformation, including the potentially dangerous practice of “abortion reversal.”

Kimberly Kimport, a researcher at the University of California San Francisco who has studied these centers, said they mainly function as religiously-run social services for low-income pregnant people and families with young children.

“What they do right now is they fill a gap in our social safety net,” she said. “But there is not evidence that they are improving maternal health or infant health outcomes.”

Dr. Kristyn Brandi, an OBGYN and fellow with the American College of Obstetricians and Gynecologists (ACOG) and a family planning specialist, agreed.

“This is not even a Band-Aid on the problem of maternal morbidity about maternal health,” Brandi said of the potential of crisis pregnancy centers to impact health outcomes. “It’s just a distraction from actually fixing the problem.”

Crisis pregnancy centers have existed for decades in Louisiana, and their primary goal is to dissuade women from having abortions, as well as provide services to pregnant women and new parents. According to the review of their websites and social media, nearly all crisis pregnancy centers in Louisiana (29 of 33) identified as Christian.

The centers’ primary health care offerings are free pregnancy tests, the same over-the-counter tests available in pharmacies (33 centers provided these), and “limited” ultrasounds (29 centers).

The centers often promoted ultrasounds as necessary for pregnancy confirmation, but Brandi, the OBGYN, said they would likely need to be repeated in a medical setting as part of routine prenatal care.

“Most medical professionals, if you present for prenatal care and said that you had this ultrasound, they’re going to repeat it,” she said, because there are no regulations governing ultrasounds at crisis pregnancy centers or who provides them. That means they’re not required to be the same quality as ultrasounds performed in a health care setting, Brandi said.

Under Mizell’s bill, all “Maternal Wellness Centers” would be required to refer for prenatal care, Medicaid enrollment and the publicly funded maternal and infant nutrition program, known as WIC. Currently, only about half said they referred for prenatal care, 10 for Medicaid and 7 for WIC.

It’s not clear what impact those referrals might have on maternal and infant health because it’s not clear how many people actually use crisis pregnancy centers.

The centers aren’t required to provide public data on how many clients they help and would not be required to do so under Mizell’s bill. One 2018 study of Louisiana prenatal patients co-authored by Kimport surveyed 269 patients at prenatal care clinics in Louisiana and found just 5% of prenatal patients had visited a crisis pregnancy center for that pregnancy.

“Not many people go to these centers,” Kimport said.

Brandi, the OBGYN, said it’s also unlikely that crisis pregnancy centers would help improve maternal health access even in parishes where none exist because “it’s like having the same thing you already have, which is no health care providers in that place.”

Only a handful of crisis pregnancy centers said they provided other health services: Five offered STD testing and two provided well-woman exams, the routine yearly check-up for women.

Only five centers had a medical director or registered nurse on staff. Mizell’s bill would require pregnancy tests to be administered by a registered nurse, but it would not require a medical director to be on staff.

One-third of the centers featured misinformation about abortion on their sites.

Some suggested that women seeking abortions in other states should still come to their centers for an ultrasound, without stating on the same page that the center was anti-abortion.

Even more, 14 centers, provided misinformation about “abortion reversal” — an unproven and potentially dangerous practice of trying to prevent a successful medication abortion. One small 2019 study that tried to evaluate whether “abortion reversal” works resulted in dangerous hemorrhaging and was shut down as a result.

In 2021, the Louisiana Department of Health took the highly unusual move of testifying against a bill that would have forced it to promote “abortion reversal” on its website. Dr. Joseph Kanter, the state health officer, said it is “not supported by expert consensus, and it’s not standard of practice.”

Two crisis pregnancy centers promoted misinformation about emergency contraception, and none said they provided or referred for emergency contraception, a common stance among these centers across the U.S.

Nor did any Louisiana center say they provided or referred for contraception in general. Two of the state’s largest crisis pregnancy centers, Woman’s New Life in New Orleans and Baton Rouge, featured misinformation on their websites claiming contraceptives, including birth control pills, intrauterine devices (IUDs) and implants, “intentionally harm the function of a woman’s reproductive system” and “are harmful to women.”

Mizell’s bill would actually reinforce this anti-contraceptive stance.

It would require crisis pregnancy centers to join one of three leading national crisis pregnancy center organizations in order to qualify for the tax-deductible donations. Two of those national groups, Heartbeat International and Care Net, state in their policies that no center can promote contraceptives.

Kimport said the result is a “two-tiered” system: Those with fewer means or who might lack health insurance may turn to crisis pregnancy centers, where they receive fewer options and less education about contraceptives. Because of the legacy and ongoing effects of racism, those people are also more likely to be Black, she added, the same population that faces the worst maternal health outcomes in Louisiana.

“People who have insurance, they are getting a different kind of care,” Kimport said.

Mizell’s bill would require crisis pregnancy centers to offer support, including material goods as well as counseling services and parenting or prenatal classes, and the vast majority already do.

Nearly all — 30 of the 33 centers surveyed — offer material assistance, ranging from baby supplies and clothes to diapers and formula.

For more than half of those centers, that support comes with conditions. At 17 centers, all or some of those items are only available to clients who participate in the center’s classes. Those classes are often provided by Christian organizations.

In a committee hearing for the bill, Mizell said that people are “rewarded with diapers or wipes” for taking these classes, and they can take more classes to “build up to getting a stroller.”

The majority of centers offered counseling, typically called “lay counseling” and focused on a client’s decision about their pregnancy. Three said they provide “professional” counseling, but none said they offered sessions with a licensed counselor. One center said it also provided marriage classes.

The majority also offered counseling for people who’ve had abortions, often framing that service as necessary to “heal” from an abortion or claiming the existence of “post-abortion syndrome.” The largest study on the effects of abortion access, “The Turnaway Study,” followed nearly 1,000 women in 21 states for five years and found no evidence of long-term mental health risks associated with abortion.

About half of the centers provided referrals for adoption, which all “Maternal Wellness Centers” would be required to offer under the bill.

Louisiana crisis pregnancy centers are unregulated by state agencies and face little oversight, including those that already receive government funding. Under Mizell’s bill, that would continue.

Louisiana distributes welfare funding to certain centers through its Alternatives to Abortion Initiative, which uses money from the Temporary Assistance for Needy Families (TANF) program. Since 2011, it has granted over $11 million in welfare grants to crisis pregnancy centers, according to a report last year by Lift Louisiana, which supports abortion rights.

The Department of Children and Family Services (DCFS), which distributes TANF grants, does not track the effectiveness or outcomes of these centers. Last year, Republicans defeated a bill that would have required DCFS to study crisis pregnancy center services and impacts.

During one of the committee hearings for her bill, Mizell said crisis pregnancy centers don’t want more government oversight, including from the Department of Health.