In the months since the US supreme court overturned Roe v Wade, at least 16 states have agreed to funnel more than $250m in taxpayer dollars towards anti-abortion facilities and programs that try to convince people to continue their pregnancies.
Much of that money is set to go to anti-abortion counseling centers, or crisis pregnancy centers, according to data provided by the Guttmacher Institute and Equity Forward, organizations that support abortion rights. It has been paid out throughout 2023 and will stretch into 2025.
That haul marks an increase from 2021 and 2022, when states sent closer to $217m towards crisis pregnancy centers and “alternatives to abortion” programs, according to the groups’ data.
In addition to the payments, at least two states, Louisiana and North Dakota, initiated programs in 2023 that implemented tax credits for crisis pregnancy centers.
The $250m may soon be supplemented with even more money, as several state legislatures across the country will open back up for business in the coming months. It is also not the sum total of all government money that may be flowing to crisis pregnancy centers, since some centers have received funding through a federal family-planning program or money set aside for abstinence-only sexuality education.
Tara Murtha, the director of strategic communications at the Women’s Law Project, said that crisis pregnancy centers help funnel public funds into the anti-abortion movement.
“So we see that very aggressive push right now,” she said. But, pointing to recent victories by abortion rights advocates to claw back state funding, she said: “There is also momentum for CPC accountability.”
More than 2,500 crisis pregnancy centers, which are also sometimes called “pregnancy centers” or similar, litter the United States. Usually faith-based, these facilities tend to offer resources like pregnancy tests, ultrasounds and baby supplies. They do not perform or refer for abortions; they’re often opposed to birth control. Beyond any state funds they may receive, the centers usually rely on private donations.
Abortion rights supporters have accused these centers of impersonating abortion clinics and misleading abortion seekers. The centers sometimes have names involving the word “choice” and are located near abortion clinics, which can confuse abortion seekers into accidentally stepping inside. Studies and news outlets have also repeatedly found that crisis pregnancy centers inaccurately exaggerate the risks of abortion and birth control, such as by suggesting that abortion causes breast cancer, which is false.
In 2022, crisis pregnancy centers saw more than 16 million individuals in person and virtually, according to a report by the anti-abortion Charlotte Lozier Institute, which has promoted crisis pregnancy centers as the solution to the chaos unleashed by the overturning of Roe.
“The demands upon pregnancy help centers have increased daily. Many states are responding with new funds and new policies to support the centers’ work,” the institute’s president, Chuck Donovan, said in a statement. “Pregnancy help center leaders see in this situation new opportunities to serve generously with love and compassion for those in need.”
Crisis pregnancy centers have long gone largely unregulated. Many of the centers are not medically licensed, so they are not generally beholden to the standards set for medical facilities, even though many provide medical services like ultrasounds. Courts have also said that efforts to curb the centers’ activities infringe on their right to free speech.
In 2018, the US supreme court ruled against a California law that forced centers to disclose whether they were a licensed medical provider. Earlier this year, a Colorado judge blocked a law that would have banned “abortion reversal”, an unproven practice to halt abortions that is often touted by crisis pregnancy centers.
States’ “alternative to abortions” programs don’t exclusively devote money to crisis pregnancy centers. But the bulk of the money often flows to or through the centers, who may in turn direct it towards a vast array of anti-abortion services and organizations. Texas, for example, runs what is by far the largest “alternatives to abortion” program in the United States. A 2022 report on the program showed that, of the roughly $50m devoted to the program that year, all but about $150,000 went to three adamantly anti-abortion organizations that run crisis pregnancy centers. Those organizations dispersed the money to dozens of centers, adoption agencies and maternity homes. Some of this money even went to centers that offer sex education programs in public schools that have been criticized as misleading or ideological.
This year, the Texas state legislature decided to raise its “alternatives to abortion” program’s annual allocation to $70m, from about $50m per year, meaning that the centers will receive roughly $140m over 2024 and 2025. Lawmakers also decided to tack on an additional $25m to the 2023 version of the program, bringing the total to $165m. (The Texas state legislature only meets every two years and maintains biennial budgets.)
There are approximately 200 crisis pregnancy centers in Texas, according to a tally by researchers at the college of public health at the University of Georgia. There are zero abortion clinics, because the state has banned almost all abortions.
Texas previously diverted money to its “alternatives to abortion” program from the federal Temporary Assistance for Needy Families program, which is meant to help lower-income families, according to data from Equity Forward. It has stopped doing so in recent years, but other states have continued to use that program to send funds to crisis pregnancy centers.
Funding for crisis pregnancy centers also surged in Florida and Tennessee after Roe’s demise. Florida legislators, who recently passed a six-week abortion ban, agreed in 2023 to dedicate at least $25m towards crisis pregnancy centers in the coming years – an increase of more than $20m. In Tennessee, which bans almost all abortions, legislators decided to also send at least $20m to the centers. That was a spike of roughly $17m. (Some of these funding increases were previously calculated by the Washington Post.)
This year also marked the start of a West Virginia program to support mothers and babies, which will be funded with $1m, according to data from Equity Forward. The program will be managed by the West Virginia Pregnancy Center Coalition, according to the program’s website. That organization works to “protect every human life from conception to natural death”, its website declares, and it works with prominent anti-abortion organizations like Heartbeat International and Care Net, which are affiliated with massive networks of crisis pregnancy centers.
Bucking the trend
The first crisis pregnancy center opened in Hawaii in 1967, amid a growing effort to loosen state abortion laws and six years before the US supreme court legalized abortion nationwide in the 1973 Roe v Wade decision. In the mid-1990s, Pennsylvania became the first state to start a program funding crisis pregnancy centers. That program eventually became the model for other states’ “alternatives to abortion” programs.
Real Alternatives, a non-profit that discourages abortion in favor of “life-affirming pregnancy and parenting services”, has maintained the contract for that program since at least 1997. Twenty years later, in September 2017, Pennsylvania’s auditor general released a report alleging that the organization had improperly used state dollars to support its work outside of Pennsylvania, a charge the group denies.
In the 2022 and 2023 fiscal years, Real Alternatives received more than $14m in state funding from Pennsylvania.
This year, Pennsylvania’s Democratic governor, Josh Shapiro, announced that he would no longer continue that contract past 31 December 2023.
“Pennsylvanians made clear by electing me as governor that they support a woman’s freedom to choose, and I will be steadfast in defending that right,” Shapiro said in a release at the time.
In Real Alternatives’ view, Shapiro’s termination of the contract undermined the state legislature’s goals for the program. Plus, it will lead to an increase in abortions, Real Alternatives said: “That is terrible and certainly not something to celebrate. Those women have had a choice taken away from them.”
Pennsylvania was one of just two states, along with Minnesota, that moved in 2023 to no longer fund crisis pregnancy centers. That defunding was the result of a years-long campaign to cast a spotlight on crisis pregnancy centers, abortion rights activists said.
The auditor general’s report was critical to their crusade, they said. State “alternative to abortion” funding is often confusing, if not outright byzantine.
“We’ve been doing a lot of advocacy in the legislature in educating legislators. A lot of our legislators didn’t even know what crisis pregnancy centers were, and that’s where we came in,” said Signe Espinoza, the executive director at Planned Parenthood Pennsylvania Advocates. Crisis pregnancy centers outnumber abortion clinics nine to one in Pennsylvania, according to Espinoza.
Democratic victories in Pennsylvania also helped. Republicans maintain control over the state Senate, but in 2022, Democrats won control of the statehouse for the first time in years.
“That didn’t happen overnight. This was certainly years in the making,” Espinoza said. “It takes time. But if you’re committed, I think that this is something we can certainly replicate across the country. We’re not going to stop until they’re completely gone.”
