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Crisis pregnancy centers pose risk to adolescent health, experts say

Andrea Swartzendruber

The Society for Adolescent Health and Medicine, or SAHM, and the North American Society for Pediatric and Adolescent Gynecology, or NASPAG, published a position statement in The Journal of Adolescent Health that highlighted the risks that crisis pregnancy centers pose to pregnant adolescents by spreading misinformation and limiting the information available to teens.

“Many [crisis prevention centers (CPCs)] give the appearance that they are comprehensive medical clinics and provide services that they do not actually offer,” Andrea Swartzendruber, PhD, MPH, co-author of the position paper and assistant professor of epidemiology and biostatistics at the University of Georgia College of Public Health, told Infectious Diseases in Children. “For example, some CPCs call themselves ‘medical centers’ or ‘clinics.’ In addition, URLs for CPCs frequently include the words ‘abortion’ and ‘choice.’”

A separate policy forum published in the AMA Journal of Ethics noted that most CPCs have religious affiliations and that many operate under a network or umbrella organization, such as the National Institute of Family and Life Advocates, Birthright International, Care Net or Heartbeat International. According to the authors, in 2010, CPCs outnumbered abortion clinics in the United States.

Additionally, the authors said many centers receive government funding. The U.S. House of Representatives Committee on Government Reform reported in 2006 that more than $30 million was given to more than 50 centers between 2001 and 2005.

Although CPCs continue to receive federal funding, Planned Parenthood — a center providing a wide variety of sexual health information and services, including testing for sexually transmitted infections and providing contraception — no longer receives federal funding through Title X.

According to CNN, receiving this funding would require Planned Parenthood to stop informing patients about abortion services.

California passed a law in 2015 that required unlicensed CPCs to disclose that they are not licensed medical facilities. The bill, known as the Reproductive FACT — Freedom, Accountability, Comprehensive Care and Transparency — Act, also required the centers to educate women about state-provided services, including family planning, prenatal care, abortions and other services.

In 2017, the Supreme Court heard a case filed by the National Institute of Family and Life Advocates that argued that the law violated CPCs’ First Amendment rights. The Supreme Court sided with CPCs on June 26, 2018, in a 5-4 vote.

SAHM and NASPAG hold the following positions on CPCs, their effect on young pregnant women and the government’s role in these centers:

• By refusing to adhere to medical and ethical practice standards, CPCs are a risk to adolescent health.

• Only centers that provide accurate and comprehensive information should receive government support.

• Both CPCs and their employees should be held to established medical and ethical standards of care.

• Schools should not provide sex education through CPCs or other programs that do not provide accurate and complete health options.

• Digital media platforms, including search engines, should enforce policies against misleading advertising promoted by CPCs.

• Health care providers should be educated on CPCs and provide this information to their young patients so they can seek safe, quality sources of sexual and reproductive information and health care.

“There are a number of steps providers can take to ensure patients have access to accurate, complete sexual and reproductive health information and safe, quality health care,” Swartzendruber said. “Providers should be aware of CPCs operating in their local areas and help educate patients about the limitations of CPC services.”

“Providers can also serve as advocates. Medical professionals can use their credibility and expertise to educate the public and policy- and decision-makers about the vast evidence supporting comprehensive approaches to sexuality education and the risks that CPCs pose to individual, family and public health.”

References:

Bryant AG, Swartz JJ. AMA J Ethics. 2018;doi:10.1001.journalofethics.2018.20.3.pfor1-1803.

SCOTUSblog. National Institute of Family and Life Advocates v. Becerra. https://www.scotusblog.com/case-files/cases/national-institute-family-life-advocates-v-becerra/. Accessed Oct. 31, 2019.

Swartzendruber A, et al. J Adol Health. 2019;doi:10.1016/j.jadolhealth.2019.08.008.

Disclosures: The authors report no relevant financial disclosures.