Crisis pregnancy centers, sometimes called pregnancy resource or counseling centers, are fake clinics explicitly created to talk people out of having abortions. They do this through sophisticated on and offline false advertising and marketing to individuals considering abortion, engaging in misinformation campaigns about the procedure, and vilifying the people who have them and perform them. They often open their doors in low-income communities or near college campuses in order to explicitly target people of color, low income individuals, and young people – those with the least resources, support and accurate medical information at their disposal.^[2]

While many CPCs intentionally appear to operate as small, standalone organizations, more than 75% are affiliated with at least one of four main national anti-abortion networks – Care Net, Heartbeat International, Birthright International and the National Institute of Family and Life Advocates.^{[3] [4]} These organizations are well funded, central actors in the faith-based “pro-life’ movement. They serve as a cornerstone of the larger anti-abortion infrastructure.

CPCs sometimes hide in plain sight, often housed within larger faith-based service organizations or institutions. They have done such a good job at misrepresenting their intentions that many legitimate healthcare centers and community centers list them alongside real abortion providers.^[5]

In fact, CPCs currently outnumber actual abortion clinics nationally 3 to 1.^[6] In a post Roe world where state trigger laws will likely lead to the closure of even more abortion providers, it’s not hard to imagine that ratio rising.

^[2] National Women’s Law Center. (2013). Crisis Pregnancy Centers are Targeting Women of Color, Endangering Their Health – NWLC [Fact Sheet]. http://nwlc.org/resources/crisis-pregnancy-centers-are-targeting-women-color-endangering-their-health/  Archived at https://perma.cc/9EVT-Z5FX

^[3] Reproaction. (2017). CPC Fact Book 2.0. https://reproaction.org/wp-content/uploads/2017/05/CPC-Fact-Book-2.0.pdf

⁴The Alliance – State Advocates for Women’s Rights and Gender Equality. (2021). Designed to Deceive – A Study of the Crisis Pregnancy Center Industry in Nine States. https://alliancestateadvocates.org/wp-content/uploads/sites/107/Alliance_CPC_Report_FINAL11-4-1.pdf

^[5] Wormer, Rachel. (2021). Mapping Deception: A Closer Look at How States’ Anti-Abortion Center Programs Operate. Equity Forward. https://equityfwd.org/research/mapping-deception-closer-look-how-states-anti-abortion-center-programs-operate

^[6] The Alliance – State Advocates for Women’s Rights and Gender Equality. (2021). Designed to Deceive – A Study of the Crisis Pregnancy Center Industry in Nine States. https://alliancestateadvocates.org/wp-content/uploads/sites/107/Alliance_CPC_Report_FINAL11-4-1.pdf

Media reports following the Supreme Court’s decision have begun to further explore how CPCs became an essential tool used to attack abortion access.  CPCs are the cornerstone of the anti-abortion movement’s highly effective ground game. This could not be the case without the strong and sustained support of philanthropy.  The more one looks into the numbers behind the growth and success of CPCs, the easier it is to see the stark imbalance in financial resources and institutional support for them versus for abortion providers and organizations working on access issues.

As the nation continues to process what reproductive health and access looks like in the aftermath of the Supreme Court’s decision, a frightening picture emerges especially in the 13 states where pre-existing trigger laws made local abortion services immediately illegal. In these 13 states, funding for organizations that include crisis pregnancy “counseling” or centers is more than six times what philanthropy has committed to frontline abortion support and services.^[7] ($45 million vs. $6.9 million dollars between 2015-2019, the last years for which full funding data is available)

The gap is only slightly less when analyzing the 37 states without trigger laws where groups supporting CPCs enjoy an almost five fold funding advantage over abortion funds and clinics ($232.6 million vs. $49.4 million). This 5:1 dollar advantage holds at the national level as well: Across all 50 states and the District of Columbia, organizations with CPCs received $278 million in funding, while funds and clinics got $56 million. An imbalance remains even in the 16 states and the District of Columbia that explicitly protect abortion rights, though it is significantly less. In these regions, organizations engaged in CPCs efforts out fund abortion funds and clinics by 1.5x ($49 million vs. $32.8 million).

This massive resource imbalance created by disproportionate funding helped build the foundation which anti-choice groups used to overturn Roe v Wade and continues to be central to efforts to eradicate abortion access across the country.

^[7]According to NCRP analysis of Candid data. For more information, see our methodology.

These fake clinics use a variety of techniques to dissuade people from choosing abortion, both inside the center and outside their walls.

Fake clinics have been known to:

•  Give people incorrect information about their own pregnancy and gestational age (how far along the pregnancy is).

•  Provide misinformation about what is involved in the abortion procedure and what its side effects could be (including incorrect information about abortion risks vs. the risks of carrying pregnancy to term).^[8]

•  Have staff pose as medical professionals when they have no medical training, education or a license.

•  Shame pregnant people for sexual history, drug use, and considering an abortion.

• Tell people not to worry about carrying an unwanted pregnancy to term because miscarriage rates are high, suggesting the pregnancy may end on its own which could push someone past the legal termination date.

•  Harass people after they’ve left the center by calling them incessantly and violating their privacy by collecting and sharing personal information with other anti-abortion groups and potentially the state and general public.^[9]

•  Promise help and services for someone who chooses to carry a pregnancy to term, then fail to follow through after birth.

•  Use geo-location and micro-targeted advertising to reach people seeking abortions.[^[10]

One particularly insidious way CPCs function in concert with restrictive state abortion policies is by targeting low-income and/or uninsured abortion seekers with non-diagnostic ultrasounds, a procedure that cannot measure the placenta or amniotic fluid, nor be used to detect fetal abnormality or fetal distress.

Abortion seekers often must search for cost-efficient ultrasounds to determine how far along their pregnancy is to know if they still qualify for abortion care in their state. In addition, several states have made obtaining an ultrasound a required part of abortion service provision as one of the many restrictions enacted to create barriers to access. Some laws and policies require that a person seeking an abortion receive information on accessing ultrasound services, while others require that a patient undergo an ultrasound before an abortion.

CPCs take advantage of pregnant peoples’ urgent need to understand their gestational status and clear the hurdles created by the state as a way to get patients in the door and then use these non-diagnostic ultrasounds to explicitly persuade clients to carry the pregnancy to term.^[12] In many instances the fake anti-abortion clinic will use this time during the ultrasound to suggest that the pregnant person is too far along into their pregnancy to have an abortion, convincing them that they have no choice. In this way, anti-abortion lawmakers and the CPC industry work together to put up barriers between pregnant people and reproductive healthcare options.

In the event that these pressure and manipulation tactics are successful, and someone decides to carry a pregnancy to term, the pregnancy center is unlikely to provide any pre or post-natal resources or care. In the Alliance study, ninety-five percent of the CPCs in the study did not offer any form of prenatal care, and less than half offered referrals for prenatal care. ^[13] The same study explains that the least often offered services at fake anti-abortion clinics were prenatal care (5.1%), well-person care (4.8%), and contraceptive care (one CPC — 0.2% of the study sample — provided all FDA-approved options and hormonal contraceptives). Some CPCs may offer “free” maternity supplies, but only upon completion of counseling, religious education, or other ideological programming.

^[8]Common Fake Clinic Misinformation. Pro-Choice North Carolina. https://prochoicenc.org/common-fake-womens-health-center-misinformation/

^[9]Dale, M. (2022, May 18). With Roe v. Wade in jeopardy, some fear tech surveillance of pregnancy. Fortune.com. https://fortune.com/2022/05/18/tech-surveillance-pregnancy-abortion-data-privacy/

^[10]Cheung, K. (2021, November 22). Abortion in the Surveillance State. Jezebel. https://jezebel.com/abortion-in-the-surveillance-state-1848076906

^[11]The Alliance – State Advocates for Women’s Rights and Gender Equality. (2021). Designed to Deceive – A Study of the Crisis Pregnancy Center Industry in Nine States. https://alliancestateadvocates.org/wp-content/uploads/sites/107/Alliance_CPC_Report_FINAL11-4-1.pdf

^[12]Ibid.

^[13] Ibid.

Getting a comprehensive picture of the funding landscape of the anti-abortion movement is not easy.

However, one thing is clear: It has deep pockets, with institutional connections to resources that provide ongoing, significant infrastructure and financial stability.

The majority of the most well-resourced organizations listed in Reproaction’s database of over 2600 CPC  locations nationwide share the same tax identification number (EIN) as larger entities, including direct service charities and/or broad pro-life groups with religious affiliations.^[14] This means that for both legal and tax purposes, they are the same organization.^[15] Being embedded in high-profile, relatively powerful and well-funded larger organizations affords CPCs financial stability and sustainability as well as significant infrastructure, and institutional support.

The (purposefully obscured) reality that many CPCs share tax ids with these larger organizations makes it unclear how much of the revenue reflected in the Internal Revenue Services’ 990 reporting forms is specifically for “crisis pregnancy” purposes.  This is one of the many reasons that straight-forward, transparent accounting of resources for the anti-abortion movement is extremely difficult to obtain.

However, two things are clear:

•  Many CPCs that appear to be standalone local operations are in fact legally and financially part of much bigger organizations that provide fiscal sponsorship, financial stability, infrastructure and institutional support; and

•  These broader institutions materially and ideologically support crisis pregnancy services that are designed to deny people access to the full range of reproductive healthcare.

^[14]Reproaction Education Fund: Anti-Abortion Fake Clinic Database, accessed April 2021 from https://reproaction.org/fakeclinicdatabase

^[15]Shared EINs were identified according to their websites or branded materials. For more information, scroll down to our methodology section. 

NCRP found tax information for approximately 2,400 of the over 2,600 CPCs in the Reproaction database.^[16] Shockingly, almost half of those groups providing “crisis pregnancy” services had shared EINs, making them part of the same legal entity. The total number of unique 501(c)3 legal entities (any one of which might have multiple locations and/or “shell” front groups with different names) that filed at least one tax form between 2015-2019 was 1291.

According to tax records, this subset of groups involved in the CPC industry received more than $4 billion dollars in revenue during this period, or around $860 million dollars per year. Of that total, at least $2.2 billion dollars, or more than half, was concentrated among the top 10 recipients, all of which are larger institutions where pregnancy services are not the sole and/or primary purpose of the organization. This means that it is reasonable to assume that only some of these dollars went directly to crisis pregnancy centers or counseling.

There is no way to know exactly how much revenue goes specifically to CPC efforts without disaggregated data reporting by the organizations, which is not currently required by tax law.  However, despite the lack of transparency on the particulars, the data we do have access to conclusively demonstrates that the majority of crisis pregnancy counseling, programs and clinics are housed within heavily resourced larger institutions.

The bottom line: CPCs are not, as their proponents would have people believe, small-scale individual church-based operations; instead they are deeply integrated into the core infrastructure of the biggest organizational players in the anti-abortion movement.

CPC Revenues (2015-2019)

^[16]For more information, scroll down to our methodology section.

It may surprise most people to know that funding for CPCs often comes in the form of public dollars through federal and/or state funding.^[17] Anti-abortion centers in at least 29 states obtain some form of state funding through initiatives such as the “Choose Life” license plate programs, of which a portion of sales benefit CPCs.^[18] Since the “Choose Life” program began in 1996, it has brought in $29 million in revenue from 29 states that benefit various CPCs in each state.^[19]

In addition, 14 states directly fund CPCs through Alternatives to Abortion programs.^[20]   At least 10 of those 14 states have diverted funding from Temporary Assistance to Needy Families (TANF), a public assistance program meant to benefit low-income families, to CPCs. Because of the lack of transparency and accountability for these centers, it is unclear exactly how much federal and state funding has been allocated to CPCs. However, Pennsylvania, the first state to begin state funding for Alternatives to Abortion in 1996,  has funneled over $100 million to the program since inception.  Since 2013, Texas has diverted $23 million in state funding to its A2A program.^[21]

It is worth noting that organizations receiving this type of state or federal funding as program contractors are subject to very little oversight and requirements compared to the strict requirements abortion clinics and providers face through Targeted Regulation of Abortion Providers (TRAP) laws.^{[22] [23]}

^[17] The Alliance – State Advocates for Women’s Rights and Gender Equality. (2021). Designed to Deceive – A Study of the Crisis Pregnancy Center Industry in Nine States. https://alliancestateadvocates.org/wp-content/uploads/sites/107/Alliance_CPC_Report_FINAL11-4-1.pdf

^[18]Ibid.

^[19] Choose Life America. (2019). https://www.choose-life.org/about-us.php

^[20] Wormer, Rachel. (2021). Mapping Deception: A Closer Look at How States’ Anti-Abortion Center Programs Operate. Equity Forward.  https://equityfwd.org/research/mapping-deception-closer-look-how-states-anti-abortion-center-programs-operate

^[21] Ibid.

^[22] Ibid

^[23]Guttmacher Institute. (2022, July 1). Targeted Regulation of Abortion Providers. https://www.guttmacher.org/state-policy/explore/targeted-regulation-abortion-providers

While public funding is a large source of revenue for the CPC industry, philanthropic funding is another.

Candid, the philanthropic sector’s main distributor of non-profit funding data, has a “Right to Life” category narrowly focused on advocacy efforts that “work for passage of legislation or other social measures which seeks to assign legal rights to an unborn human being and seeks to criminalize the termination of unwanted pregnancies.”^[24]   From 2015-2019, there was $53 million in foundation funding in the Right to Life category, or roughly $10.6 million per year.^[25]

However, this only captures one small aspect of funding for the broader anti-abortion movement, leaving out a host of other activities by 501c3s and 501c4s such as the work done by CPCs. These fake clinics get hidden in other (often counter intuitive) data categories, including women’s rights, individual liberties, and even maternal health and prenatal care despite the fact, as detailed earlier, that the vast majority of CPCs are not actually healthcare facilities and do not provide medical services.

In addition to funding for the Right to Life category, NCRP identified foundation funding for 1,084 of the CPCs identified in Reproaction’s database totaling $278 million between 2015-2019, or around $55 million per year.^[26]

Foundation Funding Supporting CPCs (2015-2019)

As with the figures from the federal tax records, on average, half of all funding went to bigger organizations where pregnancy services were not the primary purpose of the organization. The top 10 recipients received over half, or $144 million, of the $278 million total philanthropic funding.

Considering just these two categories of grantmaking, the anti-abortion movement has received at least $325 million in philanthropic funding between 2015-2019. Combined with other forms of revenue, such as state revenue using taxpayer dollars and the massive coffers of most of CPCs larger “parent” institutions, the broad anti-abortion movement is backed by billions of dollars.

Beyond financial resources, the movement is also well connected to power and influence through government ties, media influence, and a nationwide infrastructure of fake clinics in every state dedicated to denying individuals the full range of reproductive choices.^{[27] [28]}

^[24] Candid. Philanthropy Classification System. https://taxonomy.candid.org/

^[25] NCRP analysis of Candid data. For more information, read our methodology.

^[26] According to NCRP analysis of Candid data.

^[27] Cha, A.E. (2019, July 29). New federally funded clinics emphasize abstinence, natural family planning. The Washington Post. https://www.washingtonpost.com/health/2019/07/22/new-federally-funded-clinics-california-emphasize-abstinence-natural-family-planning/

^[28] Dobkin, J. (2022, January 18). Anti-Abortion Center “Spheres of Influence.” Equity Forward, using Little Sis’ interactive mapping tool, Oligrapher. https://littlesis.org/oligrapher/7439-anti-abortion -center-spheres-of-influence

Pregnant people deserve agency and autonomy, but fake anti-abortion clinics across the country are committed to creating as many barriers to reproductive freedom as possible. It is incumbent upon funders to understand the ideological agenda they are supporting – and its harmful consequences – when their dollars go to some of these broader institutions that house CPCs and to do more to support real abortion clinics and centers providing accurate, comprehensive reproductive healthcare nationwide.

Funders who seize the opportunity to do the right thing and be better stewards of philanthropic resources have plenty of choices. There are dozens of legitimate health facilities and non-profits that would be better recipients of direct resources and support.

Those who provide safe, transparent and welcoming care include organizations such as the following:

Sister Reach supports the reproductive autonomy of women and teens of color, poor and rural women, LGBTQIA+ people, and their families, through the framework of Reproductive Justice. Its mission is to empower our base to lead healthy lives, raise healthy families and live in healthy and sustainable communities. Their strategy includes education, policy & advocacy, cultural shift, and harm reduction.

CHOICES. Memphis Center for Reproductive Health: CHOICES envisions a world where sexual and reproductive healthcare is recognized as an essential human right. Their services are open to everyone. They offer medication and procedural abortions, gynecological wellness care, gender-affirming hormone therapy, HIV testing and referrals, no-cost birth control, midwife-led prenatal care and births, and more.

National Birth Equity Collaborative creates transnational solutions that optimize Black maternal, infant, sexual, and reproductive wellbeing. They shift systems and culture through training, research, technical assistance, policy, advocacy, and community-centered collaboration.

The Birth Justice Care Fund is a SisterSong Birth Justice Team needs-based initiative, for Georgia and North Carolina residents, in response to the social crisis that communities of color are experiencing more critically now due to the COVID-19 Pandemic. The relief funds are intended for Black and other birthing people of color, especially Queer and Trans folks in need of support during their pregnancy and within one year postpartum.

Indigenous Women’s Rising is committed to honoring Native & Indigenous People’s inherent right to equitable and culturally safe health options through accessible health education, resources, and advocacy. The Indigenous Women Rising Midwifery Fund is a response to the reality that too often, Indigenous people are not provided adequate, quality, or culturally sensitive care in a hospital setting. IWRising knows midwives and doulas provide quality care but can be out of reach for many of their relatives. This fund will help pregnant Indigenous people in New Mexico access quality care for themselves and their latest addition.

No matter one’s personal stance on abortion access, funding for reproductive health should always prioritize access to accurate, comprehensive, and confidential care from transparent, trustworthy service providers. The eminent fall of Roe v. Wade only increases this need.

The sector needs to intentionally fund abortion with all circumstances considered, including the work of fighting against anti-abortion groups, to secure access and sustain those leading the work. Click through and read more about some of the action steps that funders can take now and in the coming months.

Identifying Crisis Pregnancy Centers 

To identify Crisis Pregnancy Centers and/or organizations engaged in CPC activities, NCRP started from Reproaction’s database of CPCs. Reproaction compiles and regularly updates a national database of fake abortion clinics. In April 2021, NCRP requested a spreadsheet extract of the database available on Reproaction’s website.

It is challenging to identify the full landscape organizations engaged in CPC efforts because they change names and locations as part of their deceptive tactics to lure in individuals seeking abortion resources or services. Despite these challenges, as of April 2021, Reproaction had identified a total of 2,640 organizations. The list includes organizations with multiple locations locally and/or in different states.

Obtaining Tax Identification Numbers 

The Internal Revenue Services’ Form 990 includes revenue and expense information for each non-profit organization that is required to file. Inconsistencies in organizational names and addresses can make finding the correct Form 990 generally challenging. This is especially true for CPCs, which routinely change their names and locations as part of a deliberate effort to mislead potential clients and researchers. Employee Identification Numbers (EINs), the IRS-assigned numbers that are unique to each filing employer, enable researchers to connect organizations to their tax information despite these name and address changes.

The Reproaction Fake Clinic database includes the name of each organization, their address, and their known website. Using this information, NCRP researchers used Google and a variety of search terms such as “name of fake clinic” + “address” + “EIN” to connect each CPC to their EIN from public sources such as ProPublica, Guidestar, or CauseIQ. We then cross-checked the EIN by looking at the most recent 990 tax form associated with the EIN to confirm that the organization and address matched the organization and address in the Reproaction database.

The deceptive tactics used by CPCs to target abortion seekers and avoid detection make tracking financial information about CPCs difficult, as these groups may change names, move locations, or close and reopen under different names. In some cases, even though some of the information between the database and 990 tax form matched (such as the address), a number of discrepancies existed between the information stated in the 990 tax form and the information in the database (such as differences in the organization’s name). In these cases, we used Google searches to confirm the alternate name was accurate.

Discrepancies we noticed included:

•  Different names between those used on tax forms and websites (i.e. the Metroplex Women’s Clinic is also named Arlington Pregnancy Services).

•  Repeated misspelled words on 990 forms, such as spelling pregnancy as “pregancy.”

•  CPCs with numerous locations would mix and match information from the different locations on tax forms and web searches, making the relationship between multiple locations hard to discern. Different locations would also not show up under the correct name or address searching when for them.

NCRP researchers identified 2374 EINs out of the 2640 CPC locations in the database. After accounting for duplicate EINs (such as multiple locations of a parent organization), we were able to identify 1785 unique EINs.

In some cases, a CPC location listed in the database shares an EIN with a larger entity, such as Catholic Charities. There are also cases where a CPC location in the database was itself part of a larger entity with an implicit or explicit crisis pregnancy program. In these cases, it is not possible to tell how much of the organization’s revenue or foundation funding information is specifically allocated to crisis pregnancy services. The CPC organization may be fiscally sponsored by or an internal program of a larger entity.

However, because they have shared EINS, they are the same organization for legal and tax purposes.

It also means that these CPC programs have access to the same legal and financial resources as the larger, well-established organizations they are connected to do.

More Specific Details About Program Expenses Hard to Come By 

NCRP also identified 36 organizations that appeared to be broader institutions that had the same EIN number as CPCs in the Reproaction Database, therefore are for legal and tax purposes the same entity. We attempted to obtain more detailed financial information on organizational expenses in the “Program Service Accomplishments” section in Part III of the Form 990.

Of these 36 organizations, only 8 had details about Program Service Accomplishments on their Form 990, and only 3 of those 8 organizations explicitly mentioned crisis pregnancy or pregnancy resource services.  This reflects the fact that most CPCs and larger organizations that fiscally sponsor and/or house CPC activities through a shared EIN are unlikely to explicitly report on these programs and/or organizational relationships. These affiliations with broader institutions afford CPCs with financial stability and sustainability as well as significant infrastructure support, while maintaining the public appearance of separation between CPC efforts and the larger institution.

The lack of disaggregated data on financial revenue and expenditures, along with the purposely obscured ties between CPCs and larger organizations further show the lack of transparency and deceptive measures these organizations use to avoid accountability.

Obtaining Revenue Information

Next NCRP gathered all federal Form 990 filings from 2015-2019 that were submitted to the IRS by the 1785 organizations for which we found unique EINs, and NCRP obtained Form 990 filings for 1291 of the 1785 unique EINs that filed at least one Form 990 in those years. From these, NCRP was able to calculate total revenue during the period surveyed.  NCRP did not obtain Form 990 filings for the remaining 494 organizations.

Not all organizations had tax filing information for every year. There are several reasons for this – an organization may have closed in the 2015-2019 time period, changed names and reopened as a new organization, and/or the tax form may not be available electronically yet. The table below shows the number of organizations that filed 990 forms per year.

Organizations that Filed 990s (2015-2019)