This week, the U.S. Supreme Court hears oral arguments in a free speech rights case that focuses on a California law requiring a variety of organizations—including anti-choice “crisis pregnancy centers,” otherwise known as fake women’s health centers—to disclose to their clients the availability of state-provided prenatal birth control and abortion services.
The case, National Institute of Family and Life Advocates (NIFLA) v. Becerra, addresses the constitutionality of California’s Reproductive FACT (Freedom, Accountability, Comprehensive Care, and Transparency) Act. Passed in 2015, the FACT Act requires organizations providing pregnancy-related care in California to disclose whether or not their facility is medically licensed and, if so, to inform patients that the state provides free or low-cost prenatal family planning and abortion services.
The law is being challenged by NIFLA, an anti-choice organization specifically established to support and defend fake women’s health centers—referred to as such since they utilize tactics of manipulation, shaming, and misinformation in an effort to deter women from accessing their full range of reproductive health care options. By pretending to be comprehensive medical facilities, these fake centers—which can either be medically licensed or unlicensed—routinely target low-income women and women of color who are considering abortion.
In its lawsuit, NIFLA claims that the FACT Act unfairly targets the organization’s political views and violates anti-choice advocates’ right to free speech. This column presents NIFLA’s core arguments and then proceeds to dismantle them. It should be noted that the arguments outlined in this column are at the heart of NIFLA’s and supporting amici curiae’s arguments about the nature of fake women’s health centers, although the petitioners have submitted several different documents to the court.
Summary of NIFLA’s position
The anti-choice argument: It is obvious that centers are not comprehensive women’s health clinics, making the FACT Act unnecessary.
Care Net, a network center, said in an amicus brief: “The Act forces the centers to be spokespersons for the abortion industry via compelled speech—specifically, the posting of notices directing women how to obtain a state-funded abortion, and forcing utterance of the obvious fact that the centers do not provide medical treatment.”
The truth: Fake women’s health centers openly admit to targeting women who mistake their facilities for abortion clinics. Abby Johnson, an anti-choice activist, stated at a training for employees of fake centers, “The best client you ever get is one that thinks they’re walking into an abortion clinic.” Susie Meister, a former volunteer at a fake clinic, reported that employees were instructed to discourage abortion; they “were told to explain that abortion was not a responsible or wise choice and focus instead on the ‘miracle of life.’ ” Lauren Chenoweth, a former media specialist at Heartbeat International, a network of fake women’s health centers, was recorded saying: “[Women are] going to Google ‘abortion,’ or they’re going to Google ‘abortion services’ or ‘pregnancy help,’ and that’s why we want to focus on our websites…We want to be strategic in getting them to our centers.” Additionally, a common tactic of fake centers is to offer free or low-cost ultrasounds to patients, blurring the line between medical provider and strictly social enterprise. By providing ultrasounds—which, in many states, are required before the patient can procure an abortion—fake centers are able to lure women who may struggle to obtain an ultrasound through other means, thereby tricking them into thinking that the center may also provide abortion services.
In order to portray the regulations of the FACT Act as unnecessary, at least some fake centers pretend that their existence is purely nonmedical. In actuality, however, even the centers that are unlicensed make a conscious attempt to appear to provide medical services so that they can attract who they term as “the best client you ever get”—one who thinks she is visiting an abortion clinic.
The anti-choice argument: The disclosures required under the FACT Act—namely the posting of a notice stating that a center is not medically licensed and the provision of information on where to obtain women’s health care services—are cost-prohibitive.
In an amicus brief, Heartbeat International claimed: “Additionally, even if advertising somehow remained desirable after the Act, it would be cost-prohibitive for most, if not all, centers … they are funded almost entirely by private donations from pro-life individuals who want to help provide practical alternatives to abortion.”
The truth: Fake women’s health centers are not low-budget, humble operations; they are funded in part by taxpayer dollars through direct funding, abstinence-only education grants, abortion restrictions that mandate pre-procedure counseling, favorable tax benefits, and sales from “Choose Life” license plates. The anti-choice lobby, a key component of the broader conservative movement, is powerful and moneyed. Influential conservative megadonors, such as Rebekah Mercer and Secretary of Education Betsy DeVos, funnel money into anti-choice infrastructure, which includes fake women’s health centers, judicial nominations, political campaigns, and conservative media.
While fake clinics claim that the regulations of the FACT Act are cost-prohibitive, these centers are known to operate massive, multicity billboard campaigns that target African-American communities. Meanwhile, the FACT Act requires fake centers to disclose that they are not licensed as medical facilities and to provide information on public programs that offer free or low-cost women’s health services. The lies fake centers tell about their funding show that they hold a stronger commitment to anti-choice ideology than to the autonomy of the women they supposedly serve.
Anti-choice argument: Centers support various reproductive health decisions and assist women not by manipulating and lying but rather by listening, supporting, and persuading.
In a brief submitted to the Supreme Court, Care Net claimed: “Pregnancy center client advocates use persuasion, not manipulation … Pregnancy center client advocates do not tell pregnant mothers what they should and should not do. They listen well, encourage, give space, and try to present the bigger picture and the truth.”
The truth: Fake centers are a key part of a strategic plan to promote a conservative anti-choice agenda; their dogged intention to limit abortions no matter how cruel the tactic has been clearly documented through their employee trainings, literature, and mission statements. For example, fake centers are known to disseminate incorrect information in order to convince patients not to choose abortion. Many centers tell patients that having an abortion increases the risks of later developing breast cancer, infertility, and miscarriage; however, there is no established link between abortion and these conditions. Fake clinics also lie about gestational age and fetus health in order to convince women that it may be too late—or unnecessary—for them to get an abortion. Some clinics have even offered food or water to patients entering abortion clinics so that they would unsuspectingly violate preprocedure guidelines for abortion.
From client testimonials, it is clear that these centers are not unbiased, nonjudgmental parties but rather have a clear agenda and are zealous in the pursuit of their goals. In an Mic expose, a center counselor said, “Your body is meant to keep that baby, not to have someone put an instrument in and rip it out.”
Anti-choice argument: Abortion is a dangerous procedure that has a negative impact on women, and, as a consequence, centers are required to provide the fullest range of options for women.
This claim has been articulated in various briefs sent to the Supreme Court, including one from the Pregnancy Care Centers in Texas, which reads, “Abortion has not only been controversial, it has had a negative impact on women”; as well as one from 23 Illinois Pregnancy Care Centers, which argued, “Pregnancy care centers are in the unique position to help women through a pregnancy when they are deciding to keep their babies.”
The truth: Abortion is a common and safe procedure that the majority of Americans think should be legal in most or all cases. About 1 in 3 American women has had an abortion, and major complications after an abortion procedure are extremely rare. Access to comprehensive reproductive health care—including abortion and birth control—allows women to continue their education, ensure their economic security, and choose if and when to have children. Moreover, many different kinds of health care providers are equipped to disseminate information about a wide range of reproductive health care options, including adoption and the continuation the pregnancy. Title X providers such as Planned Parenthood are far superior to fake centers in that they provide patients with evidence-based information on many different options without bias or judgement.
Despite their claims, the only unique positioning that fake centers hold is that they are able to trick women into believing that they are medical providers. The truth is that fake centers sidestep medical regulations, are not staffed by medical professionals, and do not provide legitimate medical services.
There is ample evidence to suggest that fake women’s health centers should be held to the standards of the Reproductive FACT Act in order to protect unsuspecting women from lies and manipulation. The specious arguments presented by NIFLA and other fake centers indicate a concerning commitment to derailing a women’s right to choose, and evidence and testimonials clearly debunk their narrative.
Anusha Ravi is a research assistant for the Women’s Initiative at American Progress.
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