Anti-abortion pregnancy centers are looking to offer much more than
ultrasounds and diapers
[October 25, 2025]
By GEOFF MULVIHILL and KIMBERLEE KRUESI
Pregnancy centers in the U.S. that discourage women from getting
abortions have been adding more medical services — and could be poised
to expand further.
The expansion — ranging from testing and treatment for sexually
transmitted infections to even providing primary medical care — has been
unfolding for years. It gained steam after the Supreme Court overturned
Roe v. Wade three years ago, clearing the way for states to ban
abortion.
The push could get more momentum with Planned Parenthood closing some
clinics and considering shuttering others following changes to Medicaid.
Planned Parenthood is not just the nation's largest abortion provider,
but also offers cancer screenings, STI testing and treatment, and other
reproductive health services.
“We ultimately want to replace Planned Parenthood with the services we
offer,” said Heather Lawless, founder and director of Reliance Center in
Lewiston, Idaho. She said about 40% of patients at the anti-abortion
center are there for reasons unrelated to pregnancy, including some who
use the nurse practitioner as a primary caregiver.
The changes have frustrated abortion-rights groups, who, in addition to
opposing the centers' anti-abortion messaging, say they lack
accountability; refuse to provide birth control; and most offer only
limited ultrasounds that cannot be used for diagnosing fetal anomalies
because the people conducting them don't have that training. A growing
number also offer unproven abortion-pill reversal treatments.
Because most of the centers don't accept insurance, the federal law
restricting release of medical information doesn't apply to them, though
some say they follow it anyway. They also don't have to follow standards
required by Medicaid or private insurers, though those offering certain
services generally must have medical directors who comply with state
licensing requirements.
“There are really bedrock questions,” said Jennifer McKenna, a senior
adviser for Reproductive Health and Freedom Watch, a project funded by
liberal policy organizations that researches the pregnancy centers,
“about whether this industry has the clinical infrastructure to provide
the medical services it’s currently advertising.”
Post-Roe world opened new opportunities
Perhaps best known as “crisis pregnancy centers,” these mostly privately
funded and religiously affiliated centers were expanding services such
as diaper banks ahead of the Supreme Court's 2022 Dobbs v. Jackson
Women's Health Organization ruling.
As abortion bans kicked in, the centers expanded medical, educational
and other programs, said Moira Gaul, a scholar at the Charlotte Lozier
Institute, the research arm of SBA Pro-Life America. “They are prepared
to serve their communities for the long-term,” she said in a statement.
In Sacramento, California, for instance, Alternatives Pregnancy Center
in the last two years has added family practice doctors, a radiologist
and a specialist in high-risk pregnancies, along with nurses and medical
assistants. Alternatives — an affiliate of Heartbeat International, one
of the largest associations of pregnancy centers in the U.S — is some
patients' only health provider.
When The Associated Press asked to interview a patient who had received
only non-pregnancy services, the clinic provided Jessica Rose, a
31-year-old woman who took the rare step of detransitioning after
spending seven years living as a man, during which she received hormone
therapy and a double mastectomy.
For the last two years, she’s received all medical care at Alternatives,
which has an OB-GYN who specializes in hormone therapy. Few, if any,
pregnancy centers advertise that they provide help with detransitioning.
Alternatives has treated four similar patients over the past year,
though that's not its main mission, director Heidi Matzke said.
“APC provided me a space that aligned with my beliefs as well as seeing
me as a woman,” Rose said. She said other clinics "were trying to make
me think that detransitioning wasn’t what I wanted to do.”
Pregnancy centers expand as health clinics decline
As of 2024, more than 2,600 anti-abortion pregnancy centers operated in
the U.S., up 87 from 2023, according to the Crisis Pregnancy Center Map,
a project led by University of Georgia public health researchers who are
concerned about aspects of the centers. According to the Guttmacher
Institute, 765 clinics offered abortions last year, down more than 40
from 2023.
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 Over the years, pregnancy centers
have received a boost in taxpayer funds. Nearly 20 states, largely
Republican-led, now funnel millions of public dollars to these
organizations. Texas alone sent $70 million to pregnancy centers
this fiscal year, while Florida dedicated more than $29 million for
its “Pregnancy Support Services Program”
This boost in resources is unfolding as Republicans have barred
Planned Parenthood from receiving Medicaid funds under the tax and
spending law President Donald Trump signed in July. While federal
law already blocked the use of taxpayer funds for most abortions,
Medicaid reimbursements for other health services were a big part of
Planned Parenthood's revenue.
Planned Parenthood said its affiliates could be forced to close up
to 200 clinics.
Some already had closed or reorganized. They have cut abortion in
Wisconsin and eliminated Medicaid services in Arizona. An
independent group of clinics in Maine stopped primary care for the
same reason. The uncertainty is compounded by pending Medicaid
changes expected to result in more uninsured Americans.
Some abortion-rights advocates worry that will mean more health care
deserts where the pregnancy centers are the only option for more
women.
Kaitlyn Joshua, a founder of abortion-rights group Abortion in
America, lives in Louisiana, where Planned Parenthood closed its
clinics in September.
She's concerned that women seeking health services at pregnancy
centers as a result of those closures won’t get what they need.
“Those centers should be regulated. They should be providing
information which is accurate,” she said, “rather than just getting
a sermon that they didn’t ask for.”
Thomas Glessner, founder and president of the National Institute of
Family and Life Advocates, a network of 1,800 centers, said the
centers do have government oversight through their medical
directors. “Their criticism,” he said, “comes from a political
agenda.”
In recent years, five Democratic state attorneys general have issued
warnings that the centers, which advertise to people seeking
abortions, don't provide them and don't refer patients to clinics
that do. And the Supreme Court has agreed to consider whether a
state investigation of an organization that runs centers in New
Jersey stifles its free speech.
Pregnancy centers don't offer exactly the same services as
Planned Parenthood
Choices Medical Services in Joplin, Missouri, where the Planned
Parenthood clinic closed last year, moved from focusing solely on
discouraging abortion to a broader sexual health mission about 20
years ago when it began offering STI treatment, said its executive
director, Karolyn Schrage.
The center, funded by donors, works with law enforcement in places
where authorities may find pregnant adults, according to Arkansas
State Police and Schrage.
She estimates that more than two-thirds of its work isn't related to
pregnancy.
Hayley Kelly first encountered Choices volunteers in 2019 at a
regular weekly dinner they brought to dancers at the strip club
where she worked. Over the years, she went to the center for STI
testing. Then in 2023, when she was uninsured and struggling with
drugs, she wanted to confirm a pregnancy.
She anticipated the staff wouldn’t like that she was leaning toward
an abortion, but she says they just answered questions. She ended up
having that baby and, later, another.
“It’s amazing place,” Kelly said. “I tell everybody I know, ‘You can
go there.’”
The center, like others, does not provide contraceptives — standard
offerings at sexual health clinics that experts say are best
practices for public health.
“Our focus is on sexual risk elimination," Schrage said, “not just
reduction.”
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