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1 Introduction
3 CPCs in Massachusetts
5 Inside a CPC
15 The Path to a CPC
18 The Finances of CPCs
19 Conclusion
21 Appendix I: Methodology
22 Appendix II: CPCs Investigated in MA
24 Endnotes
For years, weve heard the stories: A woman thinks she might be pregnant. Looking for counseling
about her options and access to appropriate medical care, she stumbles across a crisis pregnancy
center (CPC) that advertises free services. Once there, shes shamed with anti-choice rhetoric,
whose goal is to prevent her from considering abortion, regardless of her circumstances.

Al NARAL IroChoice Massachuses ve beIieve lhal every voman deserves lo make ersonaI
private decisions about her pregnancy free of intimidation and coercion. Our mission is to protect
and promote access to the full range of reproductive choices and health care options, including
preventing unintended pregnancy, bearing healthy children, and choosing safe, legal, accessible
Based on anecdotal evidence collected in the Commonwealth and research conducted nationally and
limeIy access lo lrue olions counseIing and regnancyreIaled care To beer undersland lheir
to take a closer look at these CPCs.
We embarked on an in-depth investigation of crisis pregnancy centers in the summer of 2010 after
the Commonwealth began issuing Choose Life license plates, which created a new revenue source
to identify and map CPCs, researched their advertising tactics and sources of funding, catalogued
the information on all of their websites, and conducted mystery client calls and in-person visits to
seee Appendix I, p. 21.
The upshot? These facilities undermine the health and well-being of women all across the
Commonwealth. Their goal is to discourage women from considering abortion as a safe and
appropriate option. Their tactics range from outright harmful to rather neglectful to simply biased.
Their impact is to corrupt a pregnant womans decision-making process and delay her access to
pregnancy-related care, whether she ultimately chooses abortion, adoption, or parenthood.
Just Because Youre Pregnant... 1
Brochure, distributed by a MA CPC
Heres what we found:
1 CPCs outnumber womens health
care providers three to one. And, location
macrs There are 30 separate locations with
active CPCs, compared with nine specialty
womens health providers who publicly advertise
lhal lhey oer aborlion care
Women in
Weslern Massachuses have access lo six CICs
CenlraI Massachuses has eighl and Soulheasl
Massachuses is home lo six In conlrasl each of
these regions has only one clinic providing abortion
Northeast and Metro Boston, where women in each
area can access three abortion providers compared
2 CPCs dcsign thcir nn!inc prn!cs
and web-based advertising to mislead
women seeking abortion care or non-
biased pregnancy options counseling. On
YeIIovagescom and Sueragescom CICs in
Massachuses aeared in lhe lo len resuIls for
ve oul of six key search lerms a voman facing
an unintended pregnancy would likely use in
the summer of 2010 and for three of the six in the
spring of 2011. (The only thing that changed in
between? NARAL Pro-Choice America conducted
a nationwide campaign to challenge these online
phonebooks to change their practices.)
3 CPCs misinform and deceive
women about their health. Three out of
information, as did six in ten of the websites. The
most common medical falsehoods included linking
abortion to breast cancer or severe emotional or
psychological problems, often described as being
akin lo osllraumalic slress disorder ITSD
Almost a third of CPCs visited also severely
overstated the likelihood that having an abortion
would undermine a womans future fertility.
4 Many CPCs misstate data about
miscarriage and pregnancy complications.
Almost a third of the CPCs visited exaggerated
miscarriage rales in an aarenl eorl lo ressure
our volunteers to get an ultrasound at the CPC or
a related anti-choice facility, or to encourage them
simply to delay making any decision about their
claim that an ultrasound can predict if youre going
to miscarry.
5 CPCs prioritize their anti-choice
agenda over a womans decision-making
and health. More than half of our volunteers
reported that they felt pressure not to terminate
the pregnancy during an in-person visit. CPCs
overwhelmingly denied referrals for abortion care,
and some even failed to discuss other options such
as adoption or provide resources for pre-natal care.
Brochure, distributed by a MA CPC
Centers in Massachusetts
Today, there are an estimated 4,000 crisis pregnancy centers
(CPCs) nationwide, a network of anti-choice facilities that dates
back to the days before Roe v. Wade.
of abortion, CPCs have grown in both number and scope, and they
now serve as a central component of the anti-choice movements
strategy to restrict and manipulate both the information women
receive when they face an unplanned pregnancy and their access
to the full range of reproductive health services.
According lo a comrehensive sludy conducled by lhe US
House of Reresenlalives Commiee on Governmenl Reform
CPCs intentionally misinform and mislead women seeking
options counseling, instead providing biased, coercive, or
patently incorrect information about a womans health and
pregnancy options, while often refusing to provide information
or referrals for abortion and birth control services.

Here in Massachuses lhere are
currently 30 separate facilities across the
Commonwealth where CPCs operate and
advertise their services both online and
in print. This makes CPCs three times as
prevalent as the nine womens health clinics
seciaIizing in reroduclive heaIlh lhal
currently advertise abortion care among
their services.

CPCs are located in every region of the
state, including communities not served by
known womens health clinics. There are
Weslern and Soulheasl Massachuses are
each home to six CPCs; yet each of these
three regions has only one womens health
facility providing abortion care. Women
in the Northeast and Metro Boston have
somewhat greater access to comprehensive
care, with a choice of three womens health
clinics that provide abortion compared with
CPC Locations in Massachusetts
Just Because Youre Pregnant... 3
Of lhe nalionaI CIC organizalions CareNel oened lhe rsl
and Birthright International has
since secured seven locations here. Perhaps most interesting,
Massachuses is home lo severaI slalebased CIC nelvorks
incIuding one vilh nalionaI signicance see Massacnuscs as
an Anti-Choice Breeding Ground).
The largest CPC network, A Womans Concern, started in
Dorchesler oslon in

and announced itself with an

advertisement in the Yellow Pages that cost $28,000 at the
ve Iocalions Dorchesler IaII River Hyannis Revere and a
Norlh Shore Iocalion under conslruclion

Pregnancy Care
Cenler lhe second Iargesl MassachusesonIy nelvork has
four CPC facilities (in Amesbury, Haverhill, Lawrence, and
Newburyport). An additional fourteen smaller CPCs operate
in communities across the Commonwealth, with no apparent
as an
Breeding Ground
While Massachusetts is often perceived
to be a bastion of liberal politics, it has
also served as a laboratory for anti-
choice strategies that have a national
For example, Massachusetts is home
to the Gerard Health Foundation,
a private charity based in Natick.
With $1,295,000 in assets in 2009,

Gerard and its founder Raymond
Ruddy serves as a major funder of
anti-choice initiatives on the more
extreme end of the political spectrum.
This includes long-standing, entrenched
organizations such as Focus on the
Family, whose founder, James Dobson,
became one of the nations most
lnNuentlal evangellcal leaoer(s) wltb
strong ties to the Reagan and Bush
and new start-ups
such as Lila Roses organization, Live
whose most recent claim to
fame includes conducting an undercover
sting at Planned Parenthood clinics
and releasing doctored footage in an
effort to discredit the organization.

Furthermore, Gerard has given at
least $900,000 to support A Womans
Concern here in Massachusetts,
a Dorchester-based sponsor of
abstinence-only sex education
programs and antiabortion crisis
pregnancy centers.
Since 2002,
A Womans Concern has received
millions in federal funds to support
CPCs often locate near reproductive health facilities, and some
follow these womens health clinics from location to location.
a CPC is located nearby within a ten-mile distance, or, if
located in Boston, within a two-mile walking distance.

Most notably, Problem Pregnancy of Worcester was originally
Iocaled in lhe same buiIding on lhe same oor and used
the same acronym as the Planned Parenthood clinic. (Their
PP logo was so similar to Planned Parenthoods that a state
court found them to be infringing on Planned Parenthoods
trademark, and Problem Pregnancy was forced to change
its logo.

) Planned Parenthood has since moved from that

building, but Problem Pregnancy followed, relocating directly
across the street.
A Womans Concern has also served
as the launching pad for high-level
antl-cbolce government otclals, most
notably Erik Kerouack, their former
medical director, who was appointed
by President Bush as Deputy Assistant
Secretary of Population Affairs within
the Department of Health and
Human Services to lead the nations
family-planning program despite his
avowedly anti-contraception views.

Meanwhile, Gerard provided a soft
landing for former Bush Administration
otclal, Clauoe Allen, wbo serveo
as a top domestic policy advisor to
President Bush until his arrest for theft
in an apparent phony refund scheme.

Allen is currently a Vice President at
the Foundation.
and distribute Healthy Futures,
its abstinence-only-until-marriage
programs, in Massachusetts and
The program, which
has been taught in Greater Boston
and Lowell schools,
states that its
mission is to promote the critical
message of sexual abstinence outside
of a faithful, lifelong relationship.
states CPCs often seek to undermine a womans ability to
choose from the full range of health care options when facing
the prospect of a pregnancy. Our volunteers found that
CICs uliIize lhree main slralegies lo deler a voman from
considering or seeking an abortion:
Inside a Crisis
Pregnancy Center
Delay support and deny options and
referrals for pregnancy-related care
Spread medical falsehoods
Sensationalize abortion and use anti-choice
rhetoric to shame or pressure
Many of these tactics particularly the medical
misinformalion and lhe sensalionaIized exlreme rheloric
are echoed on the CPC websites and in materials women
receive at their facilities.
Our voIunleers reorled dicuIlies making aoinlmenls
and, once they reached a CPC, they were often encouraged
to schedule a follow-up appointment and/or to take their
time making any decisions about what to do tactics that
would likely delay appropriate medical care related to a
womans pregnancy.
Our volunteers were given false and misleading information
about pregnancy, the physical and mental health impact
of aborlion and lhe eecliveness and arorialeness of
using contraception. Yet only just under one-third (31%) of
the unlicensed CPCs contacted by phone or in person
disclosed that they were not medical facilities.
In addition to bogus health claims, volunteers were
subjected to biased information about abortion procedures
and fetal development that, while not technically false, was
sensalionaIized and resenled oul of conlexl in an eorl lo
reinforce the CPCs anti-choice agenda.
Raymond Ruddy
Just Because Youre Pregnant... 5
Delaying Support & Denying Options
While CPCs present themselves as a service to help
pregnant women in need, many failed to answer their
phones or respond to messages in a timely fashion.
to contact failed to answer or were slow to respond,
including seven that volunteers ultimately visited.
When volunteers connected with the CPC, the
intake person on the phone would often schedule an
appointment for many days away, if not as long as a
week later. This lack of responsiveness and tendency
to delay stands in stark contrast to the traditional
practices at womens health providers.
This delay tactic also wastes vital time during which
a pregnant woman might otherwise be obtaining
options counseling, securing a prenatal care visit, or
scheduling an abortion if not obtaining the care itself.
both mother and child, with maternal mortality 3 to 4
times higher in women who receive no prenatal care
Further, while
complications from surgical abortion are rare,
nonetheless increase as the pregnancy progresses, as
trimester are also generally less accessible.

Both on the phone and in person, women often received incomplete and biased counseling
and insucienl referraIs a raclice nol in keeing vilh slandards of care for vomen may be
pregnant. Of the CPCs contacted in person or through in-depth phone calls, more than one
quarler oered no informalion on adolion onesixlh oered no informalion
misIeading or olhervise on aborlion and one in oered no counseIing of any kind
The vast majority (83%) either refused outright to provide a referral for abortion services or
made voIunleers so uncomforlabIe lhal lhey feIl lhey couIdnl ask for one Yel faiIed lo
disclose up front that they were a pro-life facility or that they would not provide such referrals.
The advice some CICs oered on regnancy and arenling maers vas aIso susecl One
volunteer was told, you dont need money to raise a child, just time and love. Another
volunteer who told the CPC that she had been drinking heavily throughout her pregnancy was
informed that new studies prove alcohol is not too harmful to a fetus. Although light to
moderate drinking in pregnancy is being considered safer, heavy drinking more than one or
two glasses once or twice a week has consistently been shown to be damaging to a pregnancy.

You dont need
money to raise a
child, just time and
-CPC Counselor
By far the most troubling tactics were the insidious
misuse of miscarriage rates and the lure of free
ultrasounds, particularly given that a woman
may be unfamiliar with the data and diagnostics
related to pregnancy. In nearly every case, the
counseIor as belveen and veeks regnanl
WhiIe lhe miscarriage rale afler lhe lh veek of
pregnancy is only 8%,
more than one in four
of lhe CICs conlacled gave misIeadingIy
high miscarriage rates for instance, making
claims such as most pregnancies are not viable
and 50% of pregnancies end in miscarriage.

One of lhe mosl common services lhal a CIC oers is a free regnancy lesl vhich vas oered
at every one of the in-person visits and suggested during all of the in-depth phone calls. Without
exception, the CPCs gave our volunteers pregnancy tests similar to those currently available over
the counter at most grocery stores and drug stores. In one instance, a volunteer was given a generic
brand, over-the-counter test that had been opened and was already expired. While over-the-counter
lesls are reIaliveIy accurale u lo eeclive a veek afler a missed eriod medicaI exerls
results whether positive or negative.
By remaining vague in their advertising about the type of
pregnancy tests available, CPCs may leave the impression that they provide the blood test that is
more sensitive than what a woman can purchase on her own thereby increasing the time it takes
her to obtain appropriate care at a legitimate health care provider.
Myth: most pregnancies are
not viable
Fact: Early in pregnancy,
there is a 25% chance of
miscarriage that drops to 8%
after the 6th week.

Our volunteers concluded that the CPCs used the incorrect miscarriage data to delay abortion
decisions in two ways. First, in every instance when an incorrect miscarriage rate was mentioned,
the CPC tried to convince our volunteer to schedule an ultrasound appointment days or weeks into
the future. One volunteer reported that she heard that the ultrasound can tell me if the pregnancy is
on a miscarriage is an acceptable way to deal with an unintended pregnancy. Our volunteers were
told, for example, just because you are pregnant, doesnt mean youll stay pregnant, or that the
good news about her positive pregnancy test is that the miscarriage rate is so high.
they could avoid going through the stress of an abortion if they were going to miscarry anyway,
which one CPC described as a much easier way to lose a child. The purpose of this misrepresentation
seems clear: if a woman who is leaning toward abortion believes she has an unreasonably high
chance that her pregnancy is not viable, she may delay seeking care in the largely vain hope that she
will miscarry. Another consequence, however, is that she will delay necessary pre-natal care, causing
adverse health consequences both for herself and for her child, should she decide to continue the

Pregnancy Testing
The Miscarriage Myth
Just Because Youre Pregnant...
Spreading Medical Falsehoods
Mental Health
The most common false claim CPCs made was that having an
abortion causes many women severe psychological harm and
fulure menlaI heaIlh robIems desile recenl ndings by lhe
American Psychological Association to the contrary.

More than half (55%) of the CPCs contacted told our volunteers
that having an abortion would or could lead to negative mental
heaIlh eecls These incIuded slalemenls lhal aborlion vouId
or couId cause deression ITSD and oslaborlion regrel
or even lead to drug and alcohol abuse or promiscuity. As one
volunteer was told, Many women who choose abortion later
have what those soldiers have when they come home. When
our voIunleer asked ITSD lhe CIC voIunleer resonded
Yeah thats it.
Another volunteer described her experience as follows: [The
counselor] discussed post-abortion syndrome and severe
deression She laIked aboul vomen vho are never abIe lo
get pregnant again and then every time they see a child on the
street who would be the age of their child if they hadnt had an
abortion they just cant take it.
The website analysis elicited similar results, with more than
half (54%) of the websites asserting that women who have had
an abortion report emotional and/or psychological trauma or
pamphlets that CPCs distributed also focused on this alleged
negalive heaIlh eecl of aborlion vilh haIf of lhe CICs
handing out one or more pamphlets that falsely describe the
mental health risks of abortion.
Myth: Abortion causes post
abortion syndrome or post
traumatic stress disorder.
Fact: Although some
women do experience
sadness, grief, and feelings of
loss after an abortion, there
is no evidence to support
the claim that mental health
issues are caused by an
abortion or that a woman
is more likely to have
mental health issues after an
abortion than if she chooses
to carry the pregnancy to

One third (33%) of CPCs informed our volunteers that abortion may cause
infertility and/or ectopic pregnancy in the future. In fact, a video shown to
one of our volunteers even claimed that most women are infertile after an
aborlion Our voIunleers vere loId lhal many vomen have lroubIe geing
pregnant afterwards because sometimes there is scar tissue that stops the
egg from being able to implant, and to keep in mind that this could be your
only child.
of future infertility, and more than a third (38%) gave incorrect information
about ectopic pregnancy after an abortion. Nearly one in three (31%) of the
websites stated that women are more likely to have a premature delivery
in a future pregnancy if they have had an abortion. Half (50%) of the CPCs
that were visited distributed one or more pamphlets that incorrectly linked
abortion with risks to future pregnancies.
Future Fertility
Myth: Abortion causes
future infertility or
pregnancy complications.
Fact: Abortion does not
increase the risk of major
pregancny complications
during future pregnancies or

abortion causes an increased risk of breast cancer. One explanation
for this increased risk was that the milk ducts start to form and then
are cul o in lheir deveIomenl so lhey deveIo cancer easier
While CPCs stated an increased risk of anywhere from 20% to 50%,
one CPC went so far as to tell our volunteer that breast cancer had
increased in [my] generation because of the pill and will increase for
[yours] because of the pill and abortion. . . . Abortion increases your
risk of breast cancer by 100%.
On their websites, CPCs perpetuate this breast cancer myth in greater
increased risk of developing breast cancer after one abortion. They
distribute medically inaccurate pamphlets at a similar rate, with
half (50%) of CPCs giving out one or more pamphlets that stated an
increased risk of breast cancer.
Just Because Youre Pregnant...
Myth: . . . Abortion increases
your risk of breast cancer by
Breast Cancer
Fact: Tbe sclentc communlty
agrees that abortion does not
increase a womans risk of
breast cancer.

Brochure, distributed by a MA CPC

CPCs medical misinformation is not limited to
pregnancy and abortion, as demonstrated by
the medically inaccurate information nearly one
in three (30%) provided about contraceptives or
STDs One voIunleer vas loId lhal she musl
have wanted a baby to be using condoms as birth
Another CPC counselor claimed that our
voIunleer had lo have an STD lesl before
aborlion olhervise DC couId cause an
unlrealed STD lo sread AIlhough mosl
websites steered clear of these topics, nearly one
in six (15%) still made inaccurate statements
about emergency contraception and, through
misleading information about contraceptives
or STIs AddilionaIIy onelhird used
materials promoting abstinence-only rather
than a comprehesive approach to preventing
pregnancy and disease.
Contraception and Sexually Transmitted Infections
. . .breast cancer had
increased in [my]
generation because
of the pill and will
increase for [yours]
because of the pill
and abortion. . .
-CPC Counselor
Brochure, distributed by a MA CPC
Brochure, distributed by a MA CPC
Sensationalizing Abortion Care and Shaming Women
with Anti-Choice Rhetoric
Abortion Procedures and Risks
More than half (55%) of CPCs discussed during an in-person visit how abortions are performed,
have to open the cervix . . . with metal rods they put in a few days beforefaIseinformalionilaIicized
Just Because Youre Pregnant... 11
continuing on to say that they take the pieces
of the baby out. In another instance, a CPC
described an abortion procedure by stating that
the doctors would deliver it part way, kill the
baby, and then cut it into pieces and take it out.
A third volunteer reported that the CPC told her a
medical abortion was dangerous.
Nearly one in three (30%) CPCs discussed
medical complications associated with abortions,
frequenlIy mischaraclerizing lhe risks Women
were told that, if they had an abortion, the doctors
could accidentally puncture their uterus or colon,
they would experience hemorrhaging or heavy
bleeding, the procedure could cause scarring or
scar tissue or lead to infection, and/or that they
oul amhIels lhal emhasized lhese risks lhe
most common being a brochure titled Before
You Decide vhich describes heavy bIeeding
infection, incomplete abortion, sepsis, dangers of
anesthesia, damage to the cervix, scarring of the
uterine lining, perforation of the uterus, damage
to the internal organs, and death as possible risks
without indicating their relative likelihood.
[The counselor] talked about women
who are never able to get pregnant again
and then every time they see a child on the
street who would be the age of their child
if they hadnt had an abortion they just
cant take it.
- Study Volunteer
Brochure, distributed by a MA CPC
Two out of three CPCs visited had a
rellglous lnNuence, accorolng to volunteers.
The counseling often incorporated a religious
element whether or not the volunteers
indicated they had religious beliefs relevant
to their decision-making. In those instances,
CPCs stresseo Goo's lnNuence ln events,
telling our volunteers that God created
[your] baby for a purpose, God wasnt
sleeping when this child was conceived, and
God doesnt approve of abortions. In one
case, a volunteer wbo loentleo as not belng
particularly religious was encouraged to take
a bible, read it, and accept the Lord into her
Framing in Religious Terms
While these are all potential risks of abortion,
CPCs present these complications to a woman
considering abortion as though these rare
outcomes are common occurrences. At one CPC,
our volunteer was told only that she could die
for instance, that only one in a million abortions
before eight weeks results in death,

may lead a
than it actually is. That, in turn, undermines her
ability to make an informed choice about her
in less than one percent of abortions such as
bleeding, infection, or scarring that require
hosilaIizalion occurring in onIy
similarly misleading. CPCs also failed to provide
information much less give equal weight to
the risks of continuing a pregnancy, including
both the medical complications and the mental
heaIlh imacl vhich are signicanlIy higher
than the risks of abortion.
In fact, none of
our volunteers reported being told about the
process of giving birth, potential risks during
pregnancy or childbirth, or the potential for
post-partum depression (which occurs among
10% of women).

Brochure, distributed by a MA CPC
Fetal Development
Another related tactic CPCs used was to mislead a woman about the degree of fetal development at
her stage of pregnancy or to use terminology that equates a developing fetus to a child that is already
the vast majority (81%) provided misleading information and nearly half (45%) relied on models or
depictions that portray the fetus as a miniature
in each successive week.
Iurlhermore nearIy lhreequarlers
of the CPCs distributed pamphlets that
sensalionaIized felaI deveIomenl using
skewed benchmarks and misleading graphics.
fetus. In many instances, CPCs presented
technically accurate information, but they
couched the discussion of fetal development
in language that implied abortion would be
inappropriate, wrong, or immoral.
Nearly two-tblros (61) ot tbe CPCs olscusseo
fetal development during the visit of those,
tbe vast majorlty (81) provloeo mlsleaolng
Lapel Pin, distributed by a MA CPC
Just Because Youre Pregnant... 13
Brochure, distributed by a MA CPC
of our volunteers who received any counseling during an in-person visit that they felt pressure
not to choose abortion. Many of our volunteers reported being disturbed by their visit, with one
describing it as an intense experience, nerve racking, emotional. [I] cant imagine that being your
only option, to go to one of these places. Another said, I left so confused and feeling awful. I cant
I left so confused and feeling awful. I cant stop thinking
about bow tbat woulo bave been a terrlble way to no
out youre pregnant.
- Study Volunteer
Aemls lo sensalionaIize aborlion
care and shame women with anti-
choice rhetoric can take a troubling
loII on vomen Characlerizing
abortions as unsafe or dirty has been
shovn lo have a sligmalizing eecl
on both women and the procedure,
and frames women as victims.

Personifying a fetus further allows
the abortion to be equated with
murder, turning the decision
to terminate a pregnancy into a
shameful choice.
These anti-choice
tactics cause a womans decision-
making lo be more dicuIl and
for particularly vulnerable groups
of women, who are less likely to
have the support they need to rise
above the resulting shame, may
create a barrier to choosing what is
best for their own health and family

Brochure, distributed by a MA CPC
The Path to a Crisis Pregnancy Center
of misleading and ambiguous
advertising tactics to draw women
who believe they might be pregnant
into their centers. One of the more
traditional methods is Option Line,
a helpline established in 2003
by two of the largest national CPC
chains, CareNet and Heartbeat
International. Option Line sponsors
billboard campaigns advertising a
toll-free number that employs 25
phone consultants who are available
24 hours a day to direct women to
CPCs in their area.

From 2003
lo an eslimaled one miIIion
women had contacted Option
Line and lhe organizalion reorls
that its website receives more than
unique users each monlh

CPCs are also branching out into

newer advertising tactics, spending
thousands of dollars each month to
purchase online search terms and
online phone book listings
reach women who are increasingly
turning to the Internet for health
information and resources.

Further, in marketing themselves,
CICs emhasize lhe avaiIabiIily
of free pregnancy tests and
uIlrasounds in an eorl lo aeaI
to young women and low-income
women who have lesser access to

Just Because Youre Pregnant... 15
Myth: Abortion is
Fact: A complication
serious enough that it
requires hospitalization
occurs in less than 0.3% of
all abortion procedures

and of procedures done
ln tbe rst 13 weeks ot
pregnancy, 97% of women
report no complications

There is a
0.0006% risk of death in
surgical abortions, caused
generally by adverse
reactions to anesthesia,
embolism, infection, or
uncontrollable bleeding.

The risk of death in
pregnancy and childbirth is
ten times greater.

Brochure, distributed by a MA CPC
Traditional Advertising
including billboards in communities such as the lower-income neighborhoods of Roxbury and
Maaan Adverlisemenls aIso aeared on lrains and bus sheIlers lhroughoul lhe cilys ubIic
lransorlalion syslem olh fealured a young voman vilh lhe lag Iine Iregnanl Scared Need
Help? and the number and website for Option Line. When a woman would call or visit the website,
she was immediately referred to a CPC operating in her area.
Online Advertising
using six search terms a woman might use if she thought she might be pregnant and seeking infor-
mation about her options, including abortion. Those terms were: abortion services, abortion clin-
ics aborlion roviders famiIy Ianning cenlers birlh conlroI informalion services and
key search terms. When the same search was repeated in February of 2011, after NARAL Pro-Choice
CPC still appeared in the top ten results of three of the six key search terms.
These ndings are nol an accidenl The rominenl osilioning of CICs in lhese searches is oflen
dollars per month for a priority listing on
or lo a monlh on suer-
CPCs, many of them include abortion services or abortion referrals. In our investigation, none of
the CPCs that advertised those services provided either abortion services or abortion referrals when
we visited them.
Example of an Option Line Billboard
Just Because Youre Pregnant...
Screen shot of a Yellow Pages online ad
The Finances of Crisis Pregnancy Centers
Mosl of lhe CIC aclivilies in Massachuses require IiIe overhead and fev exenses so mosl of
mosl signicanl oeraling exenses are comensalion if lhey have emIoyees ralher lhan being
slaed enlireIy by voIunleers and occuancy IargeIy renl and reIaled cosls Irogram exenses
including advertising, printing, and the cost of pregnancy tests, tend to be modest for all CPCs,
or using donated space, and relying on volunteer hours, CPCs can thrive on very small annual
revenues. There are three main sources of funding available to these anti-choice entities: federal and
state grants, state-collected revenues, and private donations.
Across the country, many CPCs receive federal
funds from various government programs,
many of them designed largely to support
abstinence-only sexuality education.
the Commonwealth does not currently accept
any federal funding for these purposes, at
least one CPC chain A Womans Concern
has historically received a direct federal grant
to operate its abstinence-only-until-marriage
education program.
Slale governmenls aIso
frequently fund CPCs directly, but although
dedicated funding stream, in 2010, it became one of 23 states that now allow the sale of specialty
Choose Life license plates
designed as a conduit for funding local CPCs.
From June 2010 through April 2011, the Registry of Motor Vehicles distributed approximately 2,000
plates, which raised roughly $80,000

for Massachuses Choose Life MCL an aIiale of lhe

nalionaI Choose Life organizalion MCL vhich receives lhe roceeds from lhe Iicense Iales has
sole discretion in determining how those funds will be distributed and states that it provides the
nongovernmenlaI nolforrol agencies nol invoIved in aborlion services in any vay vho oer
free counseling and services to women with a crisis pregnancy.

the state-collected funding or how much MCL has given them.
(Our investigation focused on the
MCLs list.) While the license plate program is still in its infancy, more established programs in other
states have already raised millions to support CPCs.

CICs in Massachuses aear lo reIy heaviIy on individuaI donalions incIuding funds raised
through events. A small number appear also to receive support from foundations known to fund a
and funding aramelers CICs in Massachuses range grealIy in size and scoe The Iargesl A
Womans Concern which claims to have six facilities around the state reported revenues of $1.3
The other multi-center entity,
Iregnancy Care Cenler reorled |usl over in revenues
and the stand-alone facility
additional four anti-choice facilities investigated had budgets clustered between $80,000-$180,000,

while three others reported revenues of less than $25,000 in 2008.
Fourteen do not appear to have
NARAL IroChoice Massachuses and lhe IroChoice Massachuses Ioundalion beIieve lhal
a woman facing an unintended pregnancy has a right to accurate, unbiased, and comprehensive
information about the full range of her reproductive health options. When facing the prospect of
pregnancy, a woman deserves to receive information that is based on medical fact, not anti-choice
impact on a womans health and life, she should not be delayed or deterred from obtaining true
options counseling and appropriate medical care.
Unfortunately, our research shows the opposite to be true at crisis pregnancy centers (CPCs) in the
Commonwealth. By delaying womens decisions, misinforming them about the risks, and shaming
vomens choices lhe vasl ma|orily of lhese faciIilies in Massachuses deny vomen access lo lhe
timely, appropriate counseling and medical services they need and deserve, including both abortion
and pre-natal care.
We encourage oIicymakers ubIic heaIlh ociaIs sociaI service agencies heaIlh care roviders
communily organizalions and concerned cilizens lo use lhis reorl lo famiIiarize lhemseIves and
lo vork logelher lo counler lhe harmfuI eecl CICs may have on lhe heaIlh and veIIbeing of
women in the Commonwealth. Chief among them is to do more to educate the public about their
reproductive health, pregnancy options, and the resources that can aid them in preventing or
terminating a pregnancy, carrying a pregnancy to term, or parenting a healthy child.
When f aci ng t he prospect of
pregnancy, a woman deser ves t o
recei ve i nf ormat i on t hat i s based on
medi cal f act , not ant i - choi ce i deol ogy
maski ng as opt i ons counsel i ng. .
Just Because Youre Pregnant...
Appendix I: Methodology
searches for regnancyreIaled organizalions served as lhe basis lo delermine lhe number and
was deemed to be a CPC if it was a center or clinic which (1) purports to provide education and
counseling services and pregnancy-related services such as pregnancy tests and ultrasounds, (2)
provides misleading, incomplete, or proven-to-be-false information related to sexuality, abortion,
abortion-related risks, and birth control, and (3) will not perform abortions or provide abortion
Those facilities still in operation were then mapped against the locations of clinics and private
again in winter of 2010/11 using six key search terms women seeking pregnancy or family planning
In the summer of 2010, a trained volunteer catalogued and conducted a content analysis of all of the
in total); we revisited the sites again in the fall of 2010 and winter of 2010/11. A volunteer with
seciaIized nance background revieved federaI lax relurns IRSs vhere ubIicIy avaiIabIe
the revenues and sources of funding in the winter of 2010/11.
Finally, in the spring of 2011, trained volunteers made direct contact with 24 of the 30 active CPCs
through 20 in-person visits (typically in pairs) and 15 in-depth phone conversations, cataloguing
what they were told, how they were treated, and which resources they were provided.
Just Because Youre Pregnant... 21
233 N. Pleasant St.
Amherst, MA 01002
(413) 549-1906
320 Gifford St.
Falmouth, MA 02540
(508) 457-0680
277 Main St.
Marlborough, MA 01752
(508) 481-2055
78 Broadway
Taunton, MA 02780
(508) 822-2921
398 County St.
New Bedford, MA 02740
(508) 996-6744
Care Net 326 Nichols Rd. #13
Fitchburg, MA 01420
(978) 342-4244
Pregnancy Center
70 Highland St.
Worcester, MA 01609
(508) 438-0144 www.compassionpregnancycenter.
Name Address Phone Website
A Womans Concern 103 Broadway
Revere, MA 02151
(866) 435-7292
(781) 284-8747
A Womans Concern
1855 Dorchester Ave.
Dorchester, MA 02124
(866) 435-7292
(617) 825-0838
A Womans Concern
484 Highland Ave.
Fall River, MA 02720
(866) 435-7292
(508) 646-2665
A Womans Concern 48 Camp St. #6
Hyannis, MA 02601
(866) 435-7292
(508) 790-3076
Pregnancy Center
466 Main St.
PO Box 344
Greenfeld, MA 01302
(413) 774-6010
79A Main St.
Framingham, MA 01702
(508) 620-0657
Appendix II: CPCs Investigated in Massachusetts
101 Tremont St. #514
Boston, MA 02108
(617) 742-9170
First Concern
2 High St.
Clinton, MA 01510
(978) 365-9817
(888) 657-1773
Just Because Youre Pregnant... 23
(413) 732-2006
Friends of the
PO Box 692246
Quincy, MA 02269
(617) 786-7903
(888) 761-8538
Heartbeat Pregnancy
Help Center
113 Winn St.
Burlington, MA 01803
(781) 229-7887
Liferight of North
57 Main St, # 208
North Adams, MA 01247
(413) 664-4106
Pregnancy Care
496 Main St.
Haverhill, MA 01830
(978) 373-5700
Pregnancy Care
140 Main St.
Amesbury, MA 01913
(978) 388-7960
Pregnancy Care
11 Hale St.
Newburyport, MA 01950
(978) 914-0036
Pregnancy Care
704 Sumner Ave.
Springfeld, MA 01108
Pregnancy Care
124 Ames St.
Lawrence, MA 01841
(978) 686-5124
Pregnancy Help
Brighton Marine Health Center
77 Warren St. #251
Brighton, MA 02135
(617) 782-5151;
(888) 771-3914
Pregnancy Help
5 Wilson St.
Natick, MA 01760
(508) 651-0753
Pregnancy Services
2 Park Ave.
Stoughton, MA 02072
(781) 344-5900
Pregnancy Support
74 North St.
Pittsfeld, MA 01201
(413) 443-7351
Problem Pregnancy
of North Quabbin
105 Main St.
Athol, MA 01331
(978) 249-4300
Problem Pregnancy
of Worcester, Inc.
495 Pleasant St.
Worcester, MA 01609
(888) 310-7217
Your Life Matters
Pregnancy Health
176 Main St.
Southbridge, MA
(508) 764-6404;
(888) 764-6404
1 For the purposes of this report, the term clinic encompasses licensed clinics and private physician practices specializing
in reproductive health services, including abortion care, in Massachusetts. According to separate research conducted by
NARAL Pro-Choice Massachusetts and the Pro-Choice Massachusetts Foundation, in the summer of 2011, there were 11
such facilities operating in the Commonwealth, only 9 of whom make it known to the general public that the scope of their
services includes abortion care. For more information, see NARAL Pro-Choice Massachusetts, Access to Abortion Care in
Massachusetts, October, 2011, available at:
2 Lin V and Dailard C, Crisis Pregnancy Centers Seek To Increase Political Clout, Secure Government Subsidy, Guttmacher
Report on Public Policy, 2 (2002).
3 In 2006, the United States House of Representatives Committee on Government Reform conducted a study that
investigated CPCs that received any form of federal funding under the Bush Administration and reached three major
conclusions: 1) the Centers provided misinformation about the link between abortion and breast cancer 2) the Centers
provided misinformation about future fertility and abortion and 3) the Centers provided misinformation on the mental
health effects of abortion. Over the telephone, women were informed that an abortion could destroy [their] chances of
ever having children again and that they may experience a downward spiral where they lose friends and family members.
The websites of these CPCs espoused statistics for similar inaccurate claims stating that most women experienced a 50%
or greater risk of breast cancer following abortion or that 2-5% of women are left sterile after the procedure. The report
notes that President Bush supported this spread of false information when his Administration edited the National Cancer
Institute website to suggest that the link between breast cancer and abortion was an unresolved scientific question. (Rep.
Henry A. Waxman, False and Misleading Health Information Provided by Federally Funded Pregnancy Resource Centers, United
States House of Representatives Committee on Government Reform -- Minority Staff Special Investigations Division (July,
2006), available at:
4 See note 1 (above). NARAL Pro-Choice Massachusetts, Access to Abortion Care in Massachusetts, October, 2011, available
5 Friends of Care Net Fitchburg, History of Care Net Fitchburg,
(last accessed August 2011.)
6 A Womans Concern, Our History,
aspx (last accessed August 2011.)
7 Id.
8 Sophie Lyons, Crisis Pregnancy Centers in Massachusetts: Ethics of False and Misleading Information, NARAL Pro-Choice
Massachusetts (2010).
9 Planned Parenthood Federation of America v. Problem Pregnancy of Worcester, Inc., 398 Mass. 480, (1986).
10 The American College of Obstetricians and Gynecologists, Healthy Women 2008, Special Edition April 27-May 3 is Cover
the Uninsured Week, April 2008, available at
11 Dudley S and Kruse B, Facts: Safety of Abortion, National Abortion Federation, December 2006, available at http://
12 Bitler M and Zavodny M, The effect of abortion restrictions on the timing of abortions, Journal of Health Economics, 2001,
13 BBC News, Mothers-to-be can drink alcohol, Oct 11, 2007,
14 Mayo Clinic staff, Home Pregnancy Tests: Can you trust the results? October 30, 2010, available at
15 Wang ,, Conception, early pregnancy loss, and time to clinical pregnancy: a population-based prospective study, 79 Fertility
and Sterility 57784 (2003).
16 This last statement is a prime example of the ways in which CPCs will take accepted medical facts and mischaracterize
and distort them. In this case, 50% is not a miscarriage rate, but rather the proportion of fertilized eggs lost before or
during implantation (typically within two weeks of fertilization, so early in the pregnancy that the woman may not even
know fertilization occurred). Center for Reproductive Health , Contraception: How it Works, University of California/San
Francisco Medical Center, available at (last accessed October 2011).
17 The American College of Obstetricians and Gynecologists, Healthy Women 2008, Special Edition April 27-May 3 is Cover
the Uninsured Week, April 2008, available at
Just Because Youre Pregnant... 25
18 In 2008, the APA Task Force on Mental Health and Abortion evaluated all of the empirical, peer-reviewed studies on
this subject since 1989. They concluded that while it is clear that some women do experience sadness, grief, and feelings
of loss following termination of a pregnancy, and some experience clinically significant disorders, including depression and
anxiety . . . the TFMHA reviewed no evidence sufficient to support the claim that an observed association between abortion
history and mental health was caused by the abortion per se, as opposed to other factors. The Task Force further noted that
perceptions of stigma, secrecy, and lack of social support for the abortion; prior mental health problems and low self esteem;
and the degree to which a woman was invested in her pregnancy are predictive of more negative psychological responses
following first-trimester abortion. APA Task Force on Mental Health and Abortion, Report of the APA Task Force on Mental
Health and Abortion, 2008,
19 Guttmacher Institute, Facts on Induced Abortion in the United States, January 2011,
20 Id.
21 Henshaw SK, Unintended pregnancy and abortion: a public health perspective, in: Paul M et al., eds., A Clinicians Guide
to Medical and Surgical Abortion, New York: Churchill Livingstone, 1999, pp. 1122.
22 The American College of Obstetricians and Gynecologists, Postpartum Depression, January 2009, http://www.acog.
23 Norris, et. al., Abortion Stigma: A Reconceptualization of Constituents, Causes, and Consequences, Womens Health
Issues. 2011 May-Jun;21(3 Suppl):S49-54, available at:
24 Id.
25 Id.
26 Option Line, About Option Line, accessed August 2011.)
27 Id.
28 Entsminger K, Building a Successful Internet Advertising Campaign for Your Pregnancy Center 2006, available at: http://www.
29 Fox S and Fallows D, Internet Health Resources, Pew Internet and American Life Project, July 16, 2003, http://www.
30 The Truth About Crisis Pregnancy Centers, NARAL Pro-Choice America Foundation, January 2010, available at http://
31 AT&T Advertising Solutions, Internet Solutions/Internet Listings,
listings (last accessed August 2011.)
32 Supermedia, Business Listings, Compare Prices,
listing-options (last accessed August 2011.)
33 Lin V and Dailard C, Crisis Pregnancy Centers Seek To Increase Political Clout, Secure Government Subsidy,
Guttmacher Report on Public Policy, 2 (2002).
34 A Womans Concern, Our History,
aspx (last accessed August 2011.)
35 Guttmacher Institute, Choose Life License Plates, State Policies in Brief, August 1, 2011,
36 Massachusetts Choose Life, Homepage, (last accessed August 2011.)
37 Massachusetts Choose Life, Frequently Asked Questions, (last accessed August
38 Massachusetts Choose Life, Pregnancy Care Organizations, (last
accessed August 2011.)
39 Choose Life It Matters!, Newsletter, available at: (last accessed August 2011.)
40 A Womans Concern Inc., Form 990, Internal Revenue Service, available at
41 Pregnancy Care Center of the Merrimack Valley Inc, Form 990, Internal Revenue Service, available at http://www2.
42 Friends of the Unborn, Inc., Form 990, Internal Revenue Services, available at
43 Care Net Pregnancy Resource Center Of North Central Massachusetts Inc., Form 990, Internal Revenue Service,
available at
massachusetts.aspx. Daybreak Inc., Form 990, Internal Revenue Service, available at
organizations/22-2474290/daybreak.asp. First Concern Pregnancy Resource Center Inc., Form 990, Internal Revenue
Service, available at
Compassion Pregnancy Center of Worcester Inc., Form 990, Internal Revenue Service, available at http://www2.guidestar.
44 Alternatives A Crisis Pregnancy Center, Form 990, Internal Revenue Services, available at
organizations/01-2930736/alternatives-a-crisis-pregnancy-center.aspx, Heartbeat Crisis Pregnancy Center, Form 990,
Internal Revenue Services, available at
center.aspx , and Liferight of North Adams Inc., Form 990, Internal Revenue Services, available at http://www2.guidestar.
45 Gerard Health Foundation LLC, Form 990, Internal Revenue Service, available at
46 See, e.g., Michael Crowley, The Rights New Kingmaker, Nov. 12, 2004,
and Focus on the Family, About Us: Our Founder, (last
accessed August 2011.)
47 Life Prizes, 2008 Life Prizes Awards Ceremony Speeches, (Life
Prizes is an initiative of the Gerard Health Foundation, (Last accessed
August 2011.)
48 Anemona Hartocollis, Latest Hidden Video by Abortion Foes Shows Bronx Clinic of Planned Parenthood, New York
Times, Feb. 8, 2011.
49 Irene Sege, Conservative causes get Bay State patron, Boston Globe, Oct. 31, 2008.
50 Healthy Futures, Media Advisory: $1.5M Grant Award by the U.S. Department of Health and Human Services to
Healthy Futures to Expand Sexual Health Education, January 28, 2004, available at: http://www.healthy-futures.
Services%20to%20Healthy%20Futures%20to%20Expand%20Sexual%20Health%20Education.pdf (hereinafter Healthy
Futures Media Advisory).
51 Healthy Futures, News Release: Healthy Futures Program Teaches Abstinence in Boston-Area Schools, Jan. 28, 2004,
available at
52 See Healthy Futures Media Advisory, Jan. 28, 2004.
53 Schaffer A, The Family Un-Planner,, Nov. 21, 2006,
54 Fletcher M and Partlow J, Arrest of Ex-Bush Aide Shocks Associates, Washington Post, March 12, 2006, http://www.
55 Hogue C et al., The Effects of Induced Abortion on Subsequent Reproduction, 4 Epidemiological Reviews 66, 67, 88-9
56 National Cancer Institute, Abortion, Miscarriage, and Breast Cancer Risk, Apr 2003 at
57 Wang ,, Conception, early pregnancy loss, and time to clinical pregnancy: a population-based prospective study, 79 Fertility
and Sterility 57784 (2003).
58 The American Psychological Association, Task Force on Mental Health and Abortion, Report of the APA Task Force on
Mental Health and Abortion, 2008,
59 Guttmacher Institute, Facts on Induced Abortion in the United States, January 2011,
60 National Abortion Federation, Abortion Fact: Safety of Abortion,
safety_of_abortion.html (last accessed August 2011.)
61 Id.
62 Id.
Contact Us
For more information about the report please contact:
Boston, MA 02108-2524
NARAL Pro-Choice Massachusetts Mission
To develop and sustain a grassroots constituency that uses the political process to guarantee every
woman the right to make personal decisions regarding the full range of reproductive choices,
including preventing unintended pregnancy, bearing healthy children, and choosing safe, legal,
and accessible abortion.

Just Because Youre Pregnant...: Lies, Half Truths, and Manipulation at Crisis Preganncy Centers in
report was designed by Brita Lund.
conducted and contributed to the undercover investigation of CPCs. We are incredibly grateful for
all of your work, enthusiasm, and dedication to womens access to reproductive health.