In the United States, about 86% of women of reproductive age lived within 15 miles of a crisis pregnancy center (CPC), and 56% lived within 15 miles of an abortion facility in 2021.
A new study from the University of Georgia College of Public Health utilized data from the Crisis Pregnancy Center Map and Advancing New Standards In Reproductive Health’s (ANSIRH’s) Abortion Facility Database to quantify how many women live close to these facilities, as well as how far the facilities are from each other.
“For decades, crisis pregnancy centers have been open about their strategy of locating near abortion facilities to engage with people who are seeking abortion care who wouldn’t have otherwise gone to a crisis pregnancy center,” said study author Andrea Swartzendruber, an associate professor of epidemiology and biostatistics. “Through this study, we can learn about CPCs’ tactics and their potential reach.”
Just down the road
Nationally, CPCs were located anywhere from a few feet away from abortion facilities to a 2-hour drive away, and the average driving distance was about 7.8 minutes. For over one-third of abortion facilities, the nearest CPC was within a 1-mile drive. Two-thirds of abortion facilities had a CPC within 3 miles.
Most women aged 15-49 lived within a “dual presence zone,” meaning they were within a 15-mile radius of both a CPC and an abortion facility.
“We know that the closer that abortion facilities are, the more likely people are to get the care they want,” Swartzendruber said. “At the same time, the closer that folks live to CPCs, the more likely they are to visit one.”
And while a majority of women lived in dual presence zones, 13% lived in a “no presence zone,” meaning they were more than a 15-mile radius away from both CPCs and abortion facilities. About 26% of women across the country lived within 15 miles of only a CPC. In contrast, less than 1% of reproductive-aged women lived in an area with only an abortion facility.
“So essentially, for 86% of women before the Dobbs decision there was the possibility that the website or online advertising they were coming across for nearby locations had the potential to be a CPC, which could create confusion about which places provide abortion and prenatal care services and which do not,” said study author Danielle Lambert, an assistant professor of epidemiology and biostatistics.
Misleading information, missing care
On top of locating near abortion facilities, CPCs sometimes mirror the name of nearby abortion facilities, which can lead to confusion.
Many people first seek information about abortion and other sexual and reproductive healthcare services online, Swartzendruber said. And if CPCs and abortion facilities are both in the area, they may both appear in search results.
For individuals seeking abortion care, visiting a CPC can delay care, Swartzendruber said, but even individuals who choose to parent or are not pregnant can face risks.
Although CPCs advertise health-related services, including ultrasounds and HIV or STI testing, they are not medical facilities. Primarily, they’re staffed by lay volunteers and do not adhere to U.S. medical guidelines.
Ultrasounds at CPCs are non-diagnostic, as opposed to those done in a medical facility, and therefore do not look for potential risks with the pregnancy.
“If you think about the potential harms of someone going to a CPC, thinking that they are licensed medical providers and they’re getting care for a pregnancy that they want to carry to term, that’s problematic as well,” Lambert said. “Regardless of what someone’s pregnancy decision is, there’s evidence that CPCs may play a bigger role in terms of public health harms and reproductive health due to inadequate, delayed, or foregone care.”
A timely study and strong baseline
This study is the first to look at CPC locations around abortion facilities and compare women’s geographic access to CPCs and abortion facilities. As CPCs continue to gain government support and funding, it becomes even more important to highlight where they are located and how to identify these facilities, the researchers said.
By using data from before the Dobbs v. Jackson Women’s Health Organization decision, which overturned Roe v. Wade in summer 2022, the researchers established a baseline for the proximity of CPCs and abortion facilities before many states enacted bans on abortion care.
“CPCs have been a public health issue since before Dobbs,” Lambert added. “And this study continues to highlight how CPCs may change in the wake of Roe v. Wade being overturned.”
About 40% of all CPCs are located in the South, which now has many states with no access to legal abortion care.
“Even though the landscape of abortion access has changed, this study highlights the need for targeted messaging around crisis pregnancy centers, what they are, and how to ensure that people get the care that they want and need,” Swartzendruber said.
This includes combatting misinformation, highlighting sources of evidence-based medical care, and bringing awareness to potential health risks from CPCs, the researchers said. They next look forward to releasing new post-Dobbs data to CPC Map later this year and continuing to study CPC locations and characteristics.
