BOSTON — “Pregnancy resource centers” are becoming increasingly prevalent in Massachusetts, outnumbering abortion providers three-to-one as these anti-abortion women’s health care centers pushback against abortion rights advocates.

Last month, Massachusetts Citizens for Life launched the Pregnancy Care Alliance of Massachusetts, a coalition of nonprofit anti-abortion organizations, to support the mission of “pregnancy resource centers” statewide.

The coalition, comprised of eight anti-abortion organizations and 20 Massachusetts centers, was formed in response to targeted legislation by municipal and state governments.

The network plans to launch public awareness campaigns, that could include billboards and radio spots, in an effort to combat the recently approved $1 million state education campaign about anti-abortion centers, three of which are located in Greenfield, Easthampton and Springfield.

“The goal is to primarily educate the public about who we really are, the services we provide, and the good things that we do,” said Teresa Larkin, the coalition’s vice chair for external relations. “We think if people really understood who we are and what we do, they would be completely supportive.”

Centers criticized

The anti-abortion centers, which abortion rights advocates also call “crisis pregnancy centers” or “fake clinics,” are accused of providing inaccurate health information and using deceptive tactics to dissuade people from accessing abortion care. The centers are sometimes religiously affiliated and often advertise free services including pregnancy testing, counseling, ultrasounds, prenatal care, diapers and social support.

Many centers have been criticized for unethical practices like using fear-based language, linking abortion to medical conditions like infertility or cancer, and delaying care to reduce or eliminate one’s options.

Aziza Ahmed, a Boston University professor of law specializing in reproductive justice, said that although Massachusetts is somewhat a leader in abortion rights, the state’s growing number of anti-abortion facilities is concerning.

“We have these crisis pregnancy centers — many of which are private actors — who are, from my perspective, committing acts of fraud,” said Ahmed. “They are holding themselves up to be health care providers and experts in reproductive health care when in fact, they are not.”

Larkin said that Pregnancy Care Alliance’s anti-abortion centers do not claim to be medical clinics or anything other than what they are.

“If there are centers that truly are masquerading and deceptive, our group is supportive of calling them out and identifying them,” said Larkin.

Anti-abortion group numbers rise

Though Massachusetts has codified and expanded access to abortion, the number of anti-abortion facilities continues to grow. In 2018, Massachusetts had 25 anti-abortion centers, the most in New England, according to a study from the University of Georgia.

Today, there are at least 30 anti-abortion centers in the state, outnumbering licensed abortion providers by three-to-one, according to the Massachusetts reproductive rights group Reproductive Equity Now (REN).

“They are working on the ground, even in protected states like Massachusetts, to sway people away from legitimate health care,” said REN communications director, Taylor St. Germain. “We know that they’re organized. We know that they’re a serious threat here in Massachusetts.”

A map of known pregnancy centers shows that some Massachusetts residents, especially in the west and southeastern regions, must travel between 50 and 110 miles for abortion care.

The so-called abortion desert of Outer Cape Cod, for example, is a two-hour drive from the nearest abortion providers in Attleboro and Boston.

Every abortion clinic in the state is located less than three miles away from an anti-abortion center, according to the map. At least five anti-abortion centers are located on the same street as abortion providers.

Reproductive rights advocates say the centers locate deliberately close to dissuade patients from receiving abortion care.

Attleboro’s Women Health Center, for example, is located right next door to Four Women Health Services, a full-spectrum reproductive health care clinic.

Marcus Gordon, medical director of Four Women Health Services, said that every week, several of his patients are lured into the anti-abortion center under false pretenses, often leaving “traumatized by the experience.”

“Attleboro Women’s Health has had their associates wear security guard uniforms and direct patients into their building by telling them it’s the facility they are looking for when they actually have appointments at Four Women,” said Gordon. “Once inside they see someone that is clearly not a qualified health care provider. Under the guise of being health care providers, they give incorrect information with ultrasounds that are generally inaccurate.”

Many anti-abortion centers like Attleboro Women’s Health Center operate under two different names and websites: one presents secularly as a women’s care center while its counterpart is religiously affiliated.

Although reproductive rights advocates say this is a deceptive practice, Larkin said that because the centers are nonprofits, some have a “donor-facing website that is designed to raise money” and a “patient- or client-facing website that is designed to let women know what the services are.”

Communities, legislators take action

Increasing concerns over the state of reproductive freedom have driven at least half a dozen Massachusetts communities to consider ordinances regulating anti-abortion centers.

In March 2022, on International Women’s Day, the city of Somerville unanimously passed an ordinance prohibiting the deceptive advertising of anti-abortion centers. The city of Salem adopted a similar ordinance in December 2022, with violations subject to a $300-a-day fine.

Other Massachusetts cities including Easthampton, Cambridge, Worcester, Boston, Framingham, and Newton have proposed ordinances against anti-abortion centers within the past year.

REN’s St. Germain said that local action is critical, calling anti-abortion centers the “foot soldiers of the anti-abortion movement.”

“Their goal of grassroots mobilization is to ensure that people don’t have access to legitimate abortion care,” she said. “We must take critical steps to help blunt the impacts.”

Lt. Gov. Kim Driscoll partnered with Rebecca Hart Holder of Reproductive Equity Now to publish a call for municipal action, asserting that reproductive freedom cannot be achieved “without the partnership of all 351 cities and towns across the state.”

“Right now, as anti-abortion activists descend on municipalities, our cities have an opportunity to lead,” they said. “We can show the rest of the country what reproductive equity at the city level looks like.”

Meanwhile, the Pregnancy Care Alliance intends on hosting open houses in June to welcome legislators, community leaders, the public, and the press into the anti-abortion centers, according to Larkin.

Larkin hopes that inviting people to tour the facilities, speak with staff, and hear from clients will help them understand the organizations’ goals and intentions.

She said she “would love to know” why state and municipal legislators are “attacking” anti-abortion centers.

“No one will get back to us. No one will respond,” she said. “They throw accusations, but frankly, it’s hearsay. We don’t know where these accusations come from.”

Most anti-abortion centers are not licensed medical facilities, are primarily staffed by lay volunteers, and do not adhere to national medical guidelines, according to the University of Georgia.

Only four of the anti-abortion centers in Massachusetts included in the Massachusetts Citizens For Life directory appear on the state Department of Public Health’s list of licensed medical clinics.

In 2015, NARAL Pro-Choice America investigated a number of Massachusetts anti-abortion centers and found that around 70% handed out pamphlets that mischaracterized the risk of abortion.

Although there is less than a 0.05% risk of major complications for first-trimester abortions, 20% of the investigated centers falsely claimed abortion causes an increased risk of breast cancer and 33% claimed abortion may cause infertility or a future ectopic pregnancy.

Some investigators were told “just because you are pregnant doesn’t mean you’ll stay pregnant,” and that “the good news” about a positive pregnancy test is that the miscarriage rate is so high. One employee even said that “50% of pregnancies end in miscarriage.”

A few centers even cited possible death as a risk without indicating the actual statistical likelihood, which is approximately 14 times lower than that of childbirth, according to the American College of Obstetricians and Gynecologists.

Abortion rights advocates, in accordance with ACOG, consider anti-abortion centers a barrier to abortion access and say the organizations’ efforts to misinform can delay patient care and reduce one’s reproductive options.

The statewide battle is taking place against a backdrop of anti-abortion legislation across the country.

Gov. Maura Healey issued an executive order last month expanding abortion protections to include abortion medication after a federal court ruling in Texas blocked the U.S. Food and Drug Administration’s approval of the pill mifepristone, which is used to end a pregnancy.

The Healey administration partnered with the University of Massachusetts to stockpile the drug in case it gets banned nationwide.

St. Germain said that the Healey administration has “acted proactively, boldly, and swiftly” to “time and time again protect abortion care.”

“Abortion care is health care and we will continue to stand up to ensure that people have access,” St. Germain said.

Marissa Walker writes for Athol Daily News from the Boston University Statehouse Program.

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