Read our 2018 investigative report on Crisis Pregnancy Centers in Maryland
Anti-choice crisis pregnancy centers (CPCs) provide information and services for individuals who may suspect or know that they are pregnant, including free pregnancy tests and “counseling” on abortion, adoption, and parenting. These centers operate with the purpose of discouraging abortion as a pregnancy outcome option, and often discourage contraceptive use as well.
These centers deceive people who think that they might be pregnant or already know that they are into believing that they are in a supportive facility that will give unbiased information on all options related to pregnancy (parenting, abortion, adoption, etc.). In the summer of 2017, volunteers from NARAL Pro-Choice Maryland visited these fake women’s health centers to assess the scope of services and staffing, and to the extent they will go to while engaging in deceptive practices to stop individuals from seeking abortion care.
Whether ultimately having an abortion or carrying to term, it is critical that pregnant individuals receive accurate, evidence-based information and proper pregnancy-related medical care to ensure the safety and best possible health outcome for themselves and their families. As such, it is necessary to address in what ways anti-choice crisis pregnancy centers engage with the public. The policy research and community outreach conducted by the NARAL Pro-Choice Maryland Fund, the 501(c)3 arm of the statewide affiliate, helps to inform the work of the 501(c)4, NARAL Pro-Choice Maryland, the policy and political arm. It is the intent of this report to help increase public awareness of these issues as well as encourage state and local jurisdictions to use legislation or ordinances in order stop deceptive practices of CPCs that can contribute to poor pregnancy outcomes.
Table of Contents
Appendix A: Publicly Accessible CPC Information Agenda Analysis
Appendix B: CPC On-Site Survey
Appendix C: CPC On-Site Survey Results
Appendix D: Samples of CPC Intake Forms
Appendix E: Samples of CPC “Medical” Forms Part 1
Appendix E: Samples of CPC “Medical” Forms Part 2
Appendix F: Samples of a CPC Pregnancy Screening Form
Appendix G: CPC Ultrasound Images
Appendix H: CPC Anti-Abortion Pamphlets Targeting Women Part 1
History of CPCs in Maryland:
In 2009, Maryland became the first state in the nation to introduce a legislative measure to address the deceptive practices of anti-choice crisis pregnancy centers or limited services pregnancy resources centers. Soon after the bill failed in committee, two similar ordinances were introduced, but were legally challenged. The 2009 Montgomery County resolution lost on appeal in the U.S. Fourth Circuit Court of Appeals in 2014; and now after nine years, the Fourth Circuit ruled against the 2010 Baltimore City ordinance. In April 2018, the City of Baltimore appealed the decision to the U.S. Supreme Court.
The Fourth Circuit’s decisions may seem like defeats, but it is important to note that Baltimore was the first city in the country to enact an ordinance to regulate anti-choice crisis pregnancy centers. Enactment of local and statewide measures in California, New York, Washington, and Hawaii have all cited Baltimore City and Montgomery County’s regulation efforts. We look forward to the upcoming ruling by the U.S. Supreme Court in the case, NIFLA v. Becerra, the 2015 California law which was upheld by the U.S. Ninth Circuit Court of Appeals, but recently appealed by anti-choice advocates. Oral arguments were held in March and the decision is to be released by the end of June. The results will help guide what is possible in Maryland to stop these deceptive practices. The California law included a provision that unlicensed crisis pregnancy centers visibly advertise that no licensed medical providers are onsite to provide care or supervise the provision of care.
In case you missed how we got here, below is a timeline of events:
Investigation: Our first investigation of Crisis Pregnancy Centers (Read it here.)
Investigation: We conduct a second, in-depth investigation of CPCs. (The Truth Revealed Report)
Legislation: Working with the Baltimore City Council, we help pass Ordinance 09-252, making Baltimore City the first place in the country to ask CPCs to disclose the truth about their practices.
Litigation: A CPC challenges the ordinance in court. The ordinance is not yet enacted, pending the court’s decision.
Legislation: Following the example of Baltimore City, Montgomery County, MD, passes Resolution 16-1252, a similar regulation on pregnancy centers.
Litigation: A CPC challenges the Montgomery legislation.
Investigation: We map out locations of as many CPCs as we can find in Maryland. (Is there a CPC in your neighborhood?)
The Fourth Circuit ruling on the Baltimore case stated that the lower court’s decision against the ordinance was too hasty and the court had denied the pro-choice defendants the opportunity to submit evidence countering the anti-choice CPC’s claims. The Montgomery County decision applied to the district court’s partial preliminary injunction of the ordinance requiring that CPCs post signs that (1) they do not have medical personnel on staff and (2) the County recommends that pregnant women seek care from a medical professional. The district court, while allowing the first provision to go into effect, had enjoined the second. The Fourth Circuit upheld that decision, and the case against the ordinance’s merits will continue in the district court.
Education: We create the It’s Lies campaign, a groundbreaking educational campaign on Baltimore City buses that educated people about the deceptive tactics used by CPCs.
Litigation: Regarding Montgomery County Regulation 16-1252, Judge Deborah K. Chasanow, rules that the regulation violates the CPC’s First Amendment’s Freedom of Speech clause. This resulted in the court striking down the entire ordinance. The court stated that The County has not demonstrated how the practices of the CPCs are causing harm. The court stated that before a government can compel speech it must “present more than anecdote and supposition.” Judge Chasanow held that the county had provided only “conjecture” and not evidence. Based upon that finding, the court granted Centro Tepeyac’s motion for summary judgment and permanently enjoined the county from enforcing the resolution. The litigation ended when the district court rejected a county motion for reconsideration.
Tepeyac v. Montgomery Cty., 5 F. Supp. 3d 745, 769 (D. Md. 2014)
Education: The It’s Lies campaign moves forward with billboards and more bus advertising in Baltimore City.
Investigation: We conduct a third, in-depth investigation of CPCs as well as legal and policy research to explore legislative options in light of recent ordinances and statewide measures that have been upheld in court challenges, such as in California, New York, Hawaii, and Washington states. Investigative report is forthcoming.
Litigation: Oral arguments were heard on October 24, 2017 in the Fourth Circuit Court of Appeals regarding Baltimore City ordinance.
Litigation: On January 5, 2018, the Fourth Circuit ruled that Baltimore City’s Ordinance 09-252 was unconstitutional as it violated the First Amendment’s freedom of speech clause. Greater Baltimore Ctr. for Pregnancy Concerns, Inc. v. Mayor & City Council of Baltimore, 879 F.3d 101 (4th Cir. 2018)
The court noted that while the city has considerable latitude in regulating public health and deceptive advertising, Baltimore’s chosen means are “too loose a fit with those ends.” Without proving the inefficacy of less restrictive alternatives, providing concrete evidence of deception, or more precisely targeting its regulation, the City was not able to prevail.
NIFLA v. Becerra
In 2015, California passed the Reproductive Fact Act, which mandated two things: first, that licensed crisis pregnancy centers post signage indicating that the state has low-cost options for services including abortion, and second, that unlicensed facilities post signage indicating that they are not licensed medical facilities. Soon after the law was passed, anti-choice groups filed suit, citing free speech, to strike down this law. On June 26, 2018, the Supreme Court ruled in favor of the anti-choice group National Institute for Family Life in America (NIFLA). Now, advocates will have to consider new and creative approaches to addressing CPCs, which may include public education, eliminating state public funding of fake health centers, and addressing unethical behavior of licensed healthcare professionals who work in them.
April: Baltimore City appeals the case to the US Supreme Court.
May: NPCMF releases a new investigative report regarding the scope of services and staffing in Maryland CPCs