The Legal and Policy Landscape of Crisis Pregnancy Centers 

Key Takeaways

• There are an estimated 2,400 to 2,800 Crisis Pregnancy Centers (CPCs) in the US. These sites, also referred to as Pregnancy Centers, are established to dissuade pregnant people from seeking abortion care and are often associated with or established by faith-based or anti-abortion organizations. They usually attract clients by offering free pregnancy tests, ultrasounds, and material goods like diapers or clothing.  
• CPCs largely lack oversight of how they handle client data, and clients have limited remedies if their data is leaked. While CPCs typically advertise or position themselves as medical clinics, the vast majority are not medical facilities. CPCs usually collect confidential health information from clients like pregnancy status or sexual history, but they are not subject to the federal medical privacy law known as the Health Insurance Portability and Accountability Act (HIPAA) because they do not bill insurance for their services or electronically transmit claims.  
• Attempts to regulate CPCs have largely been unsuccessful in the courts. Citing CPC’s First Amendment protections, multiple courts, including the U.S. Supreme Court, have sided with CPCs against attorney general investigations, state laws designed to regulate CPCs, and private-sector actions to inform the public about their anti-abortion mission.  
• In response to these legal challenges and with support from the Alliance Defending Freedom, a conservative Christian legal advocacy organization, some states have enacted legislation prohibiting state governments from interfering with the expression and association rights of CPCs or restricting CPCs’ ability to provide certain services.  
• On the federal side, the Trump administration and anti-abortion legislators have prioritized CPC expansion. On Mother’s Day 2026, HHS established a new website, moms.gov, and it spotlights CPCs as a resource for pregnant people without identifying their anti-abortion mission and limited provision of services. The administration also opened the door to the possibility of extending federal funding support to CPCs through the federal Title X family planning program, through the program’s most recent funding guidelines, even though CPCs do not provide contraceptive services or supplies. 

Introduction

On Mother’s Day 2026, the Trump administration launched moms.gov, a website designed as a resource for mothers and their families. At the top of the page, the website features a link to a non-government website that helps locate “pregnancy centers,” also known as Crisis Pregnancy Centers (CPCs), as a resource for support, and positions CPCs alongside Federally Qualified Health Centers, nutrition facts, and guidance on opening Trump investment accounts. While there is no standard definition of what qualifies as a CPC, these unregulated sites typically are associated with or established by faith-based or anti-abortion organizations, with their primary mission being to dissuade pregnant people from seeking abortion care. This brief examines the legal status of CPCs, attempts to regulate them, and future efforts to expand their footprints as they gain more recognition and funding from local, state, and federal programs.

What Are Crisis Pregnancy Centers and How Do They Attract Clients 

CPCs have their origins in the 1960s in the early days of the antiabortion movement. They usually offer pregnancy tests, ultrasound, and material goods like diapers or clothing to support pregnant clients at no cost. However, these services are sometimes conditioned on clients attending religious seminars. According to the U.S. Government Accountability Office as of 2025, between 2,400 and 2,800 CPCs were operating across the country, and most of them were affiliated with three anti-abortion organizations — Heartbeat International, National Institute for Family and Life Advocates (NIFLA), and Care Net. Post-Dobbs, the number of newly opened or reopened CPCs has been highest in the South, which is also where more states ban the provision of abortion or impose early gestational limits on the provision of abortion care. 

The main purpose of CPCs is to dissuade people from opting for abortion, instead encouraging them to choose adoption or parenting using a variety of approaches to reach individuals whom they call “abortion-determined” clients. For years, CPCs have opened near reproductive health facilities, a practice known as “co-locating,” so they can approach patients attempting to visit abortion clinics and discourage them from seeking or obtaining abortion care. The American College of Obstetricians and Gynecologists has stated, “by using deception, delay tactics, and disinformation, CPC staffs undermine the tenets of informed consent and patient autonomy and impede access to comprehensive, ethical care.” In addition to co-locating near comprehensive reproductive health clinics, CPCs position themselves as attractive to young people, people with low incomes, people who are uninsured or underinsured, people experiencing unintended pregnancies, and communities that have historically experienced barriers to health care.  

In 2024, over 71% of CPCs nationwide offered nondiagnostic ultrasounds, 28% advertised testing for Sexually Transmitted Infections (STIs), and 6% advertised HIV testing. As hospital labor and delivery units close and OB-GYN practitioners leave states like Idaho that ban the provision of abortion care, several CPCs have begun to see increased foot traffic. However, CPCs will not be able to fill persistent and growing gaps in the maternity care safety net for a variety of reasons, including their requirements for recruiting qualified clinicians. For example, the 7B Care Clinic, a CPC, on the Idaho-Washington border, recently sought to provide prenatal services due to the recent closure of the local hospital’s labor and delivery unit. 7B created a contract with a rural Washington hospital to bring qualified clinicians into the center to see clients; however, the center required potential clinicians to sign a pledge that aligned with Christian values. The contract with the hospital was subsequently canceled when providers refused to sign the pledge, thus leaving 7B with no ability to expand prenatal services.  

Most Crisis Pregnancy Centers Are Not Medical Clinics

Although Crisis Pregnancy Centers either advertise or position themselves as medical clinics, the vast majority are not medical facilities. While CPCs offer a variety of services, including ultrasounds, and some advertise the ability to rule out conditions like an ectopic pregnancy, many CPCs do not have a credentialed or practicing qualified physician or a registered nurse affiliated with their center. CPCs that have a trained clinician affiliated with their center may employ them only on a part-time or volunteer basis.  

Although some CPCs may offer limited medical services that are already available over the counter to consumers, such as pregnancy and STI testing, other clinics offer ultrasounds as a tool to persuade patients not to seek an abortion rather than as a diagnostic test. CPCs are sometimes staffed by volunteers with limited or no medical training, and because only a medical professional with specialized training can interpret ultrasounds or assess fetal health, the ultrasounds performed by CPCs are largely considered non-diagnostic. Instead, ultrasounds at CPCs are used as a persuasive tool to show pregnant clients their fetus. These nondiagnostic ultrasounds can lead to inaccurate gestational age calculations or missed pregnancy complications such as ectopic pregnancy.  

The misdiagnosis of serious medical conditions by CPCs has resulted in several lawsuits against the centers. Some CPC networks have instructed their affiliates to avoid offering ultrasounds to clients suspected of having serious medical conditions like an ectopic pregnancy. Recently, a non-profit group compiled a list of CPCs that advertise their ability to “rule out” ectopic pregnancies, even though these centers lacked the medical expertise and equipment to properly diagnose an ectopic pregnancy. In Massachusetts, a class-action lawsuit was filed against Clearway Clinic, a CPC, after the clinic failed to diagnose a woman’s ectopic pregnancy. In response, Massachusetts enacted a law regulating who may perform pregnancy-related ultrasounds. Under the new law, a person may not provide ultrasound services related to a possible or actual pregnancy unless supervised by a licensed health care provider who, acting within their scope of practice, provides medical care to people who are pregnant or may become pregnant.  

Other states have also enacted similar laws regulating the provision of ultrasound services. In the state of Washington, all ultrasounds must be performed only under the supervision of a licensed health care professional acting within their scope of practice. Connecticut similarly has a law that prevents a person from performing an ultrasound unless it was ordered by a health care provider acting within their scope of practice for a medical or diagnostic purpose. Only four states (New Hampshire, New Mexico, North Dakota, and Oregon) require providers of ultrasounds to have a license issued and regulated by the state. 

Ultrasound licensing statutes make it illegal for someone without a medical imaging license to perform ultrasounds. In practice, however, there is not a consistent enforcement mechanism to hold unlicensed individuals accountable for providing ultrasounds. North Dakota’s own licensing board acknowledges it has no jurisdiction over unlicensed individuals, and New Hampshire has also not taken any action against unlicensed volunteers performing ultrasounds at some CPCs, leaving enforcement to criminal prosecutors who thus far have not pursued it. This is in sharp contrast to states like California, where the attorney general has used subpoena power and cease-and-desist authority against CPCs to enforce violations of California law, which requires ultrasound technology to be used only in licensed facilities or by licensed providers.  

Most Crisis Pregnancy Centers Are Not Subject to HIPAA, the Federal Health Privacy Law  

Crisis Pregnancy Centers collect confidential health information from clients; however, they are not required to adhere to medical privacy regulations. The Health Insurance Portability and Accountability Act (HIPAA) privacy rule is a federal standard prohibiting medical entities from disclosing confidential health information without patient consent. Coveredentities subject to the HIPAA Privacy Rule are defined as: (1) health care providers; (2) health plans (insurance companies); and (3) health care clearinghouses that transmit patient health information in connection with health care transactions. A health care transaction is an exchange of information to conduct financial or administrative activities related to health care, such as processing payment for services.  

While some CPCs work with health care providers, neither the centers nor the providers who work or volunteer there are considered covered entities bound by HIPAA if they do not conduct health care transactions, such as billing insurance. Most CPCs do not charge for their services, nor do they accept insurance. Instead, CPCs are funded through private donations, national CPC networks, state government funds, and federal funds through programs like Temporary Assistance for Needy Families (TANF). It is estimated that CPCs received over $2 billion in revenue in 2024; however, none of this was generated from charging clients. CPCs’ variety of funding sources allows them to offer their services without needing to conduct health care transactions.  

Data Privacy Violations at Crisis Pregnancy Centers Often Escape Regulatory Enforcement 

Some CPCs have misled clients about the safety of their confidential personal information by including notices on their website, alleging HIPAA compliance, or by requiring clients to sign authorization forms. However, these steps can give clients a false sense of confidentiality: because CPCs are not bound by HIPAA, there is no oversight of how they handle client data, and clients have limited remedies if that data is leaked. In 2024, it was reported that Heartbeat International, one of the largest CPC networks, posted on the internet a training video with the full names, date of last menstrual period, and services received by clients of one of its affiliate centers in Louisiana. The breach of client health information was reported to the Department of Health and Human Services Office for Civil Rights (OCR), the entity responsible for enforcing HIPAA. However, OCR closed the complaint after determining that the CPC was not a HIPAA-covered entity and that it therefore lacked authority to investigate the violation, leaving the affected clients without recourse and no penalties for Heartbeat International. In contrast, violations of HIPAA for covered entities can lead to criminal penalties and fines of up to $2 million per violation based on the severity of the data breach and whether the entity took corrective action.  

Additionally, there is currently no enforcement mechanism to stop organizations not bound by HIPAA from falsely claiming HIPAA compliance. While entities like the Federal Trade Commission (FTC) work to protect consumers from fraud and deception, they only have authority over businesses and other for-profit organizations, not non-profits. Therefore, because clients at CPCs receive services for free, CPCs fall outside the FTC’s jurisdiction. Some advocacy groups have submitted complaints to state attorneys general urging investigations into CPCs that misrepresented their HIPAA compliance, and some centers subsequently removed HIPAA-compliance language from their websites. However, CPCs continue to collect client medical information with little accountability for protecting privacy. 

Courts Have Shielded CPCs from State Oversight

Across multiple states, courts have consistently sided with CPCs against attorney general investigations and private-sector pushback, citing First Amendment protections. 

Compelled Notice Requirements

NIFLA v. Becerra (CA, 2018): California’s FACT Act required CPCs to post notices about state-funded family planning services (for licensed clinics) or disclose their unlicensed status (for unlicensed clinics, closely matching CPCs). NIFLA sued, and after losing at the district court and Ninth Circuit, won at the Supreme Court. 

Outcome: The Supreme Court struck down both notice requirements as unconstitutional compelled speech, establishing the foundational precedent that state governments cannot force CPCs to disclose licensing status or promote state services. Later cases rely on this Supreme Court ruling as precedent.

Abortion Pill Reversal Claims  

NIFLA v. James (NY, 2024- ongoing): Attorney General Letitia James sued Heartbeat International and 11 CPCs under New York’s deceptive trade practice statute, alleging their abortion pill reversal advertising misrepresented the treatment as safe and effective.  

Outcome: This underlying case is still pending, but a related ruling in NIFLA v. James (described below) has weakened the state’s position going forward. 

NIFLA v. James (NY, 2024): In response to the suit above, NIFLA and two New York CPCs filed a separate countersuit against James, arguing her enforcement effort to prevent CPCs from advertising abortion pill reversal chilled their speech and discriminated against them for their pro-life views.  

Outcome: The Second Circuit affirmed a preliminary injunction protecting NIFLA and the 11 CPCs, holding the First Amendment allows CPCs to promote abortion pill reversal, a precedent likely to help Heartbeat International defend the still-pending case above. 

California v. Heartbeat International (2023–ongoing): Attorney General Rob Bonta filed a lawsuit against Heartbeat International for their promotion of abortion pill reversal. The false-advertising suit survived a First Amendment summary judgment challenge, and there was a 6-week trial which began in June 2026 in Alameda County; closing arguments were held on September 17, 2026. 

Outcome: Still unresolved, but it is one of the few cases where a state’s claims have proceeded to trial rather than being blocked outright. California requires state judges to issue a ruling within 90 days after the case is officially submitted for decision. 

Investigative Subpoenas 

First Choice v. Platkin (NJ, 2002-2026): Attorney General Matthew Platkin subpoenaed a CPC for donor, donation, and data-handling records amid fraud allegations.  

Outcome: In 2026, the Supreme Court ruled that compelling disclosure of CPC donor identities violates associational First Amendment rights, since such demands can chill donors from supporting the group. While the Court’s decision did not fully extinguish the attorney general’s subpoena, it established First Amendment protections for CPCs that lower courts must now follow. This could make it harder for states to subpoena records of CPCs’ donors, volunteers, board members, or clients during investigations.

Private Sector Pushback

Yelp v. Paxton (TX, 2023–ongoing): Attorney General Ken Paxton sued Yelp on CPCs’ behalf over its consumer notices describing CPCs’ limited medical services, alleging misrepresentation under Texas law. A Bastrop County court initially dismissed the case for lack of jurisdiction (Feb. 2024), but the Texas 15th Court of Appeals reversed in October 2025, holding Texas courts do have jurisdiction; Yelp has appealed to the Texas Supreme Court.  

Outcome: This case is ongoing and, unlike the other cases, does not turn on CPCs’ own First Amendment rights. This case demonstrates that private companies criticizing CPCs can themselves face sustained legal exposure from CPC-supportive state governments. 

State Laws Limiting Regulations of Crisis Pregnancy Centers  

Recently, the Alliance Defending Freedom, a conservative Christian legal advocacy organization, has pushed for states to enact their model legislation protecting CPCs. The Center Autonomy and Right of Expression (CARE) Act prohibits state governments from interfering with the First Amendment free expression and association rights of CPCs or restricting their ability to provide pregnancy services because they do not counsel for, or offer, abortions or contraception. The CARE Act has passed in at least four states, including Kansas, Montana, Oklahoma, and Wyoming, providing CPCs protection from regulation. In Wyoming, for example, government entities are prohibited from: (1) requiring CPCs to perform abortions; (2) requiring CPCs to provide medication abortion or contraception; (3) requiring CPCs to refer clients for abortion or contraception; or (4) requiring CPCs to counsel in favor of abortion or contraception. Beyond the First Amendment protections, the CARE Act further restricts states’ ability to regulate CPCs.  

Looking Ahead 

With the launch of moms.gov and other proposed policies to promote fertility, Crisis Pregnancy Centers may gain greater attention and potentially increased federal funding in the coming years. Obria, one CPC chain with sites in five states, has begun to expand their medical offerings to position its centers as an alternative to national abortion providers like Planned Parenthood. From 2022 to 2025, twenty-one states provided $491 million in funding to CPCs, not including funds allocated through federal programs like Temporary Assistance for Needy Families (TANF). In 2019, the first Trump administration awarded Obria, a chain of CPCs that opposes abortion and contraception, $1.7 million of funding under Title X, a program designed to provide free or reduced-cost family planning services to low-income and uninsured people.  

In July 2026, the Trump administration released its revised Fiscal Year 2027 Notice of Funding Opportunity (NOFO) for Title X. The NOFO stated that the Trump administration would prioritize grantee applications that “reduce overmedicalization by strengthening approaches focused on underlying behavioral and lifestyle factors of health and evidence-based practices such as fertility-awareness based methods; promote health and body literacy; advance reproductive goals counseling for all clients; and support family formation.” In response, the National Family Planning and Reproductive Health Association (NFPRHA), Planned Parenthood Federation of America, and 23 States (CA, CO, CT, DE, HI, IL, KY, ME, MD, MA, MI, MN, NV, NJ, NM, NY, OR, PA, RI, VT, VA, WA, WI) have each filed lawsuits challenging the FY 2027 NOFO, arguing that its priorities depart from the factors Congress intended HHS to consider in awarding Title X grants and instead impose politically driven, vaguely defined criteria that disadvantage qualified applicants.  

These new priorities could re-open the door for CPCs to receive Title X funds in addition to ongoing efforts by anti-abortion states to invest more resources into these centers. As states and the federal government continue to direct funds into CPCs, challenges and gaps in regulating these centers will likely persist, driven by First Amendment protections and a growing body of state laws designed to shield them from oversight.