AUGUST 2023

Ohio Crisis
Pregnancy
Centers
Revealed
An investigative
report and policy
suggestions.

12000 Shaker Blvd.,

Cleveland, Ohio 44120

966 South High Street,

Suite 2, Columbus, Ohio
43206

Prochoiceohio.org
Introduction
& Background
In 2013, Pro-Choice Ohio Foundation (previously “NARAL Pro-Choice Ohio Foundation”) conduct-
ed its first official investigation into centers known as Crisis Pregnancy Centers (CPCs). The research
presented in this report is a follow up to that investigation, specifically investigating CPCs located
within the city limits of Columbus, Ohio. This research was funded by a contract with Columbus City
Council to investigate the practices of CPCs, the services they provide and ways that Council can
support parents and families within the city.
with strings attached.
What are CPCs? In 2022, the U.S. Supreme Court’s ruling in

“These centers, which are specifically Dobbs v. Jackson Women’s Healthcare Or-
aligned with the anti-abortion movement, ganization, a decision that overturned Roe v.
frequently purport to provide “all options” Wade, allowed states to enact dangerous bills
in counseling and support services, but their
services often include judgment and shame blocking access to reproductive healthcare
unless the person chooses the option that services that include abortions. Anti-abortion
CPC prefers.” politicians and leaders have touted CPCs
as the “solution” to the “harms” caused by
CPCs are facilities that promote free services
abortion bans they enacted. This position is
like pregnancy tests, maternity and baby sup-
unsound. If an individual wants abortion care
plies, counseling, and sometimes, non-medical,
they should be able to access these services in
limited ultrasound services to people facing an
their community, without having to cross state
unplanned pregnancy. These centers often at-
lines, without an attempt to shame and deter
tract pregnant people to their facilities with the
them from their decision through coercion and
offer of free pregnancy tests and ultrasounds
manipulation, and without delay. Put simply,
— services that might cost hundreds of dollars
abortion bans block people from getting the
when procured at a medical facility.1,2 These
care they need. CPCs do not “reverse” that,
centers, which are specifically aligned with the
and in fact in some ways can introduce and
anti-abortion movement, frequently purport to
exacerbate harm into what should be a pri-
provide “all options” in counseling and support
vate medical decision.
services, but their services often include judg-
ment and shame unless the person chooses
Although CPSs have tried to present their
the option that CPC prefers. A 2013 statewide
facilities as “neutral” locations where people
report on CPCs in Ohio found that even sup-
can discuss pregnancy options, their repre-
port services for people choosing to continue
sentatives and spokespeople have instead
their pregnancies often comes
actively advocated for complete abortion

1
bans, including testifying before the legislature many women out of the workforce, limiting
in support of proposed bills, lobbying for the their earning potential not only for that time
passage of bills that outlaw abortion, and even period but, in many cases, for the rest of their
filing amicus briefs with the U.S. Supreme Court lives.
urging the court to both overturn Roe and
allow abortion bans to be implemented and Using their own words from their amicus brief
enforced. In their brief to the Court in Dobbs, in Dobbs, the organization Equity Forward
Heartbeat International, a CPC network based analyzed the services these facilities provide,
in Columbus, Ohio, stated that CPCs are “high- illustrating just how inadequate CPCs are in
ly effective not only at providing options coun- providing what a new parent would need to
seling, but at helping women through all stages raise a baby in the first year. In their brief, Heart-
of their pregnancy and beyond – including beat International stated that, “In 2019, preg-
prenatal care, parenting classes, life-skill class- nancy help centers provided nearly 1.85 mil-
es, and material assistance – to help ensure lion people with free services … and material
that women can participate equally in the assistance including more than 2 million baby
economic and social life of the nation.” 3
clothing outfits, more than 1.2 million packs of
diapers, more than 19,000 strollers, and more
Statements like this ignore the fact that preg- than 30,000 new car seats.”5 According to
nancy discrimination is a reality — Ohio does Equity Forward, that includes “a stroller to 1% of
not guarantee in any way that a new parent their clientele, a car seat to 1.6% of their clien-
has paid parental leave following the birth of a tele, 0.6 packs of diapers per person, and 1.5
child. Lack of paid parental leave forces new outfits per person.”6 Not only do these centers
parents to decide between being able to pay not address the larger societal issues facing
their rent or mortgage over their physical and parents and families, but even the material
mental recovery from the birth of their child, support that they claim shows their successful
and forces many people back to work when track record falls far short of what families
they should be home, recovering and bond- really need.
ing with their new baby. Nothing illustrated
this challenge more clearly the impact that NOTES
parenting has on women than the COVID-19 1. Kimport, K. (2020). Pregnant Women’s reasons for and experiences of visit-
ing antiabortion pregnancy resource centers. Perspectives on Sexual and
pandemic. In the months leading up to the Reproductive Health, 52(1), 49-56. https://doi.org/10.1363/psrh.12131
2. Kimport, K., Dockray, J.P., & Dodson, S. (2016). What women seek from a
pandemic (December 2019-February 2020), pregnancy resource center. Contraception, 94(2), 168-172. https://doi.
org/10.1016/j.contraception.2016.04.003
the number of working women overtook work- 3. https://www.supremecourt.gov/Docket-
PDF/19/19-1392/185354/20210729164709878_Dobbs%20Amicus%20Brief%20
ing men. But by September of 2020, four times -%20FINAL.pdf
4. Gogoi, Pallavi, (2020). Stuck-At-Home Moms: The Pandemic’s Dev-
more women had left the U.S. workforce than astating Toll On Women, NPR, October 28, 2020. https://www.npr.
org/2020/10/28/928253674/stuck-at-home-moms-the-pandemics-devas-
tating-toll-on-women
men.4 5. https://www.supremecourt.gov/Docket-
PDF/19/19-1392/185354/20210729164709878_Dobbs%20Amicus%20Brief%20
-%20FINAL.pdf
6. Equity Forward (2021). Seven Reasons Why Anti-Abortion Centers Are a
The demands of child care, online schooling, Problem, Not a Solution. https://equityfwd.org/research/seven-reasons-
why-anti-abortion-centers-are-problem-not-solution
and taking care of a household forced so

2
Previous Research The Black/white disparity ratio was 2.5,
meaning a non-Hispanic Black baby was
on CPCs in Ohio: 2.5 times more likely to die in their first
year of life than a non-Hispanic white baby.
In 2013, Pro-Choice Ohio Foundation (formerly In Franklin County for 2022, non-Hispanic
Blacks accounted for 47% of infant deaths
NARAL Pro-Choice Ohio Foundation) investi- yet only 32% of overall births.
gated the practices of CPCs across Ohio. This
research consisted of phone calls to every that: nearly one in seven women in Ohio has
CPC, followed by in-person visits to half of the been to at least one CPC, CPC attendance is
facilities. higher among non-Hispanic Black women and
those with lower socioeconomic status, and
The results painted a clear picture of the de- that CPC attendance does not differ by how
ceptive and incomplete services provided important religion is in the person’s life.11
to pregnant individuals by CPCs across the
state. Less than half of the centers were up- Additional research has found that individuals
front about what they stood for, with only 42% who sought information at a CPC before ac-
openly stating they were anti-abortion (“pro- cessing abortion care felt that the centers stig-
life”), and 60% of the facilities were unwilling to matized their decision, making them feel bad
admit they were not, in fact, actual medical about their decision. Not only does this impact
facilities. In visits where the investigator felt that their experience at the CPC or when access-
the CPC counselor disagreed about an abor- ing abortion services elsewhere, but because
tion decision they were making, 53% of inves- CPCs are advertised as though they are legiti-
tigators felt that the counselor had an obvious mate health care centers, clients may believe
negative reaction to their decision. Workers at they are being judged from actual medical
these centers also frequently provided medi- professionals which could, as their research
cally inaccurate information about the risks of explained, “lead them to expect stigmatization
abortion to attempt to change the individual’s in other healthcare settings or avoid seeking
mind about abortion including, risk of future healthcare at all.” 12
infertility, drawing a false connection between
future breast cancer risk and abortion, and Racial disparities in healthcare exist throughout
purporting an increased risk of mental health our medical system, but their impact is even
conditions following an abortion. All of these greater when one looks at maternal and infant
have been repeatedly disproven in medical health outcomes. In Franklin County (the
literature and are not endorsed by mainstream county in which Columbus is located) the over-
medical organizations.8,9,10 all infant mortality rate13 was 8.0 in 2022, the
non-Hispanic Black rate was 13.1, for non-His-
Researchers at the Ohio Policy Evaluation Net- panic white rate was 5.2. The Black/white
work (OPEN) have published several reports on disparity ratio was 2.5, meaning a non-Hispanic
these CPCs in Ohio. Their research has found Black baby was 2.5 times more likely to die in
their first year of life than a non-Hispanic white

3
baby. In Franklin County for 2022, non-Hispanic This idea that just because someone needs
Blacks accounted for 47% of infant deaths yet assistance they are “lazy” or “feel entitled”
only 32% of overall births. In fact, the non-His-
14
and need to “learn and better themselves”
panic white infant mortality rate has been indicates that stigma within these centers is not
under the Health People 2020 goal of 6.0 since limited just to people who come through the
2012, but the non-Hispanic Black rate is still doors asking about abortion, but even those
more than two times higher than that goal. 15
planning to continue their pregnancy who are
The fact that CPCs contribute to the stigma in- seeking assistance. This is especially troubling
dividuals — especially Black individuals — feel since several of these facilities now receive
in the healthcare system can lead to furthering state funding through a TANF (Temporary Assis-
racial disparities in health due to people avoid- tance for Needy Families) block grant, which
ing seeking health care services because of is a program designed to give material assis-
a previous stigmatizing experience. Research tance to families who need support through
published in 2023 by OPEN included results direct cash assistance. But instead, in Ohio,
from interviews conducted with paid staff at our state government wants people in need to
CPCs around the state about the services go to CPCs and potentially be shamed about
offered, the mission of the CPC, and perceived their life circumstances before they can get
community needs. Through this research they the help that they need.
found similar results to the 2013 Pro-Choice
Ohio research — that “while CPC clients may NOTES
receive an occasional gift, they are otherwise 7. NARAL Pro-Choice Ohio Foundation (2013), Ohio Crisis Pregnancy Centers
Revealed. https://prochoiceohio.org/wp-content/uploads/2023/06/
expected to earn material aide.” These are CPC_Report_2013.pdf
8. American College of Obstetricians and Gynecologists, FAQs: Abortion
earned through programs often called “baby Care. https://acog.org/womens-health/faqs/Induced-Abortion
9. American College of Obstetricians and Gynecologists (2009). Induced
bucks” which requires the individual to partic- Abortion and Breast Cancer Risk, Committee Opinion Number 434. https://
acog.org/clinical/clinical-guidance/committee-opinion/articles/2009/06/
induced-abortion-and-breast-cancer-risk
ipate in educational programming (parenting 10. American Psychological Association (2022). The facts about abortion and
mental health. https://apa.org/monitor/2022/09/news-facts-abortion-
or abstinence education) and Bible study.16 mental-health
11. Rice, R., Chakraborty, P., Keder, L., Norris Turner, A., and Gallow, M.,
One CPC staff person, Karli, described why (2021). Who attends a crisis pregnancy center in Ohio? Contraception,
104(4), 383-387. https://www.sciencedirect.com/science/article/abs/pii/
they don’t simply give the person what they S001078242100158X
12. Warren, E., Kissling, A., Norris A., Gursahaney, P., Bessett, D., and Gallo,
need to raise their child:

“
M., (2022). “I Felt Like I Was a Bad Person…Which I’m Not”: Stigmatization
in Crisis Pregnancy Centers. Social Science and Medicine - Qualitative
Research in Health. https://doi.org/10.1016/j.ssmqr.2022.100059
13. Infant Mortality Rate (IMR) is the number of deaths to infants under 1 year
Our society now, it’s like ‘gimme of age (364 days and younger) per 1,000 live births.
14. Columbus Public Health (2022) Infant Mortality Report- Franklin County.
gimme gimme’… In our society today, https://public.tableau.com/app/profile/columbus/viz/InfantMortalityRe-
port/IMReport
and especially in this community, no 15. Ibid
one wants to work. Everyone just wants 16. Kissling, A., Gursahaney, P., Norris, A.H., Besset, D., and Gallo, M., (2023).
Free, but at what cost? How US crisis pregnancy centers provide
to live off the government … They think services. Culture, Health & Sexuality. 25(8), 1024-1038. https://www.
tandfonline.com/doi/epdf/10.1080/13691058.2022.2116489?needAc-
they’re entitled to everything, and we cess=true&role=button
17. Ibid
want to teach them a work ethic. You
have to do something. We want you to
learn and better yourself and then we

”
will give you what you need.”17

4
CPC Funding Details on CPCs in
Structures: Columbus:
The State of Ohio supports CPCs through a In the city of Columbus there are 10 CPCs,
variety of mechanisms. The largest is through compared to only two medical facilities that
the Ohio Parenting and Pregnancy program, currently provide abortion care (Image One).
created in 2013, which funds CPCs with money
from the federal TANF block grant.18 Funding for
this program began at a half million per year
in 201519 and has now grown to $7.5 million per
year as of the 2024-2025 fiscal year budget.20
In April 2022, leading up to the Dobbs deci-
sion and the subsequent enactment of Ohio’s
6-week abortion ban, Governor Mike DeWine
signed an executive order giving the Parent-
ing and Pregnancy Program an additional
$1,758,333 in anticipation of additional clients
at CPCs in the wake of the overturning of Roe
v. Wade.21

In addition to the direct funding through the

Ohio Parenting and Pregnancy Program, the Image One: Map of CPCs (purple markers) and
Abortion Clinics (green star markers) in Columbus
state of Ohio also facilitates additional funding
for CPCs through “Choose Life” license plates.
Through this state-sponsored program, individu-
als pay an additional $10/year for this specialty
plate. The funds are then disbursed to CPCs
that offer programming in the county in which
the plate was purchased, or in an adjacent
county. The last funding information on these
specialty plates available is from back in 2012,
and shows nearly $50,000 being distributed
through this fund.22 Further, some CPCs also get
support through offering “abstinence only” sex
education funding – allowing them to continue
to instill people with shame about their life ex-
periences when they should be learning health Image Two: Zoom of the full city map showing
CPC placement around abortion clinics, green
education topics that help them live a healthy, star marker is the Planned parenthood clinic on
happy, and well-adjusted life free of guilt and E. Main Street, two different CPCs are located on
adjacent corners to the clinic.
shame.

5
As shown in image 2, one of the main tactics runs three facilities in the city and Women’s
that CPCs use to bring in people is to open Care Center operates two locations. These
centers near abortion clinics — there are two latter two are also the two facilities that have
CPCs within a block of the Planned Parent- received state funding through the Ohio Par-
hood clinic on E. Main Street in Columbus. enting and Pregnancy program — receiving
Frequently, protestors outside of the Planned tax-payer funding through the TANF program
Parenthood clinic urge people to go to the to provide unbiased assistance to pregnant
CPCs instead of the Planned Parenthood facil- people and parents in the community.
ity. In our 2013 report, we found that nearly half
of the clinics that provide medical services that The research contained in this report is critical
include abortion in Ohio had at least one CPC to understanding the role that these organiza-
located within one mile of their location. tions play in our community, especially with the
6-week abortion ban litigation still pending with
The names of the facilities are also set up to the Supreme Court of Ohio. Knowing that the
make the client think that they are visiting halt on the ban going into effect is most likely
actual medical facilities that provide women’s temporary unless a constitutional amendment
health care: Women’s Care Center, Pregnan- to protect abortion is passed in November
cy Decision Health Centers, and The Women’s 2023, information in this report will be crucial to
Clinic of Columbus are a few examples of this helping cities like Columbus provide resources
deceptive marketing technique. These centers to families in need and to do all they can to
frequently have no medical personnel on staff preserve abortion access.
and provide very limited medically-adjacent
services such as over-the-counter urine preg- NOTES
nancy tests. 18. 130th Ohio General Assembly, H.B. 59. http://archives.legislature.state.
oh.us/BillText130/130_HB_59_EN_N.html
19. 131st Ohio General Assembly, H.B. 64. https://search-prod.lis.state.oh.us/
solarapi/v1/general_assembly_131/bills/hb64/EN/08/hb64_08_EN?for-
When looking at the websites for CPCs in Co- mat=pdf
20. 135th Ohio General Assembly, H.B. 33. https://search-prod.lis.state.oh.us/
lumbus, the services they claim to provide are solarapi/v1/general_assembly_135/bills/hb33/EN/06/hb33_06_EN?for-
mat=pdf
nearly identical, including pregnancy tests, 21. https://governor.ohio.gov/media/executive-orders/executive-or-
der-2022-09D
counseling, maternity and baby items, and 22. http://www.ohiochoose-life.org/distributions.php
23. NARAL Pro-Choice Ohio Foundation (2013). Ohio Crisis Pregnancy Centers
referrals. Some centers have a confidentiality Revealed. https://prochoiceohio.org/wp-content/uploads/2023/06/
CPC_Report_2013.pdf
statement, as they are not medical facilities
and do not bill like a medical facility and thus
are not governed by the strict confidentiality
rules that medical facilities are required to fol-
low under the federal Health Insurance Porta-
bility and Accountability Act (HIPAA).

Most CPCs in Columbus are solo entities, al-

though Pregnancy Decision Health Centers

6
RESEARCH
METHODS
Methods Outline: the facility receives state funding for its ser-
vices. Public records were also obtained from
Research for this report was conducted be- the Ohio Department of Job and Family Ser-
tween January and August of 2023. The re- vices for CPCs in Columbus that receive state
search began with identifying all of the CPCs funding via the Ohio Parenting and Pregnancy
(Crisis Pregnancy Centers) that were operating Program to examine how much funding the
within the city of Columbus, OH. The centers centers received and what the funding was
were identified through web-based research used for at the facility. These public records
and through anti-abortion websites like Ohio were originally obtained by Equity Forward,
Right to Life1 and Optionline2. Through this and permission was granted to use them in this
search we identified 10 CPCs operating in Co- report.
lumbus.
Following the background gathering, research
Research was divided into three prongs: back- investigators were hired and trained to con-
ground research into the finances, websites, duct the in-person investigations and phone
social media, and advertisement practices of calls to the facilities. Investigators were trained
the facilities; phone calls and in-person visits to on various scenarios — how to conduct the
the facilities using a pre-determined scenario/ visits and fill out data report forms for each
script; and public information gathering via visit and call. Separate data report forms were
two community meetings — one in person and created for in-person visits and there were four
one virtual, along with an online story collec- scenarios used for the phone calls.
tion form that was advertised on social media. A random number generator was used to as-
sign a facility to a certain scenario number. The
Background research was conducted on each four scenarios were:
of the 10 CPCs in Columbus. Their websites
were examined for affiliations, topics/issues ad- 1. Diapers and Materials Assistance: Caller asked
dressed, and services offered. We also exam- if they could stop in and get diapers for their
ined whether these centers were listed on city 8-month-old baby because they had run out of
government referral websites, pulled organi- diapers, stating that they had to have diapers in
zational 990 documents from www.Guidestar. order to drop the baby off at daycare that day.
com to look into where the funding for these The script included asking questions about what
facilities comes from, including whether or not was required to get diapers if they provided this

7
service, if a person could come back again and wanted to do about the pregnancy, and then
get more if needed, and questions about other they would ask for information about all of their
services the facility provided. options.

2. “Abortion Reversal”: Caller asked about the Following the individual visits, the teams record-
medically unproven notion of stopping a med- ed information on a visit data sheet detailing
ication abortion after the first pill (mifepristone) the information that they were given by the
had been taken. They said that their friend had volunteer or staff member at the facility. This
taken the first pill but was now thinking that was information included details about the ap-
a mistake and then asked follow up questions pearance of the facility, whether or not it was
about what was involved in the process. located near a Planned Parenthood or other
women’s health center, what kind of position
3. Prenatal Care: Caller asked if the facility provid- the people had with whom they interacted
ed prenatal care because her friend needed it. with (volunteers, staff, medical personnel),
Follow up questions included questions about what the session included, whether or not
services the facility provided and if they could they signed confidentiality documentation,
refer her to a prenatal care provider if they whether the center disclosed that they were
didn’t provide those services. not a full-service medical facility, noted if they
did not refer the person to abortion providers,
4. Positive Pregnancy Test: Caller said that they
whether they identified as religiously-affiliated,
had taken a home pregnancy test and it was
as well as other details of the visit.
positive and asked about services the facility
provided. Follow up questions included more The investigators also gathered as much print-
details about what the appointment would ed information (pamphlets, brochures) as they
entail, whether they would meet with a doctor could from the CPC’s they visited. All of this
or nurse, and general abortion and adoption information was analyzed for the results report.
questions.
Once all of the visits and calls were com-
Concurrently with the phone investigations, plete, the data from the report forms were
in-person visits were attempted for all 10 CPCs entered into a spreadsheet. The visit and
in Columbus. All visits began as walk-in visits but phone data sheets included both open-end-
if the center asked the investigators to come ed and closed-ended questions to collect
back at another time all attempts to accom- nominal data (yes/no). Qualitative data from
modate that request were made. For in-person open-ended questions on the visit data sheets
visits a team of two investigators went together was evaluated using inductive thematic analy-
to the facility; one posing as the pregnant per- sis. A researcher thoroughly reviewed all re-
son, one as their support person. The pregnant sponses entered on the visit data sheets to de-
person was instructed to say that they had tak- velop codes that described the data. Themes
en a home pregnancy test and it had come were identified by grouping the codes from all
back positive and they were unsure what they visit data sheets to develop a coding frame-

8
work. A coder then coded each visit data
sheet using the developed coding framework.
The same process was used for the phone call
data. Data was then analyzed and summa-
rized for this report.

The final portion of the research was a series

of information-gathering activities. Two public
meetings were held to talk to people about
CPCs and to hear stories from people who had
visited the facilities. One of these meetings was
held in person in the meeting room of a local
public library, the other was held virtually via
Zoom. Both meetings were publicized on Face-
book and Instagram using boosted posts to
advertise the events, were posted on the Pro-
Choice Ohio Twitter and TikTok accounts, sent
to the Pro-Choice Ohio email list, and shared
by various partners in Columbus.

Data gathered from the events included both

information from participants who had gone
to CPCs but also what folks thought the city of
Columbus should do to better support parents
and families in the city. Following the event, a
story collection form was created and publi-
cized via the same channels to allow people
to anonymously share their stories about visiting
CPCs to include in the report. All identifying
information about the individuals was removed
before inclusion in this report. Stories collected
after this report is published will be included on
the website www.ColumbusCPC.com.

NOTES
1. https://ohiolife.org/ohio_pregnancy_resource_center_map/
2. https://optionline.org/

9
RESULTS

CPC Visit Data

Analysis
All visits were attempted as drop-in appointments. One facility asked the investigators to return later
in the day, which was accommodated. Although there are nine CPCs in the city of Columbus (see
chart 1), one center, Alpha Pregnancy Center, was never open when investigators tried to stop in, did
not return phone calls made to the center attempting to schedule an appointment, and when they
did eventually reply to an email we sent asking to schedule an appointment, they said they had no
appointments available for the next week. Because we could never successfully visit or call this cen-
ter it was not included in the visit or call data.

Table 1: CPCs In Columbus

CPC Name CPC Address CPC Zip Code

Alpha Pregnancy Help Center 299 E. Dublin-Granville Rd, Suite 108 43231
Birthright Columbus 3445 Great Western Blvd 43204
Pregnancy Decision Health Center 5900 Cleveland Ave 43231
Pregnancy Decision Health Center 22 E. 17th Ave 43201
Pregnancy Decision Health Center 4111 W. Broad St 43228
Stowe Pregnancy Resource Center 888 Parsons Ave 43206
Women’s Care Center 935 E. Broad St 43205
Women’s Care Center 3273 E. Main St 43213
Women’s Clinic of Columbus 3242 E. Main St 43213

The visits ranged in length from 20-120 minutes, In half of the visits, the investigators felt that the
with the average visit length of 56 minutes. On facility was designed to look like a medical fa-
average, the “client” waited in the waiting cility. Illustrating that different people can see
room between 0-30 minutes with an average things in different ways, there were times where
of 10.6 minutes, and the accompanying “sup- the investigator posing as the client recorded
port person” was generally asked to wait in the one answer in this category and the support
waiting room while the center took the “client” person gave a different answer, indicating that
back to speak with them alone. Because of this is very much up to the individual and many
that, the “support person” waited on average people are going to see things differently when
28 minutes, with a range of 0-65 minutes. arriving at these centers. Other words used to

10
describe the centers overall included it looking in/intake forms (3), health/medical informa-
like a counselor’s office (1), and looking “hom- tion forms (1), and at one facility, because
ey” (5). the investigator didn’t have their photo ID, the
center took a picture of them for the center’s
All of the staff and volunteers our investiga- records —that investigator was asked to sign
tors encountered in the centers presented as paperwork giving permission for them to take/
female, and their ages ranged from young use the picture.
to older/retired, although the majority of the
individuals at the center were middle-aged (9), During the intake process, a variety of topics
followed by young (4), and then older/retired were discussed with the investigator including,
(1). The titles presented by these individuals home/relationship situation (6), previous preg-
were: counselor/consultant/therapist (5), nurse nancy history (6), medical history (5), services
(4), volunteer (3), front desk/receptionist (3). provided by CPC (5), ultrasound services (5),
feelings about pregnancy (5), birth control use
During the intake process, a majority of the (4), and STD/STI history.
centers (6) informed the investigator that their
information would be kept confidential, but In an interesting difference from our 2013
only three centers had the investigator sign study1, CPCs in this investigation were much
paperwork about the confidentiality of their less likely to even have a conversation with our
information (Figure 1). In addition to confidenti- investigators unless they took a pregnancy test
ality paperwork the investigator was also asked and it came back positive. The reason most
to fill out general information forms (3), check often given was simply that they needed to

11
confirm pregnancy through a pregnancy test. Ultrasound was also much more prevalent in the visits
than in the 2013 study, with six of the eight facilities offering ultrasound at their facility. There were a
variety of reasons the center representatives used to explain the importance of getting an ultrasound
(Figure 2); the most common one was to purport to accurately date the pregnancy or to rule out an
ectopic pregnancy.

In another interesting divergence from our previous study, centers did not use fetal models or pictures
of fetal development in the conversations around gestational age. Only two of the eight facilities in
this study used visual materials about fetal development.

Investigators felt pressure to choose to continue their pregnancy from CPC personnel at three facil-
ities, and no pressure at the remaining five facilities (Figure 3). In six CPCs the staff had a reaction to
the choice when the investigator indicated they were leaning towards abortion. In three of those
cases, they attempted to change the investigator’s mind, in two cases they respected the investiga-
tor’s decision, and in one they were openly hostile to the investigator’s decision (Figure 4).

12
CPC personnel used a variety of tactics to persuade the investigators to not have an abortion (Fig-
ure 5). But these tactics have also shifted somewhat from the 2013 study. Talking about the physical,
emotional, and relationship tolls that abortion would have on the individual was still the top tactic
(4), but in a more subtle approach, redirecting the client was equally used. Investigators reported
that the CPC personnel used redirecting to a conversation about parenting or endorsing fears about
abortion and de-emphasizing fears about parenting in an equal number of visits (4).

Most facilities waited until the investigator mentioned abortion to have a conversation about the
topic (4) compared to two facilities where the CPC personnel brought up abortion on their own. The
most commonly discussed topics during the conversation about abortion were consistent with our
previous research, medical complications of abortion (3) and mental health issues following an
abortion (3) (Figure 6).

13
Like we saw in the 2013 study, center representatives sometimes bring up a discussion about adop-
tion but it is not central to the conversation, and is not deeply discussed. In most cases when adop-
tion was discussed, investigators said that it was mentioned as an option but the conversation didn’t
go much further than that. Adoption was more commonly brought up without the investigator asking.
In four facilities, adoption was brought up by the CPC personnel, compared to two facilities where
it wasn’t discussed until the investigator asked. In conversations about adoption, the most common
themes identified were that the birth mother is in charge/gets to make all of the decisions (2), open
vs. closed adoptions (1), and that the investigator didn’t need to decide about adoption right now
(1).

Although facilities were interested in talking about the risks of abortion they were much less likely to
talk about risks associated with pregnancy. Only once center representative discussed the potential
risks of carrying a pregnancy to term, and that was only after the investigator asked about the topic.
Whereas the center personnel overemphasized the risks of abortion, in one discussion of pregnancy
risks, the CPC personnel grossly underrepresented the risks of pregnancy, redirecting the question
instead to talk about how abortion carries “more risk” and stating that maternal mortality rates are
exaggerated.

In our 2013 report, center representatives often used the resources they offered to push people to
continue their pregnancy, but in this investigation, only half of the centers discussed the resources

14
they offer to pregnant and parenting individu-
als. In these discussions, the themes were equal
Phone Data
across the centers with two center representa- Analysis
tives mentioning coupons that you can earn to
Phone calls were divided into four scenarios:
get baby items/learn to earn programs, classes
1) diapers and material assistance (four calls),
and groups available, physical items available
2) abortion “reversal” (three calls), 3) prenatal
(diapers/baby clothes), and government assis-
care (five calls), and 4) positive pregnancy test
tance programs.
looking for information (three calls). Calls were
randomly assigned to the various centers result-
As we found in our 2013 report, the misinfor-
ing in different numbers of calls for each sce-
mation presented by the staff at these centers
nario. A minimum of three calls were made for
did not stop with abortion. It was also found in
each scenario. The idea of abortion “reversal”
discussions of birth control. At these centers,
is one created by the anti-abortion movement,
the only type of birth control they would dis-
in which they claim that if a person takes the
cuss positively was periodic abstinence (aka
first pill (mifepristone) of the medication abor-
“natural family planning”). When other types of
tion regimen they can stop the abortion with a
birth control were discussed, failure rates were
high dose of progesterone. This is not a proven
emphasized, or, as one person at a CPC said,
effective medical treatment, and in fact re-
they don’t discuss birth control because birth
search has shown that it could be dangerous
control “causes an abortion.”
to patients, causing hemorrhage.2

Scenario 1: Three facilities said that the per-

son could come in and get emergency dia-
NOTES
pers, although one said it was something they
1. NARAL Pro-Choice Ohio Foundation (2013), Ohio Crisis Pregnancy Centers
Revealed. https://prochoiceohio.org/wp-content/uploads/2023/06/
“don’t usually do” and that usually you had to
CPC_Report_2013.pdf
2. Creinin, M.D., Hou M., Dalton, L., Steward R., and Chen, M., (2020). Mife- be a previous client of the facility to get those
pristone Antagonization With Progesterone to Prevent Medical Abortion.
Obstetrics & Gynecology 135(1) 158-165. https://journals.lww.com/green- services. One facility that said no stated that
journal/Abstract/2020/01000/Mifepristone_Antagonization_With_Progester-
one_to.21.aspx they had to have a prior client relationship to
receive material aide. Only one facility said
that the person could come back if they were
in a similar situation again. When asked about
requirements to get material assistance, two
centers required previous client relationships,
needing an appointment, a parent’s ID, and
child’s proof of birth were each mentioned
once.

15
Scenario 2: Only one of the three facilities did Scenario 4: When investigators asked centers
abortion “reversal” at their location; the other about the services they offered by phone all of
two provided referrals. The facility that provid- the facilities surveyed said they provided preg-
ed these services was the only one that could nancy tests, ultrasounds, education, and class-
answer how the process worked, the client es. Two of the three said they provide supplies
would have to come into the center for an to pregnant individuals. One center directly
ultrasound, they would see a doctor and the mentioned abortion counseling, and none of
doctor would prescribe the medication. One the facilities said that the investigator would
of the two facilities referred our investigator to meet with a doctor or nurse. When asked what
the Step One hotline, a service of the the appointment would involve, all three said a
Columbus Medical Association that connects pregnancy test and ultrasound, two said op-
patients to prenatal care. The facility called tions counseling, one said counseling on abor-
the investigator back after the initial call and tion risks, and one told the investigator they
told them that their “friend” should go to the would need a photo ID to be seen.
ER or call a specific local health care facility.
The other facility referred our investigator to the Website Information Analysis
abortion “reversal” hotline. Along with the phone and visit data, in-
formation was also gathered from the
Scenario 3: None of the facilities surveyed websites of all of the CPCs in Columbus.
provided prenatal care. All but one of Because Pregnancy Decision Health Cen-
them gave a direct referral. One of the ters and Women’s Care Centers both have
representatives referred our investigator to multiple locations, website analysis was of
the Step One hotline, a service of the Co- six CPC websites (Table 2)
lumbus Medical Association that connects
patients to prenatal care. Three referred
the investigator to a specific healthcare
provider. One referred the investigator to
another CPC. The one that did not give
a direct referral told the investigator to
come in and they would get them help.
The theme of trying to get the investigator
to come into the facility was seen in other
comments made in this scenario. Two facil-
ities described other services they provide
to pregnant and parenting people, and
one offered to provide proof of pregnancy
if the healthcare provider needed that.

16
CPC Name CPC Website Address

Alpha Pregnancy Help Center (APHC) http://www.justasking.org/

Birthright Columbus https://birthright.org/

Pregnancy Decision Health Center (PDHC) https://pdhc.org/

Stowe Pregnancy Resource Center https://www.stoweprc.org/

Women’s Care Center (WCC) https://www.womenscarecenter.org/

Women’s Clinic of Columbus https://columbustwc.org/

The Alpha Pregnancy Help Center (APHC) website had the most detailed information of any of the
CPC websites we analyzed. Their disclaimer said that they were not a medical facility, and that they
did not provide medical services beyond a free pregnancy test (Figure 7). At the bottom of the page
they stated, “Our center offers accurate information about all options associated with pregnancy;
however, we do not provide or refer for abortions.”

Figure 7: APHC description of services and medical disclaimer.

The APHC website also contained multiple instances of medically inaccurate information about
abortion and birth control. They inaccurately claimed that both Plan B (the “morning after pill”) and
birth control pills are abortifacients, when in fact neither can impact an established pregnancy (Fig-
ures 8 and 9

17
Figure 8: APHC Website - inaccurate claims that Plan B causes an abortion

Figure 9: APHC Website – inaccurate claims that birth control pills cause abortion

Additionally, many of the inaccurate claims that we found were being told to clients about
abortion inside these centers are also on the APHC website, including increased risk of
infertility, increased risk of suicide and other mental health issues, and the increased risk of
breast cancer (Figure 10).

Figure 10: APHC Website – inaccurate claims that abortion increases the risk of breast cancer

Birthright’s website was much more limited in content — their website lists available services
and how to connect with a local facility. Interestingly, their services do not include any mention
of abortion, even in their “information about” section (Figure 11).

18
Figure 11: Birthright Website - Services Listing

The website for the three Pregnancy Decision Health Centers showed several videos and other
media where medical staff is insinuated even though there are no healthcare providers in those
facilities (Figure 12). Similar to the Birthright website, they have services listed, but the website
does not go into any detail about the services such that a person would have to call or come
into the center to obtain information. The section of the website about abortion only contains
information telling potential clients that they need to confirm their pregnancy, confirm the
location of the pregnancy (rule out ectopic) and learn about all of the options, with no links to
any additional information (Figure 13).

Figure 12:

19
Figure 13: PDHC Website – Abortion

In multiple instances on the PDHC website, the potential client is encouraged to get an
ultrasound, both to know if you need an abortion (Figure 14) or more general reasons as to why
someone would get an ultrasound (Figure 15). Both of these sections seem to indicate that the
ultrasound services at PDHC are just like what you would get at a medical facility, but they are
not a medical facility.

Figure 14: PDHC Website – Abortion Ultrasound

20
Figure 15: PDHC Website – General Ultrasound Information

The Stowe Pregnancy Resource Center (SPRC) is associated with a larger program called the
Stowe Mission. If you do an online search for Stowe you are taken to the Stowe Mission
Website, and the website for the pregnancy center is located in the menu under “healthcare
services” which could obviously mislead people into believing that this is an actual health care
provider (Figure 16).

Figure 16: SPRC Website – “Healthcare” listings

When discussing abortion, the website does clearly state that they do not refer people for
abortion services but instead discuss all of their other options. The abortion section on their
website contains multiple references to medically inaccurate information about abortion,
including the non-medically proven notion of “abortion reversal” (Figure 17).

21
Figure 17: SPRC – Abortion Discussion

Under the topic of abortion highlighting all of the risks and dangers is a section on “alternatives”
which are listed as parenting and adoption. The tone of the “alternatives” section is completely
different, listing both options as optimal (Figure 17). The parenting section allows that parenting
is a lot of work, but “the gems of lessons learned, legacy, and love are well worth it.” When
discussing adoption, it is framed as “a beautiful option” and that it “takes a strong person to put
the needs of her child first.”

Figure 17: SPRC Website – Alternatives to Abortion

The Women’s Care Center (WCC) website is limited, giving very little information about any of
the topics covered, with the assumption they are trying to get people to contact them by phone
or to come in for a visit to obtain information. Their “about” section does state that they do not

22
provide prenatal medical care or abortion services. Their “abortion” section is very similar to
the PDHC website, stating only that one should first verify their pregnancy, determine how far
along they are and then understand the procedure (Figure 18).

Figure 18: WCC Website – Abortion Information

Also similar to the PDHC website, WCC focuses in several places on the importance of an
ultrasound. Their website says that ultrasounds are important to know if you are actually
pregnant and didn’t have a miscarriage, and that an ultrasound is important before an abortion
because many pregnancies end in miscarriage, and also to confirm that the pregnancy is not an
ectopic pregnancy (Figure 19). Again, like the PDHC website, there is no mention that this
ultrasound is different from one you would get in a real medical facility conducted by a
professional.
Figure 19: WCC Website – Ultrasound Information

23
Finally, the Women’s Clinic of Columbus website seems very much to want the reader to believe
that they are a healthcare facility. Their “About” page makes several references to healthcare
and reproductive health services (Figure 20). But when you click on the menu labeled “Get
Care” there are no actual health care services available (Figure 21).

Figure 20: Women’s Clinic of Columbus Website: About Us

Figure 21: Women’s Clinic of Columbus Website – Get Care

24
Similarly to both PDHC and WCC, the Women’s Clinic of Columbus’ website emphasizes
ultrasound, and, like WCC, they directly refer to the risk of miscarriage as a reason to get an
ultrasound at their facility, along with accurately dating the pregnancy and detecting an ectopic
pregnancy (Figure 22).

Figure 22: Women’s Clinic of Columbus Website – Ultrasound Information

25
DISCUSSION
& RECOMMENDATIONS
it for the rest of my life. That my boyfriend and
Research Discussion I would have ‘death’ between us instead of
‘life,’” the majority of staff at these centers
Several trends and practices stood out as as-
used less aggressive tactics like redirecting the
pects that had changed since our 2013 study.1
conversation away from abortion.
The biggest was the CPC staffs’ insistence
on the investigator taking a urine pregnancy
One investigator reported that although the
test before a conversation could happen in
CPC personnel said things like “it is my belief
the center. We think that this could be a new
that abortion is unhealthy for women, physi-
universal policy at these centers, or it could be
cally and emotionally” and “I’ve never met
one that was adopted specifically by centers
a girl who wants an abortion; no one wants
in Columbus because
to get one, they feel like they have to,” they
the staff were aware that Pro-Choice Ohio had
immediately followed it with statements saying
contracted with the City of Columbus to con-
that they would support her no matter what
duct this research.
decision they made and quickly redirected the
conversation to parenting, emphasizing that as
The contract was first approved in an ordi-
a preferable decision without explicitly stating
nance during a public meeting in July 2022,
it. Similarly, in another facility, an investigator
and the was extended by ordinance at a
said that the center “really emphasized that
public meeting in early 2023. Only more re-
[the decision] was up to me and let me lead,
search into centers in other areas of the state
but they really jumped on my abortion fears,
could help us determine if this is a local policy
but not my parenting fears.”
change or a more
universal one.
These more subtle practices were also seen in
our website analysis. Instead of posting all of
Our investigators also felt that the pressure on
the medically inaccurate information on abor-
them to make the “right” decision (the de-
tion that was previously seen on these types of
cision to continue a pregnancy) was more
websites, it was more common in this investiga-
subtle, not as overt as we saw in the first study.
tion to see the CPC websites describe to
Although some centers still pushed medical-
potential clients that they need to confirm their
ly inaccurate “risks” of abortion— as in one
pregnancy test in the center and have an
facility: “[the CPC personnel said] that abortion
ultrasound first, and then they could discuss
would give me depression, that I would regret
abortion, forcing the patient to come in for a

26
Because the facility did a pregnancy test they could make an informed decision. When
and multiple ultrasounds, the individual the individual shared their story, they men-
was under the impression they were getting
medical care. It was only when they finally tioned feeling manipulated several times, and
did connect with a prenatal care provider his emotions when sharing showed that even
and tried to get their records from the CPC though years had passed since the visit, the
that they realized that they had not actu-
ally gotten medical care and there were no feeling around manipulation was still strong.
medical records to obtain from the CPC. The
individual said that they felt betrayed and The second story shared was one where the
duped.
person went to a CPC with no intention at all
to talk about abortion. They had made the
non-medical ultrasound before getting the decision to continue their pregnancy and were
information they desired. These more subtle looking for prenatal care and general assis-
pressure tactics combined with our investiga- tance. Because the facility did a pregnancy
tors feeling like they were in a real medical fa- test and multiple ultrasounds, the individual
cility in half of their visits, along with increased was under the impression they were getting
conversations around confidentiality (but lack medical care. It was only when they finally
of paperwork guaranteeing it) re-affirms previ- did connect with a prenatal care provider and
ous research showing that when an individual tried to get their records from the CPC that
feels like they are in a medical environment they realized that they had not actually got-
and they experience judgment coming from ten medical care and there were no medical
the facility’s personnel, it can have detrimental records to obtain from the CPC. The individual
impacts not only on the person seeking care said that they felt betrayed and
for the pregnancy, but lead them to expect duped.
stigmatization in other healthcare settings — or
cause them to avoid seeking healthcare at Stigmatization also comes through the use of
all.2 ultrasound. In these facilities, the reasons that
areoften presented for needing ultrasound,
Backing up the research around stigmatization both in person and via the facility websites, are
at CPCs are anecdotal stories from people threefold: to confirm and date the pregnancy,
who had previously visited a CPC. At the same to confirm a miscarriage has not occurred,
time that we were conducting these research and to ensure that the pregnancy is located in
visits, Pro-Choice Ohio conducted two com- the uterus and is not ectopic. Research by the
munity meetings; one in-person at a local Ohio Policy Education Network (OPEN) has in-
library in the city, and one virtually via Zoom. dicated that these may be the public reasons
In the Zoom meeting, two stories were shared; for pushing ultrasound services, but internally
one by a male who talked about inadvertently their reason is much different. In their research
attending a CPC when his then-girlfriend got on abortion stigma and CPCs, one CPC staffer
pregnant by accident. They were simply try- said that the ultrasound room was “where so
ing to get information on their options so that many miracles happen.”

27
“
When he returned, they spent time urging him
not to get an abortion before performing the
‘our machine has a ultrasound. The staff member doing the ultra-
mission. That mission sound couldn’t see a heartbeat but said she
is to reveal the life wasn’t concerned — she informed Ray that

within to the woman he was either miscarrying or was earlier in his

pregnancy than he suspected and sent him
who is considering
home. Two days later Ray was in excruciating
abortion … in hopes pain, immediately went to the hospital where
of confirming life.’3

”
they determined he had a ruptured ectopic
pregnancy. He was immediately sent for emer-
The increased push for ultrasound combined gency surgery and had to have blood transfu-
with information from previous research may sions because of the amount of blood he lost.
indicate why our investigators encountered He was told that if he had waited five more
fewer videos, fetal models and other visual minutes to go to the ER he probably would not
aides in their visits than we did in 2013. Instead have survived.4
of showing people pictures and models, they
want them to have an ultrasound to (in their Facility after facility in our research pushed our
words), “reveal the life within.” In these situa- investigators to get an ultrasound in part to rule
tions, ultrasounds are a tool for manipulation, out ectopic pregnancy. But these centers are
not healthcare not regulated, they are not medical facilities,
and the ultrasounds performed are not medi-
In addition to the problematic pressure and cal-grade, they are limited, non-diagnostic ul-
stigmatization that is occurring through these trasounds. If someone suspects that they have
ultrasounds, recent media reports indicate an ectopic pregnancy they should go to a real
that the fact that these non-medical facilities medical facility, not to an unlicensed, unregu-
performing tests that are usually done in a lated CPC.
medical office can also pose potential physical
risks to the individuals. In Cedar Rapids Iowa, In another story out of Louisville, Kentucky, a
Ray, a trans man who had recently aged out nurse wanted to give back to her community
of the foster care system, went to a CPC after by volunteering at a CPC. One of the things
testing positive on a home pregnancy test. He they wanted to train her to do was to provide
wanted confirmation of the pregnancy. The
CPC personnel invited him back, “prayed over They are being told by center staff that they
him,” read from the Bible and finally, gave can rule out a dangerous, potentially
deadly, ectopic pregnancy, but this is
him a pregnancy test. It was the exact same questionable at best. Ultrasounds should
test he had purchased himself from a dollar be conducted by medical professionals in a
store. That test was also positive. They told Ray
real medical facility.
to return two weeks later for an ultrasound.

28
ultrasounds. During her training she started Although facilities were more subtle in their
to see red flags immediately. The center was approach, there was also plenty of medically
using an expired disinfectant to sterilize the inaccurate information presented. Some of this
transvaginal probe used in early pregnancy has already been highlighted in this discussion
ultrasounds. And the type of disinfectant they – centers discussing mental health issues and
were using had been found to not kill the hu- inaccurate risk discussions during the visits and
man papillomavirus (HPV) a widespread and through language on their websites. But this
potentially deadly STI responsible for more than misinformation was not limited to abortion ser-
90% of cervical cancers. So not only was the vices. Centers also presented misinformation,
center using an expired product, they were us- both in visits and on their websites, about birth
ing one that doesn’t kill the most prevalent STI. control, inaccurately describing it as “causing”
As she said to the Guardian, “You’re saying you an abortion. Birth control, including emergency
want to help these women… yet you’re poten- contraception (aka the “morning after pill”) do
tially going to transmit an infection to them?” not interfere with an established pregnancy
She filed multiple complaints, talked to the ad- and do not cause abortion.
ministrators of the center and found out how
hard it was to make changes because the Additionally, in one visit to a CPC, our investi-
centers are unregulated and unlicensed. She gator asked the individual at the CPC about
also found they were not using the right type of health risks in pregnancy since the CPC person-
lubricant for the transvaginal ultrasounds per- nel was talking about the risks of abortion. In an
formed. Industry standards state that the gel extreme example of the redirection that was
used for abdominal ultrasounds might not be mentioned above, the CPC personnel tossed
sterile enough for transvaginal procedures.5 aside the concerns of maternal mortality. Our
investigator reported, “When I asked about
These examples illustrate that not only are maternal mortality, the lady scoffed and shook
there dangers of stigmatization and persecu- her head, (and) was like ‘no that’s overblown,
tion by a “medical professional” when visit- when you take out people who don’t do pre-
ing one of these centers, but that because natal [care] everyone is fine.’” We saw several
the ultrasounds are limited in scope, and the times in this research that when the investigator
facilities are unregulated and unlicensed, the asked about pregnancy risks the CPC person-
person visiting the center has no idea of the nel immediately redirected them to discussing
disinfection protocols or the limited scope of abortion and described how abortion is more
the ultrasound. They are being told by center risky than carrying a pregnancy to term. This is
staff that they can rule out a dangerous, po- blatantly false. Research on individuals giving
tentially deadly, ectopic pregnancy, but this birth and having abortions between 1998 and
is questionable at best. Ultrasounds should be 2005 found that the pregnancy-associated
conducted by medical professionals in a real mortality rate among people who delivered
medical facility. live neonates was 8.8 deaths per 100,000 live
births. The mortality rate related to induced

29
abortion was 0.6 deaths per 100,000 abortion.
The risk of death associated with childbirth was
approximately 14 times higher than from abor-
tion.6

Two CPC networks in Columbus receive money

from the Ohio Parenting and Pregnancy (OPP)
program which gives funds from the Temporary
Assistance for Needy Families (TANF) block
grant to CPCs across the state to provide mate-
rial assistance to individuals in the community.
These centers are Pregnancy Decision Health
Centers (PDHC), (three in Columbus), and
reflected in the next year’s budget. This leads
Women’s Care Center (WCC), (two facilities in
to the hypothesis that this grant period includ-
the city).
ed the purchase of some type of equipment —
possibly an ultrasound machine. This hypothesis
When examining the budgets submitted to
is backed up by the fact that the 11/21-6/22
the state by these facilities, we note that the
budget only allocated for staff time/benefits
amount of money that goes to direct patient
in general but the budget for the next time
education and support is not the facilities’
period includes allocations both for general
main expenditure.7 From December 2021 to
staff time/benefits and a specific line item for
June 2022, PDHC allocated only 5.65% of their
ultrasound staff time/benefits. Even with that
budget to participant support and education.
larger allocation, the 26.7% was not higher
From July 2022 to June 2023, only 3.1% was al-
than the amount allocated to staff time/ben-
located to those services. Comparably, PDHC
efits, at 42.8%. In the next grant year (7/22 to
allocated 12.7% and 15% of their budget in
6/23), the amount allocated to patient support
each time period to marketing, and 64% and
and education dropped precipitously to only
67% to salary, benefits, and staff travel. PDHC is
1.6% of the grant amount, compared to 6% for
spending double or triple the amount that they
marketing, 65% for general staff time/benefits,
spend on participant support and education
and 13.4% for ultrasound staff time/benefits. This
on marketing, and more than 10x on staff and
is very concerning. This program is supposed
overhead.
to be providing direct support to families in
need, providing material assistance to individ-
When looking at the submitted budget from
uals such as diapers, cribs, baby clothes, etc.
WCC between 11/21 and 6/22, they allocated
Looking at the budgets, it is not surprising to
26.7% to Participant Education and Support.
see that when in our phone surveys both WCC
This included a large allocation in Participant
facilities were called using Scenario 1, neither
Support (supposed to be material support for
indicated that providing things like emergency
participants in the program) that is not
diapers were something that they did regularly.

30
One facility said that the person could come
in for supplies but that they “don’t usually do
NOTES
that,” and the other said that you had to be 1. NARAL Pro-Choice Ohio Foundation (2013), Ohio Crisis Pregnancy Centers
Revealed. https://prochoiceohio.org/wp-content/uploads/2023/06/
CPC_Report_2013.pdf
a previous client to get material assistance. 2. Warren, E., Kissling, A., Norris A., Gursahaney, P., Bessett, D., and Gallo,
M., (2022). “I Felt Like I Was a Bad Person…Which I’m Not”: Stigmatization
When asked how one becomes a client, the in Crisis Pregnancy Centers. Social Science and Medicine - Qualitative
Research in Health. https://doi.org/10.1016/j.ssmqr.2022.100059
individual said they needed to come in and 3. Ibid
4. Stern, M.J., (2023) The Decisions We Forget: Supreme Court rulings tend
get a pregnancy test and ultrasound, and to have a short shelf life in the public memory. But the way cases collide
can make a catastrophic difference. Slate, May 22, 2023. https://
then they could continue the relationship. Or, slate.com/news-and-politics/2023/05/crisis-pregnancy-centers-influ-
ence-post-dobbs-abortion-supreme-court.html
someone could join their “crib club,” a learn- 5. Morel, L.C., (2023) ‘It’s a public health risk’: nurse decries infection control
at US anti-abortion crisis center. The Guardian, February 2, 2023.
to-earn program where the individual has to 6. Ramond, E.G., and Grimes, D.A., (2012) The comparative safety of legal
induced abortion and childbirth in the United States. Obstetrics & Gyne-
cology. https://pubmed.ncbi.nlm.nih.gov/22270271/
take classes or do other activities to earn items 7. Public Records, Obtained by Equity Forward, 3/30/23
that they need. This once again reaffirms how
important getting people into the centers is to
these facilities.

The combination of these public records and

our research shows the gross inadequacies of
the services provided by these centers and
how wrong the priorities of these centers are
when it comes to using the public funds they
receive. By spending more on marketing to
get people to come to their centers than they
do on supporting them once they get there
we see just what the goals of these facilities
are – spreading misinformation and stigma, not
providing help. The TANF program is supposed
to be one of the few programs where lower
income families can receive funds to buy the
things that they need, but instead, our Ohio
legislature is forcing people to go to these fa-
cilities and face shame and stigma in order to
get the help they need.

31
cal facilities and community organizations that
Research Limitations provide services without stigma, judgment, and
and Future Needs manipulation. Columbus City Council made
a great start into this with its July 2023 funding
As this research was limited to CPCs located
of Just Choice, which creates an “all options”
within the City of Columbus, the results cannot
and material support program in the city. It’s
be generalized without additional research
obvious from this and other research that there
into facilities outside of the city. Additionally,
is a great need in our community for material
because these results were based on individual
assistance — but we must also invest in facilities
visits, it is possible that going on another day
that treat people who need assistance with
and encountering another individual might
compassion and understanding, not stigma. In
present information different than what we saw
addition to Just Choice, there are other orga-
in this research.
nizations within the city in which investments
could help address these issues, like Motherful
Because there were several newer trends that
and Restoring Our Own Through Transforma-
we saw with this research, it would be worth-
tion. Additional investments in programs to
while to explore if those trends exist outside of
help people get unbiased resources they need
Columbus – especially the hard push for the
is critical.
person to take a pregnancy test at the center,
even if they had already taken one at home.
As these other programs are invested in and
Furthermore, this was the first time that we
grow, the City of Columbus needs to examine
could compare results of centers that receive
their resources pages to ensure that the re-
money from the Ohio Parenting and Pregnan-
sources listed are actual places people can go
cy Program, and it would be beneficial to do
to get the assistance they need in a welcome
additional research with other grantees of the
and opening space, not one that potentially
program in other areas of the state to see what
exposes them to stigma and shame.
programmatic requirements other centers
have for accessing material assistance.
The community meetings also provided a
space for people to brainstorm a variety of
Recommendations for ways that local governments and communi-

Columbus City Council ty organizations can support parenting and

pregnant individuals. The main theme that
and Beyond came out of these conversations was that
Based on this research and community meet- people need comprehensive, longer-term,
ings we have had, we have several recom- wrap-around services that uplift individuals and
mendations for Columbus City Council, other families. This includes:
elected officials, and community organizations:

• Addressing food insecurity, including access to

Public funding should be limited to real medi- fresh foods year-round

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• Better transportation programs that acknowl- Undoing the harms caused by these centers
edge that buses don’t go everywhere people won’t happen overnight, but these are some
need to go —programs should include some steps that can help us move in the right direc-
sort of voucher program for rideshare services tion. Everyone should agree that when people
like Lyft and Uber turn to a facility for help discussing pregnancy
options, or for material assistance, they should
• Affordable housing, available without long wait be met with respect and empathy, not shame
lists and stigma.

• Childcare —not only traditional programs for

people at a 9-5 job but also for shift workers,
people who need childcare to attend appoint-
ments, or just to get a break for self- care

• Support programs for families to help keep kids

out of the foster care system, and programs
to help with reunification if children do go into
foster care

• Green spaces and environmental justice pro-

grams to ensure families live in healthy environ-
ments that help them thrive

• Address the information/technology gap — re-

liable access to the internet is critical for edu-
cation, job training, health information, and so
much more

• Comprehensive sex education programs giving

people the information they need around sexu-
ality and sexual health

• More real healthcare facilities where people

can get free pregnancy tests and low-cost
ultrasounds, especially to get the paperwork
needed to confirm pregnancy for Medicaid
and other assistance programs

• Marketing campaigns so that people know

where they can go to get access to these ser-
vices

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