In recent years, anti-abortion pregnancy centers across the United States have increasingly expanded their scope of services, moving beyond their traditional role of discouraging abortion to providing a variety of medical care options, including testing and treatment for sexually transmitted infections (STIs) and even primary medical care. This shift has accelerated since the Supreme Court overturned Roe v. Wade in 2022, enabling many states to enact abortion bans or severe restrictions. As a result, these centers are positioning themselves as comprehensive reproductive health providers, sometimes filling gaps left by the closure or downsizing of established healthcare providers such as Planned Parenthood.
Historically known as “crisis pregnancy centers,” these mostly privately funded entities have long been affiliated with religious organizations and focused primarily on dissuading women from terminating pregnancies. However, with the changing legal landscape around abortion, many centers have broadened their offerings to include a wider range of medical and educational services. Some now even provide primary care and specialized services. For example, Alternatives Pregnancy Center in Sacramento, California, which is affiliated with Heartbeat International—one of the largest pregnancy center networks in the country—has added family practice doctors, a radiologist, a specialist in high-risk pregnancies, nurses, and medical assistants in recent years. For some patients, this center is their only healthcare provider.
One notable patient of Alternatives is Jessica Rose, a 31-year-old woman who detransitioned after spending seven years living as a man and undergoing hormone therapy and surgery. Since her transition back, she has received all of her medical care, including hormone therapy, from the center, which has an OB-GYN specializing in such treatments. Rose’s story is unusual, as few pregnancy centers advertise or provide care related to gender transition or detransition, but Alternatives has treated several patients in similar circumstances. Rose praised the center for respecting her identity and beliefs, contrasting it with other clinics that she felt pressured her to maintain a gender identity she no longer wanted.
This expansion of services among anti-abortion pregnancy centers has coincided with a decline in the number of clinics offering abortions. According to the Guttmacher Institute, the number of abortion clinics in the U.S. dropped from 805 in 2023 to 765 in 2024. At the same time, the number of anti-abortion pregnancy centers increased to more than 2,600 in 2024, up 87 from the previous year, according to the Crisis Pregnancy Center Map, a project led by University of Georgia public health researchers.
Several factors contribute to this trend. One major element is the shift in public funding. Nearly 20 states, primarily led by Republican governments, now allocate millions of taxpayer dollars to these pregnancy centers. Texas alone dedicated $70 million to pregnancy centers in the current fiscal year, while Florida has committed over $29 million to its “Pregnancy Support Services Program.” This influx of public money bolsters the centers’ capacity to offer expanded services.
Meanwhile, Planned Parenthood—the largest provider of abortion services in the country and also a key provider of cancer screenings, STI testing and treatment, contraception, and other reproductive health services—has been forced to close clinics and reduce services in some states due to changes in Medicaid funding. A tax and spending law signed by former President Donald Trump barred Planned Parenthood from receiving Medicaid funds, which had been a significant revenue source for its non-abortion services. As a result, Planned Parenthood affiliates could close up to 200 clinics nationwide. Some closures and service cuts have already occurred, such as the end of abortion services in Wisconsin and the elimination of Medicaid-funded services in Arizona. An independent clinic network in Maine also stopped offering primary care for similar reasons.
This changing healthcare landscape has raised concerns among abortion-rights advocates, who worry that more women will be left with few options other than the anti-abortion pregnancy centers, which they argue do not provide comprehensive, evidence-based reproductive health care. Critics point out that many of these centers do not accept health insurance, allowing them to avoid federal medical privacy laws such as HIPAA, though some claim to follow these regulations voluntarily. They also do not have to meet the licensing and quality standards required of most medical providers, except for those with medical directors who must comply with state requirements.
Additionally, abortion-rights groups have criticized pregnancy centers for their anti-abortion messaging, refusal to provide contraception, and limited ultrasound services, which are often performed by individuals without formal training to diagnose fetal anomalies. There is also growing concern about the promotion of