The U.S. Supreme Court will soon decide whether the government can regulate crisis pregnancy centers (CPCs): a term used to describe facilities, oftentimes religiously affiliated, that aim to dissuade women from getting abortions and instead promote parenting or adoption. CPCs provide incomplete, false, and misleading information to women seeking abortion and contraceptive care.

The pending case, National Institute of Family Life Advocates (NIFLA) v. Becerra, deals with a California law passed in October 2015 called the Reproductive FACT Act. This law requires state-licensed crisis pregnancy centers to provide written or digital information to their clients that California has public programs that provide abortions, prenatal care, and family planning services for little to no cost. The Reproductive FACT Act also requires any non-licensed crisis pregnancy center (which comprise the majority) to post a notice that the center is not licensed as a medical facility and has no licensed medical provider on site.

An analysis of the case posted on SCOTUSblog suggests that the Court will likely strike down the California law. Irrespective of the legal merits, the American Medical Association considers such an outcome “an ethical violation that undermines women’s health.”

Even if the law is upheld, however, there is still troubling potential for crisis pregnancy centers to continue misleading women. Except for a handful of local ordinances in various states, there are hardly any laws specifically regulating these centers. It is critical for women to know the intent of crisis pregnancy centers—to prevent them from accessing all of their reproductive health options.

Deceptive Tactics of Crisis Pregnancy Centers

There are nearly 4,000 CPCs in the United States and fewer than 1,500 abortion providers. In some states, such as Minnesota, CPCs outnumber abortion clinics 15 to 1. CPCs often intentionally locate near abortion clinics so as to intercept women trying to go to a licensed reproductive health clinic, and often use ambiguous names, such as “Women’s Pregnancy Support” or “Pregnancy Resource Center.” They will sometimes even use the word “Choice” in their name, despite the fact that these are anti-choice organizations.

In some states, such as Minnesota, CPCs outnumber abortion clinics 15 to 1.

When women call a CPC asking for pricing on abortion services, CPCs will often use evasive and dishonest tactics to lure women in to their centers. The CPC phone operators are trained to say that the caller must come in for an appointment in order to get pricing information, rather than stating outright that the center does not provide abortions.

CPCs have been known to make blatantly false medical claims about the consequences of abortion, including that abortion leads to increased risk of breast cancer, future infertility, and mental health disorders. Research studies by the American Cancer Society, the National Institute of Health, and the American Psychological Association find no evidence to support these claims.

Another example of one of the more disturbing practices a CPC employs is lying about a woman’s gestational age—counselors at CPCs have been known to tell women that their pregnancy is not as far along as it actually is. As a result, women miss the window of opportunity for an abortion, particularly in states with shorter time restraints on legal abortion procedures—oftentimes leaving them with no option but to carry an unwanted pregnancy to term.

These are only a few examples of the tactics employed by CPCs. A recent report from NARAL provides more detail.

Public Policy Concerning Crisis Pregnancy Centers

Attempts have been made at both the federal and local levels to regulate CPCs with little success to date. In 2006, Rep. Carolyn Maloney (D-NY) first introduced the “Stop Deceptive Advertising for Women’s Services Act,” a bill requiring the Federal Trade Commission to publicize rules against deceptive advertising of abortion services by facilities that do not actually provide them. The bill has been reintroduced several times since by both Rep. Maloney and Senator Robert Menendez (D-NJ), most recently in May 2017.

Localities in a handful of states have also pushed to regulate CPCs. The County Board of Supervisors for Dane County, Wisconsin, unanimously passed an ordinance in 2013 requiring any reproductive health providers contracted by the county to provide clients with unbiased, comprehensive reproductive health information. In 2014, after a number of legal challenges, the New York Second Circuit Court of Appeals upheld part of a New York City ordinance requiring CPCs to disclose whether they had a licensed medical provider on site, but struck down the provision of the same ordinance requiring CPCs to disclose whether they refer women for abortion and contraceptive services. The Supreme Court declined to hear the case in 2014, leaving the Second Circuit Court ruling in place.

In contrast, several other local attempts at regulation have ultimately failed. In 2010, the Austin city council passed a resolution requiring CPCs to post signs saying that the center does not provide abortion, abortion referral, or contraceptive services and does not have a licensed medical provider on site. A federal court struck down the ordinance in 2014. In Maryland, the Baltimore City Council and Montgomery County Council passed similar ordinances in 2009 and 2010, requiring CPCs to disclose whether they provide abortion and contraception referrals. After a number of legal challenges, the U.S. District Court struck down the Montgomery county ordinance in 2014. The Baltimore case is still pending. The National Institute for Reproductive Health provides further detail on the status of legal challenges to CPCs.

The reality is that crisis pregnancy centers currently operate in a legal grey area by design.

The reality is that crisis pregnancy centers currently operate in a legal grey area by design. As long as they can exploit legal loopholes to continue their deceptive services, women’s access to health services are at risk.

What Comes Next After the Supreme Court Decision

If the Supreme Court strikes down the Reproductive FACT Act, crisis pregnancy centers in California will continue disseminating misleading and inaccurate information to women—often those who urgently need unbiased medical facts and care. The prospect of further legal regulation of CPCs would be bleak.

If the Supreme Court upholds the California law, ideally, other states will follow suit and promote informed decisions and protect a woman’s right to choose—without the CPCs’ misinformation. However, it is unlikely that states with highly restrictive abortion laws will implement these regulations in the near future, given their political leanings. Federal legislation is necessary to ensure that all states are regulating CPCs and providing women with complete, accurate medical information. The prospects for such legislation in this Congress are dim as well.

Short of public policy, other strategies can and should be used to increase awareness about CPCs and their deceptive practices. Activist groups, women’s rights organizations, and student groups on college campuses have made strides in doing so. One prominent example is #ExposeFakeClinics, a national campaign with more than fifty partner organizations. Participants in this campaign have organized demonstrations outside of CPCs, published step-by-step guides for effective community activism, and created online portals through which women can review their experiences at various facilities. A number of other online resources and initiatives are also helping to increase awareness about CPCs and promote comprehensive reproductive health. Writer and editor Leigh Anderson created and published a guide for identifying a CPC on LifeHacker. A similar guide for avoiding CPCs and finding real abortion clinics was published on LegalVoice’s website, and created an online petition with the goal of preventing tax dollars from funding CPCs.

The Supreme Court will determine whether and under what circumstances the state has the legal authority to regulate misleading and deceptive practices of CPCs. In any outcome, advocates for fully informed women’s health choices should pursue rigorous and widespread initiatives to ensure that all women know how to access unbiased, comprehensive, and factual reproductive care.