JMIR Publications

ABSTRACT

Background:

Crisis pregnancy centers (CPCs) are non-profit organizations that aim to dissuade people considering abortion. The centers frequently advertise in misleading ways and provide inaccurate health information. CPCs in the United States (U.S.) are becoming more medicalized and increasingly gaining government funding and support. We created CPC Map, an online geolocated database of all CPCs currently operating in the U.S, to help individuals seeking health services know which centers are CPCs and facilitate academic research.

Objective:

The objective was to describe the methods used to develop and maintain CPC Map and baseline findings regarding the number and distribution of CPCs in the U.S. We also examined associations between direct state funding and the number of CPCs and relationships between the number of CPCs and state legislation proposed 2018-2019 to ban all or most abortions.

Methods:

In 2018, we used standard protocols to identify and verify the locations of and services offered by all CPCs operating in the U.S. CPC Map was designed to be a publicly-accessible user-friendly searchable database that can be easily updated. We examined the number of CPCs and, using existing data, the ratios of women of reproductive age to CPCs and CPCs to abortion facilities nationally and by region, sub-region, and state. We used unadjusted and adjusted negative binomial regression models to examine associations between direct state funding and the number of CPCs. We used unadjusted and adjusted logistic regression models to examine associations between the number of CPCs by state and legislation introduced 2018-2019 to ban all or most abortions. Adjusted models controlled for the numbers of women of reproductive age and abortion facilities per state.

Results:

We identified 2,527 CPCs operating in the U.S. Of these, 66.1% offered limited medical services. Nationally, the ratio of women of reproductive age to CPCs was 29,304. The number CPCs per abortion facility was 3.2. The South and Midwest had the greatest numbers of CPCs. The number of CPCs per state ranged from three (Rhode Island) to 203 (Texas). Direct state funding for CPCs was associated with a greater number of CPCs in unadjusted (coeff: 0.87, 95% CI: 0.51, 1.22) and adjusted (coeff: 0.45, 95% CI: 0.33, 0.57) analyses. The number of CPCs was associated with state legislation introduced 2018-2019 to ban all or most abortions in unadjusted (OR:1.04, 95% CI: 1.01, 1.06) and adjusted analyses (OR: 1.11, (5% CI: 1.04, 1.19).

Conclusions:

CPCs are located in every state and particularly prevalent in the South and Midwest. Distribution of CPCs in the U.S. is associated with state funding and extreme state proposals to restrict abortion. Researchers should to track CPCs over time and examine factors that influence CPCs’ operations and impact on public health and policy.