VoxPopuli examined websites for nine Orange, Lake County pregnancy centers likely to draw people seeking abortion. Here's what we found.
When you visit the website for the Life Choices Medical Clinic in Altamonte Springs, you’re immediately greeted by a pop-up video of a cheery woman wearing a white lab coat. Even though you may have come to the site looking for information about abortion, she’s there to tell you that you may not need one because “one in four pregnancies end in miscarriage naturally … without having to go through the pain and cost of an abortion.”
She promises the “technology exists” to predict if someone is likely to miscarry.”
Coming from someone dressed like a physician, at a website that resembles a doctor’s office, it certainly sounds plausible. And for people who are desperate not to be pregnant but perhaps don’t have money for an abortion, the idea of “natural miscarriage” may seem like the perfect solution.
It’s meant to.
And it’s woefully misleading.
That 25 percent miscarriage rate. What Dr. Lab Coat does not explain is that number is for all miscarriages — including women who miscarry without ever realizing they were pregnant. The actual miscarriage rate for women with established pregnancies is closer to 10 percent. That leaves a 90 percent chance of remaining pregnant.
“Even if you think there’s a 20 or 25 percent chance of miscarriage, you still have a 75 to 80 percent chance that you'll progress in that pregnancy,” Shiela Bahn, chief of obstetrics and gynecology at Community Health Centers in Winter Garden, said in a Zoom interview.
“If your ultimate goal is, I do not wanna continue this pregnancy, then I think you should look at options early. The last thing I want to see is a patient who's 20 weeks and then is trying to figure out how to have a termination somewhere. It's much more risky to her,” she said.
Promoting misleading, false, sometimes alarmist information appears to be a core strategy for pregnancy centers — also known as crisis pregnancy centers or anti-abortion centers. Their mission is to prevent access to abortion and contraception, according to The Alliance State Advocates for Women's Rights and Gender Equality.
Amy Weintraub, reproductive rights director for Progress Florida, told VoxPopuli that these centers have a “real interest in delaying any type of care for folks with unintended pregnancies. The extremist’s fondest hope is that someone is too far along in pregnancy to access abortion.”
With Florida’s ban on abortion after six weeks gestation, State Rep. Anna V. Eskamani (D) of Orlando, worries that even more people will be led to these centers.
“It’s very concerning,” Eskamani said in a recent interview. “You're looking for your options, and then you're going to be brought to a website and then an organization that is going to intentionally spread misinformation, dissuade you from seeking abortion out of state or other options you have, like PlanCPills.org.”
She said it’s important to direct people toward legitimate resources like
abortionfinder.org and Charley Chatbot. “People are already misled with crisis pregnancy centers, but it's going to become far worse [after] the six-week ban goes into effect."
[The ban became effective May 1.]
It may seem counter-intuitive, but pregnancy centers aren’t required to provide medically accurate information. The centers are exempt from regulatory, credentialing and licensure oversight because they don't provide medical care and aren't real clinics; as such, they're not bound by the same rules as a regular medical practice .
But because centers that belong to the Florida Pregnancy Care Network now receive upwards of $29 million in tax dollars annually from the state, Democrats attempted to impose some regulatory guidelines during this year's legislative session — like mandating accurate medical information and imposing fines for violations.
“We wanted to make sure that it's medically accurate, especially knowing that people are going to be in a desperate situation and trying to move quickly,” State Rep. Rita Harris (D) of Orlando said in a recent interview.
The legislation, Senate Bill 256, never made it out of committee.
“Most people aren't going to even know that they're pregnant in time,” Harris said, referring to the six-week abortion ban. “But those who are fortunate enough to find out at four weeks, like, [they] test as soon as they miss a period, they're going to be looking for information as soon as possible to try to figure out what they can do. My concern is they'll be led to these websites, and they're not going to get the information that they need.”
The Journal of Ethics published by the American Medical Association, calls pregnancy centers’ practices “deceptive” and “unethical":
“Because the religious ideology of these centers’ owners and employees takes priority over the health and well-being of the women seeking care at these centers, women do not receive comprehensive, accurate, evidence-based clinical information about all available options… their propagation of misinformation should be regarded as an ethical violation that undermines women’s health.”
“Pregnancy care centers aren’t healthcare clinics,” Weintraub said. “While a few may offer well-woman exams and testing for sexually transmitted infections, the majority don’t have medical staff onsite. They can’t do much more than offer you the same pee-stick pregnancy test you can buy at your local drugstore. Their mission is to talk pregnant people out of getting abortions using a variety of tactics. They’re anti-abortion centers.”
Christine Francis, MD, a board-certified ob-gyn and CEO of the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), understandably, takes a different view. “The pregnancy care centers that AAPLOG works with, we supply them with evidence-based information that they can give to women that are coming to see them so that women can make informed choices. This is not what's happening at most abortion facilities.”
VoxPopuli examined the websites for nine pregnancy centers* from Winter Garden to Winter Park to get a handle on the kind of information people seeking care would find when they accessed these pregnancy centers’ sites — the gateways to the centers themselves. Here’s what we found.
Medical Center Masquerade
Some centers, like the Apopka Pregnancy Care Center are up front about being a "Christian-based, life-affirming non-profit organization ... [that does] not perform abortions nor ... make abortion referrals."
But others masquerade as medical centers. They employ wording like “women’s clinic” or “medical clinic” in their business names. They use search engine optimization to pop up alongside real clinics in online searches for "abortion" and target people looking for abortion online with ads for their centers. According to the government watchdog group Equity Forward, “Florida Pregnancy Care Network spent a quarter of a million in tax dollars in 2022-2023 on SEO, paid advertising, and marketing strategy to target people with deceptive ads.”
Many center websites are also designed to look just like medical sites, with drop-down menus of medical services. A short list of services — pregnancy testing, testing for sexually transmitted infections and “limited” or “non-diagnostic” ultrasound — is one way to tell a pregnancy center from a medical practice. They also generally won’t have the full complement of physicians, physician's assistants or nurse practitioners on staff to provide the HIV testing, cancer screenings, pelvic exams, STI treatments (sexually transmitted infection), prenatal care and primary healthcare services that a licensed health clinic or medical center provides. It may not be clear who works at a center. We only found two pregnancy centers that listed staff: Choices Women's Clinic and The Pregnancy Centers, which had a mix of nurses and sonographers who perform ultrasounds.
Using Ultrasound
Ultrasound is very important. While not as comprehensive as a prenatal ultrasound — it won't determine gender or identify fetal abnormality — “limited” ultrasound, as the National Institute of Family and Life Advocates (NIFLA) explains on its website, boosts a center’s “credibility” (and brings in more donors).
“They use it to bolster their credibility because ultrasound is a very powerful tool,” Amy Bryant, MD, associate professor of obstetrics and gynecology at the University of North Carolina, Chapel Hill, and the co-author of the Journal of Ethics article, said in a phone interview. “These centers try to capitalize on that and really manipulate that.”
NIFLA claims to have “pioneered” the use of ultrasound in pregnancy centers in the mid-1990s, to open a “window to the womb.” Since then, according to NIFLA, “Established pro-life medical clinics report that more than 80 percent of abortion minded mothers choose life after they see their unborn baby via ultrasound.”
NIFLA provides no evidence for that statistic. And research doesn’t bear that out. According to the research group, Advancing New Standards in Reproductive Health at the University of California San Francisco, “ultrasound viewing" does not change women’s minds about abortion.” Still, that hasn’t deterred NIFLA from its “goal” of converting more of its 1,600 member pregnancy centers into ultrasound-providing "medical centers" through its Life Choice Project, a step-by-step program that assists with everything a center would require for conversion, from insurance to ultrasound training.
Repeated requests to NIFLA’s media center to interview an organization representative went unanswered.
Pregnancy centers can offer “limited ultrasound,” which NIFLA provides training for, as long as a licensed physician or chiropractor operates as medical director. For a while, Choices Women’s Clinic’s medical director was a pediatrician, although its current medical director is an ob-gyn.
Fiona Jackson Pregnancy Center founder/director Belinda Ford has spoken in a web video about “teach[ing] women their identity in Christ through the resources of pregnancy testing and ultrasound.” Last year, an article about Ford and her centers in Winter Garden and Pine Hills featured a photo of her standing next to ultrasound equipment. A call to the center confirmed they previously provided ultrasounds although they’re not currently offering the procedure because they lost their sonographer. They are seeking a replacement.
Like many pregnancy centers, Fiona Jackson's website lists no medical staff, only a board of directors. People connected with the center were reticent to discuss the medical director. Board Member Nate Robertson, vice president of Sidewalk Advocates for Life, refused to answer repeated text questions about who the center’s medical director is and referred all questions back to Ford.
A person answering phones at the center said the medical director was someone named “Dr. Asha.” Ford told VoxPopuli in an email that Dr. Asha only volunteers in the center’s ministry and that the center’s medical director is Dr. Nicole Eisenbrown.
A Google search found a Dr. Nicole Eisenbrown, who is board-certified in urology and female pelvic medicine and reconstructive surgery, with offices in Panama City and Orlando. She focuses on sexual wellness for women, men and couples who are dealing with sexual dysfunction after cancer treatment, low libido, painful sex and erectile dysfunction. According to the Florida Board of Medicine there is only one Dr. Nicole Eisenbrown practicing in Florida.
When asked for clarification about the medical director, Ford stopped responding to questions and phone calls. Despite several phone calls to her Orlando office and messages sent via her website and Facebook page, VoxPopuli was unable to reach Eisenbrown to verify any connection to the center. But an irate office administrator at Eisenbrown's Orlando practice told VoxPopuli in a Friday phone call that she was “unaware of Dr. Eisenbrown’s connection to any other clinic.” She said that Dr. Eisenbrown ran a “reputable clinic” and was a “reputable doctor” and threatened to sue if we printed false information. “She does not play,” the administrator warned.
This raised red flags for Bryant, who is a medical director herself of a clinical practice in the North Carolina Triangle area. She described the Fiona Jackson Pregnancy Center situation as “suspicious” and wondered “what are they trying to hide and why?
“I also work at Planned Parenthood, and it is very clear who our medical director is,” she said in a phone interview. “This just raises the whole question of how these quote unquote clinics try to have it both ways. They want to be seen as legitimate medical clinics, and yet they do not want to be regulated like legitimate regular medical clinics.”
Separate Sites
Another hallmark of pregnancy centers is that their services are usually free. The nine websites we examined advertised no-cost pregnancy and STI testing, ultrasounds and counseling. Pregnancy centers often post some variation on ThriVe Orlando’s assurance that because the center does not benefit financially, “you can be confident that we’re a safe place with unbiased resources…” [emphasis added]. Some centers, like Choices Women’s Clinic, even co-opt the language of the reproductive rights movement with phrasing like “The choice is yours” and “we value and respect your choices.”
“The centers can provide free services because religious organizations are funding them. They can’t accept insurance because they aren’t true medical facilities staffed by trained medical providers,” said Progress Florida’s Weintraub. And the centers do benefit financially. “The more people they bring in, the more capacity they can report, and the more donations they receive.”
According to Designed to Deceive, a study done by the Alliance State Advocates for Women’s Rights and Gender Equality, pregnancy centers often maintain two separate sites — one for people seeking healthcare and one for donors.
Choices Women’s Clinic maintains two such sites, and its ministry affiliation is not at all apparent from its pregnancy center site. On the ministry website, the language about valuing and respecting women’s choices disappears, and the center’s mission becomes clear: to bring the “abortion determined” around to the “healthy” choice through “education and ongoing support through the love of Jesus Christ.” According to the clinic’s profile on the Evangelical Council for Financial Accountability, Choices Women’s Clinic was “established in 1984 … to save unborn babies and their families from the tragic consequences of abortion.”
This is not to suggest that Choices is concealing its ministry — it’s public at Choices Friends. Only that a pregnant person seeking abortion information would be hard-pressed to make the connection between Choices Women’s Clinic and the ministry Choices Friends because the two sites aren’t linked, and nothing on the pregnancy center site indicates that it is backed by an anti-abortion ministry.
Choices Executive Director Vicky Mathews did not respond to VoxPopuli’s repeated email and phone call requests for an interview. But after Choices opened its Oviedo office near the University of Central Florida in 2021, Mathews told Pregnancy Help News, “We told our community we were going to go where abortion was happening, that we were going to change abortion in Orlando. There’s a Planned Parenthood one mile from campus on a main artery road, and we are one mile from campus on the other main artery road. That’s our strategy here. We’re very strategic about reaching those who are abortion-minded. That’s our demographic. That’s who we advertise to. That’s the majority of who we see.”
Disinformation Campaign
While many pregnancy centers promise "comprehensive abortion education," we found that often entails false, misleading and debunked claims. The Pregnancy Center in Winter Park, for instance, posted alarmist information about a "rise" in ectopic pregnancies to encourage people to come in for ultrasounds. However, they left out some important context: that the increase in pregnancies lodged in a fallopian tube was noted in the early 1980s and, according to the American Academy of Family Physicians, is attributed to better diagnostic tools that allowed physicians to identify and remove more of them before they became life threatening. (Eskamani noted on X, formerly Twitter, that with the six-week abortion ban, physicians now have to "consult with legal departments before they can provide care.")
Pregnancy centers also continue to promote widely debunked claims that abortion raises breast-cancer risk. The National Cancer Institute quashed the breast cancer connection in 2003 when it gathered 100 experts on pregnancy and breast cancer to review the research and concluded there was no connection.
Another risk routinely cited: Post-abortion traumatic stress syndrome. Without evidence, The Pregnancy Center adds additional “potential” risks: eating disorders, trouble connecting with future children, difficulty with relationships, feelings of hopelessness and nightmares.
“We know based on large international studies that there's a seven times increased risk of suicide after abortion and that women have a significant risk of depression and anxiety,” AAPLOG’s Francis said.
“Oh no! That is so debunked,” Bryant responded when she heard the litany of psychological stresses attributed to pregnancy termination. She said those findings came from poorly designed studies. “They did not use proper statistical technique, and they looked at people who had a higher risk of mental disorders before they had their abortion, not after, though it’s implied in the study that it was after. It’s just not good science.”
It’s also worth noting that neither the American Psychological Association nor the American Psychiatric Association recognize “post-abortion traumatic stress syndrome.” Results from a large British study, which included more than 13,000 women with unintended pregnancies, found no difference in mental health problems among those who gave birth and those who chose abortion. In addition, data from the Turnaway Study which monitored 1,000 women recruited from 30 abortion clinics in 21 states from 2011 to 2016, found that women who had an abortion had no higher risk for PTSD, suicidal thoughts or substance abuse than those denied an abortion because they were past the date limit for the procedure. Interestingly, that study found, being denied an abortion was associated with greater risk of anxiety, high-risk pregnancies and financial hardship.
The Pregnancy Center did not respond to an email request for comment.
Despite the scare language on pregnancy center sites, research shows that childbirth actually carries a higher mortality risk than abortion — 14 times higher, according to one study that examined data from the Centers for Disease Control and Prevention’s Pregnancy Mortality Surveillance System. The risks are higher still for Black women who have three and a half times the risk of dying from pregnancy complications as white women.
“Death from abortion is under 1 in 100,000,” said Bryant. “It’s far safer to undergo a termination than it is to continue a pregnancy.”
The Turnaway scientists noted that “95 percent of women report that having the abortion was the right decision for them over five years after the procedure.”
Risky Business
Remember that 95 percent statistic. That’s because there’s a relatively new, scientifically unproven procedure gaining traction in anti-abortion circles that’s predicated on the idea that women change their minds in the middle of a medical abortion and want to reverse course. Nearly all of the sites we examined link to a site with a hotline, chatbot and resources to connect with practitioners who claim to be able to reverse the abortion pill.
First, a quick refresh on how medical abortion works: The first pill, mifepristone blocks the hormone progesterone and causes the embryo to detach from the uterus. That’s followed 24 to 48 hours later by the second pill, misoprostol, often prescribed for gastric ulcers, to induce cramping and empty the uterus. Now used for 63 percent of all abortions in the U.S. medical abortion is 94 to 98 percent effective at eight weeks or earlier. At nine or 10 weeks, the numbers dip to 91 to 93 percent, but with an extra dose of misoprostol, it increases to 99 percent.
Ads for abortion pill reversal aim to persuade people in those hours between the first and second pills. “If you regret your decision after taking the first abortion pill, you can still save your pregnancy,” promises the Abortion Pill Rescue Network, which claims 1,000 physician, nurse and pregnancy center members. “But time is of the essence!”
(Remember that satisfaction rate. Research says that fewer than 0.005 percent of people who start a medical abortion change their minds and choose to continue their pregnancies.)
The theory is that if mifepristone blocks progesterone, which is essential for pregnancy, administering progesterone would save it. Pregnancy centers like to highlight the results of a study that found pregnancy continuation rates between 48 percent and 68 percent for women who received progesterone after taking mifepristone.
But many researchers say that study is flawed and its success rate overblown. They fault that study for not having institutional oversight, a control group, inconsistent progesterone delivery methods among women who also had various gestation dates and a general lack of consent or follow up among participants.
Another study of mifepristone and progesterone done at University of California, Davis, needed to be stopped early after three women were hospitalized with severe hemorrhaging. A report in the New England Journal of Medicine said there was “no evidence” that administering progesterone was any better than simply doing nothing after taking mifepristone. Half the women in a 2015 study who took mifepristone without administering progesterone remained pregnant.
The American Association of Pro-Life Obstetricians and Gynecologists supports abortion pill reversal — and links directly to the Abortion Pill Rescue Network. The American College of Obstetricians and Gynecologists and the Food and Drug Administration (FDA) do not.
There’s concern that not only have proponents of abortion pill reversal created a new drug protocol (mifepristone + progesterone) without adequate research — a violation of the Federal Food, Drug and Cosmetic Act — the combination may endanger women. Legislation has already passed in 15 states (though not in Florida) that mandates healthcare providers give patients information about abortion pill reversal.
Bryant said there is “no known safe way” to reverse a medical abortion once it’s started. “It's an unproven treatment plan without proper studies, without FDA approval,” said Bryant. “People just need counseling prior to having a medical abortion as to whether they really want it or not. The irony is they're trying to take mifepristone off the market for not being safe when [abortion pill reversal] is completely unproven. It's really mind boggling. Women's safety is certainly not their actual goal, I would say.”
Contraceptive Confusion
Pregnancy centers’ aim to prevent abortion. Yet few offer reliable, accurate information about contraception or even provide condoms, which also protect against sexually transmitted diseases.
Asked about that, AAPLOG's Francis noted that condoms had one of the highest failure rates among contraceptives. (Indeed, with real world use they are about 85 percent effective.)
"What we need to do is not just be handing out condoms and sending people on their way," she said. "We need to be talking about some of these choices that you're making that are naturally going to lead to a pregnancy, and if you're not ready to be pregnant, then you need to think about that." Rather than condoms, she said, what women needed was self-esteem classes, job skills classes. "These are things that pregnancy care centers are providing. These are not things that abortion facilities are providing for women."
Yet a study from the Washington University School of Medicine in St. Louis shows that when people at risk for unplanned pregnancies had access to free birth control, abortion rates dropped between 62 percent to 78 percent. Researchers at the Guttmacher Institute attribute lower abortion rates to fewer unplanned pregnancies and increased access to long-acting birth control, like intrauterine devices (IUDs), available through the Affordable Care Act’s mandated contraceptive coverage.
But pregnancy centers often mischaracterize how birth control works. Life Choices Medical Clinic highlights risks for oral contraceptives without context. It warns, for instance, that oral contraceptives can raise the risk for sexually transmitted diseases. What the site neglects to mention is that the study that risk was based on was done with Kenyan sex workers who were already at high risk for STDs, and that the researchers cautioned that more research needed to be done before their findings could be applied to the general population.
Life Choices Medical Clinic also describes contraceptives as “methods of … ending a pregnancy,” which is not what “contraceptive” means. IUDs are described as abortifacients, using medically incorrect explanations: “contraceptives can attempt to prevent a baby from implanting in the mother’s uterus after fertilization.”
Weintraub called that claim “absurd.”
“Fertilized eggs” get implanted, explained Community Health Centers’ Bahn, who describes herself as a “pro-life Christian. “It’s some cells, multiple cells. Does that end up being a baby? Yes. When does the baby start? There’s a big debate on that.”
One birth control method that pregnancy centers do focus on is emergency contraception, also known as the “morning after pill.” There are two formulations. One contains the hormone progestin and is sold over the counter as Plan B One Step, Next Choice and a host of other generics. The other, called ella, contains ulipristal acetate and requires a prescription.
Both ella, Plan B One Step and other progestin-based formulations prevent ovulation, or the monthly release of an egg from the ovary. Taken within 24 hours of unprotected sex, Plan B One Step is 95 percent effective at preventing pregnancy, according to drug makers. At 72 hours, it’s about 87 percent.
“The sooner you take it, the more likely you are to prevent yourself from ovulating,” said Bryant.
After ovulation, emergency contraception is ineffective.
For a while it was unclear if Plan B One Step and its generics could also prevent a fertilized egg from implanting in the uterus. But in 2022, the Food and Drug Administration unequivocally stated that the medication's only action is to delay ovulation. But that hasn't stopped pregnancy centers from continuing to equate emergency contraception with abortion pills and insist it ends pregnancies.
At ThriVe Orlando Women's Healthcare Express site, Plan B is listed among the abortion methods. The site states that Plan B "may end a pregnancy by preventing an egg from being released or inhibiting implantation of an embryo in the uterus."
Asked about the biological impossibility of ending pregnancy by preventing ovulation as well as labeling Plan B as an abortifacient, Amber Wilder, ThriVe's executive director, emailed VoxPopuli Tuesday to say, "Our statement on Plan B is a copy error. It was not updated correctly when the FDA released their memo about Plan B and how it does not inhibit a fertilized egg from implanting into the womb. We will be updating our website with the correct information, and taking Plan B out of the Abortion section and placing it into the emergency contraceptive section."
The Pregnancy Center claims "If the egg has already been released, the lining of your uterus will become irritated, and this irritation will interfere with the ability of the fertilized egg to implant in your uterus. (Your body will reject the baby, and he/she will die.)"
Bryant said that emergency contraception preventing implantation doesn't make logical sense. "If you're preventing ovulation, you can't prevent implantation because there's nothing there to get implanted."
First Life Center for Pregnancy includes the copper IUD in its website section on emergency contraception. IUDs are the most effective emergency contraceptive available — 99.9 percent effective if inserted within five days of unprotected sex, according to Planned Parenthood. But First Life adds, “when inserted after ovulation, the copper IUD is used to prevent the implantation of the developing embryo." Life Choices Medical Clinic states on its site that IUDs "end the life of a developing fetus."
Neither of those statements are factual. Both embryos and fetuses are developmental stages well past the five-day limit of emergency contraception's effectiveness.
“We do not put IUDs into people who are known to be pregnant,” Bryant said.
Neither First life Center for Pregnancy, The Pregnancy Center nor Life Choices Medical Clinic responded to email requests for comment.
With ending abortion as a mission, stocking emergency contraception in pregnancy centers would seem to be mission critical. Fewer unintended pregnancies = fewer abortions. Yet not a single pregnancy center website that VoxPopuli examined mentioned providing emergency contraception to clients or highlighted its 95 percent effectiveness rate when taken within 12 to 24 hours of unprotected sex. If sites mention effectiveness at all, they tend to focus on the lower 72-hour rate of 87 percent.
Weintraub said preventing unwanted pregnancy is not the point for pregnancy centers. The mission “is to end abortion access,” she said. “They are not comprehensive healthcare providers and have no interest in actually providing family planning services.”
Jeannette Moninger contributed reporting to this story.
_______________________________
VoxPopuli looked at websites affiliated with Fiona Jackson Pregnancy Center (Winter Garden, Pine Hills); Choices Women’s Clinic (Orlando, Oviedo, Kissimmee); Life Choices Medical Clinic (Altamonte Springs); The Pregnancy Centers (Winter Park, Sanford); Life’s Choices Women’s Clinic (Clermont, Eustis); ThriVe Orlando Women’s Healthcare Express (Orlando); First Life Center for Pregnancy (Orlando); JMJ Pregnancy Center (Orlando, Kissimmee); Apopka Pregnancy Center.
Updated May 7, 2024 to reflect the addition of ThriVe Orlando executive director's comments and a new Google map.
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