California was the first state to pass state-level legislation aimed at regulating CPCs. The California Reproduction Freedom, Accountability, Comprehensive Care, and Transparency Act mandated that unlicensed CPCs disclose that the centers are not health facilities and licensed CPCs provide information about state programs that provide abortion, prenatal, and family planning services at little or no cost to eligible individuals.

However, the investigators did not assess data quality or verify information reported by the organizations. Other maps and directories of CPCs have also suffered from key limitations. For example, state-level directories, by definition, are limited in scope. Furthermore, methods for producing these directories are not readily accessible leading to questions about rigor and comparability. As previously mentioned, umbrella organizations that support CPCs maintain directories of affiliated centers, but none is comprehensive of all CPCs currently operating in the country.

Other national maps and directories of CPCs have been produced but are limited because they are known to be incomplete, their methods have not been reported, it is unclear if the data have been verified, they are not searchable, or they are difficult to navigate.

Despite increasing medicalization of CPCs, to date, no comprehensive database has categorized or estimated the number of CPCs that provide information only or limited medical services in addition to information.

The number of facilities that provide abortion has declined over the past decade [ 19 ]. To date, no studies have compared the number of CPCs and facilities that provide abortion by state. Despite a rapidly changing policy environment, studies have not examined how government sponsorship influences the proliferation of CPCs or how CPCs might influence abortion policies. In and the first half of , a record number of states introduced extreme legislation to ban all or most abortions [ 20 - 22 ].

As an active, grassroots part of the pro-life movement, a greater number of CPCs may signal a galvanized base of support for and potential legislative success in limiting abortion access. Here, we describe the methods used to create and maintain the database, key design features of the tool and related operating procedures, and baseline findings regarding the number and distribution of CPCs in the United States.

Specifically, we examined the number of CPCs nationally and by state, subregion, and region and in relation to the number of women of reproductive age and abortion facilities. We also investigated associations between direct state funding for CPCs and the number of CPCs per state and relationships between the number of CPCs and legislation proposed in and from January through July to ban all or most abortions.

Potential CPCs were identified through multiple internet searches conducted in March-May , by trained research assistants following a standard protocol. All searches were conducted using Google search engine in incognito mode. If no website was provided, we searched for the site using the following keywords: [name of center], [city], and [state]. Next, we identified and reviewed existing maps by state to identify additional unique entries that were then added to the master list.

We also reviewed an existing crowd-sourced Web-based directory of CPCs by state and added unique entries to the master list [ 28 ]. Finally, we searched websites of listed entries for additional potential CPC addresses and added unique entries to the master list. Each search and entry were independently verified. For all entries, we recorded the method s by which the center was identified.

Centers were eligible for inclusion if they were determined to be 1 currently in business and 2 a CPC. Mobile clinics and maternity homes were excluded.

Using a standard script and protocol, trained research assistants called all centers with addresses not listed on a proprietary domain. Centers with disconnected or out of service telephone numbers and those that could not be reached within five call attempts were categorized as not currently in business.

Using a standard script and protocol, trained research assistants called all centers with websites that did not explicitly advertise free pregnancy tests or testing and centers with no identified client-facing proprietary website.

Callers did not identify themselves as research assistants or explain the nature of the call. We also identified whether each eligible CPC provided information or counseling only or limited medical services in addition to information or counseling.

CPCs that advertised free limited ultrasound services excluding referrals on a proprietary domain or confirmed the availability of free limited ultrasound services for any type or group of clients during a telephone call to the center were categorized as providing limited medical services.

All other CPCs were categorized as providing information only. Intended users included individuals seeking health services, public health and medical professionals, social service organizations, researchers, and decision makers. Key features include 1 accessibility and an open-source widget that allows distribution of the CPC Map on existing websites and apps, 2 faceted search, 3 geo-tracking to facilitate localized search results, 4 Google map and data visualization, 5 categorization of CPCs that provide information only vs limited medical services, 6 enumeration of CPCs, 7 marker clustering, 8 a webform to provide updates about included CPCs, 9 a webform to suggest a CPC not already included, and 10 a webform to request access to the CPC Map data set.

Below, we describe these features and related protocols in greater detail. The website, which is both desktop and mobile responsive, was publicly released on September 10, In addition, an open-source iFrame available on the site allows distribution of and access to the directory through existing websites and mobile apps.

The directory, whether accessed through the main CPC Map website or widget display, is searchable by state, city, and zip code. Users who search by city or zip code are able to select radii of 5, 10, 25, 50, and miles.

CPC results can be presented in both map and list views. The homepage displays the map view with markers indicating locations of CPCs and includes a scroll panel that lists CPC names and addresses.

A separate, searchable list view can be accessed via an icon on the homepage. Both the list and map views allow users to select presentation of CPCs that offer information only or limited medical services in addition to information, or all CPCs.

CPCs that offer information only are indicated via blue markers, and centers that offer limited medical services in addition to information are indicated via green markers.

All search results include the total number of centers in the geographic area selected. To aid visual representation of a large number of markers on the homepage map, which presents all CPCs currently operating in the United States, the CPC Map utilizes marker clustering, a grid-based clustering technique that groups CPCs within close proximity and displays the number of CPCs within each cluster.

As the user zooms out, the groups consolidate. As the user zooms in, individual centers are marked. We intend to review and update the site annually. The CPC Map website also includes several webforms to facilitate maintenance and accuracy of the directory over time. Through webforms, users may suggest centers that should be included in the directory and submit changes to information eg, name and address changes and types of services offered about listed centers.

Information provided via the webforms is sent to an email address maintained by the research team. Upon receipt of information about additional centers that should be included, the research team verifies the suggested information and determines whether the center is eligible for inclusion using the process described above. Centers that meet existing eligibility criteria are then added to the directory by research team members who have rights-based permission to make changes.

Similarly, upon receipt of suggested information changes for centers already included in the directory, research team members verify the submitted information and update the directory, as necessary. Users can request access to the database via a webform available on the CPC Map website. Individuals requesting access to the database are asked to provide their first and last name, organization, reason requesting access as specifically as possible, email address, and phone number.

Requests are considered on a case-by-case basis. Access to the database is intended to be used for research and program planning purposes only. Program planners may use the data to geographically target or inform their efforts. Testers were asked to attempt to complete six user tasks and report back on their experiences and any problems in completing the tasks.

Feedback from the testers confirmed that the website and its functions were user-friendly and potential users were enthusiastic about the usefulness of the directory. Feedback was also used to finalize the site. We conducted analyses to describe the number of centers identified during data collection and final enumeration of eligible CPCs and distribution of CPCs in the United States.

We also conducted analyses to examine policy factors related to CPCs, website user data, and search engine visibility. First, we used summary statistics to enumerate centers identified during collection and the number of CPCs currently operating in the United States, in total and by types of services offered.

We also used descriptive statistics to assess the distribution of CPCs by region, subregion, and state. Next, we calculated the ratio of women of reproductive age ages years to CPCs and the ratio of CPCs to abortion facilities nationally and by region, subregion, and state. Estimates of mid-year populations were obtained from the US Census Bureau [ 30 ]. The number of abortion facilities was obtained from a study that conducted a systematic Web-based search of abortion facilities in the United States [ 19 ].

Next, we examined policy factors related to the number of CPCs in each state and the District of Columbia. We used negative binomial regression models because analyses showed that Poisson models were not a good fit. Adjusted models controlled for the number of women of reproductive age and number of abortion facilities per state. Information about states that directly fund CPCs was obtained from a report released by a national advocacy organization [ 31 ]. We used unadjusted and adjusted logistic regression models to examine associations between the number of CPCs and state legislation to ban all or most abortions introduced in and from January through July We separately assessed associations between the number of CPCs and legislation to ban all or most abortions introduced in , , and in either year Information about states that introduced legislation to ban all or most abortions was obtained from the Guttmacher Institute [ 20 ].

States that introduced legislation were coded as 1; all others were coded as 0. Finally, we used Google Analytics to describe the total number of views and unique views of the CPC Map within the first 10 months following release of the website.

In addition, we used SEMRush to analyze search engine results and catalog relevant queries keywords with notable volume that drove organic traffic to the site. Using the multiple data sources described above, CPCs were initially identified through the search procedures. The compiled list was then reviewed for duplicate entries.

Black people who have visited pregnancy resource centers have told her they faced racist assumptions about things like their income or whether their fathers are in their lives, Flint said. They also, she said, sometimes heard the increasingly common anti-abortion message that abortion is a conspiracy against black people. In , Missouri and Pennsylvania began to allocate state funding to pregnancy resource centers.

Today, 16 states directly fund the centers, Swartzendruber told Vox. Meanwhile, the Trump administration last year awarded a grant to Obria , a network of pregnancy resource centers in California, under Title X, a program designed to provide family planning support to low-income Americans. The same year, the administration issued a rule barring providers that receive Title X funds from providing or referring for abortions.

That forced Planned Parenthood and many other providers that offer a full range of reproductive health services — including, in some cases, prenatal care — to stop taking Title X money , and some have closed as a result. Kimport acknowledged some limitations in her study. Since the people she interviewed had visited a prenatal care clinic after going to a pregnancy resource center, the study might not have captured the full range of experiences of people who went to the centers — for example, she might have gotten a different picture if she interviewed people who went to the center but then ended up getting abortions.

Our mission has never been more vital than it is in this moment: to empower through understanding. Financial contributions from our readers are a critical part of supporting our resource-intensive work and help us keep our journalism free for all.

Please consider making a contribution to Vox today to help us keep our work free for all. Cookie banner We use cookies and other tracking technologies to improve your browsing experience on our site, show personalized content and targeted ads, analyze site traffic, and understand where our audiences come from. By choosing I Accept , you consent to our use of cookies and other tracking technologies. Reddit Pocket Flipboard Email. Next Up In Explainers. Delivered Fridays. Thanks for signing up!

Check your inbox for a welcome email. Email required. By signing up, you agree to our Privacy Notice and European users agree to the data transfer policy. For more newsletters, check out our newsletters page. The Latest. While most studies of abortion care recruit participants at clinics, this study sought to recruit people earlier in the decision-making process to better understand their experiences and barriers to care. State abortion restrictions have contributed to the reduction of abortion clinics in many parts of the United States, which places a burden on pregnant people seeking abortion.

Rather than travel significant distances, they may instead seek care at a nearby CPC. And because CPCs are often branded with ambiguous names and market free pregnancy-related services, like ultrasounds, people seeking abortions may visit a CPC without realizing it does not provide abortion care. Previous research has shown that as abortion care becomes less available, the impacts are disproportionately felt by communities of color, those without health insurance, or those of lower socioeconomic or educational status.

Unlike abortion facilities, which provide counseling on all available pregnancy options, CPCs do not provide abortion care or referrals and often provide false information about the risk of abortion.

In reality, the risk of death from childbirth in the U. After the study team reviewed CPC names and locations provided by respondents, they found that around 13 percent had visited a confirmed CPC.