Why are crisis pregnancy centers saying they can 'rule out' ectopic pregnancy?

A billboard in South Bend, Indiana, advertises a crisis pregnancy center in 2021. The centers can look like medical clinics, but they rarely have medical staff working there. Taylor Glascock for The Washington Post/Getty Images hide caption

On Mother's Day, the Trump administration launched the website Moms.gov , which directs "expecting parents who are navigating difficult or unexpected pregnancies" to crisis pregnancy centers around the country.

"Many centers offer pregnancy tests, ultrasounds, STD/STI testing and treatment, parenting support, childbirth classes, medical referrals, and material goods like clothes and diapers — at no cost to you," Moms.gov explains.

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There are thousands of crisis pregnancy centers across the country — around 2,500 according to a 2024 estimate from the Government Accountability Office. Many are Christian organizations; all try to keep people from having abortions. Staff are often volunteers who may or may not have medical training, and some wear scrubs or white coats and have clients fill out medical questionnaires.

Many also offer free ultrasounds and tout the benefits of the test.

"It's important to rule out an ectopic pregnancy or a natural miscarriage and find out how far along you are via limited ultrasound," reads the website of MyChoice Pregnancy Care Center in New York's Hudson Valley. "Contact us for a free ultrasound."

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Ectopic pregnancy is a rare complication that happens when an embryo implants outside of the uterus. If it implants in a fallopian tube, the tube can rupture, which can be life threatening.

The problem is that a single ultrasound can't determine whether a pregnancy is ectopic.

Watchdog calls for an investigation

This week, Campaign for Accountability , a nonprofit watchdog organization, sent a letter to New York Attorney General Leticia James requesting that her office investigate whether crisis pregnancy centers in New York are fraudulently advertising to women about their ability to diagnose ectopic pregnancies.

"By leading patients to believe that their services are adequate substitutes for medical diagnoses, [crisis pregnancy centers] may cause women to forgo comprehensive medical care, resulting in their suffering grievous bodily injury," reads the letter , shared exclusively with NPR.

The organization found 100 examples in 49 states of pregnancy centers using language on their websites about how they can "rule out" ectopic pregnancies.

The harm is not hypothetical. The letter cites cases in Texas and Massachusetts , where women in those states went to pregnancy centers that missed ectopic pregnancies.

"They were told that their pregnancies were viable or told that everything was fine," explains Michelle Kuppersmith , executive director of Campaign for Accountability. "And then later they found themselves in the hospital with an ectopic pregnancy that was not diagnosed by the crisis pregnancy center."

Kuppersmith says they may send more letters to attorneys general in other states. "We're hoping that by continuing to expose this issue, that there will be additional attention to it, and that perhaps these centers will do the right thing and stop trying to make claims to women about things that they can't actually do."

"We really don't like to see that language"

A membership organization of crisis pregnancy centers — the National Institute of Family and Life Advocates , or NIFLA — agrees that the centers shouldn't be promising to "rule out" ectopic pregnancies.

"Do not advertise, 'We can rule out an ectopic,'" advised NIFLA's Vice President of Legal Affairs Anne O'Connor last year in a webinar for the The ProLife Team Podcast. "We really don't like to see that language because it is near impossible to rule out an ectopic."

She went on to explain that the diagnosis requires multiple blood tests and multiple ultrasounds, and these centers cannot provide ongoing medical care for patients.

She said that centers can still talk about ultrasounds, but using suggested language like: "We're doing the ultrasound to see if the fetus is in the womb where it's supposed to be."

NIFLA did not respond to multiple requests from NPR for comment for this story.

A response to the growth in medication abortion

Crisis pregnancy center marketing about ectopic pregnancies often references abortion medication, which has grown substantially since Roe v. Wade was overturned four years ago this week.

"If you plan on taking abortion pills, book an ultrasound to rule out an ectopic pregnancy," reads the MyChoice Pregnancy Care Center website .

Besides the fact that centers are typically unable to provide an ectopic pregnancy diagnosis, it's also not medically necessary to obtain such a diagnosis before taking abortion medication, says Dr. Jonas Swartz , professor of obstetrics and gynecology at Duke Health.

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"Telemedicine abortion with medication abortion has been shown to be safe even without ultrasound," says Swartz, who has done research on crisis pregnancy centers. He adds that abortion medication won't resolve an ectopic pregnancy, but it also won't make it worse.

If someone does have an ectopic pregnancy, they will need multiple follow-up visits and medical or surgical treatment.

Crisis pregnancy centers often offer material support, such as baby clothing, to parents. Here Pamela Palumbo, CEO of Wellspring Life Ministry, is at a crisis pregnancy center in Maryland, in June 2023. Maria Danilova/AFP/Getty Images hide caption

Swartz says he's sympathetic to patients navigating the confusing early weeks of pregnancy, who might be worried and who might not be able to get in to see an OB-GYN quickly.

"Theoretically, people who would reach out to a crisis pregnancy center are in crisis — they are having an unexpected pregnancy or something going on in their pregnancy and they need help," he says.

"I would think the best place to get that help would be a place where you know that you are seeing a trained medical team who have medical licenses and are working in a regulated facility," he adds. "I would love to encourage us to devote our public tax resources and other resources toward increasing the availability of those services."