Earlier this week, within hours of leaked news that the Supreme Court intends to overturn Roe v. Wade, VICE’s Motherboard reported that a location data firm had been selling the private information of people visiting abortion clinics. The firm soon announced it would discontinue this practice, but the concerns it sparked stand: Are people seeking abortion care being surveilled? The short answer is yes.
And it’s not just private data firms that are collecting, storing, and potentially distributing abortion seekers’ data. It’s also state-funded “crisis pregnancy centers,” or CPCs—anti-abortion organizations that lure primarily poor people of color with unwanted pregnancies to their premises, and aggressively try to dissuade them from having abortions.
“Crisis pregnancy centers are basically the ultimate movement building tool of the anti-abortion movement,” Kim Clark, an attorney at the gender justice legal advocacy group Legal Voice, told Jezebel. Legal Voice is part of The Alliance: State Advocates for Women’s Rights and Gender Equality, which recently released a study that exposes the extensive surveillance of fake clinics and their nationwide networks.
Some of these “clinics” even have contracts with state governments to help collect data from callers seeking abortion care, in a conjoined effort to stalk, possibly criminalize, and force people to give birth. And because, in most cases, they provide no actual health care, they notably aren’t subject to the patient privacy standards set by HIPAA.
In February, Oklahoma became the latest in a string of states that have introduced or enacted legislation to require that pregnant people seeking abortion care consult with a CPC or anti-abortion “care agent.” In Oklahoma’s bill and several other states’ bills, abortion seekers are then assigned a “unique identifying number” that must be added to their medical record and tracked in a database maintained by the state. A law like this passed Arkansas’ legislature last February and is also under consideration in Alabama and Texas. Similarly, an Iowa bill (also introduced last February) would give CPCs funding to target pregnant people online. This model of legislation was directly introduced to state legislators by the anti-abortion crisis pregnancy center network, Human Coalition.
Fake clinics’ websites are the key to their surveillance and data collection, primarily through their prominent placements on search engines like Google. Shireen Shakouri, deputy director of Reproaction, tells Jezebel she’s heard from people who live in communities with fewer or no abortion clinics, who see only crisis pregnancy centers pop up when they Google abortion clinics. The ratio of crisis pregnancy centers to abortion-providing clinics in the US notably stands at 3 to 1, with even higher disparities in states that fund CPCs, like Pennsylvania (where the ratio is 9 to 1), and Minnesota (11 to 1.)
This is an ongoing issue that Shakouri says Google should take action to address. “It shouldn’t be on the individual user to have to sift through and do their research to find what is actually healthcare when they’re trying to use a publicly available search tool for medical care.”
In addition to search engines, Shakouri notes that CPCs’ methods to entrap abortion seekers are extensive: As Jezebel has previously reported, they employ geo-fencing to literally target the ads of people near abortion clinics, so they’ll see ads for fake clinics. But CPCs’ tactics aren’t just digital. “On a person-to-person basis, they’re the ones giving pamphlets to protesters outside abortion clinics, and literally following people to their cars, to their partners’ cars, toward to the public transit,” Shakouri said. Many also set up shop near or next to real clinics, to deceive patients. “This is something that’s been happening even before fake clinics had all these technological avenues to spy on people. But now that people carry their phones with them all the time, there’s increasing awareness of the ways the internet can equip them.”
“Big data is revolutionizing all sorts of industries. Why shouldn’t it do the same for a critical ministry like ours?” Heartbeat International has said of its data collection practices. According to Clark, thousands of crisis pregnancy centers across the country use Option Line.
Clark also says that many CPCs’ websites have privacy policies that state something along the lines of, in her words, “To the extent that we’re collecting customer information—and who knows what that means—we reserve the right to use that information as we see fit.” And because, again, CPCs are simply cosplaying as health care providers, they aren’t subject to HIPAA and can do what they please with abortion seekers’ information. On top of their use of Option Line to collect data, anti-abortion groups have also notably funded and partnered with fertility apps that track people’s periods—not unlike how the director of Missouri’s health department tracked Planned Parenthood patients’ menstrual cycles on a spreadsheet.
The consequences of this chilling level of surveillance have already proven to be terrifying. In recent years, there have been several cases of digital forensics, including online searches for abortion pills, text messages, or geo-fencing being used to criminalize people who have lost their pregnancies or induced their own abortions and are then charged with feticide or child endangerment. In 2018, Latice Fisher, a Black mother of three in Mississippi, was jailed after experiencing a stillbirth because prosecutors argued that she’d killed her own baby, citing her previous online searches for abortion pills as “motive.” Before Fisher, Purvi Patel, an Indian-American woman in Indiana, was jailed and similarly charged with feticide in 2015 for allegedly inducing an abortion; her online purchase of abortion pills and text messages to a friend were used by the prosecution as evidence against her.
In its study, The Alliance expressed concern with the role of CPCs in making laws like Texas’ abortion ban, which is enforced by citizen surveillance and the threat of costly lawsuits to providers: “CPCs are positioned to play a central role in surveillance of pregnant people in such a vigilante system,” the report stated. “They exist, after all, to reach people experiencing unintended pregnancies, and collect extensive digital data on their clients and their reproductive histories.”
The fall of Roe significantly worsens this threat. Because medication abortion can’t be distinguished from a miscarriage, all pregnancy outcomes could result in investigation and criminalization; the bodies of all pregnant and pregnant-capable people would essentially be reduced to crime scenes. Already, with Roe in place, criminal charges for miscarriages and stillbirths have significantly increased in recent years, from 413 prosecutions between 1973 and 2005 to more than 1,250 between 2006 and 2020, per National Advocates for Pregnant Women. As recently as last month, Lizelle Herrera in Texas was briefly jailed and charged with homicide for allegedly self-inducing an abortion.
To top it all off, what happens inside fake clinics—and to their victims long after they leave—is just as invasive and dystopian. One victim testified to the Expose Fake Clinics campaign that after she left a clinic, a CPC worker “began calling her almost daily and telling her aggressively that she would die, or end up in hell, or get very sick if she were to go through with the abortion.” Several people who have been lured to fake clinics told the campaign they were forced to sign contracts pledging to not have an abortion, before leaving the clinic. Shakouri tells Jezebel she’s heard from several health providers whose patients told them that, while at crisis pregnancy centers, staff “locked them in exam rooms and told them ‘you’re not leaving until you say you’re not going to have an abortion.’”
As Jezebel has previously reported, there are crucial ways to protect yourself from surveillance and criminalization if you seek an abortion, or seek help for pregnancy complications.“Fake clinics can’t be an afterthought when we talk about abortion bans and the threat they pose,” Shakouri said, “Abortion bans directly support fake clinics.”
The Supreme Court and anti-abortion state legislatures across the country have made it clear: They’re coming for our reproductive rights. And their crusade on our bodily autonomy wouldn’t be possible without the frightening, invasive surveillance apparatus that crisis pregnancy centers provide them.