On Valentine’s Day 2023, I found myself inside a crisis pregnancy center called Obria Medical Clinics in a Los Angeles suburb, telling the nurse I was pregnant and wanted more information. For decades, I had heard horror stories about clinics like this one, which were known for their religious agenda of convincing—even coercing—pregnant, often low-income, women not to have abortions. But my visit to Obria began just like my recent ob-gyn appointment: I took a urine test to confirm my pregnancy; saw a sonographer to view my baby, still a fetus, onscreen; then met with a nurse practitioner. And it was all free.
Long staffed by volunteers in mom-and-pop religious operations, many crisis pregnancy centers like Obria have been undergoing a transformation. They have been medicalizing and professionalizing—hiring nurses and doctors and providing other services in addition to pregnancy tests and sonograms, such as STD testing and treatment. They say their goal is to better serve women, while the pro-choice movement says it’s a smokescreen for continuing their antiabortion efforts. Since I’m a journalist, and I was pregnant in the spring of 2023 when I got this assignment, I visited one of Obria’s three clinics in Los Angeles County—one of nearly two dozen centers across the U.S. owned by the Obria Group—to see for myself. I also called up Obria’s then-CEO, Dawn Hughes.
Dawn Hughes, former Obria CEO.
When I first spoke to Hughes, a former hospital administrator, I was surprised to hear her agree that crisis pregnancy centers had historically been “set up to lure people in” who were looking for abortions and to change their minds, and further that she didn’t approve of that model. Under her watch, she told me, Obria was steadily continuing its transformation into a health care organization that, while still faith-based, would now be transparent with its patients about not offering abortions. “I’m not one to try to be deceptive or make us something that we’re not,” she said.
But just months after our interview, in August 2023, I got an email from Obria announcing a leadership transition. Hughes was gone; she’d been replaced by a man with no health care experience. Almost immediately, the language in Obria’s emails to its donors shifted to more strident antiabortion rhetoric. Where before the emails sometimes discussed general women’s health issues like maternal mortality or lack of affordable health care, now nearly every email was signed: “Choosing Life.” When I reached Hughes by phone, she said she’d been ousted for trying to turn Obria into more of a women’s health care organization—as she’d been hired to do—and “basically because I was telling the truth” to patients that they did not offer abortions. She also told me “they said we don’t want to talk about birth control—but as a health care provider, you have to.”
Then Hughes began to tell me what her time was like there, accusing Obria of inflating statistics and detailing the tactics it used to manipulate patients. Hughes opposes abortion, yet she confirmed what many in the pro-choice movement had been saying about crisis pregnancy centers for years: “They don’t want a pregnant woman who is looking for help,” she said. “Their whole goal is to get you to say: ‘I’m going to keep the baby.’… They are zealots.”
Crisis pregnancy centers, or CPCs—also known as pregnancy resource centers, antiabortion centers, or even “fake clinics”—have for decades offered women in America free or low-cost pregnancy tests and ultrasounds, but with an underlying agenda: to convince them not to have abortions. The American College of Obstetricians and Gynecologists, the leading association of ob-gyns in the U.S., says these centers “undermine the tenets of informed consent and patient autonomy” by “using deception, delay tactics and disinformation.” Such clinics have outnumbered abortion clinics three-to-one for years, especially across the midwest and south, where CPCs are concentrated. In some states, like Minnesota, that ratio is as high as 11-to-one. As the number of CPCs ticks upward, in the wake of the Supreme Court’s decision in the Dobbs v. Jackson Women’s Health Organization case that took away a woman’s protected right to an abortion, dozens of abortion clinics have closed (though telehealth and newly opened clinics in other states have helped fill in the gaps).
The Obria Group, which began as a single center in 1981, today operates 21 clinics in six states: Georgia, Iowa, Texas, Oregon, Washington, and California, where I visited a clinic. The network gained national media attention in March 2019, when the Trump administration awarded a three-year grant of $5.1 million in Title X government funding to Obria. Considering that the Title X program was created to provide high-quality, affordable family planning, including birth control, to patients, particularly those with low incomes, and that Obria had never offered birth control, the decision outraged reproductive health groups.
When it received the funding, Obria founder and then-CEO Kathleen Eaton Bravo said her goal was for Obria to become a nationwide competitor to Planned Parenthood, to spread the pro-life message far and wide. Obria’s tax filings similarly described its mission as being “to create a unified national brand of pro-life health clinics to more effectively compete with major pro-abortion providers.” In 2021, Eaton Bravo told the host of a religious podcast that she closely studied Planned Parenthood to see why it was so effective, and decided it was because of its medical model. “They were bringing women in and killing their babies in a medical model. They also do STI testing. Why?” she said. “To get girls on that slippery slope of drugs, plugs, jellies, and jams.” To divert women to her crisis pregnancy centers instead, she explained, “we had to create a medical brand that could attract women out of Planned Parenthood” and also get them “out of the hooking-up mentality.” (In another earlier interview, Eaton Bravo argued that Christian Europeans were being “replaced” by immigrant Muslims because of contraception and abortion.) Eaton Bravo has since retired from the organization.
Obria, like other CPC conglomerates, gets some of its funding from conservative private donors and religious groups. In 2013, according to Obria’s strategic plan for 2019–2025, it received at least $2.5 million from the Catholic Campaign for Human Development and $515,000 from the California Community Foundation; both grants were to support its expansion and the development of the first pro-life telemedicine app. But it has repeatedly asked for—and secured—significant public funding as well.
Obria ended up distributing its Title X dollars to 14 of its California CPCs before it lost the funding in 2021. Hughes said that Obria told its donors the money dried up because a Democrat who supported the right to an abortion had been elected president, but that that wasn’t the full truth.
A 2021 letter to Obria from the Department of Health & Human Services shows that Obria was in danger of losing its remaining federal funding because HHS had serious concerns about how it had spent the money it received over the first year and a half of its three-year grant. The letter stated that the number of clients actually served was “significantly below” the number promised—Obria saw roughly 3,000 women in 18 months, instead of a projected 12,000 per year. Additionally, the geographic area it operated in was smaller than estimated, and the percentage of low-income clients was lower than anticipated. It also wasn’t clear what actual contraceptive services were provided, if any, and Obria fell short of meeting the requirement to partner with federally funded health care centers that do offer the full range of family planning services, including contraceptives. Despite substantially reducing the anticipated number of clients it would serve in the third year of the grant, Obria had asked the federal government for even more funding that year: nearly $2 million.
Reflecting on her time at Obria, Hughes said she is blowing the whistle on the organization because she no longer believes its efforts to medicalize were sincere. Instead, she told me, “the movement tried to come up with something to make themselves more legitimate, other than ‘We want to save babies from abortion,’ and found a way to get federal monies”—the same funding Planned Parenthood and other legitimate clinics have long relied on to provide women’s health care and access to contraception—“and then did not know how to use it.”
In addition to the Title X funds, the Obria Group received over $578 million between 2020 and 2021 from President Trump’s COVID-19-related Paycheck Protection Program. Obria has also gotten funding from conservative states such as Texas, where it operates multiple centers, and where it benefited from a state program formerly called Alternatives to Abortion (now renamed Thriving Texas Families), which funds many CPCs statewide. In 2023, at least 19 states funded CPCs like Obria, commonly through “Choose Life” license plate programs, according to the Guttmacher Institute, a reproductive rights research group. In fiscal year 2022, crisis pregnancy centers received a total of $344 million in state and federal funds, according to an analysis of tax documents by the pro-choice group Health and Freedom Watch that was shared with the Guardian. Equity Forward, a progressive watchdog group, also found that from 1995 to 2024, more than $1 billion dollars in state tax dollars went to crisis pregnancy centers.
Hughes said she was disturbed by the lack of transparency as they received that money. “They’re misrepresenting themselves as medical clinics, but they really are not medical clinics,” she said. “If they would just say what they are, it would be so much nicer for patients.”
For decades, frightening tales have come out of CPCs. One reproductive rights advocate told me that she became an activist after visiting a crisis pregnancy center in Texas while pregnant 10 years ago. She said she was shown a “creepy” video of a man in a lab coat cutting up a baby limb by limb, warned she would get breast cancer or become infertile if she got an abortion, and told the abortion pill was illegal in Texas at the time—all of which was untrue.
But in the years since her visit, and in a post-Roe America, many CPCs have transformed their strategy. They’ve rebranded themselves with stylish websites geared toward millennial women, just as they’ve presented themselves as medical. The website for a CPC in Ohio, for example, speaks of its “empowering” and “comprehensive care” for women (despite not providing any abortion or contraception services), much of which is written in lowercase with punctuation marks that look like a mash-up of sparkles and a cross. Bella Health + Wellness, a CPC in Colorado, bills itself as a “life-affirming” medical clinic that “exists to make people whole,” and its website recently included stock photos of laughing young women alongside text that says they’re “in constant awe of what a woman’s body can do.” The language on the website for Obria brags of its “Whole Care for the Whole You” by board-certified physicians and registered nurses at its 21 medical clinics.
In 2018, some CPCs formed a new trade association called the Pro Women’s Healthcare Centers in Fairfax, Virginia, designed to be a consortium that “adheres to a set of standards and values.” Yet at a launch event during that year’s March for Life, an annual antiabortion rally in Washington, D.C., consortium members muddied the line between the religious and the medical. Dede Chism, a consortium member who co-founded Bella Health + Wellness in Colorado, for example, described the origin of her clinic this way: “For us, the Holy Spirit just came upon my daughter and I while we were in the high Andes of Peru finishing a medical mission, and the Lord said we must bring this care back home.” Neither Chism nor the consortium responded to a request for an interview.
Among the consortium’s other listed clinics are the Guiding Star in Tampa Bay, Florida, which boasts of providing “a ‘new norm’ in holistic women’s healthcare”; Tepeyac OB/GYN in Fairfax, Virginia, which claims to offer “comprehensive OB/GYN services” yet doesn’t offer contraceptives; and the Aid to Women Center, with multiple locations in Arizona, which lists “Abortion” under its pregnancy options menu but actually only provides abortion counseling. Despite the claims, again, none of these centers provide abortion or contraceptive services to women. (The consortium currently appears to have disbanded, but the clinics remain open.)
A 2021 report called “Designed to Deceive” by The Alliance, a coalition of state advocates from law and policy centers for women’s rights and gender equality, found that CPCs that were calling themselves medical clinics made claims that did not stack up. The report, which reviewed 607 centers in nine states, found that fewer than half of the clinics were clear about whether they actually had a licensed medical professional on staff; only 16.3 percent indicated having a staff physician; and none were clear about whether their medical professionals were employees or volunteers, or part- or full-time. The report also indicated some physicians working with CPCs are licensed in fields unrelated to reproductive health, including optometrists and chiropractors.
Among centers that said they had medicalized, the three most common services on offer were not actually medical: urine pregnancy tests one could easily get at a pharmacy, free maternal or baby supplies, and counseling. The report also found that the ultrasounds many of these clinics offer are “frequently non-diagnostic and obtained by untrained, unlicensed staff” and that many CPCs still “disguised the fact that they do not provide or refer for abortion.” Many also operated near abortion clinics such as Planned Parenthood, presumably to confuse and redirect patients.
When I visited the Obria clinic in a Los Angeles suburb—just blocks from a Planned Parenthood—it was when Hughes was still in charge. I was 15 weeks pregnant, and my visit began normally enough, with the urine test for pregnancy confirmation and a sonogram. As Hughes had promised, the sonographer was honest with me, when I asked, that Obria did not provide abortions, which seemed like an improvement over what I’d read about the CPCs of years past.
But when I spoke with a nurse practitioner, things got stranger. She asked me where I was “at with everything,” to which I replied that I’d been stressed and nauseous throughout my first trimester, but was planning to parent. She said that Obria could provide me with “spiritual, emotional, and mental support” for my pregnancy. But she added that if I was looking at termination at this point, it would have to be surgical, not by pill. In a brusque voice, she added that a doctor would have to “pull out the fetus piece by piece.”
While it’s true I was past the 11-week limit on medication abortions, at 15 weeks, I could still have had an aspiration abortion, and generally the fetus isn’t large enough by then to come out in pieces, according to a senior program manager for abortion services at a Planned Parenthood I spoke with. It took me a while to process the unsolicited, graphic, and nonmedical description of an abortion she’d given me. By this time, she had spent another 10 minutes giving me more standard pregnancy advice, leaving me wondering if she’d really given that description of abortion. At the end of the call, her voice suddenly became kind again in a way that felt inauthentic: “I want you to come back,” she said. “I don’t want you to walk out feeling overwhelmed and like you don’t know what to do.”
In making the move to go medical, reproductive rights groups say, CPCs may be less likely to use deception or aggressive scare tactics, as they did in the past. In my experiences there, the visits are sometimes more subtly coercive. State regulators say the shift toward not-always-brazen violations actually makes it harder for women to recognize these centers as having an antiabortion agenda—and harder for their offices to regulate. In June 2022, California Attorney General Rob Bonta’s office issued a consumer warning against CPCs, warning that “at first glance, crisis pregnancy centers may look like an abortion care clinic or reproductive health clinics.”
As Hughes explained it, “Obria has been very good at skirting rules by getting close to the line.” Bonta told me that his office can only step in when a clear line is crossed. “Ambiguity, confusion, being unsure—that’s not the experience that we, at the California Department of Justice, want for everyday people, patients, women,” Bonta said. “There should be clarity; there should be knowledge about what offerings are provided by the clinic you are walking into.”
In September 2023, Bonta’s office announced it had filed a lawsuit against RealOptions, an affiliate of Obria Inc. (which, according to the complaint, is a 501(c)(3) nonprofit organization that operates five clinics operating under the name “RealOptions Obria Medical Clinics,” but not the clinic that I visited), along with Heartbeat International, another antiabortion group, to stop them from using misleading claims to advertise abortion pill reversals. Both defendants have sought to dismiss the complaint; in late June, the court ruled against their attempts to do so.
In recently filed answers to the complaints following the ruling, both defendants continue to deny the allegations and that they are deliberately providing false or misleading information about the abortion pill reversal procedure. The procedure, which has been denounced by the ACOG as “unproven” and “not based on science,” involves prescribing a high dose of progesterone to a pregnant woman who has already taken the first of two pills in a medication abortion, in an effort to stop the abortion process.
At Obria’s annual gala in 2023, George Delgado, the self-described founder of the abortion pill reversal, was the keynote speaker. He told the audience that when pregnant mothers use it, “the one that was going to be the killer now becomes the savior.” The abortion pill reversal has become a top priority for many CPCs-turned-clinics.
When I got home from my visit to Obria, I opened up a packet the staff had given me, which contained a list of places for new mothers to get aid, a pocket New Testament, and some pamphlets from Focus on the Family, an evangelical Christian group. “Witness this miracle in the making,” one pamphlet read, followed by week-by-week updates on the development of the fetus. I was again struck by the conflation of the religious with the medical.
When I reached Focus on the Family, a spokeswoman told me the group did not just provide pamphlets to Obria; they were also directly involved in helping Obria medicalize. She said they’d provided funding to Obria clinics for “new, top-line ultrasound machines,” medical training, and, less directly, digital marketing, though they did not disclose how much.
A few weeks later, I visited Obria once more for another prenatal checkup, though by this point it was clear that if they were checking up on anything, it was that I wasn’t going to get an abortion. The nurse practitioner had asked me to come back, and this time I requested to visit their Compton clinic in Los Angeles County. According to a 2021 announcement posted on Obria’s website, the network opened a center in Compton after a pastor told Obria that unplanned pregnancies were on the rise there due to the release of county inmates who “were sexual predators…targeting young women” after they got out of jail.
“We will be moving right into the heart of the evil one, rescuing innocents from abortion and offering help and care to young women,” according to the announcement on Obria’s website. “We know we are entering into the enemy’s territory, and he won’t like it!”
The Compton center in Los Angeles County, which advertised as a “fully-licensed medical community care clinic and women’s health center,” is located in a trailer beside a Pentecostal church, with a sign out front that read “Every Life Counts.” Inside, I was again given a sonogram, during which they played my baby’s heartbeat. Then they sent me to meet a provider, who asked me twice if I planned to keep my baby. Both times, I told her yes, but she didn’t seem to believe me. A third time, she asked: “After you’ve heard your baby’s heartbeat, what do you plan to do?”
Inside an Obria clinic in L.A.
This time, I must have said yes more convincingly, because a broad smile broke across her face. “Congratulations!” she said, then led me out past a roomful of gifts, including rows of diapers and baby clothing, like a game show contestant who has won a prize. She said the clinic was giving me a few things “because you decided to keep the baby,” and then introduced me to another woman, who handed me a plastic bag containing diapers and wipes. The woman told me the clinic would be in touch with support, and then sent me on my way. I never heard from Obria again.
As a journalist, I knew from the time I walked into Obria that they were approaching me from an antiabortion perspective, if not with an outright agenda. But Hughes said other women who visited Obria didn’t have the same knowledge. Several times during her tenure, she said, the Texas antiabortion group Human Coalition, which maintains its own CPC network, sent women to an Obria clinic who thought they could get an abortion there, only to learn upon arrival that they could not. (The Human Coalition did not respond to a request for an interview.)
Hughes’ position was that Obria should give women information about their options and leave it at that. “You don’t want people coming in who want an abortion and then you say no—they lose their mind,” she said. The “psyche” of a person who is deciding to terminate a pregnancy, Hughes added, is “just not something you should be playing with.”
In Obria’s email from last August announcing Hughes’ replacement, the board wrote that a transition was needed to “better fulfill our mission.” The email also urged supporters to “continue to be a valuable partner during this time, as the demand for our services continues to rise with the reversal of Roe v. Wade.”
With Roe overturned and with many states increasingly hostile to abortion access, clinics like Obria, Bella, and other CPCs-turned-clinics across the country are able to access a host of new government funding that moves them closer to their goal of rivaling Planned Parenthood. Since the Dobbs Supreme Court decision, 19 states have allocated roughly $250 million in taxpayer money to CPCs. In April 2023, Texas voted to increase funding by $80 million for CPCs, while at the same time Tennessee allotted $20 million to such clinics in its budget. Should Republicans retake Congress and the presidency in 2024, these clinics may see a gold rush of federal funding as well.
In the wake of Hughes’ departure, at least one CPC that Obria had helped transition to a medical clinic closed and became a CPC again. The Texas clinic briefly offered prenatal care, well-women exams, and STD testing before ending those services, citing a dearth of reimbursements from insurance as the reason, after less than six months in operation.
In Obria’s Easter email sent last spring, the new CEO, Henry W. Taylor—a man with a fundraising background and no health care experience—sent out a photo to supporters of a baby wearing bunny ears and holding a carrot, and wrote: “Thank you for choosing life and standing with us as we speak love and life to everyone that walks into our clinics.” The email contained a link to donate, which boasted that between January and September of 2023, 1,452 babies had been “saved” by its clinics, though Hughes said Obria regularly inflated those numbers, since they didn’t follow a woman until birth.
When interviewed by video call, Taylor said that “saved” meant that a “pregnancy was taken to term and the baby was born.”
Taylor also shared his plan for Obria’s future: sex education programs for children and adults, more support to fathers—particularly African-American fathers, he said—in helping women choose to give birth, and opening more Obria clinics in states across the U.S. He recently hired all new senior staff, including a marketing person who would build nationwide brand awareness of Obria. With his background in fundraising, Obria would continue to look at “every source of funding,” he said. “The vision that I certainly embrace is growing that national network to an even larger footprint.”
In response to questions about CPCs’ history of deceptive practices, Taylor argued that it was unfair to lump in Obria with others, and said that after recently visiting nearly all of Obria’s 21 clinics, he saw only “substantive and high-quality” care. He said that, with the help of a medical advisory board, Obria would continue to medicalize, and that some of their clinics are already offering women not only ultrasounds, pregnancy tests, and STD testing, but also Pap smears, and screening for cervical cancer and gestational diabetes.
As always, Obria will not provide birth control, abortions, or abortion referrals, he said. On its current website, small print cautions that “Obria Medical Clinics do not perform nor refer for abortions.” But, Taylor said, “Even when a woman chooses to have an abortion, we are still there to support her after that. We do that because of our Christian faith, not in spite of it.”
As for Hughes, she moved on to a medical center outside of California—where she says she can help women without being surrounded by zealots. She remains opposed to abortion, but she has a message for pro-life medical clinics: “My strong feeling is that if a woman is on the fence, and there are things you can help them with, that’s great,” she said. “But if someone is completely determined to [get an abortion]…you don’t spend an hour browbeating her. You give her the information and let her go make her own decision.”
Elizabeth Flock is an Emmy Award-winning journalist and author of The Furies: Women, Vengeance, and Justice. Her work has also been featured in the New Yorker, the New York Times, and The Atlantic, and on PBS NewsHour and Netflix, among other outlets. She is the host of Blind Plea, a podcast about criminalized survival from LemonadaMedia. Her reporting is supported by the Pulitzer Center, PEN America, and the International Women’s Media Foundation. Her first book, The Heart Is a Shifting Sea, won a Nautilus Book Award for books that inspire and make a difference. She lives in Los Angeles and Chicago.