One of the support groups of the largest crisis pregnancy center in the United States is to tell its member clinics to avoid prenatal ultrasound in women who suspect that they have ectopic pregnancies, according to the recordings obtained by NBC News of a recent group of a legal group that advises non -profit organizations based on faith. The guide occurs following a lawsuit against a Massachusetts center that erroneously diagnosed an ectopic pregnancy.
The National Institute of Families and Defenders of Life (NIFLA), a group that provides legal support and medical training for crisis pregnancy centers, advised the members of a meeting earlier this year that proceed with caution when giving an ultrasound to a woman who suspects that she can have an ectopic pregnancy, calling for the condition “the largest medical risk of the clinics”, according to the records of the presentation of the presentation of the presentation of the presentation of the presentation of the presentation of the presentation NBC, through a conference conference.
“I do not want to see any website or advertising, ‘come to us and we will rule out an ectopic,” said a NIFLA representative. “It is impossible to rule out an ectopic unless HCG is doing,” they added, referring to a blood test that measures hormonal levels to confirm a pregnancy.
In the Massachusetts demand presented in 2023, a crisis pregnancy center was accused of not diagnosing an ectopic pregnancy and causing a potentially deadly emergency for a client. The complaint claimed that Clearway Clinic participated in deceptive advertising, with the aim of persuading women to renounce abortions instead of “providing them with the range of medically appropriate options.”
The plaintiff, a world resident who remained in the anonymity in the lawsuit, claimed that the nurse who made her ultrasound scan in the center “did not undertake enough medical measures” to ensure that pregnancy was viable. The demand alleges that the woman’s fallopian tube broke approximately one month after ultrasound scan, “causing massive internal hemorrhage and emergency surgery that requires.”
After a favorable ruling from the lower court for the plaintiff, the crisis pregnancy center resolved the case in June 2024 without admitting responsibility.
Crisis pregnancy centers operate in the United States with the aim of persuading pregnant women to continue their pregnancies. Many open near abortion clinics, promoting family planning services and limited medical care services, such as pregnancy tests and ultrasound. Many generally do not offer regular prenatal checkups or gynecological services, nor offer abortion procedures, abortion medications or care for women who have spontaneous abortions.
According to Andrea Swartzendruber, an epidemiologist of reproductive health of the Faculty of Public Health of the University of Georgia that studies the crisis pregnancy centers, many centers have announced free ultrasound as a way to diagnose an ectopic pregnancy and take women through their doors.
“They talk about ectopic pregnancies in their advertising and on their websites,” said Swartzendruber. “They use it to participate and try to motivate people to come to ultrasound.”
An ectopic pregnancy occurs when a fertilized egg is implanted and grows out of the uterus. While the condition is rare, it affects only 1% to 2% of pregnancies, it can be potentially deadly. At the beginning of a pregnancy, symptoms can include vaginal bleeding or mild pain or cramps, but women may not realize that they are experiencing an ectopic pregnancy at that stage. The condition is diagnosed by an ultrasound, a pelvic exam or a blood test.
Some of the cases that Nifla has represented the clinics has reached the Supreme Court, including a 2018 case that delivered an important victory of the first amendment to the crisis pregnancy centers in California. Although Nifla did not represent Clearway Clinic in the case of Massachusetts, the center appeared as a member in 2023.
“Just when I am walking here, I received a call from a center,” said one of the lawyers in the recording, telling a story of a clinic that suspected that a client had an ectopic pregnancy. “They had a woman who was in cramps, and she said on a scale of 1 to 10, was just below a 6. And I’m like, Yikes, like, would not scan it.”
The lawyer acknowledged that the correct movement would be to send the client to the emergency room.
Nifla has issued a guide similar to its member centers in the past. A 2018 document entitled “Medical Policies and Procedures” advises to the centers that “if a patient has symptoms of an ectopic pregnancy or a spontaneous abortion, an ultrasound exam will not be offered and it is recommended, verbally and in writing, to obtain medical care immediately.”
According to Swartzendruber, that guide is not always attended by the industry.
“That seems a very marked change, especially since so many CPCs are using fear around ectopic pregnancy as a reason to enter and be scanned,” he said.
Nifla did not respond to multiple requests for comments.
Nifla training materials presented at the meeting and obtained by NBC News say that these health services create “access points” to “help prevent unwanted pregnancies and intervene in the lives of people who are more vulnerable to abortion.”
According to the American College of Obstetricians and Gynecologists, crisis pregnancy centers “represent themselves as legitimate clinics of reproductive health care that provide attention to pregnant people, but in reality they aim to deter people from accessing certain types of reproductive medical care, including abortion care and even contraceptive options.”
“Because the religious ideology of the owners and employees of these centers has priority over the health and well -being of women looking for attention in these centers, women do not receive comprehensive, precise and evidence -based clinical information on all available options,” says an article published in the Journal of Ethics of the American Medical Association.
During the NIFLA panel, lawyers and a participant doctor advised centers that against the scan of women who suspect that they have ectopic pregnancies.
After a audience member asked whether to scan a woman with low HCG levels, the hormone produced by the placenta during pregnancy, a doctor urged that audience member to reject the woman and be seen by her medical provider.
Human chorionic gonadotropin, or HCG, is colloquially known as the pregnancy hormone. According to the Cleveland Clinic, HCG levels increase after conception and continue to increase up to approximately 10 weeks after pregnancy. Low or HCG decline levels may indicate a spontaneous abortion or ectopic pregnancy.
“I am not scanning. If you have a low level like that, it could be early pregnancy, but that is one of the cardinal signs of ectopic and one of the cardinal signs of spontaneous abortion, slowly ascending HCG. Please, no,” said the doctor. “She already has a supplier. Leave it again.”
“She should return to her supplier,” added a legal representative.
Another slide deck of the summit, entitled “Bining: the impact of prenatal ultrasound”, advised attendees to “words to avoid legal risk reduction” during an ultrasound. The words listed are “good”, “good”, “ok”, “normal” and “perfect.”
Concerns about federal privacy laws
During the panel, a lawyer addressed another controversy that faces the centers: Federal Health Privacy Laws. While some crisis pregnancy centers offer limited prenatal care or gynecological services, they are generally treated by volunteers and are not bound by federal health laws. However, many of them declare in their privacy policies that they comply with the Federal Law on Portability and Responsibility of Health Insurance, known as Hipa. NBC News previously reported on letters to the general prosecutors of the State about possible privacy problems around the centers that announce their services as “compatible with hypa.”
At the NIFLA meeting, the representatives recognized privacy concerns.
“There is this movement not to say hypaa, and finally I got everyone to spell well. So I’m a bit annoying,” said one of the lawyers in the panel. “We want you to comply with these policies, but it is not announced as compatible with hypa.”
Debra Rosen, executive director of the reproductive defense group Health and Freedom Watch, said this approach can be misleading.
“Unregulated pregnancy clinics are disguised as medical facilities, they are not entities covered under Hipa, and for decades they have strongly withdrawn even against the most basic forms of responsibility,” Rosen said. “Women throughout the country face real damage since these marginal clinics catch them between illusions of confidentiality and the real legal protections they receive. This dangerous gap demands a legislative action.”
State requirements for ultrasound
Although the seminar guided attendees to exercise caution around ectopic pregnancies to avoid legal responsibility, NIFLA representatives also described the opposition of the organization to legislative efforts in some states to strengthen the license requirements around the ultrasound of health ultrasound. While pregnancy centers use a medical staff, much of the work done there is through volunteers, some without medical history.
“Some of them could be quite harmful to the centers,” said a representative. “Therefore, we want to make sure that if you listen to any invoice in your states, we want to know and want to help you with that.”
A representative of the State of Indiana, Democrat Maureen Bauer, said she presented the bill in response to an ectopic pregnancy that was lost in a crisis pregnancy center.
“That is why I presented HB 1094 to require a license for anyone who operates an ultrasound machine in Indian He identified with cypal pregnancy.
