Imagine arriving at a clinic for a common medical procedure listed on the clinic’s website, only to learn that the clinic neither provides it nor refers to providers who do. Instead, the staff attempts to dissuade you from obtaining the procedure using moral arguments and scientifically inaccurate information. While disconcerting, this scenario plays out regularly in the thousands of unregulated pregnancy clinics (UPCs) (often referred to as crisis pregnancy centers) across the United States, as well as in other countries.
UPCs are nonprofit clinics, often religiously affiliated, that offer services like free pregnancy tests and ultrasounds with the intent of diverting and dissuading individuals from seeking abortion. UPCs have been criticized for falsely advertising themselves as full-service reproductive health clinics (e.g., depicting staff wearing stethoscopes or scrubs on their websites, or by claiming to provide “Options Counseling”), despite not providing services like abortion or abortion referrals, contraception, miscarriage management, or treatment for ectopic pregnancy. As UPCs are not staffed by medical providers and do not offer medical services (despite what their advertising may suggest), UPCs and their staff are not subject to regulatory oversight or federal privacy protections. Medical experts have warned that UPCs endanger health by delaying or preventing abortion care and promoting unproven and potentially dangerous treatments, such as abortion “reversal.”
Despite posing clear public health threats, UPCs are subject to relatively few transparency, oversight, and accountability mechanisms in the United States. Today’s ruling by the U.S. Supreme Court in First Choice Women’s Resource Centers v. Davenport provides yet another example of how UPCs wield First Amendment arguments to resist state regulation. Against this backdrop, international human rights law offers a useful framework for preventing private entities, like UPCs, from interfering with pregnant people’s ability to access abortion care, in addition to information about such care.
The U.S. Context
U.S. states have attempted to fill regulatory gaps around UPCs but have faced numerous challenges. In 2018, the Supreme Court struck down a California law requiring UPCs to disclose to patients whether they were unlicensed medical facilities, ruling that it violated First Amendment free speech protections. In the wake of that decision, states have sought to regulate UPCs through their public health powers, including by enforcing consumer protection laws, consumer privacy statutes, and medical licensing laws.
Yet, many of these tactics for responding to UPCs’ fraudulent and deceptive practices are also under threat. Today, the Supreme Court issued a decision that could make it more difficult for state governments to investigate UPCs under consumer protection laws. The case arose when a UPC in New Jersey sued to block the state’s attorney general from investigating it, arguing that the attorney general’s subpoena — which requested donor information — violated the UPC’s First Amendment right to free association. Siding with the UPC, the Court held that the UPC has standing to challenge the subpoena in federal court. Relatedly, in December 2025, a U.S. appeals court blocked the New York attorney general’s attempt to prevent UPCs from promoting abortion “reversal,” an unproven and potentially harmful “treatment.”
Meanwhile, some states have sought ways to better regulate UPCs, while others have moved in the opposite direction. States — including Kansas, New Hampshire, Oklahoma, and Wyoming — have introduced or passed legislation to shield UPCs from regulatory measures, and entitle them to damages when the law is violated. Equally alarming, the number of UPCs has dramatically increased since the Dobbs decision in 2022, as has taxpayer funding. In 2018, there were 2,500 UPCs in the United States (three times the number of abortion clinics). By 2024, this number had risen to 2,633. Between 2022 and 2023, state appropriations to UPCs increased by 78% from $184 million to $329 million. As a result, UPCs are taking in nearly $2 billion in annual revenue.
International Human Rights Law
UPCs may have originated in the United States, but they have since spread to countries all over the world. Other countries have begun exploring and adopting a range of mechanisms to counter UPCs’ deceptive practices, even before international human rights bodies directly examined their impact and reflected on State obligations related to their regulation.
South Africa’s Choice on the Termination of Pregnancy Act (CTOPA) of 1996, for example, penalizes any person found to “preven[t] the lawful termination of a pregnancy or obstruc[t] access to a facility for the termination of a pregnancy.” The Canadian government’s abortion website (Abortion in Canada), alternatively, warns that: “Crisis pregnancy centres are usually run by anti-abortion organizations. They often look like clinics or support centres, but they are designed to discourage people from getting an abortion.” In 2024, the government also considered legislation to amend the Income Tax Act to require registered charities (which receive tax benefits under the law) to explicitly disclose if they do not provide abortions, birth control, or referrals to such services as part of “abortion counselling.”
While its oversight bodies have yet to directly address UPCs, international human rights law offers a useful framework for examining and countering their deceptive tactics. The rights to health, information, and the benefit of scientific progress, among others, provide a compelling basis for increasing oversight and regulation of UPCs around the world.
The right to health includes the right to sexual and reproductive health. Human rights bodies have explained that this right encompasses both entitlements and freedoms, including the rights to “control one’s health and body” and make decisions free of coercion “regarding matters concerning one’s body and sexual and reproductive health.” Under the right to health’s AAAQ framework, States are to ensure that access to sexual and reproductive health services is available, accessible, acceptable, and of high quality. Under international human rights law, States are also obligated to protect the right to health — namely by preventing third parties from interfering with individuals’ full realization of that right. As a result, States have an obligation to ensure that UPCs do not undermine individuals’ ability to access abortion care, which would constitute an infringement upon the right to sexual and reproductive health.
The right to information is a central part of both the right to health and the right to the freedom of expression. The accessibility element of the right to health previously referenced explicitly encompasses “information accessibility.” In the context of reproductive health, the World Health Organization (WHO) provides that the right to information requires States to make “accurate, evidence-based abortion information available to individuals on a confidential basis.” At least one human rights body, moreover, has characterized the failure to provide a 13-year-old pregnant girl in Peru with information on abortion care as a violation of her right to freedom of expression. By failing to inform people seeking abortions of their options, UPCs are intentionally withholding information contrary to this right.
Finally, the right to benefit from scientific progress ensures access to medical advancements and protects against the spread of medical misinformation. One UN Special Rapporteur has stressed that women are “particularly targeted by pseudoscience put forward by those who want to maintain control over them,” specifically referencing attempts to restrict access to medication abortion. Accordingly, States are required to protect people from the “harmful consequences of false, misleading and pseudoscience-based practices.” Much of the information provided to abortion seekers by UPCs arguably qualifies as such, meaning that a State is obligated — under international human rights law — to protect individuals from their deceptive tactics.
Lawmakers and advocates in the United States face various challenges in effectively regulating UPCs. Following today’s Supreme Court decision, looking not only to the recent experiences of other countries but also to long-standing international human rights standards has the potential to unearth approaches to regulating UPCs’ deceptive practices and mitigating their harm to pregnant people throughout the country.
DISCLAIMER: The views and opinions expressed in this piece are those of the authors and do not reflect the views of the O’Neill Institute.
