You might have seen the billboards: A young woman, visibly pregnant, ethnically ambiguous, accompanied by the words “Pregnant? Scared?” Or “Pregnant? Need Help?” Or, even more to the point, “Pregnant and Alone?”

These ads, promising free and confidential help for women experiencing an unplanned pregnancy, are intentionally vague. The goal is to reach women who may be considering an abortion, and direct them to a Crisis Pregnancy Center, or CPC. At first glance, these clinics appear to provide free medical services, such as pregnancy tests and ultrasounds, while providing “non-biased” counseling for women considering their options. In reality, these clinics are often run by Christian nonprofits, with the primary goal of stopping abortion.

Over 3,500 CPCs in the United States are operated by three major organizations: the National Institute of Family and Life Advocates (NIFLA), Care Net (formerly the Christian Action Council), and Heartbeat International.

A recently released study from NARAL Pro-Choice America finds that CPCs engage in intentionally misleading strategies to reach women they designate as the “abortion-vulnerable.” According to NARAL, “every interaction a prospective client has with a CPC is carefully designed to give the impression that the CPC is a health-care clinic that provides comprehensive, medically-accurate counseling about all reproductive health-care options.”

That impression, they argue, could not be further from the truth.

In an effort to reach their intended target of women considering an abortion, CPCs have a history of vague, and even flat-out dishonest, advertising practices. Aside from the billboards, the umbrella organizations that run CPCs spend upwards of $18,000 a month on pay-per-click advertising. In 2014, Google removed ads for CPCs that were deemed “deceptive,” and in violation of Google’s advertising policy. According to analysis performed by NARAL and presented to Google, 79 percent of CPCs indicated they actually provided abortion services—the very thing they exist to oppose.

Another strategy the report uncovered is “co-locating” near actual health clinics. While most CPCs are not licensed medical facilities, proximity to licensed health-care providers can give the illusion of legitimacy. Herein lies the most egregious misleading practice of CPCs: allowing women to believe they are receiving sound medical advice from unbiased, qualified medical practitioners. The study found that the majority of CPCs provide inaccurate information on abortion risks, claiming strong associations between abortion and infertility, mental health issues, and even death.

Ultrasounds provided by many CPCs at no cost are “non-diagnostic and limited in scope.” In fact, CPC workers may not even be trained to read an ultrasound at all. As they aren’t technically providing “medical” services, they are not governed by any regulations. Several women collecting data undercover for NARAL reported that CPC staff required them to administer and read their own drugstore pregnancy test, allowing the centers to technically dodge the claim that they’re practicing medicine.

This facade of legitimacy can have disastrous results. In a widely reported case, one woman’s IUD was mistakenly identified as a fetus at two separate CPCs. In a statement provided to The Daily Beast, Roland C. Warren, president and CEO of Care Net, addressed the issue of medical services at their centers:

“Care Net-affiliated centers that provide medical services do so in accord with their state laws and operate under the direction of a licensed medical director. They don't just appear to be medical. They are medical. Also, every claim that Care Net advises its centers to make about the potential effects of abortion has been checked, double-checked, and triple-checked against the available social science and medical research, and those claims are solid and grounded in the research."The site makes a point of stating that some of the over 1,100 Care Net-affiliated centers provide medical services. It does not, however, disclose how many. It appears the small disclaimer at the bottom of the Care Net website is worth heeding: “This information is intended for general education purposes only and should not be relied upon as a substitute for professional and/or medical advice.”Perhaps the most shocking information the study discloses pertains to the millions of dollars of government funds diverted to CPCs across the country. They are eligible for federal abstinence-education grants because they do not provide comprehensive sexual education. In 11 states, they receive revenue from “Choose Life” license plate programs. They also receive numerous tax breaks. As Care Net’s site states, “Without tax-exempt status...it is nearly impossible to raise enough funds to operate.”Pro-choice organizations, such as NARAL and Planned Parenthood, want CPCs to be held accountable for their deceptive practices.“Planned Parenthood has long been concerned about the deceptive practices of CPCs. According to NARAL Pro Choice California’s report, 81 percent of CPCs in the state are unlicensed, and we believe the CPCs should be more upfront with the women they serve,” Kathy Kneer, president and CEO of Planned Parenthood Affiliates of California, told the Daily Beast. “We’re not asking them to be pro-choice. We’re asking them to be truthful and transparent.”