Reproductive health advocates worry that clinics operated by anti-choice activists could sow confusion among people seeking care during the COVID-19 outbreak.

Since most anti-choice centers are not licensed, they have no oversight, which could be dangerous as COVID-19 spreads, said Roxanne Sutocky, director of community engagement at The Women’s Centers.

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For continuing coverage of how COVID-19 is affecting reproductive health, check out our Special Report.

Networks of anti-choice clinics, or largely unregulated crisis pregnancy centers (CPCs), are staying open during the COVID-19 outbreak even though they don’t provide health care and use dishonest messaging that can confuse people seeking abortion services.

Meanwhile, reproductive health clinics are closing in a cratering U.S. economy and anti-choice organizations are pushing state officials across the country to use the pandemic as an excuse to suspend abortion rights—despite medical organizations like the American College of Obstetricians and Gynecologists saying abortion is time-sensitive, essential care.

In an April 2 email to supporters, Heartbeat International, an anti-abortion organization that has more than 2,800 affiliate clinics around the world, said it is “still open for business.” In a video that has since been taken down, Heartbeat International Vice President Cindi Boston said that calls to the organization’s hotline have increased during the pandemic. In another email on the same day, the National Institute of Family and Life Advocates (NIFLA), which has a network of “over 1,500 pro-life pregnancy centers and medical clinics,” claimed that its services are essential.

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But experts disagree, noting that anti-choice clinic services are nonessential and pose a unique risk to pregnant people and public health during the COVID-19 pandemic.

Katrina Kimport, an associate professor at Advancing New Standards in Reproductive Health (ANSIRH), told Rewire.News that the services CPCs offer wouldn’t be considered essential. In a study published in February in the journal Perspectives on Sexual and Reproductive Health, Kimport found that patients who visited these clinics largely came to confirm they were pregnant.

Some received a sonogram and what the centers call “options counseling,” which Kimport said “often had a religious component” and urges the person not to seek abortion care.

“None of the services they received were essential for the health and safety of them or their pregnancies,” Kimport said, adding that respondents didn’t know whether the people with whom they interacted were medical professionals. “In fact, most understood the people that they were working with to be volunteers.”

So even when respondents received care that was more specialized, it wasn’t delivered by a professional.

“Often the people who are doing the sonogram, based on my respondents’ experience, had pretty low training,” Kimport said. “All they were able to do was confirm that there was a pregnancy,” and they were unable to answer respondents’ questions. “The sonograms were not diagnostic, and, to that extent, do not serve a medical purpose.”

Rewire.News reached out to Heartbeat International and anti-choice clinic network Care Net about whether their centers would continue to remain open during the COVID-19 lockdowns, and what medical services they provide that would be considered essential; they did not respond.

As anti-choice clinics mostly staffed by volunteers stay open, reproductive health clinics are closing. On Monday, Planned Parenthood of Greater New York began laying off and furloughing workers, citing resources being strained by the pandemic, according to the Times Union. Planned Parenthood of Illinois has temporarily consolidated its services to six clinics. And a post on a blog run by Heartbeat International celebrated the closure of 11 California Planned Parenthood clinics and noted that states are asking people to temporarily delay “elective” and “nonessential” procedures.

The end of the Heartbeat International post states, “Many pregnancy help organizations (PHOs) are remaining open and amending their approach to adapt and streamline providing essential, life-saving services and resources to clients.” They do not clarify which of their services qualify as essential or how they are “amending their approach.”

NIFLA President Thomas Glessner said in an April 2 statement that the organization is committed “to equipping and protecting pro-life pregnancy centers” in the face of the COVID-19 pandemic.

“We are helping our network of more than 1,500 centers nationwide to pivot and meet essential needs during the difficult conditions brought on by the coronavirus,” Glessner said. “While advising our members to follow federal and CDC guidelines and reduce exposure risks, NIFLA is hosting weekly online training with updates, policies, and procedures designed to help centers operate during the rapidly-evolving crisis without shutting down.”

Glessner told Rewire.News that the organization is encouraging its member clinics “to continue serving their communities while adhering to all federal and CDC guidelines to prevent the spread of COVID-19.” He said the organization’s clinics are essential during the pandemic because they provide “diapers, baby wipes, baby food, formula, prenatal vitamins, and other assistance.”

Meanwhile, anti-choice activists have cheered on governors and state attorneys general who have used the COVID-19 crisis to temporarily stop legal abortion care in their state.

Amanda Thayer, deputy national communications director at NARAL Pro-Choice America, said in a statement to Rewire.News that the anti-choice movement “will stop at nothing, not even a pandemic, to push their ultimate agenda to control women and ban abortion.”

“So-called ‘crisis pregnancy centers’ … ignore sound science, often lying to women and pregnant people about their full range of reproductive healthcare,” Thayer said. “Amid a global public health crisis, people need reliable information grounded in actual medical expertise.”

NIFLA, Care Net, and Heartbeat International have cited the virus in recent calls for donations. Save the Storks, an anti-choice organization that operates “Mobile Medical Units” in vans, is also trying to raise money to keep anti-choice clinics open.

Anti-choice clinics could soon get a lifeline from the Trump administration through small business loans made available through the COVID-19 stimulus legislation, which might exclude organizations like Planned Parenthood. The administration, rife with abortion rights opponents, has broken with precedent in recent years and funneled Title X family planning funds into clinics operated by anti-choice activists.

None of the anti-choice groups responded to Rewire.News’ request for comment on small business loans from the federal government.

Roxanne Sutocky, director of community engagement at The Women’s Centers, a network of five independent abortion clinics in Pennsylvania, Georgia, New Jersey, and Connecticut, told Rewire.News that the services the centers offer, unlike most of those offered by anti-choice clinics, are essential because they’re time-sensitive. They’re also being offered by licensed, legitimate providers.

“Abortion procedures or emergency contraception are all services that if there is a delay in access, there’s a risk that people may not be able to access that care at all,” Sutocky said. “Crisis pregnancy centers do offer a range of services like ultrasounds, pregnancy testing, and pregnancy options counseling. Those things could be time-sensitive, but as services not being provided by medical providers, that information could potentially be inaccurate.”

Since most anti-choice centers are not licensed, they have no oversight, which could be dangerous as COVID-19 spreads, she said.

“Reproductive health providers right now are making a lot of adjustments to protocols and procedures to make sure that we’re seeing people in a way that’s safe,” Sutocky said. “These places that don’t have that kind of relationship with the medical community or oversight by any public agency, how [are] they able to maintain the provision of services that are safe for the public.”

Even without a pandemic, Sutocky says anti-choice clinics create barriers to legitimate health care. Those barriers could have even more dire consequences now, as states quickly change their health-care protocols, and courts in some states rule on whether people can access reproductive care.

“The potential of [crisis pregnancy centers] to waste folks’ time when access tomorrow is not guaranteed is troublesome,” Sutocky said.