To the Editor:

I am concerned about inferences and biases in the article about options for unintended pregnancies in the April 2025 edition of American Family Physician.¹ In the article, Table 2 on counseling resources for physicians and patients categorizes crisis pregnancy centers (CPCs) as a resource to avoid. This is unfortunate because CPCs are the only resource in the table that might specifically support a woman in continuing an unintended pregnancy and parenting. Instead, the listed website, crisispregnancycentermap.com, mischaracterizes all CPCs as “fake clinics.” I disagree with this disparaging generalization because I have volunteered as a family physician in three CPCs. These centers provided excellent care, classes, and physical resources for pregnant patients. In my experience, a CPC is a place where a woman with an unintended pregnancy can review her options and often receive ultrasonography and accurate pregnancy dating to inform her decision. She can also access extra resources for pregnancy and parenting if that is her choice. Rather than discouraging patients from seeking assistance from CPCs, I suggest that clinicians first visit the centers in their area to determine what kinds of services they provide.

In Reply:

Thank you for your thoughtful letter and for sharing your perspective as a family physician who has volunteered in CPCs. Your firsthand experience supporting patients facing unintended pregnancies is deeply valued, and we appreciate your commitment to their care.

Our goal in the article was to provide evidence-based resources for comprehensive, nondirective counseling on all pregnancy options, including continuation, adoption, and abortion. The inclusion of information about CPCs was not intended to dismiss their importance to patients who choose to continue a pregnancy, but rather to reflect documented concerns regarding the variability in services and accuracy of information provided at many of these centers.

Research has shown that many CPCs present themselves as medical clinics but offer limited or no licensed medical care. Studies have also identified dissemination of misinformation about abortion risks and reproductive health at many CPCs.¹ These concerns have been echoed by the American College of Obstetricians and Gynecologists, which emphasizes that CPCs often do not adhere to principles of informed consent or evidence-based counseling.²

We acknowledge that not all CPCs operate this way. We agree that clinicians who are considering referring patients to a CPC should personally evaluate local centers to ensure alignment with evidence-based, patient-centered care. We appreciate the opportunity to engage in this important conversation about how best to support patients facing complex reproductive health decisions.