We Need to Talk About ICE and Anti-Abortion Centers

These groups prey on immigrant women and collect their data. It's not hard to imagine what happens next.

We all know anti-abortion crisis pregnancy centers don’t offer real health care. They set up shop near actual clinics to lure in potential abortion seekers, collect their data, and inundate them with disinformation designed to dissuade them from seeking abortion. But under the Trump administration, these over-funded fake clinics are situated to play another potential role: enforcing Republicans’ racist immigration policies by targeting vulnerable, pregnant immigrant women.

And because CPCs aren’t real health providers, many aren’t bound to the same medical privacy laws. That means they can share people’s personal information with the government—and many do, as a condition of receiving state funding. CPCs have become the enforcement arm of not just the anti-abortion movement, but also, increasingly, the government itself.

With CPCs’ renewed focus on Spanish-speaking communities, it’s not hard to imagine what happens next. Already, in 2017, pregnant immigrant women and girls who found themselves in federal custody and requested abortion care were sent to CPCs instead.

Lupe M. Rodriguez, executive director of the National Latina Institute for Reproductive Justice, has witnessed firsthand how anti-abortion organizations prey on immigrants and Spanish-speaking patients.

Immigrants and Spanish speakers are at greater risk of being reeled into CPCs, Rodriguez says. They’re more likely to be uninsured, less familiar with the United States’ overly complicated health system—especially this country’s head-spinning abortion access landscape—and more vulnerable to CPCs’ offers of free ultrasounds and other services.

Rodriguez and her colleagues once met a family in the Bronx who turned to a local CPC as their sole health provider—not realizing that they weren’t really receiving health care at all. “They’d just immigrated to this country and weren’t familiar with all these systems,” Rodriguez explained.

And, again: It’s not just that immigrant women are more vulnerable to being preyed on. During Trump’s first term, immigrant minors in federal custody who asked for abortions were deliberately sent to CPCs. Trump’s Office of Refugee Resettlement (ORR) maintained a list of “Trusted Providers in HHS Cities”—almost all of them CPCs. And a 2017 ACLU lawsuit alleged that ORR had a policy of forcing detained immigrants who were considering abortion to receive counseling at these anti-abortion centers.

At these facilities, patients are spied on, told that abortion and birth control are unsafe, or sometimes lied to that they’re too far along in their pregnancies to have an abortion—preventing them from trying.

CPCs posed a disparate threat to immigrant communities long before Dobbs, but these threats have recently escalated: Republicans’ new, sweeping budget bill both defunds reproductive health care, threatening to shutter one in four abortion clinics, and invests over $100 billion in ICE and border enforcement.¹ And in a landscape where CPCs outnumber abortion clinics 3:1, more abortion seekers will unwittingly find themselves at fake clinics that have no problem collaborating with law enforcement.

Policing, surveillance, and state violence against immigrant communities are sharply on the rise under this administration. And it’s been abundantly clear for years now that CPCs aren’t protecting the patient data they collect—including through intake forms that sometimes ask about citizenship status and a range of other invasive questions. Again, CPCs don't adhere to standard patient privacy laws like HIPAA, even though they often lie that they do. As usual, attacks on immigrant rights are inseparable from attacks on bodily autonomy writ large: That CPCs tend to prey on immigrants and Spanish speakers presents a rising, unspoken risk to immigrant communities.

CPCs collect patient data—“for any and all purposes”

Most CPCs are members of a few massive anti-abortion conglomerates, or use the same internal management systems. One such organization is Heartbeat International, which operates the widely used Option Line chat program to allow these groups to communicate with prospective abortion seekers online. Heartbeat International’s own terms of use state that “all remarks” sent through Option Line can be used “for any and all purposes… appropriate to the mission and vision of Option Line.”

Heartbeat International’s network includes over 3,400 CPCs across the country, and CPCs that use the Option Line can share messages with anyone they choose to—that could potentially include immigration and law enforcement agencies. And that relationship is already well-established: During Trump’s first term, Heartbeat International created the list of CPCs and anti-abortion “counseling” services that immigrant detention centers were instructed to send pregnant women and girls to.

Heartbeat International has said of its data collection practices:

“Big data is revolutionizing all sorts of industries. Why shouldn’t it do the same for a critical ministry like ours?”

In October, Susannah Baruch, executive director of the Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics at Harvard Law School, told NBC that rank-and-file CPCs across the country share all patient data they collect with larger anti-abortion networks like Heartbeat International, adding, “We don’t know exactly what they would do with the information.”

Around the same time as that NBC report, the Campaign for Accountability wrote to state attorneys general in Idaho, Minnesota, New Jersey, Pennsylvania, and Washington, warning that CPCs in their states violate consumer protection laws by telling clients their personal health information is protected under HIPAA, even though that isn’t the case. (Abortion, Every Day first reported on this large-scale violation.)

And they’re not just collecting pregnant patients’ names and addresses—CPCs are compiling wide-ranging, detailed information from the people who walk through their doors.

When Abortion, Every Day reviewed intake forms from CPCs enrolled in Texas’ “Thriving Families” program, for example, we found they asked for an alarming amount of personal information—including citizenship status. The groups also wanted to know how far along women were in their pregnancies; the date of their last period; details about the biological father; a complete list of household members; who the head of the household was; birth control methods; STI and substance use history; mental health history; income; race; past abortions (including gestational age); and more.

Texas CPCs only receive state funding if they report client information to the government.

What’s more, CPCs appear to ramp up their trickery when creating materials for Spanish-speaking clients. Consider the English and Spanish webpages of this Care Net affiliate in central Texas: the Spanish homepage says “Access Abortion” in huge type, right up top; the English version simply says, “You Have Options.” (You can find a sampling of CPC websites at ChoiceWatch.org to look at the difference in Spanish-translated materials.)

The potential exploitation of language barriers extends beyond website copy. Consider how CPCs sometimes pressure pregnant people to give up their babies to the adoption industry, or live in exploitative maternity homes—and how much more vulnerable this confusing landscape is for new or non-English language speakers.

Intake forms and online correspondence, of course, are just one layer: We know what happens when individuals—often young, low-income, and desperate—enter these “clinics.” Last year, I spoke to Texas reproductive justice organizer Maleeha Aziz about her experience at a CPC when she was a teenager and had just immigrated to the country. She recounted feeling physically trapped at the facility and being forced to sit in a room “through 30 minutes of torture watching this propaganda video.”

Afterward, CPC staff used every minute she spent at the facility to collect highly personal information about her: “To this day, I don’t know what they used it for, if they still have it.”

“The whole time I was there, they kept talking to me, trying to make me feel like they’re my friends so I would tell more about myself—actual health care workers have never asked me the things they asked, like about my family, my life.”

Reporting to the surveillance state

Earlier this year, the Trump administration moved to rescind policies that once restricted immigration enforcement in sensitive locations like domestic violence shelters, hospitals, and churches. As a result, Rodriguez says “the fear of even seeking health care at all” has increased among immigrant communities.

And while most CPCs have never provided legitimate medical care, they do have a history of reporting data to—and actively colluding with—government agencies and law enforcement. That collusion takes on new meaning post-Dobbs for immigrants and those who have undocumented family members, in a climate in which pregnancy-related surveillance and criminalization are on the rise.

Trainings held by the anti-abortion Justice Foundation, for example, teach their members how to strengthen relationships with law enforcement. The organization even provides template letters for anti-abortion activists and CPCs, relaying how to ask police to intervene and stop wanted abortions. They instruct members to frame the abortions as coerced, and to tell police officers they have legal obligations to stop them.

“Your participation in, or failure to prevent, a forced abortion may subject you to personal liability,” one letter states. They even encourage police to use abortion as an excuse to go on a fishing expedition for other crimes:

“An involuntary abortion case is also a potential criminal case such as homicide, child abuse, kidnapping, domestic partner violence, etc., depending on the specific facts and upon your state's criminal law.”

And, according to the Justice Foundation, this strategy is effective. In one training video, the presenters recount successfully convincing police to stop a minor from having an abortion by claiming they were being coerced by their parents. The group’s influence is growing, as well: In May, the organization offered a similar training at a conference for Heartbeat International—the country’s largest network of crisis pregnancy centers.

The objective is clear: strengthening relationships between CPCs and law enforcement—relationships that, in many cases, are already established: A Care Net CPC in Dalhart, Texas, states on its website that it “[partners] with local agencies like CASA and the Dalhart Police Department.” In 2022, a network of CPCs in Florida sought to hire “off-duty police officers” for security. And the Maryland State Police has a history of donating goods to local CPCs—as do other police departments across the country.

Policing is innate to the anti-abortion movement; they are, after all, hellbent on policing our pregnancies. This is a natural alliance, with massive ramifications, especially for immigrant and other marginalized communities targeted by the state.

Relationships between CPCs and state agencies aren’t accidental; in some cases, they’re mandatory. Last August, the organization Equity Forward reported that since Dobbs, 23 states poured $500 million in state funding into CPCs. And in states like Texas and Florida, continued funding can be contingent on reporting client data to the government.

Texas CPCs, for instance, are required to report the number of clients, number of those enrolled in Medicaid, and other demographic information—including age, pregnancy gestation, number of children, marital status, and government assistance programs they may be enrolled in—to the state. In Florida, state law requires CPCs that receive state funding to report “demographic details and service counts for women, parents, and families served” by July 1 each year. At the same time, anti-abortion states are ramping up efforts to collect patients’ abortion-related medical data.

What’s happening isn’t even remotely subtle: Anti-abortion lawmakers are building the foundations for a reproductive police state that carries disparate harm for immigrant communities.

“It’s all connected”

Over the last several months, ICE raids have been perpetrated largely by masked, plain-clothes officers lacking anything to outwardly identify themselves as federal agents. There have been reported instances of civilians posing as agents to harass, assault, and kidnap people of color. There’s a striking parallel between people posing as ICE agents, and CPCs posing as health care providers, amid an overall political climate rife with so much deceit and manipulation that many people may be too confused or afraid to seek health care at all. At the same time, anti-abortion laws are increasingly enforced through incentivizing neighbors to surveil and snitch on each other.

Even trying to get an out-of-state abortion is fraught: Texas, for instance, is rife with immigration checkpoints that make it difficult to cross state lines. Or, like the Bronx family Rodriguez worked with, immigrant families are ensnared by CPCs that prey on them: In one Rio Grande Valley community where the National Latina Institute organizes, the reproductive health clinic that served as the primary health provider for the community’s Spanish-speaking, immigrant families recently shuttered. Since then, a CPC has set up shop exactly where the clinic once was.

“It’s very deliberate,” Rodriguez said. And as real clinics close and CPCs flourish, this is unlikely to be an isolated incident.

All in the same breath that Republicans target immigrant and Spanish-speaking pregnant patients and implicitly pressure or force them to give birth, they’re enacting a mass deportation agenda bent on tearing immigrant families apart.

“You can see a connection between all of the different types of ways our government, law enforcement, have tried to control people’s ability to make all kinds of choices—not just about abortion and reproductive health care, but about our families’ ability to stay together,” Rodriguez said.

“Family separation has always been a reproductive justice issue.”

You can learn more about how to support the National Latina Institute for Reproductive Justice’s work here. You can find and share resources on safely accessing abortion as a non-citizen at INeedAnA.com.

1. The portion of the bill that defunds abortion providers is being challenged in court and is currently blocked for some clinics.