Advocates: Pregnancy care centers lack regulations, training to provide care for Hoosiers
The Indiana Senate passed a resolution in support of pregnancy care centers — but advocates said they have “serious concerns” about the move from lawmakers. Some OB-GYNs said it’s important to understand what pregnancy care centers are, and what they are not.
Pregnancy care centers, or crisis pregnancy centers, are nonprofit organizations that present themselves as health care clinics. But they’re not regulated as health care facilities, which means they aren’t held to the same standards.
Dr. Caroline Rouse is a maternal fetal medicine specialist and an advocate with the Good Trouble Coalition. She said OB-GYNs are required to train for years to read ultrasounds. Her specialty includes even more training on top of that.
But, Rouse said people working in pregnancy care centers aren’t required to have training, specialized or otherwise.
“Ultrasound can be very complicated, and missed diagnoses or erroneous diagnoses can be very dangerous,” Rouse said. “Ectopic pregnancy can be challenging to detect and diagnose on ultrasound and it requires the expertise that we as, for example, OB-GYNs have that people who have not been through our training and experience would not have.”
Rouse’s example requires identifying when a fertilized egg implants and grows outside the main cavity of the uterus. She said the lack of regulation and training can lead to a misdiagnosis or delayed prenatal care.
This can make an ectopic pregnancy, which is already dangerous and has risks, even more deadly, according to Rouse.
Dr. Verónica Santana-Ufret, an OB-GYN resident and an advocate with the Good Trouble Coalition, said these centers can add confusion for patients and their medical providers. As someone currently training in the state, she said she’s helped triage patients as they come into the hospital.
Santana-Ufret said it becomes a real issue for patients and providers down the line when an early diagnosis is missed.
“Because their initial point of contact, as far as medical care went, was one of these health centers. And they don’t do some of the testing that you would do at a hospital or maybe their ultrasonography skills aren’t quite as good,” Santana-Ufret said.
Santana-Ufret said it already affects the health of patients in Indiana. She said Senate Concurrent Resolution 24 further legitimizes pregnancy care centers. She said Indiana needs to move in a direction that helps connect people to OB-GYN care, but she said SCR 24 undermines medical expertise, education and training.
“To see those things delegitimized and devalued, continues the trend that makes it hard as physicians to form trusting relationships with patients. And makes it feel like sometimes we’re fighting an uphill battle with trying to get people the care that they need,” Santana-Ufret said.
Because they aren’t medical facilities, Rouse said pregnancy care centers are not held to the same standards when it comes to things like patient privacy, medical records or providing full and accurate information.
“There’s a lot of published data suggesting that part of their proposition is to dissuade people who may be seeking abortion care,” Rouse said. “And since again, they’re not medical facilities, they’re not required to give patients all of the information that that patient may need to make the right decision for themselves and their family. So, you know, not giving complete information and or giving erroneous information about their gestational age, about what abortion options may be, about risks associated with abortion.”
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Rouse said it’s important for people to pay attention to where they are accessing care and what standards the people working there are required to meet.
“Some of these centers are very good at making themselves look like legitimate medical facilities,” Rouse said. “I would say to really prioritize seeking out prenatal care with obstetric care providers like certified nurse midwives, OB-GYNs, and many family practice providers provide obstetric care.”
Both Santana-Ufret and Rouse noted the shortage of obstetrics care providers in Indiana, and said these centers are also aware of that shortage.
“They were taking advantage of the challenges that patients have to face with an overloaded OB-GYN system in general and offering them something that seems more accessible,” Santana-Ufret said.
Almost 25 percent of Indiana counties are considered obstetrics care deserts, which means there’s no provider or delivering hospital.
Rouse said it’s easy to understand why a patient who may think that they are pregnant or wants a pregnancy assessment would go to one of these centers. She said they can seem more accessible when all someone needs to do is confirm a pregnancy — but she cautions against that.
“While there are challenges in the state of Indiana for accessing OB-GYN care, I would say that it is still really important to be getting medical care when you think you’re getting medical care,” Rouse said.
Santana-Ufret said lawmakers should focus their energy into actions that will support the obstetrics care providers that are supporting Indiana patients. She said that includes supporting efforts to increase access to OB-GYN care — especially in rural areas, address workforce shortages and protect the Medicaid programs that support lower-income pregnant people.
Abigail is our health reporter. Contact them at [email protected].
