Payouts of forgivable federal loans to crisis pregnancy centers may total up to $10m while Planned Parenthood had to return $60m

Inside a crisis pregnancy center in Georgia, which offers free baby clothes and supplies in exchange for watching anti-abortion videos and pregnancy tutorials. Photograph: Khushbu Shah/The Guardian

Anti-abortion crisis pregnancy centers across the United States received at least $4m and possibly more than $10m in forgivable federal loans as part of the government’s first coronavirus bailout package, called the paycheck protection program (PPP).

Formally part of the Cares Act, the program was meant to give employers a cash infusion to retain employees just as coronavirus lockdowns caused revenue to nosedive. It allowed religiously affiliated and faith-based non-profits to apply.

Crisis pregnancy centers often operate out of storefronts with the look and feel of full-service reproductive health clinics. However, the organizations often provide “sham” medical treatments such as abortion “reversal” pillsoppose modern birth control methods and exaggerate medical risks of abortion to persuade women not to have them.

Doctors have described the centers as “legal but unethical”.

“Although crisis pregnancy centers enjoy first amendment rights protections [part of the US constitution], their propagation of misinformation should be regarded as an ethical violation that undermines women’s health,” wrote gynecologist Dr Amy G Bryant and co-authors in the American Medical Association’s Journal of Ethics.

The $4m-$10m range was calculated by examining data on PPP loans released by the US Small Business Administration. The SBA did not release exact amounts of loans, but published ranges for loans, for example $150,000 to $350,000. The total calculated is probably an undercount of the amount given to crisis pregnancy centers, since the SBA did not release data on loans under $150,000 and crisis pregnancy centers applied under a variety of industry categories.

The money given out to the centers, much of it in early April, paints a picture of a rush for cash among such organizations that the largest anti-abortion organizations promoted.

“Experts believe this program will be more popular than toilet paper, so act fast!” wrote Tony Gruber, the chief financial officer of the anti-abortion group Heartbeat International, as he announced a webinar on 7 April for members.

Heartbeat International claims to have 2,700 crisis pregnancy center affiliates worldwide, and was itself approved for a PPP loan of between $350,000 and $1m, according to data released by the SBA. Heartbeat International said it would save 42 jobs.

Crisis pregnancy centers seek “to prevent people from having and considering abortions”, said Andrea Swartzendruber, an assistant professor of epidemiology and biostatistics at the University of Georgia College of Public Health. Swartzendruber also spearheads the Crisis Pregnancy Center Map, which charts the location of more than 2,500 such groups.

“They also have secondary objectives too, which include Christian evangelism and promoting sexual abstinence before marriage,” said Swartzendruber.

The clinics are frequently more accessible than abortion clinics in the US, and have also spread internationally with American support. Their growth has also come at a time when abortion rights across the US have faced numerous efforts, especially from conservative state legislators, to restrict their ability to function.

The emergency funding given to crisis pregnancy centers represents an expansion of government support to anti-abortion organizations, at the same time as evidence-based family planning organizations have been systematically excluded from federal grant programs.

The PPP funding is in addition to up to $4m received by independent, anti-gay and anti-abortion lobbying groups. Meanwhile, the SBA has sought to claw back $80m Planned Parenthood received from the PPP. Planned Parenthood is the nation’s largest network of reproductive rights clinics, which provide a full spectrum of sexual health services, including abortion.

In at least one instance, PPP funding went to a crisis pregnancy center which had already received millions in federal family planning grants, and whose director had espoused theories promoted by white supremacists.

The SBA approved the Obria clinic in San Jose, California, for up to $350,000 in PPP loans, and the group said it would save 31 jobs. The Obria network of clinics already receives federal funding from the Trump administration, including a Title X federal family planning grant worth up to $5.1m over three years.

In a 2015 interview with the Catholic World Report, Bravo said abortion “threatens our culture’s survival”. She continued: “Take the example of Europe. When its nations accepted contraception and abortion, they stopped replacing their population. Christianity began to die out. And, with Europeans having no children, immigrant Muslims came in to replace them.”

The “white replacement theory” Bravo espoused is a common argument among white supremacists.

The Trump administration has also systematically excluded reproductive rights groups from the Title X program. In 2019, the administration instituted a “gag rule”, which barred family planning clinics from referring patients for abortion services. Existing federal law already barred these groups from using any federal money to pay for abortions.

The rule forced Planned Parenthood to abandon the program and $60m, even as Obria got a $5.1m grant. Obria was the first crisis pregnancy center to oppose birth control and abortion and and receive federal family planning dollars.