Sandpoint, Idaho — An anti-abortion pregnancy center on the outskirts of this Idaho Panhandle town greets visitors with an abridged Bible verse painted on the wall of its waiting area: "Come to me & I will give you rest."

7B Care Clinic has been operating in Sandpoint since 2001 and was previously called Life Choices Pregnancy Center and Sandpoint Crisis Pregnancy Center. It is an affiliate of a nationwide network of Christian evangelical centers called Care Net. 7B, one of about 1,200 pregnancy centers affiliated with Care Net, offers pregnancy tests, limited ultrasounds, parenting and life skills classes, community support groups, and other free resources, such as children's clothing. Donations from people, businesses, and more than 40 churches keep 7B's operations running, Executive Director Janine Shepard said.

Such centers are known as crisis pregnancy centers or pregnancy resource centers. They offer limited resources and medical services to pregnant women and aim to dissuade them from having abortions. Healthcare groups including the American College of Obstetricians and Gynecologists have said many crisis pregnancy centers use unethical and deceptive practices to bring women into their organizations.

Traffic at 7B has picked up since the local hospital shuttered its labor and delivery unit and its OB-GYNs moved out of state three years ago. The closure left a hole in reproductive health services in this town of more than 10,000 on the shores of Lake Pend Oreille and surrounding rural areas.

"We are seeing a lot more people," Shepard said.

By December 2024, more than two years after the U.S. Supreme Court overturned nationwide abortion rights in its Dobbs decision, Idaho had lost a third of its OB-GYNs. 7B is expanding, with the goal of bringing obstetric care back to Sandpoint. The organization plans to add to its current building once it's paid off, Shepard said, and it's in talks with a hospital about 30 miles away in Washington state to bring in an OB-GYN once a week to provide prenatal care.

If obstetric care existed now in Sandpoint, Shepard said, "we wouldn't even be considering" the expanded services. "But there's such a need. And our community suffers because of it."

As rural communities face the closure of hospitals and labor and delivery units, crisis pregnancy centers are growing in influence. Some states have approved legislation granting the organizations greater protections from oversight and regulation, and clinics have seen a massive influx of state and federal funding in recent years.

In a town with limited maternity care, 7B has been providing important resources to struggling low-income women. But critics say the religious nonprofit, which is not medically licensed and isn't required to meet regulatory standards for medical facilities, has an agenda that makes it an inappropriate place for pregnant patients to seek medical care.

Jen Jackson Quintano, a Sandpoint resident and the founder of the Pro-Voice Project, a nonprofit that advocates for abortion rights in Idaho, said crisis pregnancy centers mislead patients by drawing them in with the offer of free pregnancy-related services before delivering their anti-abortion pitch.

"We all need clarity on what those services are: ministry-first, rather than comprehensive medicine," Quintano said.

Shepard said there are misconceptions about the organization, and she invites people to take a tour of 7B to learn what it does. She said her staff talk to pregnant women about abortion, adoption, and parenting as options and hope they feel supported enough to make a "life-affirming" decision.

7B reflects a trend of crisis pregnancy centers seeking to expand their operations in maternal care deserts and regions with gaps in women's healthcare, said Andrea Swartzendruber, an associate professor of epidemiology and biostatistics at the University of Georgia College of Public Health. Swartzendruber has studied and mapped crisis pregnancy centers in the U.S. since 2018.

"Crisis pregnancy centers have, for years and years, capitalized on gaps in access to healthcare," she said. "In no way, shape, or form do crisis pregnancy centers have the infrastructure or ability or training to bridge those gaps."

According to Swartzendruber's research, more than 2,600 crisis pregnancy centers operated in the U.S. as of 2024, more than three times the number of brick-and-mortar abortion clinics. Many centers have been found to engage in manipulative and deceptive practices with clients, including putting misleading information on their websites making them appear to be legitimate medical clinics with the goal of attracting women who are seeking abortions.

The organizations are also seeing support from the Trump administration. On May 10 — Mother's Day — the Department of Health and Human Services debuted a website sharing resources and information for new and expectant mothers. It includes a map to find pregnancy centers, which cites services the centers provide, such as pregnancy options, pregnancy tests, ultrasounds, and medical referrals.

"The perfect place for this"

Sandpoint is a small mountain town in a deeply conservative and Christian part of a state with a strict abortion law put into place after the Supreme Court overturned Roe v. Wade.

Amelia Huntsberger, one of the OB-GYNs who left Sandpoint three years ago, said the town is "the perfect place for this," referring to the expansion of the 7B Care Clinic.

In underresourced areas, the benefits that crisis pregnancy centers may bring are welcome.

Lori Sabin, a licensed midwife in Bonners Ferry, about 30 miles north of Sandpoint, said that 7B is a helpful resource to the community, especially for people who struggle to get healthcare because of a lack of health insurance or who face challenges in traveling for care.

"The nicest thing about 7B is all their services are free," Sabin said, adding that the classes and free baby items are particularly helpful for young first-time mothers. "They can point them in the right direction. They tell them where the midwives are; they tell them where the OBs are."

Huntsberger, who practiced in Sandpoint for more than a decade and now lives in Oregon, also acknowledged the benefits she saw 7B bring for patients, including the parenting classes and support groups. But she has concerns about its resemblance to a medical facility that provides healthcare.

Lisa Battisfore, founder of Reproductive Transparency Now, a Chicago-based organization that provides education and outreach about crisis pregnancy centers, acknowledged that the limited services they provide can be helpful but said the bad outweighs the good.

"If someone needs diapers or someone needs formula and a crisis pregnancy center is willing to give that to them, it's difficult to say that that in isolation is a bad thing, but you have to look at the bigger picture," Battisfore said.

Crisis pregnancy centers are largely unregulated and are protected by First Amendment rights to free speech and religious exercise. The Supreme Court recently allowed crisis pregnancy centers to go to court to block a state attorney general's subpoena for donor funding information. Critics say lack of oversight allows centers to spread misinformation about abortion and abortion pill "reversal," a procedure the American College of Obstetricians and Gynecologists has called "unproven and unethical."

Crisis pregnancy centers have won big legal victories against states trying to increase regulation and oversight. Those protections have allowed some of the organizations to blur the line between anti-abortion activism and medical care.

"They seem to be really good at walking on both sides of that line when it suits them best, and that does not suit pregnant people best," Battisfore said.

She referenced a recent case in Texas in which a woman was hospitalized for an ectopic pregnancy days after she received an ultrasound and a clean bill of health from a crisis pregnancy center. An OB-GYN who works with the Abundant Life Pregnancy Resource Center told The Dallas Morning News "there is nothing to fix" when asked about the error. There have been other reported cases of misdiagnosis at crisis pregnancy centers.

What's next for Sandpoint

Bonner General Health angered a lot of locals when it closed its labor and delivery unit three years ago. Residents lamented that women needed to travel farther to give birth and mourned the loss of the OB-GYNs. Since then, the hospital has been working to rebuild trust with the community.

This year, the hospital created a women's health committee that includes hospital board members, staff, and others. Hospital CEO John Hennessy and Chief Medical Officer Stacey Good, a physician, said their priority is to hear from the community and increase awareness about the women's healthcare that's still available.

Women can still receive a range of services, including prenatal care from a nurse practitioner who travels to Bonner General from Coeur d'Alene once a week and other clinicians who can provide more basic gynecological care. A position for a gynecologist at the hospital has been open since May 2023, and Hennessy said filling it remains a priority.

Sandpoint resident Makayla Sundquist, a licensed counselor, grew up in town. She got married last year and has been thinking about starting a family with her husband. She wondered if she would feel safe knowing she'd need to travel at least an hour to the nearest hospital with labor and delivery services.

But she also has doubts about 7B as a potential option for local care. She was skeptical that an anti-abortion, faith-based organization would provide accurate information on the options available to her.

"It is something that I do think about and do have fear about," Sundquist said. "I wish that wasn't my reality."

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