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Abstract
INTRODUCTION: In 2022, Dobbs v. Jackson Women’s Health Organization overturned the federal right to abortion in the United States (U.S.), resulting in increased travel times and distances to abortion providers, especially in states with abortion bans or restrictions. Meanwhile, crisis pregnancy centers (CPCs), which use deceptive tactics to delay or deter individuals seeking abortion, have sustained or expanded their presence in these states, maintaining proximity to abortion facilities and strong online visibility. METHODS: This work evaluates the impact of Dobbs by assessing changes in proximity between brick-and-mortar CPCs and abortion facilities pre- and post-Dobbs and measuring CPCs’ presence in national Google search results for abortion-related search terms, focusing on states with abortion bans or restrictions. RESULTS: Post-Dobbs, the number of census block groups with both a CPC and abortion facility within 15 miles decreased by 8%. Block groups that gained a CPC were 2.5 times more likely to be in states with bans or restrictions (p=0.02). Nationally, nearly 10% of block groups lost access to an abortion facility, with the largest decline in the South (22%). Block groups that lost access had higher mean numbers of reproductive-aged women, non-White residents, and people living below the poverty line. Online, nearly 10% of all “abortion near me” search results were CPCs, while 61% were abortion providers. The odds of a search result being a CPC were 45% higher in states with bans or restrictions (p=0.008). In 73% of U.S. counties, search results included at least one CPC with the highest proportions in the South and Midwest, and nearly 40% included two or more. Among all CPCs in states with bans or restrictions, a larger proportion in abortion-related search results advertised abortion screening services online (19% vs. 5%, p<0.001). CONCLUSIONS: Post-Dobbs, abortion facility access declined in states with bans or restrictions, while CPCs remained prevalent. CPCs are highly visible online despite policy efforts to minimize their reach. As states restrict abortion and increase funding and support for CPCs, these centers will continue to employ deceptive tactics to redirect individuals seeking abortion to their physical locations and websites, potentially worsening disparities in vulnerable communities.