Crisis Pregnancy Centers Under Scrutiny Over Ectopic Pregnancy Screening Claims

A lawsuit against a Massachusetts crisis pregnancy center has put a clinical spotlight on whether CPCs can safely perform ultrasounds to rule out ectopic pregnancy — a question with direct legal and patient-safety consequences as the sector expands its medical footprint.

Clearway Clinic, a crisis pregnancy center in Worcester, Massachusetts, was sued in 2023 for allegedly failing to diagnose a patient's unviable ectopic pregnancy, according to NBC News. The case is among the clearest examples to date of litigation testing whether CPCs can bear the clinical duty of care that comes with offering diagnostic ultrasound services. In response to documented safety concerns, some CPCs have been advised to stop performing ultrasounds when ectopic pregnancy is suspected.

What Diagnosis Actually Requires

The clinical bar for ruling out ectopic pregnancy is specific. Transvaginal ultrasound is the primary imaging modality — it allows visualization of the exact location of a pregnancy and detects ectopic implantation by identifying a yolk sac or embryo in the adnexa. The Ectopic Pregnancy Trust notes that a first transvaginal scan detects over 70% of ectopic pregnancies, but the American Academy of Family Physicians is explicit that definitive diagnosis requires ultrasound visualization of a yolk sac and/or embryo in the adnexa — a finding that demands trained interpretation. When clinical indicators such as vaginal bleeding or abdominal pain are present in the first trimester, Medscape classifies bedside ultrasonography as indicated.

Ultrasound alone is not sufficient for exclusion. HCG blood tests — which quantify serum hormone levels — are necessary to rule out ectopic pregnancy in equivocal presentations, NBC News reported. Most CPCs do not have on-site laboratory capacity to run serial HCG panels, a gap that limits their ability to manage the diagnostic workup when transvaginal ultrasound is inconclusive.

The CPC Funding Landscape

The Clearway lawsuit sits inside a broader policy environment shaped by federal funding flows to the CPC sector. The Government Accountability Office published a report in March 2026 covering fiscal years 2018 and later, documenting federal funds obligated to CPCs. The Sexual Risk Avoidance Education program — one of the federal channels through which CPCs have received grants — funded Crisis Pregnancy Center of the Lehigh Valley in fiscal year 2025, according to HHS grant records.

At the same time, the Trump administration has moved aggressively to redirect federal reproductive health dollars. In April 2025, it withheld funding for 22 grants under Title X, the federal government's sole dedicated family planning program, according to the Guttmacher Institute. A separate funding freeze affected $27.5 million in grants to organizations supporting contraceptive services, KFF reported. The administration's fiscal year 2026 skinny budget requests a 26.2 percent cut to the Department of Health and Human Services from 2025 levels, per the Commonwealth Fund.

The net effect is a funding environment that has squeezed traditional Title X grantees — many of which are full-scope reproductive health clinics — while federal grant streams that flow to CPCs remain intact or grow. That asymmetry matters for patients seeking first-trimester care who may encounter a CPC as their primary or only accessible option.

Why It Matters for Policy

The Clearway case is a live stress test for whether crisis pregnancy centers can sustain malpractice exposure commensurate with the clinical services they advertise. Ectopic pregnancy carries a roughly 1-in-50 prevalence rate among symptomatic first-trimester presentations, and a missed diagnosis can be fatal within hours of rupture. The standard of care in emergency and primary care settings calls for the combination of transvaginal ultrasound and serial HCG quantification precisely because neither tool alone is sufficient in every case.

CPCs operate in a legally ambiguous space: some states license them as limited-service pregnancy centers, which carries disclosure requirements but not the full clinical accountability framework applied to licensed medical clinics. Litigation like the Clearway suit is one of the primary mechanisms through which that accountability gap is being tested in the absence of comprehensive federal or state regulatory standards.

For congressional staff, state health officials, and Title X administrators tracking the sector, the Clearway case and the GAO's March 2026 funding report together represent the sharpest convergence yet of clinical safety questions and federal appropriations oversight around crisis pregnancy centers.