Lawsuit Questions Whether Crisis Pregnancy Centers Can Safely Diagnose Ectopic Pregnancy

A Massachusetts lawsuit is raising questions about whether crisis pregnancy centers — clinics that often discourage abortion — can safely use ultrasounds to rule out ectopic pregnancy, a life-threatening condition. The case matters both legally and medically as these centers expand the services they offer.

Clearway Clinic, a crisis pregnancy center in Worcester, Massachusetts, was sued in 2023 after allegedly failing to diagnose a patient's ectopic pregnancy, according to NBC News. An ectopic pregnancy occurs when a fertilized egg implants outside the uterus — usually in the fallopian tube — and cannot survive. The lawsuit is one of the clearest tests yet of whether crisis pregnancy centers have the medical training and resources to take on this kind of diagnostic work.

What Properly Diagnosing Ectopic Pregnancy Requires

Ruling out ectopic pregnancy is not straightforward. The standard tool is a transvaginal ultrasound — a probe inserted into the vagina that gives doctors a close-up view of where the pregnancy is located. A transvaginal ultrasound can spot an ectopic pregnancy by finding a yolk sac or embryo where it shouldn't be. The Ectopic Pregnancy Trust reports that a first transvaginal scan catches more than 70 percent of ectopic pregnancies, but the American Academy of Family Physicians says a clear diagnosis requires a trained doctor to actually see the yolk sac or embryo in the ultrasound images.

Here is the catch: ultrasound alone cannot rule out ectopic pregnancy in every case. Doctors also need to run blood tests that measure pregnancy hormone levels. These tests help clarify unclear ultrasound results, NBC News reported. Most crisis pregnancy centers do not have laboratory capacity to run these blood tests on-site, meaning they cannot perform the complete diagnostic workup when ultrasound results are uncertain.

The Money Behind These Centers

The Clearway lawsuit comes at a moment when the federal government is shifting how it funds reproductive health services. The Government Accountability Office published a report in March 2026 about federal funding to crisis pregnancy centers in fiscal years 2018 and later, documenting the dollars involved. One federal program that channels money to crisis pregnancy centers — the Sexual Risk Avoidance Education program — funded the Crisis Pregnancy Center of the Lehigh Valley in fiscal year 2025, according to federal grant records.

At the same time, the Trump administration has reduced funding for traditional family planning clinics. In April 2025, it withheld funding for 22 grants under Title X, according to the Guttmacher Institute. Title X is the federal government's main program for funding family planning services. A separate freeze affected $27.5 million in grants to organizations providing contraceptive services, KFF reported. The administration's budget proposal for fiscal year 2026 requests a 26.2 percent cut to the Department of Health and Human Services from 2025 levels, per the Commonwealth Fund.

The result is a funding environment where traditional family planning clinics have lost federal money while the federal grant streams to crisis pregnancy centers have stayed the same or grown. This shift matters because some patients seeking early pregnancy care may end up at a crisis pregnancy center simply because it becomes their only available option.

Why This Matters

Ectopic pregnancy occurs in roughly one in every 50 early-pregnancy cases that involve symptoms like bleeding or pain. A missed diagnosis can be fatal within hours if the pregnancy ruptures. That is why doctors in emergency rooms and primary care clinics use both transvaginal ultrasound and blood hormone tests — neither one alone is enough to safely rule out ectopic pregnancy in every situation.

Crisis pregnancy centers exist in a gray legal zone. Some states license them as limited-service pregnancy centers, which comes with certain disclosure rules but not the full medical accountability that applies to licensed clinics. Lawsuits like the Clearway case are among the main ways that accountability gap is being tested in court, since there are no comprehensive federal or state rules governing what crisis pregnancy centers can and cannot do.

Congressional staff, state health officials, and people overseeing Title X funding are watching both the Clearway lawsuit and the federal report on funding to crisis pregnancy centers. Together, they highlight a new level of attention to both the medical safety questions and the federal money flowing to these centers.