Reproductive Health and Freedom Watch: “As abortion is increasingly criminalized and maternal health systems suffer devastating cuts, UPCs are positioning themselves to fill critical care gaps they are not regulated to manage.”
WASHINGTON, DC – Today, Reproductive Health and Freedom Watch released a new memo exposing alarming guidance from UPC industry leadership regarding the detection and management of ectopic pregnancy—guidance that underscores the grave risks posed by these unregulated clinics. The memo includes new research on UPC industry training materials, internal guidance, and marketing practices that prioritize legal liability avoidance over patient safety in potentially life-threatening situations.
The research reveals that ectopic pregnancy is treated more as a legal threat than a medical emergency within the UPC industry, with patient well-being subordinated to ideological and institutional protection. Rather than centering patient safety, UPC industry leaders frame ectopic pregnancy as “the greatest medical and legal risk” to clinics, not patients, with trainings emphasizing discharging clients immediately to avoid liability.
The memo states: “UPC staff are often explicitly instructed not to diagnose, not to follow up, and above all, not to assume responsibility. As abortion is increasingly criminalized and maternal health systems suffer devastating cuts, UPCs are positioning themselves to fill critical care gaps they are not regulated to manage.”
Key findings include:
- Inconsistent diagnostic protocols: Training materials reveal conflicting advice around ultrasound practices, with trainers frequently telling staff to “ask your medical director,” highlighting a lack of unified, evidence-based medical standards.
- Marketing deception: While UPCs prominently feature ectopic pregnancy warnings in their websites, literature, and social media to promote ultrasound services, internal guidance consistently instructs centers not to offer follow-up care or diagnosis for suspected ectopic cases.
- Dangerous discharge practices: Training sessions explicitly warn against scheduling follow-ups for suspected ectopic pregnancies, with one presenter stating that doing so could imply “continuation of care” and expose clinics to lawsuits.
- Surge in incidents: According to industry training materials, NIFLA has reported more ectopic pregnancies from member clinics in the last two years than in all previous 24 years combined, with training content acknowledging multimillion-dollar lawsuits and at least one death due to missed ectopic diagnosis.
The memo builds on a NBC News investigation, which exposes a systemic pattern within the UPC industry: rather than prioritizing patient safety in potentially life-threatening situations, these clinics prioritize minimizing their own legal exposure by discouraging diagnosis or follow-up care. The investigation revealed that the National Institute of Family and Life Advocates (NIFLA), which oversees 1,700 member clinics nationwide, is explicitly advising its affiliates to avoid performing prenatal ultrasounds on women suspected of having ectopic pregnancies, guidance that emerged following a Massachusetts lawsuit in which a UPC was accused of misdiagnosing an ectopic pregnancy and creating a life-threatening emergency for a patient.