Missouri banned abortion. Why is it spending millions to promote alternatives to procedure?

Even after Missouri banned nearly all abortions, the state continues to spend millions on a program designed to dissuade women from the procedure.

Under the state budget that took effect this month, Missouri allocated roughly $8.3 million to the Department of Social Services to fund its “Alternatives to Abortion” program. The program directs people to services that help them carry a pregnancy to term instead of getting an abortion.

On top of that funding, DSS is spending $266,000 on a contract with a Christian anti-abortion marketing firm to promote the program. The contract with Columbia-based Choose Life Marketing was originally awarded in May and renewed by the state through June 2024 late last month.

The marketing plan comes as Republicans have claimed that companies such as Google have blocked outreach efforts from similar programs that supporters say provide women with resources for unplanned pregnancies

“I think it absolutely makes sense for a state like Missouri, where elective abortions are illegal, to try to make sure people are aware that services are available. That you’re not alone,” said state Rep. Doug Richey, an Excelsior Springs Republican.

But critics who spoke with The Star argued that the state should not be paying to promote centers that they say mislead women into thinking they’re getting comprehensive medical services when many of the centers don’t offer them. And they say that the marketing plan uses state money to push a religious ideology while capitalizing on confusion caused by the state’s near-total ban on abortion.

“When folks really are in crisis, they need true information,” said state Rep. Maggie Nurrenbern, a Kansas City Democrat. “That’s what is so frustrating. That the state is actively pushing misinformation and directing folks to, you know, quote, unquote, a crisis pregnancy center that really isn’t going to give them a full range of options.”

Missouri’s deal with Choose Life Marketing comes roughly a year after the U.S. Supreme Court struck down the federal right to abortion. Minutes after the ruling, a 2019 trigger law took effect in Missouri, making it the first state to ban nearly all abortions.

The ban has sown confusion and fear among women and health care providers. Some argue that a provision allowing abortion in medical emergencies is poorly defined and has caused hospitals to deny life-saving care, forcing women to flee the state in search of abortion care.

Some of the organizations promoted by Missouri’s alternatives to abortion program are crisis pregnancy centers, which have been found to provide misleading information about the services they provide.

“When a patient goes to a crisis pregnancy center, they’re getting theology over accurate information,” said Katie Baylie, the director of legislative affairs and associate general counsel for Planned Parenthood Great Plains. “They’re giving out misinformation, omitting information and providing patients with false information that interferes with their medical decision-making.”

On its website, Choose Life Marketing states that its mission is to “reach more abortion-minded women and impact a culture to choose life through communication strategies grounded in research and biblical values.”

A self-described Christian-led company, the company’s online store sells a wide array of Christian-themed merchandise, including a $15 Jesus travel tumbler.

“It is quite frankly maddening that this is what is being pushed,” Nurrenbern said. “In the state of Missouri, we are using tax dollars now to push a full on Christian agenda.”

Nurrenbern clarified that a “very select view of Christianity” was being pushed, pointing to numerous religious leaders who have criticized Missouri’s abortion ban.

Under Choose Life Marketing’s proposal to the state, it promised to demonstrate, creatively, how contractors within the state program “can help women at-risk for abortion, and will best break through the Big Tech blocking challenges the program faces online.”

The company plans to do this through a searchable online database of program contractors as well as social media campaigns on Facebook, Instagram, Spotify, Snapchat and YouTube.

“We’ll be helping to promote the various benefits of the Alternatives to Abortion Program,” said Scott Baker, a spokesperson for the company. “There are artificial hurdles put in place by Google and some of these other platforms…that we’ll work to overcome on behalf of these A2A contractors.”

Since being awarded the contract, Baker said the company has been working to get its marketing plan up and running.

Baker’s comments echo concerns from several Republicans, including Sen. Josh Hawley of Missouri, who argue that Google and Facebook-owner Meta have worked to throttle online ads from crisis pregnancy centers as well as Choose Life Marketing itself.

“I am concerned that, in the name of providing ‘clarity’ in search results, your company is deliberately limiting pregnancy resource centers’ outreach efforts,” Hawley wrote in a 2022 letter to Google.

But others say Google and other tech firms have not done enough to curtail misleading ads from crisis pregnancy centers. Critics argue those ads are dangerous and promote misinformation by steering women to clinics specifically designed to dissuade against abortions.

A report last month from the Center for Countering Digital Hate, an international nonprofit that pushes against online hate and disinformation, found that anti-abortion pregnancy centers in the U.S. spent roughly $10.2 million on Google Search ads over a two-year period. More than 70% of those clinics used deceptive tactics, such as promoting the false claim that abortions are linked to cancer and other diseases, the report found.

And nearly 40% of the clinics, the report found, did not include disclaimers making it clear that they do not provide abortions.

Missouri’s program has been codified in state statute since 2007. Before that, it was funded through appropriations since 1996. The state also offers a tax credit for people who contribute to crisis pregnancy centers.

Last month, Kansas released official abortion statistics for 2022. The report shows that the number of Missouri residents receiving abortions in Kansas declined over the past year, falling from from 3,458 in 2021 to 2,883 in 2022, even as the total number of out-of-state abortion patients in Kansas jumped by 117%.

In Kansas, lawmakers allocated $2 million this year to fund an alternatives to abortion program and directed Kansas Treasurer Steven Johnson, a Republican, to oversee the process of choosing a contractor for the program. The office is currently waiting on approval for their request for proposal before seeking the contractor.

Missouri’s contract with Choose Life Marketing comes at a crucial time when patients are turning to social media and online search engines to navigate the complex legal landscape of Missouri’s abortion ban, said Baylie, with Planned Parenthood.

“This is a way for the state to push anti-abortion messaging to the top of the searches and steer people away from safe and essential health care,” she said. “Really, it’s just another opportunity, another state-sanctioned misinformation campaign.”

Baker pushed back on this criticism, saying that his firm and the pregnancy centers that work with the state are transparent.

“I think most of the people who say that are people who, you know, they think anything pro-life is misleading,” he said. “We are transparent in what we’re trying to do, with who we represent. These centers are very clear on what they offer and what they don’t offer. So it’s a hollow accusation.”

Asked to respond to criticism about the marketing contract, Adam Crumbliss, the deputy director for DSS, in a statement to The Star said that the department was “proud to collaborate with our partner state agencies in furtherance of our mission to empower Missourians to live safe, productive, and healthy lives.”

Richey, the Excelsior Springs Republican, acknowledged that Missouri’s abortion ban has sparked questions from people facing unexpected pregnancies. The marketing plan is in response to that, he said.

“What the state of Missouri is working to try to accomplish is the very thing that people who are pro-choice, pro-abortion are often accusing us of and that is if you’re saying that a lady can’t have access to an elective abortion, then what are you going to do to help?” he said. “This is a part of that effort to help.”

Nurrenbern pointed to surrounding states, including Kansas, where abortion is still legal. She said it’s important for women to know how to access that care.

“That is what these, quite frankly, these Christian nationalist legislators in Missouri have done — they have forced women to flee our state to seek basic health care,” she said.

Baylie, with Planned Parenthood, said that state agencies should be trusted sources of health information. Patients shouldn’t have to sift through “state-promoted political propaganda,” she said.

“That is just really inappropriate for the state to be funding, especially considering they are using crucial funds to steer pregnant folks away from essential health care that lawmakers have already ensured they can’t access in Missouri,” she said.

The Star’s Katie Bernard contributed reporting.