In the corner of a conference room at Waterleaf Women’s Center in Aurora sits a statue of the Virgin Mary, painted brightly in the Latin American style. Like most such facilities that bill themselves as crisis pregnancy centers and seek to discourage women from having abortions, Waterleaf is a faith-based organization, affiliated with the Catholic Church. Last year, Waterleaf’s seven registered nurses saw more than 1,200 women. Some knew they were pregnant when they went in, others didn’t. Some pregnancies were planned, others weren’t. All the women were given ultrasounds to determine the gestational age of their fetuses, followed by “options counseling.”

“There are three sets of options,” says Waterleaf’s executive director, Julie Garofalo. “Those options include parenting, adoption, and abortion. We are here to treat them without judgment, and we give them factual information.”

That’s not how Illinois attorney general Kwame Raoul sees it. In May, his office helped pass the Deceptive Practices of Limited Services Pregnancy Centers Act, which allows the state to levy fines of up to $50,000 on centers that “aim to dissuade pregnant persons from considering abortion care through deceptive, fraudulent, and misleading information and practices.” Along with Connecticut, Colorado, and Vermont, Illinois is one of four states with laws targeting such practices. Illinois’s is by far the most restrictive.

It’s warranted, argues Brigid Leahy, vice president of public policy at Planned Parenthood Illinois Action, who collaborated on the bill with Raoul. She has seen what she views as deceptive tactics employed by such centers and their supporters. In Flossmoor, Aid for Women opened a crisis pregnancy center across the street from a Planned Parenthood site. Activists set up a “Check in Here” sign outside Planned Parenthood’s door, then directed women to the Aid for Women center, Leahy says. In another instance she cites, a woman received an ultrasound at a pregnancy center, but was told to come back in a week, when a doctor could give her the results. By the time she learned how far along the fetus was, it was too late to get an abortion.

Governor J.B. Pritzker has vowed to make Illinois “the most progressive state for women’s reproductive rights.” In anticipation of the Supreme Court overturning Roe v. Wade, he signed the Reproductive Health Act, establishing abortion as a fundamental right in Illinois. The new pregnancy center law, which Pritzker has said ensures “Illinoisans can make their own decisions about their bodies using accurate and safe information,” is the latest piece of that campaign.

In its zeal to protect the right to abortion, though, is Illinois stepping on other, more fundamental rights? That’s the contention of a federal lawsuit supported by the Thomas More Society, a Chicago-based Catholic public interest law firm that specializes in anti-abortion litigation. The suit, filed in July by the National Institute of Family and Life Advocates, charges that by regulating what pregnancy center employees can say about abortion, the state “tramples on pro-life organizations’ protected speech and religious freedom, in violation of the First and Fourteenth Amendments to the U.S. Constitution.”

“What Illinois did was the most radical restriction on free speech rights in relation to pregnancy centers,” says former state representative Peter Breen, the society’s executive vice president and head of litigation. “Other states are doing more generic laws, which won’t really have much impact. Illinois specifically calls out certain speech and bans it, and that is flagrantly unconstitutional.”

“Pregnancy centers can’t be required to give advice about abortion. But they don’t have a constitutional right to lie.”

— Andrew Koppelman, Northwestern law professor

The law specifically prohibits “conveying untrue claims that abortion causes cancer or infertility and concealing data that shows the risk of death associated with childbirth is approximately 14 times higher than the risk of death associated with an abortion.” Breen calls the latter statement “a flagrant misstatement of what we understand to be the truth.”

In August, U.S. District judge Iain Johnston, a Trump appointee, issued an injunction to halt the law’s enforcement, calling it “both stupid and very likely unconstitutional … a blatant example of government taking the side of whose speech is sanctionable and whose speech is immunized — on the same subject no less.” The case against the bill is expected to be heard next year.

State representative Terra Costa Howard, one of the Pregnancy Centers Act’s chief sponsors, disputes that her bill violates free speech. Howard cites the case of a center that performed an ultrasound and deliberately inflated the fetus’s gestational age so the patient believed it was beyond the point when it could have been terminated by a mifepristone abortion. “This bill is about consumer fraud and protection,” she says. “The First Amendment does not give you the right to lie. To suggest that they’re not lying is false.” The law, Howard points out, does not require pregnancy center employees to discuss abortion; it just says they can’t be fraudulent when doing so.

Andrew Koppelman, a First Amendment expert at Northwestern University’s Pritzker School of Law, says the law raises free speech issues. “Pregnancy centers can’t be required to give advice about abortion,” Koppelman says. “But they don’t have a constitutional right to lie to their clients about what they are offering. This law might perhaps be construed to require anti-abortion centers to disclose information they don’t want to disclose, and in some circumstances that would raise constitutional concerns. But it doesn’t have to be read that way, and courts normally interpret ambiguous statutes in ways that avoid constitutional difficulties. Deception and fraud are as a general matter not constitutionally protected.”

Illinois has come to be seen as a “safe haven” for abortion. As one of the few Midwestern states that don’t restrict the procedure, it is increasingly drawing patients from elsewhere. In the first six months of this year, there were 44,690 abortions performed in Illinois — a 70 percent increase over the first six months of 2022, before Roe was overturned.

Breen believes the state’s leaders are treating the procedure as a product to be marketed: “When you’ve got a state where the leaders very much want to promote abortion, they’ve moved from promoting abortion into restricting a woman’s ability to access resources to avoid an abortion. But the question you start asking is, ‘Have you moved from being pro-choice to being pro-abortion?’ ”

That’s a distinction the courts will have to make.