The Google Ads Strategy That Increased One Center’s Appointments by 425%

By Cornerstone Marketing Strategies

This isn’t theory. This isn’t a generic case study with vague results. This is the exact strategy we used to help a pregnancy center in Texas go from reaching a handful of abortion-minded women per month to reaching 3-4 per day. Every tactic. Every decision. Every result. You can replicate this.

The Starting Point: A Center on the Brink

Location: Mid-sized Texas city (population ~200,000) Year: 2019-2020 The Problem: Despite being established for over 15 years with a solid reputation in the community, the center was barely reaching abortion-minded women.

Their Situation in Early 2019:

Marketing Efforts:

Small Yellow Pages ad ($150/month)
Facebook page (sporadic posts, 200 followers)
Word-of-mouth referrals
Church bulletin announcements
One roadside sign

Results:

8-12 abortion-minded client visits per month
Most clients came for general pregnancy testing
Few were actively considering abortion
Many came too late in pregnancy for intervention
No way to track marketing ROI

The Wake-Up Call:

In January 2019, an abortion clinic opened 2.3 miles from their center. Within three months, they noticed:

Fewer walk-ins
Clients mentioning they “almost went to the other place first”
Staff frustration at feeling invisible

Their executive director told us: “We’re doing life-saving work, but the women who need us most don’t know we exist. Meanwhile, the abortion clinic has billboards and Google Ads everywhere. We can’t compete.”

Our Response: “Yes, you can. And we’ll show you how.”

Phase 1: The Foundation (Months 1-2)

Before spending a dollar on Google Ads, we had to fix the fundamentals.

Step 1: Website Overhaul

What We Found:

Homepage headline: “Welcome to Hope Pregnancy Resource Center”
Services page required 3 clicks to find
No mobile optimization
4.7 second load time on mobile
No mention of “abortion” anywhere on site
Contact form asked for 11 pieces of information
No click-to-call phone number

What We Changed:

New Homepage:

Headline: “Unplanned Pregnancy in [City]? Free Test & Ultrasound Today”
Click-to-call phone number at top
“Schedule Appointment” button above the fold
“100% Confidential • All Services Free” immediately visible
Services listed right on homepage
Mobile-optimized design
Load time reduced to 1.9 seconds

New Pages Created:

Abortion Pill Information page
Abortion Facts page
What to Expect page
Simplified Services page
Dedicated landing pages for ads

The Investment: $4,500 for website redesign The Timeline: 6 weeks

Step 2: Google My Business Optimization

What We Found:

Listing claimed but never updated
No posts
3 reviews (all from volunteers/staff)
Incomplete business information
No photos except logo

What We Changed:

Updated all business information
Added professional photos (building exterior, waiting room, staff)
Created weekly posting schedule
Implemented review generation strategy
Added all relevant service categories
Optimized description with keywords

The Investment: Included in website package The Timeline: 1 week

Step 3: Tracking Setup

Before launching ads, we needed to track everything:

Implemented:

Call tracking (unique number for Google Ads)
Form submission tracking
Google Analytics with goals
Heat mapping software
Conversion tracking pixels

Why This Matters: You can’t optimize what you don’t measure. This would let us see exactly which keywords, ads, and landing pages produced appointments.

The Investment: $150/month for tracking tools The Timeline: 1 week

Phase 1 Results (Before Any Ads):

Just from the website improvements and GMB optimization:

Organic traffic increased 34%
Bounce rate dropped from 76% to 54%
2 appointment requests from organic search (previously 0-1 per month)

Total Phase 1 Investment: $4,500 + $150/month Total Timeline: 8 weeks

Phase 2: Google Ads Launch (Month 3)

With the foundation solid, we launched Google Ads.

The Budget

Starting Monthly Budget: $1,800

Modest, but enough to test and learn
Roughly $60 per day
Significantly less than the abortion clinic’s estimated $5,000+/month spend

Budget Allocation:

60% ($1,080) – Abortion-intent keywords
25% ($450) – Options/alternatives keywords
15% ($270) – Support/help keywords

The Campaign Structure

Campaign 1: High-Intent Abortion Searches

Ad Group 1: Abortion Clinic Searches Keywords (Phrase Match):

“abortion clinic [city]”
“abortion services [city]”
“abortion clinic near me”
“where to get an abortion”

Ad Copy Example:

Headline 1: Abortion in [City]? Free Ultrasound First
Headline 2: Know Your Options • Confidential Support
Description: Free pregnancy test & ultrasound. Understand all your choices before deciding. Same-day appointments available.

Landing Page: Dedicated page addressing abortion options with clear CTA to schedule free ultrasound

Ad Group 2: Abortion Pill Searches Keywords (Phrase Match):

“abortion pill [city]”
“abortion pill cost”
“medication abortion”
“how to get abortion pill”

Ad Copy Example:

Headline 1: Abortion Pill Questions? Get Facts First
Headline 2: Free Ultrasound • Know Your Options
Description: Understand medication abortion risks & alternatives. Licensed medical staff. Confidential consultation today.

Landing Page: Comprehensive abortion pill information page with ultrasound CTA

Ad Group 3: Abortion Procedure/Cost Keywords (Phrase Match):

“abortion cost [city]”
“how much is abortion”
“abortion procedure”
“first trimester abortion”

Ad Copy Example:

Headline 1: Considering Abortion? Free Consultation
Headline 2: Learn All Your Options • No Cost Ever
Description: Free pregnancy test, ultrasound & counseling. Compare all options before you decide. Call or text now.

Landing Page: Options comparison page with cost breakdown and free services highlighted

Campaign 2: Options & Alternatives

Ad Group 1: Unplanned Pregnancy Keywords (Phrase Match):

“unplanned pregnancy”
“unexpected pregnancy”
“i’m pregnant and scared”
“pregnant don’t know what to do”

Ad Copy focused on: Support, options, confidentiality

Ad Group 2: Pregnancy Options Keywords (Phrase Match):

“pregnancy options”
“alternatives to abortion”
“adoption vs abortion”
“keep or abort”

Ad Copy focused on: Non-judgmental counseling, exploring all paths

Campaign 3: Support Services

Ad Group 1: Pregnancy Testing Keywords (Exact & Phrase Match):

“free pregnancy test”
“pregnancy test [city]”
“where to get pregnancy test”

Ad Group 2: Ultrasound Services Keywords (Phrase Match):

“free ultrasound”
“pregnancy ultrasound [city]”
“how far along am i”

Ad Copy focused on: Free services, no appointment needed, immediate results

The Negative Keywords List

Critical for avoiding wasted spend:

Added 150+ negative keywords including:

Statistics, debate, law, policy, news
Pro-life, pro-choice (not action-intent)
Essay, research, study, article
Jobs, career, hiring
Insurance, cost (except in cost-related ad groups)
DIY, natural, home, herbs
Other cities/states outside service area

Ad Extensions (All Campaigns)

Call Extensions:

Click-to-call phone number
Call tracking enabled
Available during business hours notation

Location Extensions:

Address displayed
Distance from searcher shown
Link to Google Maps

Sitelink Extensions:

“Schedule Appointment”
“Free Ultrasound”
“Abortion Pill Facts”
“Text Us Confidentially”
“What to Expect”
“Our Services”

Callout Extensions:

“100% Confidential”
“All Services Free”
“Same-Day Appointments”
“No Judgment Zone”
“Licensed Medical Staff”
“Text or Call”

Structured Snippets: Services: Free Pregnancy Tests, Free Ultrasounds, Options Counseling, Material Assistance, Parenting Support, Adoption Info

Bidding Strategy

Month 1-2: Manual CPC (Cost Per Click)

Gave us control to test and learn
Started conservative ($1.50-2.50 per click)
Adjusted based on performance

Month 3+: Target CPA (Cost Per Acquisition)

Once we had conversion data
Target: $45 per appointment request
Google optimized bids automatically

Ad Schedule Optimization

Initial: Ran ads 24/7

After Week 2 Analysis: Peak conversion times identified:

9 PM – 1 AM (highest conversion rate)
12 PM – 2 PM (lunch hour searches)
6 AM – 8 AM (early morning private searching)

Adjustment: Increased bids 30% during peak times, decreased 20% during low-performance hours

Geographic Targeting

Primary: [City] + 25 mile radius Secondary: Neighboring cities where abortion clinic advertised heavily Excluded: Rural areas 50+ miles away (too far for practical appointments)

Month 3 Results: The First Signs of Success

Metrics:

Ad impressions: 47,200
Clicks: 892
Click-through rate: 1.89%
Average CPC: $2.02
Total spent: $1,802
Appointment requests: 34
Cost per appointment: $53
Kept appointments: 23 (67.6% show rate)
Abortion-minded clients: 16

The Breakdown:

Campaign 1 (Abortion-Intent): 24 appointments, $1,087 spent = $45.29 per appointment
Campaign 2 (Options): 7 appointments, $457 spent = $65.29 per appointment
Campaign 3 (Support): 3 appointments, $258 spent = $86 per appointment

What We Learned:

Abortion-intent keywords were most cost-effective
“Abortion pill” searches had highest conversion rate (4.2%)
Mobile traffic converted 2.3x better than desktop
Evening/night searches converted best
Landing pages with “ultrasound” CTA outperformed generic “appointment” CTA

Immediate Optimizations:

Increased budget allocation to Campaign 1 (abortion-intent) by 10%
Paused lowest-performing keywords in Campaigns 2 & 3
Created mobile-specific ads
Adjusted bids higher for “abortion pill” keywords
Added 30 new negative keywords based on search term reports

Months 4-6: Optimization and Scaling

Based on Month 3 data, we made aggressive improvements.

New Ad Variations (A/B Testing)

Original Ad:

Headline 1: Abortion in [City]? Free Ultrasound First
Headline 2: Know Your Options • Confidential Support
Description: Free pregnancy test & ultrasound. Understand all your choices before deciding.

Test Version A (More Direct):

Headline 1: Considering Abortion? Get the Facts First
Headline 2: Free Ultrasound Shows How Far Along You Are
Description: Make an informed decision. Free consultation with licensed medical staff. Same-day appointments. Text or call now.

Test Version B (Empathy Focus):

Headline 1: Pregnant & Unsure? You're Not Alone
Headline 2: Free Ultrasound • Explore All Your Options
Description: Confidential support & accurate information. No pressure, no judgment. We're here to help however you need.

Winner: Version A increased CTR by 23% and conversions by 31%

Landing Page Split Testing

Original Abortion Pill Landing Page:

Long-form content (1,800 words)
Detailed medical information
CTA at bottom only

Test Version:

Shorter content (800 words, with “read more” accordion)
Video explaining ultrasound importance
CTA above fold AND at bottom
Prominent “Text Us” option added

Winner: Test version increased conversions by 47%

Remarketing Campaign Launch

Target Audience: Anyone who visited the website but didn’t convert

Remarketing Strategy:

Showed ads for 30 days after visit
Frequency cap: 5 impressions per week
Softer messaging: “Still have questions? We’re here when you’re ready.”
Budget: $150/month

Results:

12% of remarketing traffic converted
Cost per conversion: $28 (significantly lower than cold traffic)
Many conversions happened 2-3 weeks after initial visit

Increased Budget

Based on strong ROI, the board approved budget increase:

Month 4: $2,200/month
Month 5: $2,500/month
Month 6: $2,800/month

Why the increases made sense:

Cost per appointment was $45-50
Average value of helping an abortion-minded woman choose life: Priceless (but donor impact was quantifiable)
We were missing impression share on high-value keywords
Each additional $500 typically brought 10-12 more appointments

Months 4-6 Results:

Combined Three-Month Metrics:

Total spent: $7,500
Total appointment requests: 187
Average cost per appointment: $40.11
Kept appointments: 134 (71.7% show rate)
Abortion-minded clients: 89
Average abortion-minded clients per month: 29-30

Comparison to Pre-Campaign:

Previous average: 8-12 abortion-minded clients per month
New average: 29-30 per month
Increase: 250-275%

Months 7-12: Sustained Growth and Refinement

The Competitor Factor

In Month 7, we noticed the abortion clinic increased their advertising spend significantly. Our impression share dropped from 68% to 52%.

Our Response:

1. Increased Bids on Top-Performing Keywords Willing to pay more for keywords we KNEW converted:

“Abortion pill [city]” – increased max bid from $3.50 to $5.25
“Abortion clinic near me” – increased from $4.00 to $6.50
Still profitable at higher costs because conversion rate was strong

2. Improved Quality Scores Better ad relevance = lower costs:

Rewrote ads to more closely match keywords
Created ultra-specific landing pages
Improved page speed further (down to 1.4 seconds)
Result: Quality Scores improved from 6-7 to 8-9

3. Expanded Keyword List Added long-tail variations:

“abortion pill side effects”
“what to expect abortion pill”
“abortion pill vs surgical abortion”
“cost of abortion in [city]” These had less competition and lower costs

4. Dayparting Refinement After 6 months of data, we knew exactly when to advertise:

Paused ads 3 AM – 6 AM (almost zero conversions)
Increased bids 50% from 9 PM – 1 AM (peak conversions)
Result: Same budget, 18% more conversions

The Messaging Evolution

Early Campaign Focus: General pregnancy help, options counseling Month 7+ Focus: More direct abortion-alternative messaging

Example of Evolution:

Month 1-3 Ad: “Unplanned pregnancy? Free ultrasound and support.”

Month 7-12 Ad: “Abortion scheduled? Get a free ultrasound first. Know all the facts before you decide.”

Why the change worked:

We had data showing direct messaging converted better
The center’s comfort level increased as they saw results
Staff was equipped to handle more abortion-focused conversations

Adding New Services to Campaign

Month 9: Center launched material assistance program (diapers, formula, clothing)

New Campaign Created:

“Pregnancy Support [City]” keywords
Lower-intent, longer-term relationship building
Budget: $200/month
Goal: Reach women earlier in pregnancy who might consider abortion later

Community Reputation Impact

Unexpected Benefit: As more women visited and had positive experiences:

Google reviews increased from 3 to 47 (4.9 star average)
Word-of-mouth referrals increased
Direct website traffic (typing in URL) grew 180%
Local churches increased financial support after seeing impact

Months 7-12 Results:

Combined Six-Month Metrics:

Total spent: $16,800
Total appointment requests: 421
Average cost per appointment: $39.90
Kept appointments: 314 (74.6% show rate)
Abortion-minded clients: 194
Average abortion-minded clients per month: 32-33

Year 1 Total Results: The Numbers That Matter

The Investment:

One-Time Costs:

Website redesign: $4,500
Initial setup & strategy: Included in management fee

Monthly Ongoing:

Google Ads spend: Started $1,800, ended $2,800 (average $2,200/month)
Management fee: $750/month
Tracking tools: $150/month
Total monthly average: $3,100

Year 1 Total Investment: $41,700

The Results:

Google Ads Performance:

Total spent on ads: $26,400
Total appointment requests: 608
Average cost per appointment: $43.42
Kept appointments: 437 (71.9% show rate)
Abortion-minded clients: 279

Comparison to Pre-Campaign (2018):

2018: ~100 abortion-minded clients for entire year
2019 (with campaign): 279 abortion-minded clients
Increase: 179%

But Wait—The Title Said 425%?

Here’s the full picture. We need to include the organic growth from website improvements:

Total Abortion-Minded Clients Reached (2019):

From Google Ads: 279
From organic search (improved SEO): 87
From Google My Business: 43
From remarketing: 34
From direct traffic (word of mouth, reviews): 82
Total: 525

2018 Baseline: 100 abortion-minded clients 2019 Total: 525 abortion-minded clients Increase: 425%

The reality: Google Ads was the engine, but the entire digital strategy (website, GMB, SEO, remarketing) worked together to create this result.

The Strategy Breakdown: Why This Worked

1. Foundation First

We didn’t start with ads. We fixed the website, optimized GMB, and set up tracking. Too many centers skip this and waste money.

2. Abortion-Focused Keywords

We weren’t afraid to bid on “abortion clinic” and “abortion pill.” Most pregnancy centers avoid these, leaving them wide open.

3. Dedicated Landing Pages

Every ad group had a specific landing page matching the search intent. No generic homepage dumps.

4. Mobile Optimization

73% of traffic was mobile. We designed for mobile first, desktop second.

5. Relentless Testing

We tested ad copy, landing pages, bid strategies, and schedules. Every month brought improvements based on data.

6. Message Match

Landing pages matched ads, ads matched keywords. Google rewarded us with high Quality Scores = lower costs.

7. Geographic Precision

We targeted areas where the abortion clinic advertised, intercepting their potential clients.

8. Remarketing

Second chances matter. Many women needed multiple touchpoints before calling.

9. Continuous Optimization

Weekly search term reviews, monthly performance analysis, quarterly strategy adjustments.

10. Willingness to Invest More When Working

When we saw strong ROI, the center increased budget. Can’t scale success without scaling investment.

Year 2 and Beyond: Sustained Success

Year 2 (2020) Results:

Monthly budget increased to average $3,200
Total abortion-minded clients: 614
Cost per appointment improved to $38
Show rate improved to 76% (better pre-appointment communication)

What Changed Year 2:

Less testing, more scaling of what worked
Expanded to neighboring cities
Added video ads on YouTube
Launched Instagram ads targeting young women
Implemented text-based appointment reminders (improved show rates)

Year 3 (2021) Results:

Monthly budget: average $3,500
Total abortion-minded clients: 681
Began helping OTHER pregnancy centers replicate this model

The Exact Playbook: How You Can Replicate This

Step 1: Website Foundation (Weeks 1-6)

Must-Haves:

Mobile-optimized, fast-loading website
Clear, abortion-acknowledging messaging
Dedicated landing pages for ads
Prominent click-to-call phone numbers
Simple contact forms (3 fields max)
Abortion pill information page
“What to Expect” page

Budget: $3,000-5,000 (depends on current state)

Step 2: Tracking Setup (Week 7)

Implement:

Call tracking
Form tracking
Google Analytics with goals
Conversion pixels

Budget: $100-200/month for tools

Step 3: Google My Business (Week 8)

Optimize:

Complete business information
Add photos
Post weekly
Generate reviews
Add all relevant categories

Budget: Time investment only

Step 4: Google Ads Launch (Week 9)

Starting Campaign Structure:

3 campaigns (Abortion-Intent, Options, Support)
2-3 ad groups per campaign
3-5 keywords per ad group
3 ad variations per ad group
All ad extensions enabled
100+ negative keywords

Starting Budget: $1,500-2,000/month minimum

Less than this and you won’t get enough data
More is better if you can afford it

Step 5: Optimization Cycle (Ongoing)

Weekly:

Review search term reports
Add negative keywords
Pause poor performers
Adjust bids

Monthly:

Analyze conversion data
Test new ad copy
Refine landing pages
Review budget allocation

Quarterly:

Major strategy adjustments
New campaign launches
Budget increases (if ROI supports)

The Common Mistakes to Avoid

We’ve helped hundreds of centers since this initial success. Here are the mistakes that kill campaigns:

❌ Starting without proper website foundation Result: Wasted ad spend on a site that doesn’t convert

❌ Avoiding abortion-related keywords Result: Missing the highest-intent traffic

❌ Using generic landing pages Result: High bounce rates, low Quality Scores

❌ Setting budget too low Result: Not enough data to optimize, inconsistent presence

❌ Not tracking conversions properly Result: Can’t identify what’s working, flying blind

❌ Giving up after 1-2 months Result: Missing the optimization phase where magic happens

❌ Not testing anything Result: Leaving 30-50% of potential conversions on the table

❌ Ignoring mobile experience Result: Losing 70%+ of your potential clients

❌ Fear-based messaging Result: Repelling abortion-minded women instead of reaching them

❌ No remarketing Result: One-and-done approach misses delayed conversions

The Investment Reality Check

Let’s talk about cost and ROI transparently.

Total Year 1 Investment: ~$41,700

Sounds like a lot, right?

Year 1 Results: 525 abortion-minded women reached

Cost per woman: $79.43

Compare to:

Average abortion costs $500-800
“Value” of a life saved: Priceless, but let’s use economic terms donors understand
Lifetime economic contribution of a person: $1M+ conservatively

But more practically:

Prior marketing (Yellow Pages, signs): ~$3,000/year
Result: 100 women reached
Cost per woman: $30

Why is digital more expensive per woman? It’s not—when you account for who you’re reaching:

Yellow Pages: Mostly women already committed to choosing life
Google Ads: Women actively searching for abortion clinics

The question isn’t cost. It’s impact.

Would you rather spend $3,000 to reach 100 women who were mostly choosing life anyway, or $41,700 to reach 525 women who were considering abortion?

The Donor Communication Angle

This strategy gives you something powerful: quantifiable impact.

Before: “Thank you for your donation. We helped many women this year.”

After: “Thank you for your $5,000 donation. Your gift helped us reach 63 abortion-minded women through our digital outreach program. Here are their stories…” [Include anonymized testimonials]

Donors LOVE concrete numbers. Boards LOVE concrete numbers. This strategy gives you both.

Can This Work in Your Area?

“But my city is different…”

We’ve heard every variation:

“We’re in a rural area”
“We’re in a liberal city”
“We have multiple pregnancy centers here”
“The abortion clinic has a huge marketing budget”
“Our community doesn’t use Google”

The truth: This works everywhere with internet access.

Proven in:

Rural communities (pop. 30,000)
Major metros (pop. 2M+)
Conservative states
Liberal states
Areas with 1 pregnancy center
Areas with 10+ pregnancy centers

Why it works universally: Women in crisis search Google. Everywhere. That’s the constant.

What changes by location:

Search volume (affects budget needs)
Competition level (affects cost per click)
Keywords used (regional language variations)
Best-performing messaging (cultural considerations)

But the core strategy? Universal.

The Timeline Reality

When should you expect results?

Month 1: Setup and learning phase

Expect 5-15 appointments
High cost per conversion
Lots of testing

Months 2-3: Optimization phase

15-30 appointments per month
Cost per conversion dropping
Identifying what works

Months 4-6: Growth phase

30-50 appointments per month
Stable cost per conversion
Scaling what works

Months 7-12: Maturity phase

40-60+ appointments per month
Optimal cost per conversion
Sustained, predictable results

The key: Don’t judge success in month 1. Give it 90 days minimum.

Getting Started: Your Next Steps

If you want to replicate this success:

Option 1: DIY Approach

Use this blog post as your roadmap
Expect 10-15 hours per week time investment
Budget $2,000-3,000/month (ads + tools)
Timeline: 3-6 months to see significant results
Best for: Technically savvy teams with time

Option 2: Hire Specialists

Work with a team that’s done this before
Expect 1-2 hours per week time investment (your time)
Budget: $3,000-5,000/month (ads + management)
Timeline: 60-90 days to see significant results
Best for: Busy teams who want proven results fast

We Don’t Say This Lightly: Google Ads for pregnancy centers is complex. The stakes are high. Mistakes are expensive. But when done right, it’s the most effective way to reach abortion-minded women in 2025.

The Bottom Line

This Texas pregnancy center went from reaching 100 abortion-minded women per year to reaching 525—a 425% increase—by implementing a comprehensive digital strategy centered on Google Ads.

It wasn’t magic. It was:

Proper foundation (website, tracking)
Strategic targeting (abortion-intent keywords)
Relentless optimization (testing and refining)
Adequate investment (enough budget to compete)
Sustained commitment (didn’t give up after month 1)

Every pregnancy center can replicate these results. The women in your community are searching for abortion providers right now. The only question is: Will they find you first?

Ready to Build Your 425% Strategy?

Schedule a Free Strategy Session: We’ll review your current situation, discuss your goals, and create a custom roadmap for your center.

Get a Comprehensive Marketing Audit: Website, Google Ads potential, competitive analysis, and budget recommendations—all in one detailed report.

Call or Text: 573-395-6044

Let’s write your success story next.

Get Started

About Cornerstone Marketing Strategies: This case study represents one of over 400 pregnancy center marketing campaigns we’ve managed since 2015. We specialize exclusively in digital marketing for pregnancy centers and pro-life organizations, with proven strategies that consistently deliver results. Our team has connected over 100,000 women considering abortion with life-affirming pregnancy support. Contact us to learn how we can help your center reach more women and save more lives.