The rising power of crisis pregnancy centers

For the average crisis pregnancy center, each abortion stopped is counted as a victory in what is often described, by both sides of the abortion-rights debate, as a war. And while unhappily pregnant women tend to seek out abortion clinics, crisis pregnancy centers tend to seek out those unhappily pregnant women.

These centers use various methods to attract women facing unplanned pregnancies, such as offering free pregnancy tests, locating next to abortion clinics, advertising for abortion services, and intercepting online searches for abortion on the Web.

But an emerging trend is for states to push women through these centers’ doors as part of new legislation that increases waiting times and mandates pre-abortion ultrasounds, something CPCs increasingly offer.

Last year, South Dakota passed a controversial anti-abortion law requiring women to visit anti-abortion pregnancy centers for counseling before they can receive an abortion. A federal judge blocked the law -- which also mandated a 72-hour waiting period --after Planned Parenthood sued the state on the grounds that the law created an unconstitutional burden on a woman's right to an abortion. On Wednesday, a state Senate committee is scheduled to hear a revised version of the bill, which still requires women to seek counseling at anti-abortion pregnancy centers but demands that the counselors be licensed.

Another anti-abortion law in Texas, which recently went into effect after surviving the majority of legal challenges lodged against it, provides women wanting to have an abortion with a list of state-sanctioned places to obtain a sonogram, a list that includes crisis pregnancy centers.

South Dakota and Texas are just two states where CPCs are slowly gaining more political power, taxpayer funding, and legitimacy from lawmakers. And with the growing movement of state legislatures adopting abortion laws that require women to first undergo an ultrasound, it is likely that these centers will begin to play an even bigger role in a woman’s unplanned pregnancy.

'Pregnancy Resource Center Month'

In the U.S., there are approximately 4,000 crisis pregnancy centers, the bulk of which are affiliated with one of three CPC networks: Heartbeat International, Care Net, and the National Institute of Family and Life Advocates. Each has ties to political organizations that have lobbied for anti-abortion legislation.

A legislative trend sweeping the country is the enactment of resolutions that “honor” crisis pregnancy centers. Last month, the Florida Legislature passed a bill that declared January “Pregnancy Resource Center Month” and commended “the compassionate work of the volunteers and staff at Florida’s pregnancy resource centers.” Ohio’s legislature passed similar legislation last month.

Several states passed pro-CPC resolutions last year, including Alabama, Arizona, Georgia, Missouri, South Dakota, Tennessee, Texas, West Virginia and Wisconsin. Oklahoma passed a pro-CPC resolution in 2010.

In these resolutions, much of the language was lifted straight from model legislation (PDF) developed by Americans United for Life, an anti-abortion policy group based in Washington, D.C. AUL’s resolution calls for recognizing services these centers have provided to citizens for free – services like baby supplies, referrals for public services and anti-abortion counseling. But a key provision, which has generally made it into the states’ version of these resolutions, is:

That the [Legislature] disapproves of the actions of any national, state, or local groups attempting to prevent pregnancy care centers from effectively serving women and men facing unplanned pregnancies.

This provision subtly refers to efforts at national, state and local levels to regulate crisis pregnancy centers, in response to allegations that these centers sometimes mislead women about what services they offer and provide them with misinformation about abortion, pregnancy, and contraception.

For instance, in Washington state, legislation was introduced last year that would require CPCs to be explicit about what services they do and don’t offer. It would also prohibit these centers from withholding medical records, such as pregnancy test results, from clients. The bill text was partially influenced by a report (PDF) co-authored by women’s rights group Legal Voice and the policy arm of the Northwest Planned Parenthood affiliate. Undercover investigators documented evidence of CPCs withholding medical records. According to the report: "Care Net in Gig Harbor and Tacoma provided volunteers with paperwork stating that it had the right under RCW 70.02.090 to withhold a person’s medical records if the center reasonably believes the information will be used to obtain an abortion. Care Net in Puyallup provided paperwork stating that it would be 'illegal' for a patient to use medical records generated by Care Net for the purpose of 'abortion or abortion-related services.'"

These measures have generally been unsuccessful. Ordinances requiring CPCs to post signage stating that they do not offer abortion services were overturned in Baltimore and New York. And a federal bill that would authorize the Federal Trade Commission to fine organizations that falsely advertise as resources for abortion services has been reintroduced into Congress every year since 2007 with little movement. A similar bill passed in San Francisco last year but is being challenged in federal court.

Another provision in AUL’s pro-CPC resolution model, which is featured in Ohio’s bill, could serve as a portal for crisis pregnancy centers to obtain public money:

That we encourage the Congress of the United States and other federal and state government agencies to grant pregnancy resource centers assistance for medical equipment and abstinence education in a manner that does not compromise the mission or religious integrity of these organizations.

It is a state version of a federal bill regularly reintroduced by U.S. Rep. Cliff Stearns (R-Fla.), which would authorize the Department of Health and Human Services to allocate money for ultrasound equipment to tax-exempt organizations that provide free medical services to pregnant women – a classification that applies to most CPCs.

An (ultra)sound strategy

With more states mandating that women obtain sonograms sometimes 24 hours before a scheduled abortion, going to a crisis pregnancy center that will do the ultrasound for free is an attractive option, especially for women on a tight budget.

Speaking at a pro-life conference hosted by the D.C.-based Family Research Council last month, Karen Snuffer, the executive director of a group of Virginia-based pregnancy resource centers affiliated with Care Net, said her centers serve more than 17,000 women and their families annually and “provide $1.1 million in free goods and services, including 2,900 ultrasounds, free of charge, by medical professionals.”

“Like centers all around the country, Care Net PRCs represent hope to these women and their families, and we do that because we have access to many resources within the community,” Snuffer said.

An FRC study (PDF) of 1,969 crisis pregnancy centers in the U.S., found that in 2010, about 230,000 ultrasounds were performed – at no or very little charge to the client – at 1,000 centers, for an estimated total cost savings of $57.5 million. (To get this statistic, FRC estimated each ultrasound at $250.)

Founded in 1993, the National Institute of Family and Life Advocates was the first CPC network to promote ultrasounds in crisis pregnancy centers; ultrasounds were seen as a new, persuasive tool to talk women out of abortions. Additionally, centers that offered ultrasound services could now be considered medical centers, giving CPCs more legitimacy. Then, in 2004, Focus on the Family started the Option Ultrasound Program, which – in tandem with a medical consultant from NIFLA – provides funding grants to pregnancy centers to obtain ultrasound machines and convert their centers to medical-style clinics.

Based in Colorado Springs and founded by James C. Dobson in 1977, Focus on the Family has grown into a $100 million tax-exempt nonprofit. In its fiscal year ending September 2010 (PDF), the group reported giving about $900,000 to about 50 CPCs for either ultrasound machines or ultrasound training. Option Ultrasound’s purpose is to convert “pregnancy resource centers” into “pregnancy medical clinics.” Medical services at these centers are usually confined to “limited obstetrical ultrasound services” and over-the-counter pregnancy tests.

Focus defines a pregnancy medical clinic as:

a medical clinic that operates under the supervision of a licensed physician and nurse manager. A PMC [pregnancy medical clinic] offers pregnancy tests, limited obstetrical ultrasound services and peer counseling to women facing an unintended pregnancy. As well, some may offer STI testing/treatment and/or prenatal care. A PMC may also offer additional support services or refer women to helpful community programs, but the focus is on providing medical services for abortion-risk women.

By contrast, a regular pregnancy resource center, according to Focus:

offers pregnancy tests, peer counseling and other supportive services to women who are facing an unintended pregnancy, which may include childbirth education and parenting classes, adoption counseling and support, post-abortion support, and practical support such as maternity/baby clothing, diapers, and furniture.

Focus on the Family demands that grant recipients undergo ultrasound training, operate the ultrasounds only under the direction of a licensed physician, and comply with the national standards defined by the American Institute of Ultrasound Medicine. Focus puts up 80 percent of the costs of the ultrasound machine (between $21,000 and $33,000) and sonography training (between $13,000 and $17,000).

As of Jan. 31, 2012, Focus reports funding 396 grants for ultrasound machines and 140 for sonography training. The group asserts that since the program began in 2004, “the estimated number of babies saved is more than 120,000 precious lives!”

“These mothers will likely never forget the day they first saw the image of their baby, kicking her feet and waving her arms on the ultrasound monitor,” reads an article on the Option Ultrasound website titled, “How Option Ultrasound Helps At-Risk Women.”They will recall the day that their hearts were changed, with gratitude they can hardly put into words, and they will be forever thankful that they had the opportunity to choose life, all because someone cared enough to give them the option of seeing their baby on an ultrasound.”

The efficacy of sonograms as abortion-deterrents has been challenged by new research.

Political connections

Heartbeat International, previously named Alternatives to Abortion, was the first of the crisis pregnancy center networks to arrive on the scene, in 1971. It was followed by Care Net, which was founded in 1975 as the Christian Action Council, a Washington, D.C.-based evangelical organization that at the time functioned as a lobbying organization, according to a 2009 report (PDF) on pregnancy resource centers produced by the Family Resource Council.

On its website, Care Net refers to its approach to abortion as “a refreshingly apolitical and practical approach to reducing abortions in North America.” But the organization’s affiliations and its founding as a lobbying group suggest a more political identity. Care Net’s “board of references,” for example, includes Beverly LaHaye, who chairs the national lobby group Concerned Women for America and is now part of presidential candidate Newt Gingrich’s “Faith Leader Dream Team.”

Heartbeat International’s board of directors includes Charles A. Donovan, president of the Susan B. Anthony List, which is one of the most active anti-abortion lobbying groups in the country. Donovan, who previously worked for Ronald Reagan’s administration and the Family Research Council, now works the Heritage Foundation, a conservative think tank. Another political player on Heartbeat’s board is Derek A. McCoy, president of the Maryland Family Council, a Focus on the Family affiliate that lobbies for anti-abortion legislation in Maryland. McCoy is also on the board of directors for the anti-abortion media group Life Always, which provoked a firestorm last year for erecting racially charged billboards in overwhelmingly black communities, with messages like, “The most dangerous place for an African-American is in the womb” and, next to image of Barack Obama’s face, “Every 21 minutes, our next possible leader is aborted.”

NIFLA was initially founded, according to FRC, as a legal support system for pregnancy centers to defend against the types of laws that seek to regulate CPCs. On NIFLA’s National Advisory Council sit James D. Bopp, Jr., attorney at Bopp, Coleson & Bostrom, and Liberty Counsel Chairman Mathew Staver, both of whom defend anti-abortion laws that are challenged in court.  NIFLA’s advisory council also includes representatives from Americans United for Life and Concerned Women for America and Virginia state Rep. Robert Marshall (R-Manassas), who sponsored Virginia’s controversial personhood bill that passed the state House last week.

Taxpayer subsidies

Back in January, Karen Snuffer boasted that the Virginia CPCs she oversees take in “no government funding whatsoever.” But many CPCs – which are generally tax-exempt 501(c)3 groups – do receive state taxpayer money.

Several state health departments allocate money for CPCs as part of programs that promote alternatives to abortion. For instance, Texas’ seven-year-old “Alternatives to Abortion” program got a $300,000 bump last year, for a total of $8.3 million, after the state legislature cut family-planning funding from about $112 million to $38 million and reduced funding for the social-service programs. Florida’s legislature recently voted to maintain $2 million in funding for the state’s CPC network, for the seventh year in a row, after making deep cuts to community health services.

During the George W. Bush administration, CPCs benefited handsomely from federal grant funding for abstinence-only education programs. The Obama administration cut most of those abstinence-only programs, but CPCs can still receive federal funding through the National Fatherhood Initiative, which each year gives $25,000 “capacity building” grants to 25 community groups, as Sarah Posner has reportedAward recipients in 2011 included Care Net Pregnancy Resource Center in Rapid City, S.D., which is one of the CPCs approved by the state to disuade women under South Dakota's new law. This Care Net affiliate is also one of the CPCs defending the South Dakota law in court. Other subsidized CPCs include Sav-A-Life, Inc., in Birmingham, Ala., and Women’s Hope Medical Clinic in Auburn, Ala.

In the past few years, a series of investigative reports by journalists, congressional committees (PDF), and abortion-rights groups like NARAL Pro-Choice America and the National Abortion Federation (PDF) have raised serious questions about crisis pregnancy centers.

The directors of most of the major CPC networks would not respond to repeated requests for comment from The American Independent about their organizations. A spokesperson for Heartbeat International told TAI that all the information we needed to know was on its website.

At FRC's pro-life conference last month, Rebecca Lewis, who worked for a Care Net-affiliated crisis pregnancy center in Alexandria, Va., for nine years (as a volunteer for five years and a director for four), told TAI that she appreciates that people are digging into CPCs -- to keep them honest. But she said she didn't see the sort of unethical tactics at her center that CPCs are often accused of.

"I didn't see that where I was," Lewis said, when asked whether her center engaged in misinformation or misrepresentation.

Lewis said her center stood for the idea that if a woman has a choice to have an abortion, she should also have a choice not to have one. She said her volunteers were taught not be judgmental of the women coming in. And the women who chose not to have an abortion were given services and material support and tracked for at least a year, Lewis said.

"We do not condemn a person who has an abortion," she said. "I never made them feel small."

 Photo: Abortion Rights Coalition of Canada