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Crisis pregnancy centers (CPCs), also known as pregnancy resource centers are non-profit organizations established to counsel women against having abortions. CPCs are are usually affiliated with Christian charities and operate under the auspices of one of three national organizations groups: Care Net, Heartbeat International, and Birthright International, while the National Institute of Family and Life Advocates (NIFLA) was formed to provide legal advice to CPCs.

There are over 4,000 CPCs in the United States, as compared with well under 750 abortion clinics. Canada has roughly 200 CPCs to about 25 abortion clinics. There are hundreds more outside of the US and Canada. At least 20 US States provide funding for CPCs. A report prepared for Henry Waxman found that from 2001 to 2005, 50 CPCs received $30 million in funding from the federal government. By 2006, CPCs had received more than $60 million dollars of federal funding, including some funding earmarked for abstinence-only programs.

CPCs provide peer counseling related to abortion, pregnancy and childbirth, and may also provide pregnancy testing, STD screening, adoption referrals, religious counseling, financial assistance, prenatal services, child-rearing resources and other services. CPCs have been found to disseminate false medical information, usually but not exclusively about the health risks of abortion.

Legal and legislative action regarding CPCs has generally punished or attempted to preempt deceptive advertising, targeting those that advertise as abortion clinics or requiring centers to disclose that they do not offer abortions or possess certain qualifications.

History

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The Family Research Council describes the beginnings of the crisis pregnancy movement in a 2009 report. In 1968, the first network of centers was established by Birthright, in Canada. Alternatives to Abortion, today known as Heartbeat International, was founded in 1971. Christian Action Council founded its first center in Baltimore, Maryland, in 1980. Christian Action Council eventually would become Care Net.

CPC activities

While CPCs often look like abortion clinics and are intentionally located near them, the overwhelming majority are not legally licensed as medical clinics and do not offer medical services. Most CPCs offer free pregnancy tests, often over-the-counter ones, and there is a movement towards obtaining medical clinic status, largely so that more CPCs may offer sonograms in an attempt to convince women to carry their pregnancies to term.

Peer counselors are typically covered by mandated reporting laws with regard to statutory rape, and are encouraged to ask about the age of the woman and the biological father. While some centers offer artificial contraception, either free or discounted, most do not and the service may be limited to married women. Others may offer Bible study sessions and peer counseling for women who have recently had abortions.

CPCs have been criticized for using heavy-handed methods such as graphic, detailed videos, religious proselytism, providing inaccurate medical information and misleading advertising. However, CPCs are increasingly distancing themselves from some of these tactics. Many are buying ultrasound machines, employing staff with medical training, and otherwise moving toward a "medical model" of serving women in the communities where they operate. Paige Johnson, a spokeswoman for Chapel Hill based Planned Parenthood of Central North Carolina stated, "I don't discount the work that they do for women who know they want to keep their babies."

CPCs may provide a variety of services, but their primary service is counseling women against abortion. This counseling may include showing clients sonograms, giving them false information about the health risks of abortion, and evangelizing or giving them religious information.

Use of sonograms

Ultrasound scanner.

About a quarter of CPCs conduct free sonograms as a way to persuade women not to abort. It is frequently claimed that women who visit CPCs and see their embryos or fetuses through the use of ultrasound technology decide against abortion, although there are no scientific studies which support this.

Colorado-based Focus on the Family had the goal of equipping 800 CPCs with ultrasound machines by 2010, through its "Option Ultrasound" program. The Southern Baptist Convention—the largest Protestant denomination in the United States—has formed an Ethics & Religious Liberty Commission (ERLC). The ERLC works to equip more CPCs with ultrasound machines, through what they call the "Psalm 139 Project". ERLC President Richard Land wrote: "If wombs had windows, people would be much more reticent to abort babies because they would be forced to confront the evident humanity of the baby from very early gestation onward."

False medical information

Journalists, congressional investigators, prospective CPC clients, and pro-choice advocates have routinely found that CPCs give out false medical information. In a few cases, such information may be based on decades-old studies that have been discredited by more recent research. In others, CPCs claim an existing scientific consensus in favor of such information. The information is usually about the supposed health risks of abortion; centers fail to mention that abortion is 11 to 12 times safer than childbirth. One woman even say that "terminating a pregnancy is far more dangerous than carrying a baby to term," although the opposite is the case.

One common piece of medical misinformation is the assertion of a link between abortion and breast cancer. One crisis pregnancy center counselor is reported to have told a client that "50 percent of women who have an abortion get breast cancer and 30 percent die within a year of the procedure"; others have claimed a 50% increase, an 80% increase,, a doubled increase, a quadrupled increase, or said that a client with breast cancer in her family would certainly get cancer and die if she had an abortion. Major medical bodies (including the National Cancer Institute) say that there is no link between abortion and breast cancer.

Another is the assertion of a link between abortion and mental health problems. CPC counselors are reported to have conveyed various supposed psychological consequences of abortion, including high rates of depression, "post-abortion syndrome," post-traumatic stress disorder, suicide, substance abuse, sexual and relationship dysfunction, propensity to child abuse, and other emotional problems. Figures included a 50% chance of long-term emotional problems or trauma, nine in ten women suffering "post-abortion syndrome," and a sevenfold increase in the suicide rate; one center said that anyone who had had an abortion was certain to experience mental health problems like those suffered by Vietnam veterans. Neither the American Psychiatric Association nor the American Psychological Association recognizes the existence of "post-abortion syndrome," and an American Psychological Association review of relevant studies found that "abortion is usually psychologically benign."

CPCs may also claim that surgical abortion is a dangerous procedure, with a high risk of perforation or infection. One CPC counselor is reported to have told an undercover investigator that a patient was left needing a colostomy bag after her bowel was perforated; several reports mention that a CPC described or depicted a woman dying as a result of the procedure. However, fewer than 0.3% of women who have abortions experience complications that necessitate hospitalization.

The alleged risk of perforation and infection is also part of the assertion that abortion negatively impacts future childbearing, by increasing the risk of infertility, miscarriages, complications, ectopic pregnancy, or fetal health problems. One center claimed that there was a one in four chance of not being able to carry another pregnancy. These claims are not supported by medical data.

Besides false information about health risks of abortion, CPCs have also been found to disseminate misinformation about birth control methods, in particular the idea that contraception and condoms do not work or have harmful effects. Some counselors said that "all condoms are defective and have slots and holes in them" or that they fail "something like 40 percent of the time." Other centers said that condoms were permeable to HIV, or that hormonal contraceptives had abortifacient effects and did long-term harm to women's health, such as causing infertility and cancer, while one said that condoms caused cancer.

Other false information may concern the methodology of pregnancy tests, the advisability of STI testing on pregnant women, the comparative risk, availability, and advisability of abortion at different stages of pregnancy, descriptions of female anatomy, the rate of postpartum depression among women who carry to term, the progression of fetal development, fetal pain, or the possibility of getting pregnant from rape.

Pro-choice organizations like Planned Parenthood, the National Abortion Federation, and Choice Ireland have criticized CPCs' dissemination of false medical information. Care Net denounces "any form of deception in its corporate advertising or individual conversations with its clients," though they also say of their promotion of an abortion–breast cancer link that their "role is clearly to include this possible risk when educate clients about all the risks of abortions."

Religious affiliation

The overwhelming majority of CPCs in the US affiliated with a Christian organization. NIFLA "strongly believes that sharing the Gospel is an essential part of counseling women in pregnancy help medical clinics". Care Net, the largest CPC network in the United States, is explicitly evangelistic in nature, and says that its "ultimate aim...is to share the love and truth of Jesus Christ in both word and deed" and that its "pregnancy centers are committed to sharing the love of Jesus Christ with every person who walks through their doors." Heartbeat International, one of the largest CPC networks in the United States and also the largest CPC network in the world, describes itself as a "Christian association of faith-based pregnancy resource centers" whose materials are "consistent with Biblical principles." Together, Care Net and Heartbeat International accounted for three quarters of CPCs in the United States, as of 2007. Birthright International has a stated philosophy of non-evangelism. Some CPCs are run by the Catholic Church or by other church groups. Unaffiliated CPCs, or CPCs affiliated with other organizations, may provide a religious perspective in their counseling. A Jewish CPC, called "In Shifra's Arms," also exists. According to Waxman's report in 2006, 50 CPCs are funded by the federal government.

Many CPCs require their staff to be Christian. For example, as a condition of affiliation, Care Net and the Canadian Association of Pregnancy Support Services, the two largest CPC organizations in the United States and Canada respectively, require each employee and volunteer of a prospective affiliate to comply with a statement of faith. CPCs unaffiliated with either of these may also require volunteers to be Christian.

Religious activity is sometimes part of a CPC customer's experience. Care Net claims to have effected over 23,000 conversions or restatements of Christian faith. NIFLA "strongly believes that sharing the Gospel is an essential part of counseling women in pregnancy help medical clinics". Some visitors to CPCs report that employees subjected them to unwanted evangelizing.

CPCs outside the United States are also frequently Christian. CareConfidential, the largest umbrella network for CPCs in the United Kingdom, runs "Christian-based pregnancy crisis centres" and is a division of the Christian charity CARE. The Canadian Association of Pregnancy Support Services, a similar network in Canada whose centers may also affiliate with Care Net or Heartbeat International, describes itself as a "Christian charity"; its affiliates "adhere firmly to Christianity." The United States-based Human Life International runs "Catholic pregnancy centers" in Mexico and also provides aid to the Centros de Ayuda para la Mujer, a network of CPCs in Latin America whose philosophy is "in conformity with the Magisterium of the Roman Catholic and Apostolic Church." As in the United States, unaffiliated CPCs may also be run by church groups or otherwise Christian.

Advertising methods

CPCs may describe themselves as offering "abortion alternatives," or with another term that indicates that they do not assist clients in obtaining an abortion. However, some falsely advertise that they offer abortion services. Pro-choice supporters have also pointed out that they use rhetoric and advertising language similar to those of abortion providers—for example, "Plan Your Parenthood" or a directory listing under "abortion services" or "clinics"—and object to the use of such techniques which they say may mislead pregnant women seeking abortion into contacting a CPC. Some crisis pregnancy centers advertise in a manner called deceptive by "the Texas Attorney General, the North Dakota Supreme Court, the Federal Centers for Disease Control, the National Organization for Women, Planned Parenthood the New York Metropolitan Religious Coalition for Abortion Rights", "NARAL Pro Choice America, Planned Parenthood Federation of America the National Abortion Federation, as well as the American Civil Liberties Union". In particular, the advertising approach of the Pearson Foundation, which assists local groups establishing CPCs, has been criticized by some other pro-life groups, including Birthright International, another CPC operator. The foundation recommends that a center seek out women who want abortions through "neutral" advertising, and refuse to answer questions that would reveal that they provide neither abortion services nor referrals to abortion services.

Planned Parenthood charges that CPC administrators portray their businesses as "medical facilities", when they do not have professional licensing from local or state health departments, and are staffed primarily with volunteers rather than medical professionals. "They are integrating increasing numbers of medical services in what they do, offering free pregnancy tests and low-cost testing for sexually transmitted diseases and sonographs," says Gloria Feldt. " if they are going to practice medicine—and as they add these tests they are practicing medicine—they either need to practice it legitimately or cut out the charade."

Care Net advises its affiliates that "any form of deception in its corporate advertising or individual conversations with its clients" is prohibited.

Safe haven

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Crisis pregnancy centers, along with hospitals and fire and police stations, are designated by state law in Louisiana as emergency care facilities where parents may surrender custody of newborn infants.

Legal and legislative action

Legal and legislative action in response to CPCs has typically focused on their advertising practices, and has usually resulted in the CPCs in question being obliged to make clear statements about the services they offer.

Court cases

In 1986, a lawsuit by the Fargo Women's Health Organization, a medical clinic that performed abortions, led to the North Dakota Supreme Court judging that the Fargo Women's Help Clinic, a CPC, had engaged in "false and deceptive advertising" by advertising that they provided abortions. The Help Clinic argued that, because it received no money from its clients and its statements were in support of a position rather than for commercial gain, they were exempt from regulations on commercial speech, but the court ruled that the CPC's advertisements were "placed in a commercial context and...directed at the providing of services rather than toward an exchange of ideas" and thus were not exempt. The court upheld a preliminary injunction forbidding the Help Clinic from advertising that they provided abortions, and from using a confusing name that might "falsely lull people...into thinking that they are, in fact, the Women's Health Organization or the Fargo Women's Health organization, Inc."

Also in 1986, the Problem Pregnancy Center in Fort Worth, Texas was sued by the Texas Attorney General's office after reports from women who had telephoned the agency, which was listed under "abortion information," and found that it was a "right-to-life outfit." A jury found that the center had violated the Texas Deceptive Trade Practices Act and required it to pay $39,000 in fines, in addition to a larger sum in lawyers' fees.

In 1994, the Center for Unplanned Pregnancy, a San Diego CPC, was legally determined to have engaged in false advertisement. This resulted in it being court-ordered to tell every client that it did not provide abortions or abortion referrals and that its counseling was "from a Biblical anti-abortion perspective," and to stop advertising under "clinics," "abortion service providers," "birth control information" or "pregnancy options counseling" in the telephone directory. The court also disallowed the center from providing pregnancy tests. Three other CPCs involved in the case—Escondido Pregnancy Services, Poway Pregnancy Counseling Center and San Diego Counseling Center—settled out of court and agreed to change their advertising practices, while the last, San Diego Pregnancy Services, had earlier closed when faced with accusations of coercion in its adoption practices.

Other CPCs in New York and California have been enjoined from providing pregnancy tests without a license, while a CPC in California was forbidden to advertise pregnancy tests as "free" if they are conditional upon hearing a presentation or counseling.

Spitzer investigation

In January 2002, then-New York Attorney General Eliot Spitzer launched an investigation into alleged deceptive business practices of 24 crisis pregnancy centers across the State and issued subpoenas to 11 of them. Spitzer's investigation was criticized by some as politically motivated harassment on behalf of political allies like NARAL Pro-Choice America. In February 2002, a number of the targeted crisis pregnancy centers filed motions in New York State court against the Attorney General's office, seeking to quash the subpoenas. Later that same month, Spitzer withdrew all the subpoenas. However, the Attorney General's office also worked out an agreement with one of the CPCs in question, intended to be used as a model, which sets out practices including informing clients that the center does not provide abortion or birth control, that it is not a licensed medical facility, and that the pregnancy tests it provides are over-the-counter.

Waxman Report

In 2006, Congressman Henry Waxman (D-CA) led an investigation of taxpayer-funded CPCs and found that they provided "false and misleading information" on an alleged link between abortion and breast cancer, on the alleged effects of abortion on fertility, and on the alleged mental health effects of abortion.

The summary of the report states:

The individuals who contact federally funded pregnancy resource centers are often vulnerable teenagers, who are susceptible to being misled and need medically accurate information to help them make a fully informed decision. The vast majority of pregnancy resource centers contacted for this report, however, provided false or misleading information about the health risks of an abortion. This may advance the mission of the pregnancy resource centers, which are typically pro-life organizations dedicated to preventing abortion, but it is an inappropriate public health practice.

Pro-life groups criticized Waxman's report, alleging that it contained inaccuracies and distortions.

Proposed "Stop Deceptive Advertising for Women's Services Act"

On March 30, 2006, Rep. Carolyn Maloney (D-NY) and eleven co-sponsors introduced a bill called the "Stop Deceptive Advertising for Women's Services Act", which would have required the Federal Trade Commission to "promulgate rules prohibiting...persons from advertising with the intent to deceptively create the impression that such persons provide abortion services" and "enforce violations of such rules as unfair methods of competition and unfair or deceptive acts or practices." Maloney re-introduced the bill in 2007 in the Democratic-controlled 110th Congress, and was joined by Senator Bob Menendez (D-NJ) in reintroducing it in July 2010 in the Democratic-led 111th Congress, but in no case did it progress out of committee.

State and local ordinances

New York City, Montgomery County, Maryland and Austin, Texas require CPCs to post signs about the nature of the services they offer. Austin requires them to disclose that they neither offer nor refer for abortion and birth control, and Montgomery County requires them to disclose that they do not employ licensed medical professionals. The New York law requires all pregnancy counseling centers to disclose whether or not they provide abortion, birth control, or prenatal care; says that those who do not must refer clients seeking abortions to those who do; and requires that the information of clients be kept private. It is expected to be challenged by groups that oppose abortion.

A law requiring Baltimore, Maryland pregnancy centers to display signs stating that they did not offer or refer clients for abortion was declared unconstitutional on free speech grounds after a lawsuit by the Archdiocese of Baltimore and a Maryland CPC. The City of Baltimore is appealing the ruling.

Some campaigns to pass disclosure laws are supported by NARAL Pro-Choice America, a pro-choice political organization, which claims "the centers mislead women." The organization took credit for the passage of the Austin law. NARAL's model, based on the one used in Baltimore, involves publishing studies on how CPCs mislead women and partnering with sympathetic lawmakers to pass legislation regulating CPCs. Matt Bowman of the Alliance Defense Fund, an anti-abortion organization, believes that NARAL is trying to stop CPCs from "taking away their clients."

Affiliation

Most crisis pregnancy centers are affiliated with several major pro-life organizations that fund CPCs; these are Care Net, Heartbeat International, Birthright International, and National Institute of Family and Life Advocates (NIFLA). Care Net is the largest network of CPCs in North America, with 1,100 centers advising over 350,000 women annually. Heartbeat International, a U.S.-based group which affiliates with CPCs both in the United States and abroad, is associated with over 1,000 centers. Some CPCs are affiliated with multiple organizations at once, so the sum does not reflect the total. The largest UK organisations are CareConfidential and LifeUK, while the largest Canadian one is the Canadian Association of Pregnancy Support Services. Human Life International, a Roman Catholic group that opposes abortion, also runs CPCs outside the United States.

Government funding

Canada

Some CPCs in Canada have received funding from provincial governments.

Ireland

In Ireland (where abortion is illegal except when pregnancy endangers the mother's life) the government has created the Crisis Pregnancy Programme (formerly the Crisis Pregnancy Agency), a nation-wide working group to address crisis pregnancies. One of its objectives is to reduce the number of women who opt for abortion; the primary method it uses in pursuit of this goal is the provision of "services and supports which make other options more attractive." The CPP funds crisis pregnancy initiatives and is in turn reimbursed by the Health Service Executive. Crisis pregnancy counseling grants are provided through a campaign called "Positive Options"; funding is awarded only to centers that offer non-directive and medically accurate counseling that discusses all possible options, including traveling abroad for abortion. Centers that "use manipulation and alarmist information" to persuade women not to have an abortion are called "rogue agencies."

United States

Federal funding

As of July, 2006, 50 CPCs had received federal funding. Between 2001 and 2006, over $60 million in federal funds were given to crisis pregnancy centers.

State funding

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Florida Choose Life tag

In 2006, 20 U.S. states subsidized crisis pregnancy centers. These included Florida, Louisiana, Minnesota, Missouri, Nebraska, North Dakota, Pennsylvania and Texas.

In 2005 Florida launched the Florida Pregnancy Support Services Program with $4 million. The funding paid for a toll-free hotline which provides information for non-abortion options and funding for CPCs. Governor Charlie Crist vetoed a funding cut in 2009 saying, "I appreciate the effort and support that chairman Dean Cannon and so many other House leaders put forth in making sure that innocent human life was protected in Florida.”

In 24 U.S. states, individuals can support CPCs by purchasing Choose Life license plates. Motorists in these states can request these plates and pay an extra fee, a portion of which is used by the state to fund adoption support organizations and crisis pregnancy centers.

See also

References

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  4. ^ Simon, Stephanie (February 12, 2007). "Abortion foes are getting public funds". San Francisco Chronicle.
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  73. "SPITZER REACHES AGREEMENT WITH UPSTATE CRISIS PREGNANCY CENTER" (Press release). Office of the Attorney General of New York. February 28, 2002. Retrieved 2010-12-08.
  74. Waxman Report Is Riddled with Errors and Inaccuracies, The Heritage Foundation
  75. Waxman's whoppers, American Life League
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