News Abortion

After One Year of Forced Ultrasounds in Virginia, Report Examines Role of CPCs

Robin Marty

A new report from the NARAL Pro-Choice Virginia Foundation shows that crisis pregnancy centers are misleading and in some cases obstructing patients from accessing abortion services, and they are doing so under the auspices of being sanctioned by the state.

It’s been just over a year since Virginia’s forced ultrasound law into effect, requiring individuals to undergo an ultrasound and then wait 24 hours, in most cases, before getting an abortion. Patients have seen an increase in expenses and a greater time commitment associated with the procedure, and abortion clinics are finding that they need more staff and other resources. Meanwhile, many crisis pregnancy centers (CPCs) are offering free ultrasounds under the new restrictions. But as a new report from the NARAL Pro-Choice Virginia Foundation (NPCVF) shows, CPCs are misleading and in some cases obstructing patients from accessing abortion services, and they are doing so under the auspices of being sanctioned by the state.

NPCVF has been conducting investigations into local crisis pregnancy centers since 2010, and has learned that the state’s CPCs, which are largely faith-based, are just as deceptive as ever. CPCs have long been known to provide inaccurate medical information about abortion types and complications, the effectiveness of contraception, and the treatment of sexually transmitted infections, but now they are being touted as a state-approved source for obtaining free ultrasounds that supposedly can be taken to abortion providers in lieu of being made to visit the provider twice.

Two CPCs investigated in the report refused to give patients a copy of their ultrasound when the patients stated they were going to have an abortion; a third said it could take “weeks” to get the documentation. One CPC directly denied a request to have an ultrasound faxed to an abortion provider, saying it doesn’t “support abortion clinics.”

The stakes here are significant. When a person visits a CPC hoping to get a free ultrasound but leaves empty-handed, she may no longer be able to undergo her preferred method of abortion, and may incur greater costs, because of legal gestational limits.

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Tarina Keene, executive director of NARAL Pro-Choice Virginia, says that the 24-hour waiting period mandated by the law for residents who live less than 100 miles from an abortion clinic is particularly dangerous. Without that requirement, all people seeking abortions in the state could get an ultrasound directly before the procedure, rather than having to seek out ultrasounds from alternative sources, many of which are CPCs that patients go to out of financial desperation.

“It’s horrible for patients,” Keene told Rewire. “Patients have to come back two, sometimes three times now. In some cases they will come in to get their pregnancy tests, then schedule another day to do the ultrasound, then schedule another day to do the procedure. The only thing that the ultrasound law granted patients is that patients who live 100 miles from a clinic had to have the ultrasound two hours before the procedure.”

Keene’s group has also heard from providers who say they cannot trust the documents they receive from CPCs, and have to perform their own ultrasounds anyway to ensure the results are valid. When a patient brings in an ultrasound image from a CPC, an abortion provider will “have to be able to look at it and say, ‘OK, I am going to trust what this [CPC] says, that this image was actually taken when it says it was, and that the woman is in fact 12 weeks pregnant as the ultrasound says she is, or ten weeks pregnant, or eight weeks pregnant.’ Or it could say that she is 15 weeks pregnant and beyond the time when she is allowed to have an abortion, and they have to believe that” if they accept ultrasounds from outside clinics, explained Keene. As a result, she said, “no provider that I spoke to said that they would accept an image from outside their office.”

The NPCVF report describes how one client got a “virtually unusable” ultrasound picture from a CPC; it lacked any form of patient identification, pregnancy center identification, measurements, and an estimate of gestational age. The group argues that in instances like this, CPCs aren’t just acting on bad faith, but are violating state law as well, by acting as medical professionals but not adhering to standards of care.

At the same time, abortion clinics must now adhere to a set of rules overseeing every aspect of their operation, from hall width to medical tools and medications found in the office. Reproductive rights advocates argue this is a double standard. “The state is not justifying it, because unfortunately, they don’t have to,” said Keene. “They are in control and they can pass and sanction anything they want.”

She went on, “It is ironic that we are putting so much emphasis on our abortion providers, that they are allegedly putting women’s lives and health at risk, yet they are willing to send women to facilities that may not have any kind of medical oversight and also have an agenda. They could be giving out not only medical misinformation about birth control, which definitely hinders public health, but they are basically trying to deceive women into not having a legal, legitimate, safe procedure by misleading them on this ultrasound.”

“They are luring them into this facility for a free pregnancy test and a free ultrasound, and at the same time giving them misinformation about both,” said Keene. “You can’t even justify that.”

News Health Systems

The Crackdown on L.A.’s Fake Clinics Is Working

Nicole Knight

"Why did we take those steps? Because every day is a day where some number of women could potentially be misinformed about [their] reproductive options," Feuer said. "And therefore every day is a day that a woman's health could be jeopardized."

Three Los Angeles area fake clinics, which were warned last month they were breaking a new state reproductive transparency law, are now in compliance, the city attorney announced Thursday.

Los Angeles City Attorney Mike Feuer said in a press briefing that two of the fake clinics, also known as crisis pregnancy centers, began complying with the law after his office issued notices of violation last month. But it wasn’t until this week, when Feuer’s office threatened court action against the third facility, that it agreed to display the reproductive health information that the law requires.

“Why did we take those steps? Because every day is a day where some number of women could potentially be misinformed about [their] reproductive options,” Feuer said. “And therefore every day is a day that a woman’s health could be jeopardized.”

The facilities, two unlicensed and one licensed fake clinic, are Harbor Pregnancy Help CenterLos Angeles Pregnancy Services, and Pregnancy Counseling Center.

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Feuer said the lawsuit could have carried fines of up to $2,500 each day the facility continued to break the law.

The Reproductive Freedom, Accountability, Comprehensive Care, and Transparency (FACT) Act requires the state’s licensed pregnancy-related centers to display a brief statement with a number to call for access to free and low-cost birth control and abortion care. Unlicensed centers must disclose that they are not medical facilities.

Feuer’s office in May launched a campaign to crack down on violators of the law. His action marked a sharp contrast to some jurisdictions, which are reportedly taking a wait-and-see approach as fake clinics’ challenges to the law wind through the courts.

Federal and state courts have denied requests to temporarily block the law, although appeals are pending before the U.S. Court of Appeals for the Ninth Circuit.

Some 25 fake clinics operate in Los Angeles County, according to a representative of NARAL Pro-Choice California, though firm numbers are hard to come by. Feuer initially issued notices to six Los Angeles area fake clinics in May. Following an investigation, his office warned three clinics last month that they’re breaking the law.

Those three clinics are now complying, Feuer told reporters Thursday. Feuer said his office is still determining whether another fake clinic, Avenues Pregnancy Clinic, is complying with the law.

Fake clinic owners and staffers have slammed the FACT Act, saying they’d rather shut down than refer clients to services they find “morally and ethically objectionable.”

“If you’re a pro-life organization, you’re offering free healthcare to women so the women have a choice other than abortion,” said Matt Bowman, senior counsel with Alliance Defending Freedom, which represents several Los Angeles fake clinics fighting the law in court.

Asked why the clinics have agreed to comply, Bowman reiterated an earlier statement, saying the FACT Act violates his clients’ free speech rights. Forcing faith-based clinics to “communicate messages or promote ideas they disagree with, especially on life-and-death issues like abortion,” violates their “core beliefs,” Bowman said.

Reports of deceit by 91 percent of fake clinics surveyed by NARAL Pro-Choice California helped spur the passage of the FACT Act last October. Until recently, Googling “abortion clinic” might turn up results for a fake clinic that discourages abortion care.

“Put yourself in the position of a young woman who is going to one of these centers … and she comes into this center and she is less than fully informed … of what her choices are,” Feuer said Thursday. “In that state of mind, is she going to make the kind of choice that you’d want your loved one to make?

Rewire last month visited Lost Angeles area fake clinics that are abiding by the FACT Act. Claris Health in West Los Angeles includes the reproductive notice with patient intake forms, while Open Arms Pregnancy Center in the San Fernando Valley has posted the notice in the waiting room.

“To us, it’s a non-issue,” Debi Harvey, the center’s executive director, told Rewire. “We don’t provide abortion, we’re an abortion-alternative organization, we’re very clear on that. But we educate on all options.”

Culture & Conversation Family

‘Abortion and Parenting Needs Can Coexist’: A Q&A With Parker Dockray

Carole Joffe

"Why should someone have to go to one place for abortion care or funding, and to another place—one that is often anti-abortion—to get diapers and parenting resources? Why can’t they find that support all in one place?"

In May 2015, the longstanding and well-regarded pregnancy support talkline Backline launched a new venture. The Oakland-based organization opened All-Options Pregnancy Resource Center, a Bloomington, Indiana, drop-in center that offers adoption information, abortion referrals, and parenting support. Its mission: to break down silos and show that it is possible to support all options and all families under one roof—even in red-state Indiana, where Republican vice presidential candidate Gov. Mike Pence signed one of the country’s most restrictive anti-abortion laws.

To be sure, All-Options is hardly the first organization to point out the overlap between women terminating pregnancies and those continuing them. For years, the reproductive justice movement has insisted that the defense of abortion must be linked to a larger human rights framework that assures that all women have the right to have children and supportive conditions in which to parent them. More than 20 years ago, Rachel Atkins, then the director of the Vermont Women’s Center, famously described for a New York Times reporter the women in the center’s waiting room: “The country really suffers from thinking that there are two different kinds of women—women who have abortions and women who have babies. They’re the same women at different times.”

While this concept of linking the needs of all pregnant women—not just those seeking an abortion—is not new, there are actually remarkably few agencies that have put this insight into practice. So, more than a year after All-Options’ opening, Rewire checked in with Backline Executive Director Parker Dockray about the All-Options philosophy, the center’s local impact, and what others might consider if they are interested in creating similar programs.

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Rewire: What led you and Shelly Dodson (All-Options’ on-site director and an Indiana native) to create this organization?

PD: In both politics and practice, abortion is so often isolated and separated from other reproductive experiences. It’s incredibly hard to find organizations that provide parenting or pregnancy loss support, for example, and are also comfortable and competent in supporting people around abortion.

On the flip side, many abortion or family planning organizations don’t provide much support for women who want to continue a pregnancy or parents who are struggling to make ends meet. And yet we know that 60 percent of women having an abortion already have at least one child; in our daily lives, these issues are fundamentally connected. So why should someone have to go to one place for abortion care or funding, and to another place—one that is often anti-abortion—to get diapers and parenting resources? Why can’t they find that support all in one place? That’s what All-Options is about.

We see the All-Options model as a game-changer not only for clients, but also for volunteers and community supporters. All-Options allows us to transcend the stale pro-choice/pro-life debate and invites people to be curious and compassionate about how abortion and parenting needs can coexist .… Our hope is that All-Options can be a catalyst for reproductive justice and help to build a movement that truly supports people in all their options and experiences.

Rewire: What has been the experience of your first year of operations?

PD: We’ve been blown away with the response from clients, volunteers, donors, and partner organizations …. In the past year, we’ve seen close to 600 people for 2,400 total visits. Most people initially come to All-Options—and keep coming back—for diapers and other parenting support. But we’ve also provided hundreds of free pregnancy tests, thousands of condoms, and more than $20,000 in abortion funding.

Our Hoosier Abortion Fund is the only community-based, statewide fund in Indiana and the first to join the National Network of Abortion Funds. So far, we’ve been able to support 60 people in accessing abortion care in Indiana or neighboring states by contributing to their medical care or transportation expenses.

Rewire: Explain some more about the centrality of diaper giveaways in your program.

PD: Diaper need is one of the most prevalent yet invisible forms of poverty. Even though we knew that in theory, seeing so many families who are struggling to provide adequate diapers for their children has been heartbreaking. Many people are surprised to learn that federal programs like [the Special Supplemental Nutrition Program for Women, Infants, and Children or WIC] and food stamps can’t be used to pay for diapers. And most places that distribute diapers, including crisis pregnancy centers (CPCs), only give out five to ten diapers per week.

All-Options follows the recommendation of the National Diaper Bank Network in giving families a full pack of diapers each week. We’ve given out more than 4,000 packs (150,000 diapers) this year—and we still have 80 families on our waiting list! Trying to address this overwhelming need in a sustainable way is one of our biggest challenges.

Rewire: What kind of reception has All-Options had in the community? Have there been negative encounters with anti-choice groups?

PD: Diapers and abortion funding are the two pillars of our work. But diapers have been a critical entry point for us. We’ve gotten support and donations from local restaurants, elected officials, and sororities at Indiana University. We’ve been covered in the local press. Even the local CPC refers people to us for diapers! So it’s been an important way to build trust and visibility in the community because we are meeting a concrete need for local families.

While All-Options hasn’t necessarily become allies with places that are actively anti-abortion, we do get lots of referrals from places I might describe as “abortion-agnostic”—food banks, domestic violence agencies, or homeless shelters that do not have a position on abortion per se, but they want their clients to get nonjudgmental support for all their options and needs.

As we gain visibility and expand to new places, we know we may see more opposition. A few of our clients have expressed disapproval about our support of abortion, but more often they are surprised and curious. It’s just so unusual to find a place that offers you free diapers, baby clothes, condoms, and abortion referrals.

Rewire: What advice would you give to others who are interested in opening such an “all-options” venture in a conservative state?

PD: We are in a planning process right now to figure out how to best replicate and expand the centers starting in 2017. We know we want to open another center or two (or three), but a big part of our plan will be providing a toolkit and other resources to help people use the all-options approach.

The best advice we have is to start where you are. Who else is already doing this work locally, and how can you work together? If you are an abortion fund or clinic, how can you also support the parenting needs of the women you serve? Is there a diaper bank in your area that you could refer to or partner with? Could you give out new baby packages for people who are continuing a pregnancy or have a WIC eligibility worker on-site once a month? If you are involved with a childbirth or parenting organization, can you build a relationship with your local abortion fund?

How can you make it known that you are a safe space to discuss all options and experiences? How can you and your organization show up in your community for diaper need and abortion coverage and a living wage?

Help people connect the dots. That’s how we start to change the conversation and create support.

This interview has been edited for length and clarity.

CORRECTION: This article has been updated to clarify the spelling of Shelly Dodson’s name.

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