Investigations Abortion

Anti-Choice Advocates Abuse Statutory Rape Reporting Laws to Target Abortion Providers

Sofia Resnick

Public health experts say there is a legitimate purpose to statutory rape and incest laws. However, in the context of abortion, these laws are effectively criminalizing normal teen sex and risk compromising patient-confidentiality agreements, as well as potentially deterring patients from seeking sexual health treatment.

See other pieces from Rewire‘s State of Abortion series here.

Review the database of state documents collected and analyzed by Rewire here.

When a 13-year-old girl came to Dr. Ulrich Klopfer’s Fort Wayne, Indiana, clinic seeking an abortion in February, the doctor terminated the teenager’s pregnancy, and then—as required by state law—he informed the authorities, he says.

Klopfer said he faxed a report to one of the state agencies he is required to notify in compliance with an Indiana statute that mandates all abortions be reported to the state once every six months.

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Now, that report is the subject of a complaint against Klopfer, filed by anti-choice activists who obtained it through a public records request. The document gives no details on the father of the aborted fetus, but does show the date on which the procedure was performed.

“It’s heartbreaking to learn that a 13-year-old became pregnant and now must live with the pain of an abortion for the rest of her life, but it’s doubly heartbreaking that Dr. Klopfer’s failure to report the abortion may have allowed the girl’s molester to walk free,” said Cathie Humbarger, an anti-choice activist and executive director of the Allen Country Right to Life, in a press release.

In fact, there was no indication that the girl had been subject to molestation. Nor was there any suggestion that the abortion was illegal. The complaint was instead based on a requirement of Indiana’s statutory rape notification law that says providers must report abortions performed on minors to the state health and child services departments within three days of the abortion. Humbarger claims that Klopfer waited too long to report the abortion, falling foul of the three-day time limit. Klopfer disputes the allegation, saying he complied with all relevant time limits.

The case could have severe consequences for Dr. Klopfer. In their complaint against him, Humbarger and another anti-choice activist pointed out that Klopfer’s report of the minor’s abortion was marked as being received by the health department in late July, despite the procedure having been performed in February. They have asked the state attorney general’s office to immediately suspend Klopfer’s medical license pending a full investigation.

Klopfer said he complied with the law, though he admitted he did not notify the child services department in addition to the health department, which goes against the statute. The doctor said he expected the departments to communicate with each other. But due to the risks inherent in the mandatory notification laws, he said he now advises minor patients and their parents that they have the option to go to Illinois or Ohio—bordering states—if they want to avoid having their abortions reported. He estimated that up to a third of patients take that option.

Disputes like this are becoming more common as a growing number of states adopt requirements for abortion providers to report all abortions performed on minors as possible cases of rape or incest, even where there is no actual evidence that either of those crimes has occurred. The laws have led to disciplinary actions and, in some cases, clinic closures, according to an analysis of state documents obtained by Rewire as part of our State of Abortion series. In many cases, the disciplinary proceedings are sparked by complaints from anti-choice groups, which are increasingly influential in crafting and passing the laws in the first place, and use them as part of a smear campaign against abortion care by trying to associate abortion with sexual abuse.

Public health experts say there is a legitimate purpose to statutory rape and incest laws: They encourage health-care providers to check for evidence of sexual abuse among young patients. However, in the context of abortion, these laws are effectively criminalizing normal teen sex and risk compromising patient-confidentiality agreements, as well as potentially deterring patients from seeking sexual health treatment, experts told Rewire.

“I think it’s very important that young people who are involved in sexual activity of whatever sort and with whatever age of partner feel free to seek medical attention associated with their sexual activity,” said Abigail English, an adolescent health legal expert and director of the Center for Adolescent Health & the Law in Chapel Hill, North Carolina.

English said a particular problem with many of these laws is that they strip away a provider’s discretion to determine whether sexual relationships involving minors are consensual or coercive.

“To the extent that the child abuse reporting laws are structured in a way that discourages that, it’s very unfortunate,” she said.

Experts questioned whether these laws have any significant impact on stopping sexual abuse, but they are certainly having an impact on abortion providers, who are now at greater risk of disciplinary actions and who sometimes face the predicament of sending vulnerable patients out of state to avoid the pitfalls of reporting laws.

A Tangled Web of Laws

Statutory rape laws follow the premise that, under a certain age, individuals cannot consent to sexual activity because they cannot grasp the ramifications of sex. Every state and the District of Columbia address statutory rape through criminal laws and civil reporting laws.

The criminal laws determine at what age an individual can legally consent to sex; mandatory reporting laws determine when sex with a minor of a certain age needs to be reported to law enforcement or child protective services and who must report this sex. In many states, certain professionals, such as doctors and nurses, are designated as “mandatory reporters,” meaning they are obliged to tell authorities when they become aware of certain instances of sex involving a minor.

But most states handle the terms of these laws in different ways. In fact, statutory rape criminal and reporting laws resemble a tangled web of convoluted policies that can make compliance difficult.

A federally funded comprehensive guide to statutory rape criminal and reporting laws published in 2004 explains that, as of 2003, only about a dozen states have a single age of consent, ranging from 14 to 18 years old. For example, in Kansas it is considered statutory rape to engage in sexual activity with a minor 15 years old or younger, regardless of the age of the sex partner.

Most states, however, determine the age of consent—in other words, when sex involving a minor is a crime—based on the ages and age differences between partners. Under Indiana’s “sexual misconduct with a minor” law, for example, it is considered statutory rape for a person at least 18 years of age to have sexual intercourse with a minor who is at least 14 but under 16. The penalties increase if the alleged offender is at least 21 years old and/or if the sexual intercourse is committed “by using or threatening the use of deadly force.”

States also differ on who is required to report potential instances of statutory rape and under what circumstances. According to the 2004 report, which was produced by the Lewin Group, a health-care consulting firm, about one-third of states mandate reporting only when the sexual abuse involves a relative or guardian, while two-thirds mandate reporting of potential child abuse, including statutory rape, regardless of the relationship between the “victim and the defendant.”

Many anti-choice advocates argue that young women and girls seeking abortions are often the victims of statutory rape, incest, or sex trafficking and that abortion providers actively ignore statutory rape reporting laws. Anti-choice groups, such as Live Action, have suggested that abortion providers safeguard rapists; others, such as the Charlotte Lozier Institute, have suggested that reproductive health facilities help to “perpetuate sex trafficking of women by failing to identify and rescue trafficked women and girls.”

There is little comprehensive research, however, to suggest that the majority of minors who seek abortions are more likely to have been victims of rape and incest than those who don’t seek abortions.

Though there are detailed, albeit knotty, requirements in every state about what to report, when, and to whom, statutory rape is often lumped in with sexual offenses or child sexual abuse in local and national data reporting. As a result, “little is known about the scope of statutory rape,” according to a subsequent Lewin Group report published in 2006.

The nonprofit research center Child Trends periodically attempts to assess rates of statutory rape among young people in the United States. In its most recent report, Child Trends analyzed data from the National Survey of Family Growth and found that, from 2006 to 2010, among individuals ages 18 to 24, 10 percent of females and 6 percent of males reported having their first sexual experience at age 15 or younger with an individual who was at least three years older, which Child Trends defined as statutory rape.

Though many health-care providers wish teenagers would wait longer before having sex, many also agree that statutory rape laws sometimes interfere with treating minors who, despite such laws, have chosen to engage in consensual sexual activity. In 2004, four major medical organizations that deal with adolescents—the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the Society of Adolescent Medicine—published a position paper in the Journal of Adolescent Health, arguing that some of the nation’s statutory rape reporting laws, and some of the interpretations of such laws, posed the risk of impeding the provider-patient relationship and were thus “detrimental to adolescents.” The article notes that providers should be allowed to use their discretion when looking for evidence of coercive sexual relationships and should not assume that sexual activity and sexual abuse are synonymous, even among adolescents.

“Well-intentioned but rigid laws can lead to outcomes that are both unintended and potentially damaging to the health of an adolescent,” the paper notes. “When a state’s laws require that sexual intercourse with a minor be reported to law enforcement or child welfare agencies, a sexually active adolescent in a consensual relationship may be placed in the untenable situation of forgoing essential health care (e.g., contraception, screening or treatment for sexually transmitted diseases, etc.) or, if he or she seeks that care, being reported to state authorities.”

In addition to potentially dissuading teens from seeking health care, it is also unclear to what extent instances of statutory rape are actually investigated, even once a report is made.

In its research, the Lewin Group found that child welfare agencies receive the majority of statutory rape reports but that many of these agencies often only investigate cases involving a family member. The child protection agencies will usually then forward along the report to the appropriate law enforcement agency, but the Lewin Group researchers noted that many times, the report will lack “sufficient details to warrant further investigation.”

Abortion providers have reported a similar trend when it comes to submitting their required statutory rape reports.

Dr. Ann Kristin Neuhaus, a former family doctor and abortion provider in Kansas, had her medical license revoked last year following a state investigation launched by then-Kansas Attorney General Phill Kline, allegedly to determine whether abortion clinics were complying with statutory rape reporting laws.

The Kansas State Board of Healing Arts ultimately ruled that the mental health examinations Neuhaus gave to 11 young women—to determine if they should be granted second- and third-trimester abortions—did not meet the state’s standard of care. The accusations were based on some of Neuhaus’ files generated using a computer program. Neuhaus disputes the main charges against her; for example, she said the board accused her of never having met some of the patients she said she consulted with because her signature was missing on some of the documents. She is currently appealing the board’s decision.

But Neuhaus told Rewire that, to her knowledge, most of the cases she reported to child protective services were never even investigated.

“If it was something questionable, then they would investigate it, but the vast majority of things that get reported are consensual sex with people between the ages of 14 and 16,” Neuhaus said.

Yet, in recent years, some state attorneys general have used statutory rape reporting requirements as a means to obtain abortion providers’ medical records, normally protected under federal privacy laws.

What transpired in Kansas resulted in minors’ private medical records being broadcast on a cable news show.

The quest for records began in 2003, when, after becoming attorney general, Kline reinterpreted a state law to demand that abortion providers report every minor under 16 who has an abortion—whereas the old law only stipulated that medical professionals had to report when they suspected minors had been injured as a result of sexual abuse.

Kline launched a years-long “investigation” into Kansas’ abortion clinics and subpoenaed patients’ medical records at a Planned Parenthood clinic in Overland Park and at Dr. George Tiller’s abortion clinic in Wichita. Kline’s stated reasoning for the investigation was to check whether the clinics were complying with statutory reporting requirements, as well as state laws restricting post-viability abortions. Following three years of disciplinary proceedings against Kline, last month the Kansas Supreme Court indefinitely suspended Kline’s law license for violating rules of professional conduct in relation to his prosecution of abortion providers.

According to Neuhaus, who worked as a consultant to Tiller from 1999 to 2007, the state never found evidence that instances of suspected statutory rape were going unreported. However, she said the state attorney general’s office used the investigation into statutory rape reporting requirements to look at the medical records of the abortion clinics.

“Then they used those records to dig for other things and to create more trouble,” Neuhaus said.

In the end, the state’s charges against Neuhaus involved her referrals for post-viability abortions rather than breaching the statutory rape reporting policy.

As part of her role with Tiller, Neuhaus provided second opinions for abortions involving fetuses that were beyond the point of viability, which is deemed to be 22 weeks’ gestation under Kansas law. In order to perform abortions in those circumstances, the law requires a second doctor’s opinion stating the abortion is necessary for the health of the pregnant person.

Neuhaus said she intentionally made her records sparse in order to protect her patients’ privacy—she worried they might someday become public. Her fears were realized one day in September 2011, when Fox News’ Bill O’Reilly broadcast information, allegedly from Neuhaus’ medical records, on his show, The O’Reilly Factor.

“This is Case File Number 3,” O’Reilly said in a segment recorded by liberal media watchdog Media Matters for America. “Dr. Neuhaus diagnosed a 15-year-old girl, who said she had a mental depression because she couldn’t bear not being able to continue riding in a rodeo.”

Neuhaus said she believes O’Reilly’s information came directly from her medical files, though to this day she does not know how O’Reilly obtained them. She told Rewire that some of her medical files were momentarily seized—and then returned to her—by one of Kline’s lawyers during their investigation of Neuhaus’ consultation practice for Tiller’s patients.

As for the characterization of her patient, transcripts from the hearings into Neuhaus’ case show that the 15-year-old girl O’Reilly referred to was training to be a professional barrel racer and had become depressed, according to Neuhaus’ diagnosis, because she feared having a baby would ruin her career ambitions.

Following the investigation, Neuhaus was ultimately charged with providing “inadequate” consultations to 11 women between the ages of 10 and 18 who sought abortions after 22 weeks’ gestation. (Tiller was acquitted of charges filed against him in March 2009; the state opened new charges but dropped them after he was murdered by an anti-choice extremist two months later.)

Neuhaus, who is now a research fellow at the University of Kansas Medical Center, said she would have documented more about these cases had she not feared the confidentiality agreement between her and her patients would have been breached, as they were. And while the reports in her case were required because they involved later pregnancies, many providers and public health advocates say the same risks are posed by laws that require reporting of any abortions involving minors.

Neuhaus said she believes wholeheartedly in statutory rape reporting laws but thinks Kansas’ rigid age restrictions are problematic, because the state defines sex with a minor under 16 years old as rape, regardless of the circumstances.

“Anyone who works with teenagers knows that it is normal teen behavior and that teens do have sex,” she said. “They generally start having sex somewhere between 14 and 16. So, this is the norm; it’s not the exception. And it goes on regardless of whatever other legislation is in place. … People are pretty sure that at 16, you’re not fully adult. However, there is this other element that people go through puberty and they start doing things that may or may not be in their best interest, but it’s happening anyway. So to criminalize it is kind of stupid and counterproductive.”

Anti-Choice Activists Use Laws to Force Clinic Closures

In some cases, breaches of statutory rape reporting requirements have resulted in abortion providers and clinics either being disciplined or shuttered. Rewire’s recent investigation into documents requested by two congressional committees turned up a handful of reports of violations in Alabama and Louisiana between 2008 and 2013 related to mandatory statutory rape reporting. But the information provided by state health departments only tells part of the story.

In response to questions from the House Energy and Commerce Committee, the Alabama Department of Public Health reported that in June 2010 the state revoked the license of the Summit Women’s Center of Montgomery, Inc., also known as the Beacon Women’s Center. The eventual closure of the Montgomery, Alabama, clinic was based on a series of violations, including failure “to report an instance of suspected sexual abuse of an unemancipated minor.”

A health department statement of deficiencies dated February 1, 2010, shows that the instance of “suspected sexual abuse” involved a 14-year-old girl and a 16-year-old boy, barely meeting the state’s definition of statutory rape. According to Alabama law, minors 15 and younger cannot legally consent to sex; however, “sexual intercourse” with someone under 16 but over 12 is not considered rape as long as the sex partner is less than two years older than the victim.

The state also charged the clinic with failing to develop clinic-specific policies or protocol related to mandatory reporting of suspected child abuse. According to the deficiency reports, during multiple visits by state officials, clinic employees only produced a general policy written by the National Abortion Federation.

Another Alabama clinic, a Planned Parenthood facility in Birmingham, was cited for a statutory rape reporting violation, among others, but did not lose its license, because it subsequently implemented a plan of correction.

But this violation arose from an undercover encounter with anti-choice activists who lied to a clinic staffer and prompted her to acknowledge a fictitious sexual relationship between a 14-year-old girl and a 31-year-old man without reporting it to authorities.

A deficiency report shows this violation was sparked by a conversation surreptitiously recorded by Live Action, best known for conducting sting operations at Planned Parenthood clinics. On July 2, 2008, Live Action President Lila Rose and a colleague visited the Birmingham clinic, where the then-20-year-old Rose posed as a 14-year-old girl who had been impregnated by her 31-year-old boyfriend. Rose told the clinic worker that the sex was consensual and that she wanted the abortion but did not want her parents to know.

According to the transcript from Live Action’s recording, the clinic worker told Rose that as a minor she would not be able to obtain the abortion without the consent of a parent or guardian. When Rose asked if there was a problem with her boyfriend being 31, the clinic worker asked if Rose consented to the sex. She eventually told Rose to call back the next day to talk to a health center manager. When Rose asked if the manager would report this situation to her parents, the clinic worker told her she didn’t think they could because of privacy laws.

In August 2008, after Live Action released this recording on its website, the Alabama health department conducted a “complaint investigation” and cited the clinic with not having developed and complied with the state’s statutory rape reporting laws.

Since 2008, Live Action has advanced its campaign using secret recordings in hypothetical situations in an attempt to prove that Planned Parenthood clinics assist child molesters and sex traffickers by failing to report abortions involving minors. Perhaps most notably, in 2011 Live Action aired a secretly taped video of a New Jersey Planned Parenthood clinic manager talking to actors posing as a pimp and underage prostitutes about how to circumvent reporting requirements. Congressional lawmakers and anti-choice leaders have used this video to advance the narrative that Planned Parenthood colludes with pimps and child molesters.

Anti-Choice Influence on Legislation

Most state laws identify health-care providers as mandatory reporters of statutory rape, but some states have updated reporting laws so that they specifically target reproductive health-care providers.

This year, Arkansas enacted a law based on language drafted by Americans United for Life (AUL), which adds employees and volunteers of “reproductive health facilities” to the state’s list of mandatory reporters of suspected sexual abuse of minors. Last year, Mississippi implemented AUL’s model law, the “Child Protection Act,” which, among other statutory rape reporting requirements, forces abortion clinics to turn over fetal tissue samples to state health officials when an abortion is performed on a minor under 14.

The strategy is not just to shutter abortion clinics, but also to create a false public belief that abortion providers are implicated in child sexual abuse.

In fact, the aforementioned federally funded research on statutory rape laws produced by the Lewin Group was reportedly pushed by conservative congressional members who wanted to check out a charge by anti-choice activists. According to a Guttmacher Institute report from 2004, the Denton, Texas-based anti-choice group Life Dynamics, Inc., had accused family planning providers of actively circumventing state child abuse reporting requirements. Family planning providers, including Planned Parenthood, receive federal funds—thus, the Lewin Group was tasked with researching how these providers handled cases of potential sexual abuse involving minors.

Through site visits, the Lewin Group researchers found that preventing sexually abusive relationships involves partnerships among several government agencies and service providers; they found no evidence that reproductive health facilities were actively circumventing reporting laws.

Indeed, these laws could actually be harming the same young women they purport to protect, according to public health experts. Not only do they place the burden of reporting on people who might not be trained to identify abusive situations, such as clinic volunteers answering the phone, but they could even frighten adolescents away from seeking medical care for fear of being reported to law enforcement.

“If young people fear that they may be reported to the authorities—whether that be child welfare authorities or law enforcement authorities—they may be more reluctant to disclose all of the information to a health-care professional that would be important in enabling that health-care provider to really provide optimal care for them,” said the Center for Adolescent Health & the Law’s Abigail English. “So I see that as the biggest downside of mandatory reporting laws.”

Analysis Abortion

‘Pro-Life’ Pence Transfers Money Intended for Vulnerable Households to Anti-Choice Crisis Pregnancy Centers

Jenn Stanley

Donald Trump's running mate has said that "life is winning in Indiana"—and the biggest winner is probably a chain of crisis pregnancy centers that landed a $3.5 million contract in funds originally intended for poor Hoosiers.

Much has been made of Republican Gov. Mike Pence’s record on LGBTQ issues. In 2000, when he was running for U.S. representative, Pence wrote that “Congress should oppose any effort to recognize homosexual’s [sic] as a ‘discreet and insular minority’ [sic] entitled to the protection of anti-discrimination laws similar to those extended to women and ethnic minorities.” He also said that funds meant to help people living with HIV or AIDS should no longer be given to organizations that provide HIV prevention services because they “celebrate and encourage” homosexual activity. Instead, he proposed redirecting those funds to anti-LGBTQ “conversion therapy” programs, which have been widely discredited by the medical community as being ineffective and dangerous.

Under Pence, ideology has replaced evidence in many areas of public life. In fact, Republican presidential nominee Donald Trump has just hired a running mate who, in the past year, has reallocated millions of dollars in public funds intended to provide food and health care for needy families to anti-choice crisis pregnancy centers.

Gov. Pence, who declined multiple requests for an interview with Rewire, has been outspoken about his anti-choice agenda. Currently, Indiana law requires people seeking abortions to receive in-person “counseling” and written information from a physician or other health-care provider 18 hours before the abortion begins. And thanks, in part, to other restrictive laws making it more difficult for clinics to operate, there are currently six abortion providers in Indiana, and none in the northern part of the state. Only four of Indiana’s 92 counties have an abortion provider. All this means that many people in need of abortion care are forced to take significant time off work, arrange child care, and possibly pay for a place to stay overnight in order to obtain it.

This environment is why a contract quietly signed by Pence last fall with the crisis pregnancy center umbrella organization Real Alternatives is so potentially dangerous for Indiana residents seeking abortion: State-subsidized crisis pregnancy centers not only don’t provide abortion but seek to persuade people out of seeking abortion, thus limiting their options.

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“Indiana is committed to the health, safety, and wellbeing [sic] of Hoosier families, women, and children,” reads the first line of the contract between the Indiana State Department of Health and Real Alternatives. The contract, which began on October 1, 2015, allocates $3.5 million over the course of a year for Real Alternatives to use to fund crisis pregnancy centers throughout the state.

Where Funding Comes From

The money for the Real Alternatives contract comes from Indiana’s Temporary Assistance for Needy Families (TANF) block grant, a federally funded, state-run program meant to support the most vulnerable households with children. The program was created by the 1996 Personal Responsibility and Work Opportunity Reconciliation Act signed by former President Bill Clinton. It changed welfare from a federal program that gave money directly to needy families to one that gave money, and a lot of flexibility with how to use it, to the states.

This TANF block grant is supposed to provide low-income families a monthly cash stipend that can be used for rent, child care, and food. But states have wide discretion over these funds: In general, they must use the money to serve families with children, but they can also fund programs meant, for example, to promote marriage. They can also make changes to the requirements for fund eligibility.

As of 2012, to be eligible for cash assistance in Indiana, a household’s maximum monthly earnings could not exceed $377, the fourth-lowest level of qualification of all 50 states, according to a report by the Congressional Research Service. Indiana’s program also has some of the lowest maximum payouts to recipients in the country.

Part of this is due to a 2011 work requirement that stripped eligibility from many families. Under the new work requirement, a parent or caretaker receiving assistance needs to be “engaged in work once the State determines the parent or caretaker is ready to engage in work,” or after 24 months of receiving benefits. The maximum time allowed federally for a family to receive assistance is 60 months.

“There was a TANF policy change effective November 2011 that required an up-front job search to be completed at the point of application before we would proceed in authorizing TANF benefits,” Jim Gavin, a spokesman for the state’s Family and Social Services Administration (FSSA), told Rewire. “Most [applicants] did not complete the required job search and thus applications were denied.”

Unspent money from the block grant can be carried over to following years. Indiana receives an annual block grant of $206,799,109, but the state hasn’t been using all of it thanks to those low payouts and strict eligibility requirements. The budget for the Real Alternatives contract comes from these carry-over funds.

According to the U.S. Department of Health and Human Services, TANF is explicitly meant to clothe and feed children, or to create programs that help prevent “non-marital childbearing,” and Indiana’s contract with Real Alternatives does neither. The contract stipulates that Real Alternatives and its subcontractors must “actively promote childbirth instead of abortion.” The funds, the contract says, cannot be used for organizations that will refer clients to abortion providers or promote contraceptives as a way to avoid unplanned pregnancies and sexually transmitted infections.

Parties involved in the contract defended it to Rewire by saying they provide material goods to expecting and new parents, but Rewire obtained documents that showed a much different reality.

Real Alternatives is an anti-choice organization run by Kevin Bagatta, a Pennsylvania lawyer who has no known professional experience with medical or mental health services. It helps open, finance, and refer clients to crisis pregnancy centers. The program started in Pennsylvania, where it received a $30 million, five-year grant to support a network of 40 subcontracting crisis pregnancy centers. Auditor General Eugene DePasquale called for an audit of the organization between June 2012 and June 2015 after hearing reports of mismanaged funds, and found $485,000 in inappropriate billing. According to the audit, Real Alternatives would not permit DHS to review how the organization used those funds. However, the Pittsburgh Post-Gazette reported in April that at least some of the money appears to have been designated for programs outside the state.

Real Alternatives also received an $800,000 contract in Michigan, which inspired Gov. Pence to fund a $1 million yearlong pilot program in northern Indiana in the fall of 2014.

“The widespread success [of the pilot program] and large demand for these services led to the statewide expansion of the program,” reads the current $3.5 million contract. It is unclear what measures the state used to define “success.”

 

“Every Other Baby … Starts With Women’s Care Center”

Real Alternatives has 18 subcontracting centers in Indiana; 15 of them are owned by Women’s Care Center, a chain of crisis pregnancy centers. According to its website, Women’s Care Center serves 25,000 women annually in 23 centers throughout Florida, Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin.

Women’s Care Centers in Indiana received 18 percent of their operating budget from state’s Real Alternatives program during the pilot year, October 1, 2014 through September 30, 2015, which were mostly reimbursements for counseling and classes throughout pregnancy, rather than goods and services for new parents.

In fact, instead of the dispensation of diapers and food, “the primary purpose of the [Real Alternatives] program is to provide core services consisting of information, sharing education, and counseling that promotes childbirth and assists pregnant women in their decision regarding adoption or parenting,” the most recent contract reads.

The program’s reimbursement system prioritizes these anti-choice classes and counseling sessions: The more they bill for, the more likely they are to get more funding and thus open more clinics.

“This performance driven [sic] reimbursement system rewards vendor service providers who take their program reimbursement and reinvest in their services by opening more centers and hiring more counselors to serve more women in need,” reads the contract.

Classes, which are billed as chastity classes, parenting classes, pregnancy classes, and childbirth classes, are reimbursed at $21.80 per client. Meanwhile, as per the most recent contract, counseling sessions, which are separate from the classes, are reimbursed by the state at minimum rates of $1.09 per minute.

Jenny Hunsberger, vice president of Women’s Care Center, told Rewire that half of all pregnant women in Elkhart, LaPorte, Marshall, and St. Joseph Counties, and one in four pregnant women in Allen County, are clients of their centers. To receive any material goods, such as diapers, food, and clothing, she said, all clients must receive this counseling, at no cost to them. Such counseling is billed by the minute for reimbursement.

“When every other baby born [in those counties] starts with Women’s Care Center, that’s a lot of minutes,” Hunsberger told Rewire.

Rewire was unable to verify exactly what is said in those counseling sessions, except that they are meant to encourage clients to carry their pregnancies to term and to help them decide between adoption or child rearing, according to Hunsberger. As mandated by the contract, both counseling and classes must “provide abstinence education as the best and only method of avoiding unplanned pregnancies and sexually transmitted infections.”

In the first quarter of the new contract alone, Women’s Care Center billed Real Alternatives and, in turn, the state, $239,290.97; about $150,000 of that was for counseling, according to documents obtained by Rewire. In contrast, goods like food, diapers, and other essentials for new parents made up only about 18.5 percent of Women’s Care Center’s first-quarter reimbursements.

Despite the fact that the state is paying for counseling at Women’s Care Center, Rewire was unable to find any licensing for counselors affiliated with the centers. Hunsberger told Rewire that counseling assistants and counselors complete a minimum training of 200 hours overseen by a master’s level counselor, but the counselors and assistants do not all have social work or psychology degrees. Hunsberger wrote in an email to Rewire that “a typical Women’s Care Center is staffed with one or more highly skilled counselors, MSW or equivalent.”

Rewire followed up for more information regarding what “typical” or “equivalent” meant, but Hunsberger declined to answer. A search for licenses for the known counselors at Women’s Care Center’s Indiana locations turned up nothing. The Indiana State Department of Health told Rewire that it does not monitor or regulate the staff at Real Alternatives’ subcontractors, and both Women’s Care Center and Real Alternatives were uncooperative when asked for more information regarding their counseling staff and training.

Bethany Christian Services and Heartline Pregnancy Center, Real Alternatives’ other Indiana subcontractors, billed the program $380.41 and $404.39 respectively in the first quarter. They billed only for counseling sessions, and not goods or classes.

In a 2011 interview with Philadelphia City Paper, Kevin Bagatta said that Real Alternatives counselors were not required to have a degree.

“We don’t provide medical services. We provide human services,” Bagatta told the City Paper.

There are pregnancy centers in Indiana that provide a full range of referrals for reproductive health care, including for STI testing and abortion. However, they are not eligible for reimbursement under the Real Alternatives contract because they do not maintain an anti-choice mission.

Parker Dockray is the executive director of Backline, an all-options pregnancy resource center. She told Rewire that Backline serves hundreds of Indiana residents each month, and is overwhelmed by demand for diapers and other goods, but it is ineligible for the funding because it will refer women to abortion providers if they choose not to carry a pregnancy to term.

“At a time when so many Hoosier families are struggling to make ends meet, it is irresponsible for the state to divert funds intended to support low-income women and children and give it to organizations that provide biased pregnancy counseling,” Dockray told Rewire. “We wish that Indiana would use this funding to truly support families by providing job training, child care, and other safety net services, rather than using it to promote an anti-abortion agenda.”

“Life Is Winning in Indiana”

Time and again, Bagatta and Hunsberger stressed to Rewire that their organizations do not employ deceitful tactics to get women in the door and to convince them not to have abortions. However, multiple studies have proven that crisis pregnancy centers often lie to women from the moment they search online for an abortion provider through the end of their appointments inside the center.

These studies have also shown that publicly funded crisis pregnancy centers dispense medically inaccurate information to clients. In addition to spreading lies like abortion causing infertility or breast cancer, they are known to give false hopes of miscarriages to people who are pregnant and don’t want to be. A 2015 report by NARAL Pro-Choice America found this practice to be ubiquitous in centers throughout the United States, and Rewire found that Women’s Care Center is no exception. The organization’s website says that as many as 40 percent of pregnancies end in natural miscarriage. While early pregnancy loss is common, it occurs in about 10 percent of known pregnancies, according to the American Congress of Obstetricians and Gynecologists.

Crisis pregnancy centers also tend to crop up next to abortion clinics with flashy, deceitful signs that lead many to mistakenly walk into the wrong building. Once inside, clients are encouraged not to have an abortion.

A Google search for “abortion” and “Indianapolis” turns up an ad for the Women’s Care Center as the first result. It reads: “Abortion – Indianapolis – Free Ultrasound before Abortion. Located on 86th and Georgetown. We’re Here to Help – Call Us Today: Abortion, Ultrasound, Locations, Pregnancy.”

Hunsberger denies any deceit on the part of Women’s Care Center.

“Clients who walk in the wrong door are informed that we are not the abortion clinic and that we do not provide abortions,” Hunsberger told Rewire. “Often a woman will choose to stay or return because we provide services that she feels will help her make the best decision for her, including free medical-grade pregnancy tests and ultrasounds which help determine viability and gestational age.”

Planned Parenthood of Indiana and Kentucky told Rewire that since Women’s Care Center opened on 86th and Georgetown in Indianapolis, many patients looking for its Georgetown Health Center have walked through the “wrong door.”

“We have had patients miss appointments because they went into their building and were kept there so long they missed their scheduled time,” Judi Morrison, vice president of marketing and education, told Rewire.

Sarah Bardol, director of Women’s Care Center’s Indianapolis clinic, told the Criterion Online Edition, a publication of the Archdiocese of Indianapolis, that the first day the center was open, a woman and her boyfriend did walk into the “wrong door” hoping to have an abortion.

“The staff of the new Women’s Care Center in Indianapolis, located just yards from the largest abortion provider in the state, hopes for many such ‘wrong-door’ incidents as they seek to help women choose life for their unborn babies,” reported the Criterion Online Edition.

If they submit to counseling, Hoosiers who walk into the “wrong door” and “choose life” can receive up to about $40 in goods over the course their pregnancy and the first year of that child’s life. Perhaps several years ago they may have been eligible for Temporary Assistance for Needy Families, but now with the work requirement, they may not qualify.

In a February 2016 interview with National Right to Life, one of the nation’s most prominent anti-choice groups, Gov. Pence said, “Life is winning in Indiana.” Though Pence was referring to the Real Alternatives contract, and the wave of anti-choice legislation sweeping through the state, it’s not clear what “life is winning” actually means. The state’s opioid epidemic claimed 1,172 lives in 2014, a statistically significant increase from the previous year, according to the Centers for Disease Control and Prevention. HIV infections have spread dramatically throughout the state, in part because of Pence’s unwillingness to support medically sound prevention practices. Indiana’s infant mortality rate is above the national average, and infant mortality among Black babies is even higher. And Pence has reduced access to prevention services such as those offered by Planned Parenthood through budget cuts and unnecessary regulations—while increasing spending on anti-choice crisis pregnancy centers.

Gov. Pence’s track record shows that these policies are no mistake. The medical and financial needs of his most vulnerable constituents have taken a backseat to religious ideology throughout his time in office. He has literally reallocated money for poor Hoosiers to fund anti-choice organizations. In his tenure as both a congressman and a governor, he’s proven that whether on a national or state level, he’s willing to put “pro-life” over quality-of-life for his constituents.

News Abortion

Leading Anti-Choice ‘Expert’ Suggests Women Turn to Crisis Pregnancy Centers to Cope With Abortion Restrictions

Ally Boguhn

Though crisis pregnancy centers often lie to women to persuade them not get an abortion, Priscilla Coleman suggested that people dealing with the additional financial and geographical barriers imposed by waiting periods turn to those organizations for help.

A leading anti-choice “expert” suggested during an interview with Rewire at the National Right to Life Convention last week that women should turn to crisis pregnancy centers to cope with the barriers to abortion care, including obstacles she helped create.

Priscilla Coleman, one of the “False Witnesses” previously featured on Rewire for her egregious falsehoods about the supposed link between abortion and mental health, said that the “scientific information” she provides in her speaking engagements and through her nonprofit, the World Expert Consortium for Abortion Research and Education (WECARE), has helped get anti-choice bills passed in states, particularly South Dakota.

Though her work has been widely discredited by the scientific and medical community, Coleman has nonetheless frequently appeared as an “expert witness” in trials and hearings. As Coleman told Rewire, she is “not a medical doctor” but has nonetheless “been really involved for ten years now with South Dakota” and its anti-choice legislation. This included the South Dakota Informed Consent Law (HB 1166), and what she deemed to be an “anti-coercion bill,” seemingly referring to HB 1217, which requires that a woman seeking an abortion wait 72 hours and visit a crisis pregnancy center prior to the abortion.

Coleman acknowledged that the anti-choice laws in the state such as the waiting period had created barriers to care, as “women have to … get a hotel, you know, or find a way back” to clinics.

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“And that’s the complaint on the other side, that it’s making access more difficult,” Coleman went on, “but as all the data out there is showing the long-term effects of abortion, spending three more days to make the decision is in the women’s best interest, no matter what side you’re on.”

When pressed to respond to those who note that anti-choice restrictions make accessing abortion more difficult, Coleman replied that she “would just say that it’s worth a three-day hotel room and … if you’re going to pay for an abortion, allow an extra couple hundred dollars … to take some time because it has lifetime implications.”

Coleman, however, struggled to account for how one might come up with that money.

“Well, they’re somehow coming up with the money for the abortion,” said Coleman. “I’m not familiar enough with fees and things, but my understanding is that most women, no matter how poor they are, still have to pay for the procedure. Is that correct?”

Though crisis pregnancy centers often lie to women to persuade them not get an abortion, Coleman suggested that those dealing with the additional financial and geographical barriers imposed by waiting periods turn to those organizations for help.

“I’m sure that if they contacted crisis pregnancy centers … women could find a place to stay for a couple of days,” said Coleman. “I’m sure that many people affiliated with those centers would be happy to house the women in their own home if there is a room for them.”

The other anti-choice law Coleman connected herself with, HB 1166, uses the same falsehoods she claims her research supports. South Dakota’s so-called informed consent law requires doctors to receive consent prior to performing an abortion, and mandates that physicians provide those seeking care with written information that, among other things, falsely claims there is a connection between abortion and both “depression and related psychological distress” and “increased risk of suicide ideation and suicide.”

Coleman “served as an expert in South Dakota” after Planned Parenthood affiliates challenged the legislation, according to WECARE’s website.

As the Guttmacher Institute explains, all states already require patients consent prior to receiving medical care, and materials provided by the states that require mandated abortion counseling often offer “information that is irrelevant or misleading.”