Investigations Abortion

From Alaska to Alabama, Investigation Shows False Testimony Formed Basis for Abortion Restrictions

Sofia Resnick

Why are states continuing to pass abortion restrictions based partly on erroneous theories that abortion harms women? And why are state attorneys general calling as expert witnesses some of the very people who proffered these spurious notions to state legislatures in the first place?

To view the full False Witnesses gallery, click here.

In October 2012, Alaska Superior Court Judge John Suddock wrote a 65-page decision affirming a state mandate that at least one parent be notified before a woman under 18 can obtain an abortion. But from the get-go, and throughout the decision, Suddock deflated anti-abortion advocates’ loudest claim: that abortion is unsafe for women.

“Hospitalizations during pregnancy occur 15 percent of the time, but are vanishingly rare for abortions,” he wrote. Further down, he added, “Modern abortion is an extraordinarily safe procedure.”

On the question of whether abortion causes mental illness—critical to the abortion-harms-women narrative—Suddock dismissed that one, too.

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“Mental illness is a constellation of subjective and objective signs and symptoms ultimately causing individual distress,” he wrote. “The illness may have genetic origins or derive from life experiences. Since the 1980’s, the majority consensus of American psychiatry is that abortion does not cause mental illness.”

Despite the court’s agreement with plaintiffs that the law in question “advances no compelling state interest in the health of minor women,” the court upheld the bulk of the law, arguing that it promotes “family involvement in a young woman’s pregnancy decision” by “the least restrictive means available.” (Plaintiffs appealed the decision, and the case is pending before the Alaska Supreme Court.)

But the court’s upfront dismissal of common but unfounded claims that abortion is a generally unsafe procedure prompts the question: Why are states continuing to pass abortion restrictions based partly on erroneous theories that abortion harms women?

And why are state attorneys general calling as expert witnesses some of the very people who proffered these spurious notions to state legislatures in the first place?

In the last few years, state legislatures have been passing abortion restrictions largely based on unfounded theories that abortion is a dangerous procedure that significantly increases women’s risk of developing breast cancer and mental health disorders, among other claims. Rewire recently profiled several of the medical professionals and researchers who routinely peddle these largely unsupported theories, first before state legislators and then later before state and federal judges, on the taxpayers’ dime. Those profiled in our False Witnesses series have collectively received at least $657,000 from state attorneys general to help them defend abortion restrictions that, in some cases, they helped enact.

In some cases, these False Witnesses have had a clear impact on the formation of state laws.

In North Dakota, for example, the state Senate Judiciary Committee’s hearing minutes included opinions from Dr. James C. Anderson and Dr. John M. Thorp, Jr. in defense of a law that requires physicians who perform abortions in North Dakota to be licensed in that state and to obtain admitting privileges at a local hospital. (The lawsuit involving this statute was settled earlier this year.) Anderson and Thorp are routinely called by state attorneys general to deliver expert witness reports supporting these types of laws—laws that are deemed medically unnecessary by major medical organizations such as the American College of Obstetricians and Gynecologists (ACOG) and the American Medical Association. Last year both groups submitted a friend-of-the-court brief opposing a Texas anti-abortion law, wherein they asserted there is “simply no medical basis to impose a local admitting privileges requirement on abortion providers.”

Yet, as Rewire’s reporting shows, these experts’ reliability has been seriously undermined. Anderson is a family medicine emergency room physician in Richmond, Virginia, and Thorp is an obstetrician-gynecologist and a professor of obstetrics and gynecology at the University of North Carolina-Chapel Hill School of Medicine. Both are outspoken in their anti-choice views and have testified in recent years in support of various laws limiting access to abortion care. Both also have been criticized by federal judges for relying on assumptions that reflect unsupported biases against abortion. Also cited in the minutes from North Dakota’s Senate Judiciary Committee, for example, is questionable research claiming abortion causes mental illness authored by Bowling Green State University family studies professor Priscilla K. Coleman and Vincent M. Rue, an anti-abortion activist and independent legal consultant who helps state attorneys general coordinate expert witnesses to testify in favor of laws that restrict abortion.

North Dakota’s attorney general later paid Anderson, Thorp, Coleman, and Rue (through his firm, Rue & Stanford-Rue PA), as well as longtime anti-choice advocate and OB-GYN Dr. Donna J. Harrison, to help defend various laws in state and federal court, including the aforementioned admitting privileges law, between 2011 and 2014.

Georgia State University law professor Eric J. Segall told Rewire that the recent proliferation of dubious evidence being used in court to defend abortion restrictions is “problematic.”

Segall, who teaches constitutional law and the federal courts, said he believes this trend in getting anti-choice doctors and researchers to testify to abortion’s supposedly widespread health risks stems from the Supreme Court’s 1990 decision in Planned Parenthood v. Casey.

“Once the Casey decision changed the law from basically no restrictions were allowed before viability to only restrictions that cause an undue burden would be unconstitutional prior to viability, there’s been an attempt for there to be a cottage industry of experts to testify [in favor of anti-abortion legislation],” Segall said. “I think the anti-choice side will do virtually anything they can to stop abortions.”

South Dakota is another state that has relied on the testimony of some of the False Witnesses identified in our series to help pass abortion restrictions. In 2005, former state Rep. Roger Hunt (R-Brandon)—who outspokenly opposes abortion—sponsored a bill that created a legislative task force to study abortion. The task force included lawmakers, anti-abortion activists, abortion-rights supporters, and supposedly neutral members. But the majority of those on the task force openly opposed abortion rights, and the resulting report presented by the task force to the governor reflected the majority’s unsupported anti-abortion stance.

Citing oral and written presentations from False Witnesses such as Joel L. Brind, Dr. Byron C. Calhoun, Coleman, David C. Reardon, and Rue, the task force asserted that abortion was harmful to women’s physical and mental health. The final report referenced Coleman’s testimony in its unfounded claim that when a woman has an abortion her ability to reason and understand is diminished. “When a decision involves a violation of one’s conscience, regression in cognitive functioning enables women to cope with the decision,” the report reads. Based on statements collected by an anti-abortion organization and directors of so-called crisis pregnancy centers, the task force also concluded that abortion is “inherently coercive.”

Ultimately, the task force concluded, “to fully protect the rights, interests, and health of the mother and the life of her unborn child, a ban on abortions is required.”

Lawmakers, including Hunt, relied on this report to pass two abortion bans (both overturned) and a law that created a 72-hour waiting period for women seeking abortions (not including holidays and weekends) and that required women seeking abortion to first receive counseling related to coercion at crisis pregnancy centers that advocate against abortion (this counseling requirement is stilled wrapped in litigation; the rest of the law has been enacted).

Other abortion restrictions, seemingly copied by state after state (some with the help of groups such as Americans United for Life and the National Right to Life Committee, which produce model legislation seeking abortion restrictions and bans), are inevitably challenged by abortion providers and medical professionals in the state and then defended in court by some of the same so-called experts whose false testimony first supported their passage. Anderson and Thorp, for example, have testified in multiple states, including Alabama, Mississippi, North Dakota, Texas, and Wisconsin, arguing that abortion providers should have to obtain admitting privileges at a local hospital because it ensures women’s safety for what they say is an inherently dangerous procedure. These laws passed despite opposition from mainstream medical associations like ACOG and the American Medical Association.

To be sure, for many other state abortion restrictions, the specific testimonies or research papers that swayed lawmakers to sponsor or vote for specific laws are difficult to pinpoint. In our False Witnesses series, we documented several instances where these medical experts’ testimonies or research papers likely helped influence the passage of anti-choice laws. For example, Coleman’s work was cited in a sweeping Arizona law that included a host of restrictions; University of St. Thomas law professor Teresa S. Collett testified before legislatures in Idaho and Nebraska in support of 20-week abortion bans; and a statement from Calhoun was presented to West Virginia lawmakers debating a 20-week abortion ban that was later vetoed by the governor.

Easier to identify is where experts have helped defend these laws once they are challenged.

After Texas enacted last year’s omnibus HB 2—which bans abortion at 20 weeks, requires that abortion clinics be transformed into ambulatory surgical centers, requires abortion providers to obtain admitting privileges at local hospitals, and places new restrictions on medication abortions—the attorney general hired some of the aforementioned expert witnesses to help defend the law in an ongoing lawsuit. According to records from the Texas Comptroller of Public Accounts, the state has so far paid Rue’s firm more than $59,000 to consult with expert witness selection and reports and has paid Anderson and Thorp at least $24,000 and $26,000, respectively, for their work as expert witnesses. (In August, U.S. District Judge Lee Yeakel condemned the state’s apparent efforts to obscure Rue’s level of involvement in the case. Yeakel also argued that Rue’s involvement in shaping testimonies undermined the reliability of the state’s experts’ opinions.)

Judges Grow Impatient With Use of Shoddy Evidence

Yeakel and Alaska’s Suddock are not the only judges to dismiss questionable evidence presented in recent abortion-related lawsuits.

In a December 2013 opinion, Appeals Court Judge Richard Posner challenged the arguments presented by the state’s witnesses in defense of a Wisconsin law requiring abortion providers to obtain admitting privileges at local hospitals. He noted, for example, that “there is no evidence that women who have complications from an abortion recover more quickly or more completely or with less pain or discomfort if their physician has admitting privileges at the hospital to which the patient is taken for treatment of the complications,” despite the state’s assertion to the contrary. He also pointed out that “[n]o documentation of medical need” for the admitting privileges requirement was presented to the Wisconsin legislature when the law was introduced.

Another federal judge, District Court Judge Myron H. Thompson, in an October 2014 supplemental opinion concerning a constitutional challenge to an Alabama admitting privileges law, explained why he discounted certain testimony from Anderson and Thorp. In Anderson’s case, Thompson wrote that the court “was struck by the flimsiness of Anderson’s basis for reliance on [Vincent] Rue and by his failure to obtain basic information about the affiliations, credentials, or employment of the consultant whose report he submitted as his own.” Regarding Thorp, Thompson wrote that the North Carolina-based OB-GYN “displayed a disturbing apathy toward the accuracy of his testimony” and that “choices that he made in developing his estimates [of abortion complications] seemed to be driven more by a bias against abortion and a desire to inflate complication rates than by a true desire to reach an accurate estimate of the dangerousness of abortion procedures.”

The judge additionally called out Thorp for hypocrisy in his assertion that doctors who perform abortions should provide “continuity of care” to their patients.

“[E]ven though the procedures he performs at his own office may, like abortion, in extremely rare cases cause complications that require post-procedure hysterectomy or laparatomy, he himself does not maintain staff privileges at a local hospital that would allow him to perform gynecological surgery for his patients,” Thompson wrote of Thorp.

Eric Segall told Rewire that he has never seen as much resistance as he has of late from lower court judges toward the use of shoddy evidence in defense of what he believes are politically motivated but medically unnecessary abortion restrictions.

“With the recent spate of decisions by lower court judges in Alabama, by Judge Posner in Wisconsin, by the lower court judge in Texas, I think we’re seeing judicial hostility towards the lack of real evidence supporting both the admitting privileges laws and the abortion-clinics-have-to-be-mini-hospital laws that I’ve not experienced in my career following the Supreme Court,” Segall said.

Segall, who supports abortion rights, said it is noteworthy that various lower court judges—including Posner, who was appointed by President Ronald Reagan to the U.S. Court of Appeals for the Seventh Circuit—are growing tired of what they’re seeing as unsupported, biased notions masquerading as scientific fact.

“This whole thing is a charade,” Segall said. “Admitting privileges laws don’t help women’s health, yet lawyers are saying that it does, legislators are saying that it does, and judges are very impatient with that dishonesty. There’s no evidence. So, I think that’s the hostility; I don’t think it’s an abortion-specific thing, certainly not for Judge Posner. I think it’s, ‘Why are states and lawyers for the states trying to put one over on us?’”

Visit Rewire Data to learn about connections between the False Witnesses we profiled and recently passed abortion restrictions.

Sharona Coutts contributed to this report.

News Politics

Anti-Choice Democrats: ‘Open the Big Tent’ for Us

Christine Grimaldi & Ally Boguhn

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

Read more of our coverage of the Democratic National Convention here.

Democrats for Life of America gathered Wednesday in Philadelphia during the party’s convention to honor Louisiana Gov. John Bel Edwards (D) for his anti-choice viewpoints, and to strategize ways to incorporate their policies into the party.

The group attributed Democratic losses at the state and federal level to the party’s increasing embrace of pro-choice politics. The best way for Democrats to reclaim seats in state houses, governors’ offices, and the U.S. Congress, they charged, is to “open the big tent” to candidates who oppose legal abortion care.

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

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Democrats for Life of America members repeatedly attempted to distance themselves from Republicans, reiterating their support for policies such as Medicaid expansion and paid maternity leave, which they believe could convince people to carry their pregnancies to term.

Their strategy, however, could have been lifted directly from conservatives’ anti-choice playbook.

The group relies, in part, on data from Marist, a group associated with anti-choice polling, to suggest that many in the party side with them on abortion rights. Executive Director Kristen Day could not explain to Rewire why the group supports a 20-week abortion ban, while Janet Robert, president of the group’s board of directors, trotted out scientifically false claims about fetal pain

Day told Rewire that she is working with pro-choice Democrats, including Sen. Kirsten Gillibrand and Rep. Rosa DeLauro, both from New York, on paid maternity leave. Day said she met with DeLauro the day before the group’s event.

Day identifies with Democrats despite a platform that for the first time embraces the repeal of restrictions for federal funding of abortion care. 

“Those are my people,” she said.

Day claimed to have been “kicked out of the pro-life movement” for supporting the Affordable Care Act. She said Democrats for Life of America is “not opposed to contraception,” though the group filed an amicus brief in U.S. Supreme Court cases on contraception. 

Democrats for Life of America says it has important allies in the U.S. House of Representatives and the U.S. Senate. Sens. Joe Donnelly (IN), Joe Manchin (WV), and Rep. Dan Lipinski (IL), along with former Rep. Bart Stupak (MI), serve on the group’s board of advisors, according to literature distributed at the convention.

Another alleged ally, Sen. Bob Casey (D-PA), came up during Edwards’ speech. Edwards said he had discussed the award, named for Casey’s father, former Pennsylvania Gov. Robert P. Casey, the defendant in the landmark Supreme Court decision, Planned Parenthood v. Casey, which opened up a flood of state-level abortions restrictions as long as those anti-choice policies did not represent an “undue burden.”

“Last night I happened to have the opportunity to speak to Sen. Bob Casey, and I told him … I was in Philadelphia, receiving this award today named after his father,” Edwards said.

The Louisiana governor added that though it may not seem it, there are many more anti-choice Democrats like the two of them who aren’t comfortable coming forward about their views.

“I’m telling you there are many more people out there like us than you might imagine,” Edwards said. “But sometimes it’s easier for those folks who feel like we do on these issues to remain silent because they’re not going to  be questioned, and they’re not going to be receiving any criticism.”

During his speech, Edwards touted the way he has put his views as an anti-choice Democrat into practice in his home state. “I am a proud Democrat, and I am also very proudly pro-life,” Edwards told the small gathering.

Citing his support for Medicaid expansion in Louisiana—which went into effect July 1—Edwards claimed he had run on an otherwise “progressive” platform except for when it came to abortion rights, adding that his policies demonstrate that “there is a difference between being anti-abortion and being pro-life.”

Edwards later made clear that he was disappointed with news that Emily’s List President Stephanie Schriock, whose organization works to elect pro-choice women to office, was being considered to fill the position of party chair in light of Rep. Debbie Wasserman Schultz’s resignation.

“It wouldn’t” help elect anti-choice politicians to office, said Edwards when asked about it by a reporter. “I don’t want to be overly critical, I don’t know the person, I just know that the signal that would send to the country—and to Democrats such as myself—would just be another step in the opposite direction of being a big tent party [on abortion].” 

Edwards made no secret of his anti-choice viewpoints during his run for governor in 2015. While on the campaign trail, he released a 30-second ad highlighting his wife’s decision not to terminate her pregnancy after a doctor told the couple their daughter would have spina bifida.

He received a 100 percent rating from anti-choice organization Louisiana Right to Life while running for governor, based off a scorecard asking him questions such as, “Do you support the reversal of Roe v. Wade?”

Though the Democratic Party platform and nominee have voiced the party’s support for abortion rights, Edwards has forged ahead with signing numerous pieces of anti-choice legislation into law, including a ban on the commonly used dilation and evacuation (D and E) procedure, and an extension of the state’s abortion care waiting period from 24 hours to 72 hours.

News Law and Policy

Texas Lawmaker’s ‘Coerced Abortion’ Campaign ‘Wildly Divorced From Reality’

Teddy Wilson

Anti-choice groups and lawmakers in Texas are charging that coerced abortion has reached epidemic levels, citing bogus research published by researchers who oppose legal abortion care.

A Texas GOP lawmaker has teamed up with an anti-choice organization to raise awareness about the supposed prevalence of forced or coerced abortion, which critics say is “wildly divorced from reality.”

Rep. Molly White (R-Belton) during a press conference at the state capitol on July 13 announced an effort to raise awareness among public officials and law enforcement that forced abortion is illegal in Texas.

White said in a statement that she is proud to work alongside The Justice Foundation (TJF), an anti-choice group, in its efforts to tell law enforcement officers about their role in intervening when a pregnant person is being forced to terminate a pregnancy. 

“Because the law against forced abortions in Texas is not well known, The Justice Foundation is offering free training to police departments and child protective service offices throughout the State on the subject of forced abortion,” White said.

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White was joined at the press conference by Allan Parker, the president of The Justice Foundation, a “Christian faith-based organization” that represents clients in lawsuits related to conservative political causes.

Parker told Rewire that by partnering with White and anti-choice crisis pregnancy centers (CPCs), TJF hopes to reach a wider audience.

“We will partner with anyone interested in stopping forced abortions,” Parker said. “That’s why we’re expanding it to police, social workers, and in the fall we’re going to do school counselors.”

White only has a few months remaining in office, after being defeated in a closely contested Republican primary election in March. She leaves office after serving one term in the state GOP-dominated legislature, but her short time there was marked by controversy.

During the Texas Muslim Capitol Day, she directed her staff to “ask representatives from the Muslim community to renounce Islamic terrorist groups and publicly announce allegiance to America and our laws.”

Heather Busby, executive director of NARAL Pro-Choice Texas, said in an email to Rewire that White’s education initiative overstates the prevalence of coerced abortion. “Molly White’s so-called ‘forced abortion’ campaign is yet another example that shows she is wildly divorced from reality,” Busby said.

There is limited data on the how often people are forced or coerced to end a pregnancy, but Parker alleges that the majority of those who have abortions may be forced or coerced.

‘Extremely common but hidden’

“I would say that they are extremely common but hidden,” Parker said. “I would would say coerced or forced abortion range from 25 percent to 60 percent. But, it’s a little hard be to accurate at this point with our data.”

Parker said that if “a very conservative 10 percent” of the about 60,000 abortions that occur per year in Texas were due to coercion, that would mean there are about 6,000 women per year in the state that are forced to have an abortion. Parker believes that percentage is much higher.

“I believe the number is closer to 50 percent, in my opinion,” Parker said. 

There were 54,902 abortions in Texas in 2014, according to recently released statistics from the Texas Department of State Health Services (DSHS). The state does not collect data on the reasons people seek abortion care. 

White and Parker referenced an oft cited study on coerced abortion pushed by the anti-choice movement.

“According to one published study, sixty-four percent of American women who had abortions felt forced or unduly pressured by someone else to have an unwanted abortion,” White said in a statement.

This statistic is found in a 2004 study about abortion and traumatic stress that was co-authored by David Reardon, Vincent Rue, and Priscilla Coleman, all of whom are among the handful of doctors and scientists whose research is often promoted by anti-choice activists.

The study was cited in a report by the Elliot Institute for Social Sciences Research, an anti-choice organization founded by Reardon. 

Other research suggests far fewer pregnant people are coerced into having an abortion.

Less than 2 percent of women surveyed in 1987 and 2004 reported that a partner or parent wanting them to abort was the most important reason they sought the abortion, according to a report by the Guttmacher Institute.

That same report found that 24 percent of women surveyed in 1987 and 14 percent surveyed in 2004 listed “husband or partner wants me to have an abortion” as one of the reasons that “contributed to their decision to have an abortion.” Eight percent in 1987 and 6 percent in 2004 listed “parents want me to have an abortion” as a contributing factor.

‘Flawed research’ and ‘misinformation’  

Busby said that White used “flawed research” to lobby for legislation aimed at preventing coerced abortions in Texas.

“Since she filed her bogus coerced abortion bill—which did not pass—last year, she has repeatedly cited flawed research and now is partnering with the Justice Foundation, an organization known to disseminate misinformation and shameful materials to crisis pregnancy centers,” Busby said.  

White sponsored or co-sponsored dozens of bills during the 2015 legislative session, including several anti-choice bills. The bills she sponsored included proposals to increase requirements for abortion clinics, restrict minors’ access to abortion care, and ban health insurance coverage of abortion services.

White also sponsored HB 1648, which would have required a law enforcement officer to notify the Department of Family and Protective Services if they received information indicating that a person has coerced, forced, or attempted to coerce a pregnant minor to have or seek abortion care.

The bill was met by skepticism by both Republican lawmakers and anti-choice activists.

State affairs committee chairman Rep. Byron Cook (R-Corsicana) told White during a committee hearing the bill needed to be revised, reported the Texas Tribune.

“This committee has passed out a number of landmark pieces of legislation in this area, and the one thing I think we’ve learned is they have to be extremely well-crafted,” Cook said. “My suggestion is that you get some real legal folks to help engage on this, so if you can keep this moving forward you can potentially have the success others have had.”

‘Very small piece of the puzzle of a much larger problem’

White testified before the state affairs committee that there is a connection between women who are victims of domestic or sexual violence and women who are coerced to have an abortion. “Pregnant women are most frequently victims of domestic violence,” White said. “Their partners often threaten violence and abuse if the woman continues her pregnancy.”

There is research that suggests a connection between coerced abortion and domestic and sexual violence.

Dr. Elizabeth Miller, associate professor of pediatrics at the University of Pittsburgh, told the American Independent that coerced abortion cannot be removed from the discussion of reproductive coercion.

“Coerced abortion is a very small piece of the puzzle of a much larger problem, which is violence against women and the impact it has on her health,” Miller said. “To focus on the minutia of coerced abortion really takes away from the really broad problem of domestic violence.”

A 2010 study co-authored by Miller surveyed about 1,300 men and found that 33 percent reported having been involved in a pregnancy that ended in abortion; 8 percent reported having at one point sought to prevent a female partner from seeking abortion care; and 4 percent reported having “sought to compel” a female partner to seek an abortion.

Another study co-authored by Miller in 2010 found that among the 1,300 young women surveyed at reproductive health clinics in Northern California, about one in five said they had experienced pregnancy coercion; 15 percent of the survey respondents said they had experienced birth control sabotage.

‘Tactic to intimidate and coerce women into not choosing to have an abortion’

TJF’s so-called Center Against Forced Abortions claims to provide legal resources to pregnant people who are being forced or coerced into terminating a pregnancy. The website includes several documents available as “resources.”

One of the documents, a letter addressed to “father of your child in the womb,” states that that “you may not force, coerce, or unduly pressure the mother of your child in the womb to have an abortion,” and that you could face “criminal charge of fetal homicide.”

The letter states that any attempt to “force, unduly pressure, or coerce” a women to have an abortion could be subject to civil and criminal charges, including prosecution under the Federal Unborn Victims of Violence Act.

The document cites the 2007 case Lawrence v. State as an example of how one could be prosecuted under Texas law.

“What anti-choice activists are doing here is really egregious,” said Jessica Mason Pieklo, Rewire’s vice president of Law and the Courts. “They are using a case where a man intentionally shot his pregnant girlfriend and was charged with murder for both her death and the death of the fetus as an example of reproductive coercion. That’s not reproductive coercion. That is extreme domestic violence.”

“To use a horrific case of domestic violence that resulted in a woman’s murder as cover for yet another anti-abortion restriction is the very definition of callousness,” Mason Pieklo added.

Among the other resources that TJF provides is a document produced by Life Dynamics, a prominent anti-choice organization based in Denton, Texas.

Parker said a patient might go to a “pregnancy resource center,” fill out the document, and staff will “send that to all the abortionists in the area that they can find out about. Often that will stop an abortion. That’s about 98 percent successful, I would say.”

Reproductive rights advocates contend that the document is intended to mislead pregnant people into believing they have signed away their legal rights to abortion care.

Abortion providers around the country who are familiar with the document said it has been used for years to deceive and intimidate patients and providers by threatening them with legal action should they go through with obtaining or providing an abortion.

Vicki Saporta, president and CEO of the National Abortion Federation, previously told Rewire that abortion providers from across the country have reported receiving the forms.

“It’s just another tactic to intimidate and coerce women into not choosing to have an abortion—tricking women into thinking they have signed this and discouraging them from going through with their initial decision and inclination,” Saporta said.

Busby said that the types of tactics used by TFJ and other anti-choice organizations are a form of coercion.

“Everyone deserves to make decisions about abortion free of coercion, including not being coerced by crisis pregnancy centers,” Busby said. “Anyone’s decision to have an abortion should be free of shame and stigma, which crisis pregnancy centers and groups like the Justice Foundation perpetuate.”

“Law enforcement would be well advised to seek their own legal advice, rather than rely on this so-called ‘training,” Busby said.