The need to regulate crisis pregnancy centers

Published July 15, 2015

by Julie TurSteth Scaled Downlbert, intern with NARAL, published in NC Policy Watch, July 15, 2014.

Last month, in one of its more troubling recent rulings, the U.S. Supreme Court sent the case challenging North Carolina’s “Choose Life” license plates back to the Fourth Circuit Court of Appeals. The justices directed that the case be reconsidered in light of their recent holding that specialty license plates constitute government speech.

As a lot of people are aware by now, the case concerns North Carolina’s refusal to issue pro-choice license plates even as it has made “Choose Life” license plates available for sale. What most people probably do not know, however, is that the debate over the plates is not simply about whether the state should give voice to differing viewpoints. North Carolina’s pro-life license plates serve a more nefarious purpose; the proceeds from their sale go to fund so-called “Crisis Pregnancy Centers” (CPCs) – anti-abortion advocacy facilities that regularly masquerade as health clinics.

I grew up in rural North Carolina, a mile from a CPC and 45 minutes from the nearest genuine clinic that performed abortions. For most of my life, I identified as pro-life. Growing up in a rural community shaped this belief partly because, at the time, it seemed that the lack of access to abortion didn’t affect me personally.

Moving away for college exposed me to different perspectives that changed my views on abortion. I identify as pro-choice now because I realize access to reproductive health, including abortion care, is fundamental to equality.

CPCs impact access, but they are not the sole reason for the lack of access to abortions in rural communities. For instance, the prevalence of abstinence-only sex education in rural schools prevents any discussion of birth control or abortion – apart from the unhelpful advice to just not get pregnant. Teaching abstinence alone impedes access and encourages teenage girls to continue their pregnancies under duress.

Social norms also make abortion access seem less imperative. Often, expectations for young women in rural areas are to get married and have children as soon as possible.

Due to these already existing barriers to abortion access, CPCs are able to have a much stronger influence in rural communities than in more urban areas.

CPCs justify their existence and activities as acts of free speech. However, the dangerous nature of CPCs should outweigh First Amendment protections. CPCs do more than just “speak.” They affirmatively pressure young women to continue their pregnancies by providing inaccurate and misleading information.

In 2011, a NARAL Pro-Choice NC study found that 92% of the CPCs in North Carolina did not have a single medical professional on staff and that only 24% of CPCs disclosed that they were not medical facilities to their clients. Sixty-seven percent of the CPCs visited during this investigation provided false information about abortion, including that it increases the risk of breast cancer, infertility and death. In addition, almost half of the CPCs told clients that there are no effective methods of birth control to avoid pregnancy. The spread of inaccurate information is amplified by the fact that, at last count, CPCs outnumbered abortion providers in North Carolina 8-to-1.

In order to make any real progress, we must work to limit the negative impact of CPCs by passing laws to regulate or eliminate them. To date, however, state laws have actually supported and encouraged the existence of CPCs.

North Carolina, along with 19 other states, actually refer women to CPCs. Eleven states fund CPCs directly, with some states supporting CPCs through “Choose Life” license plates. In the 2014-2015 state budget, North Carolina lawmakers voted to support the Carolina Pregnancy Care Fellowship, a conglomeration of CPCs in the state, with $250,000 in taxpayer dollars. The group will also receive a portion of the profits from the sale of “Choose Life” license plates. North Carolina is currently enjoined from issuing these license plates until the Court of Appeals issues its final ruling.

While state legislatures have yet to have much success in curtailing CPCs, several cities and counties have enacted ordinances aimed at doing so. Court challenges forced the repeal of ordinances in Austin, Texas and Montgomery County, Maryland, but ordinances in Baltimore, San Francisco and New York City remain on the books even as the CPC’s wage court challenges. The enacted ordinances limit the power of CPCs by requiring disclaimers stating that they are not a licensed medical facility and that they neither provide abortions nor provide referrals for abortions. A promising bill proposed in the California legislature would, if enacted, require CPCs to tell clients they are not a licensed medical facility.

Sadly, it seems likely that the Fourth Circuit will find that North Carolina has the right to offer only “Choose Life” license plates and isn’t required to offer a pro-choice alternative. This decision will do more than support one-sided government speech by the state; it will further legitimize CPCs through state funding and support.

Access to abortion in North Carolina for all women has become more difficult in recent years. However, CPCs help make things dramatically worse for women in rural communities. Ultimately, if North Carolina is to provide real access to reproductive health services for all women, it will be imperative to rein in these centers and their misleading propaganda. Providing funding through “Choose Life” license plates is another step in the wrong direction.

Julie Tulbert is a policy intern with NARAL Pro-Choice North Carolina this summer and will be entering her final year of law school at William & Mary Law School this fall. She grew up in the northwest North Carolina town of Elkin.

- See more at: http://www.ncpolicywatch.com/2015/07/15/protecting-rural-communities-the-need-to-regulate-crisis-pregnancy-centers/#sthash.6cWGLCkx.dpuf

July 23, 2015 at 10:10 am
Sharon Kelly says:

When I read this article I was not surprised by the nature of the opinion of the writer. That is basically all this is, an opinion without true facts. Obviously the writer, Julie Tulbert, has not done her own research but has only taken the word of the organization (NARAL) she is associated with as her cites indicate.

I write this to defend the Pregnancy Centers across the State of North Carolina as well as the one she grew up one mile away from in her hometown of Elkin. First of all I would invite Julie to come take a tour of our center and see first hand how we operate. Believe me, it is nothing as she has falsely accused in her opinion, rather just the opposite. I am the Executive Director of LifeLine Pregnancy Help Center in Elkin and I personally would like to invite Julie to come in for a visit. To my knowledge, she has never done that.

I don't know how research from NARAL was conducted that cited that 92% of pregnancy centers didn't have a single medical professional on staff. First of all, not all pregnancy centers are medical. The ones that are medical are abiding by the standard set forth by the NC laws. In order to be medical, which in this case is offering limited ultrasounds and in some cases STI testing, the pregnancy center must have a Medical Director (Licensed Physician who oversees the program), an RN (who sets up policies and is trained to perform the ultrasounds) and in some cases an Ultrasound Technician. Every center that I am aware of in North Carolina follows these credentials. In our case, we have 2 Physicians, an RN and an Ultrasound Technician on our staff. We have had our CLIA license for 15 years, even before we became medical (offering limited ultrasounds). The CLIA license is basically stating we have been approved to be a lab for performing pregnancy testing. All information given to our clients is medically accurate. There is no denying that research has proven that abortion does have significant physical as well as emotional side effects. We only want to be truthful with our clients who come to us on their own volition. In our case, we give accurate information on all of their options including abortion, adoption and parenting. It is left up to them (our clients) to decide on their options. We do not pressure our clients in making any decisions, we only provide accurate information for them to make an informed decision. The purpose of the ultrasound is to determine the age of the baby and to confirm the pregnancy, not to diagnose abnormalities or determine the gender.

It seems to me that the writer, Julie, has a distaste for the work of the pregnancy centers yet she never once stated that she had either visited one or been involved in one first hand. If she feels so strongly against the work of the pregnancy centers, she should do her own research. I find it very interesting that she is so concerned about the State of North Carolina budgeting $250,000 in taxpayers dollars to the Carolina Pregnancy Care Fellowship. She doesn't add that this money is offered to pregnancy centers who apply for the block grant through the CPCF. It is tightly regulated and divided among the 28 pregnancy centers who actually applied and received the grant. She doesn't make any comments on the amount of taxpayers money the State of North Carolina gives to Planned Parenthood. Now that's interesting, in light of the day before this opinion article was published, Planned Parenthood was exposed to the public as selling aborted baby organs. I don't have to go into detail about this gruesome and barbaric practice. It speaks for itself.

I don't know how the writer came to the conclusion that pregnancy centers make things dramatically worse for women in rural areas of North Carolina. If she could read the exit surveys we have in our office from women who have been in our center, she would see that it is not the case. We offer compassionate, confidential care to all of our clients without discrimination. We have a great working relationship with 3 county health departments and our clients give them positive feedback concerning the care given them at our center. As I stated previously, our clients come to us on their own volition and are not forced to continue coming to our pregnancy and parenting classes. We offer over 100 lessons in our curriculum for pregnancy, labor & delivery, and parenting classes. We offer our services to our clients until the child reaches their second birthday. How can this possibly be making things dramatically worse for the women in our town? Maybe the writer is more concerned that the abortion rates are down 23% since 2010 in our county. Now that would affect the bottom dollar for Planned Parenthood I suppose. Did I mention that all of our services at LifeLine Pregnancy Help Center are at NO COST to our clients? Did I mention that our income comes from either private donors or fundraisers we plan throughout the year and a small amount of grant money mentioned earlier (2014-2015)? On the other hand, Planned Parenthood receives millions of dollars every year from taxpayers' money to provide the kind of service that truly does a disservice to not only women but men, children, grandparents, aunts, uncles, and friends of the women as well. Recent findings of Planned Parenthood and abortion clinics make it difficult to imagine that a "genuine medical clinic" could operate under such conditions. If we want to see stricter regulations on clinics, maybe we should start with the abortion providers.

The reason I felt compelled to respond to this is mainly because I am concerned that the writer has a total misconception of what goes on inside a pregnancy center, especially since she grew up only a mile from the pregnancy center in which I have been the Executive Director for 16 years. I extend an open invitation to Julie to visit our center. We are now located at 525 Samaritans Ridge Court in Elkin, NC 28621. This is a different location from the one in which she was familiar with growing up. We are in the medical office complex of Woodlands Professional Offices.

And by the way, the Choose Life license plates that will soon be made available to interested North Carolinians, have been in the process for approximately 17 years. And if citizens of North Carolina want to display this plate and express their support of Life, it is their choice to do so. This is not going to be a big money maker, but rather an opportunity for concerned citizens to voice themselves on their own vehicles. If we can voice ourselves on other issues such as "save the turtles" or "confederate ancestors" for example, why can we not express our concern for Life, human Life?