Should anti-choice organizations be able to deceive women, or even trick them into delaying health care, in an effort to compel them to have babies? That's a question that the Supreme Court will consider on Tuesday in a case called National Institute of Family and Life Advocates v. Becerra, with an examination of the constitutionality of California's Reproductive FACT Act. The law targets "crisis pregnancy centers," pseudo-clinics that often give the impression that they provide abortions and other reproductive health services but are actually designed to shame or scare women out of getting abortions. The state wants these centers to inform women of their right to health care access, and the centers are fighting back.
“Information is power and all women must have access to factual information regarding their health care," California Attorney General Xavier Becerra said in an emailed statement to Salon.
Crisis pregnancy centers "often locate themselves really close to actual abortion clinics and other family planning clinics, so that people don’t know where they’re going or are confused," explained Blake Rocap, the legal counsel for NARAL Pro-Choice Texas, in a press call. "They use deceptive names like Women’s Choice and True Care, and deceptive advertising, including using Google . . . so if you search for how to get an abortion, you end up with misinformation from one of these fake clinics."
Once inside the door, women are often subject to a barrage of lies and other deceitful tactics. A study from California's NARAL branch, where volunteers went in as clients, found that both the centers that were licensed clinics and those that weren't spread falsehoods, such as claiming abortion causes breast cancer and infertility. (It doesn't.) Centers also frequently tried to trick women out of abortion by implying that a pregnancy would go away on its own, or discouraged women from using contraception by downplaying the chance of pregnancy from unprotected sex.
Multiple state and local governments have tried to stop this barrage of lies with laws requiring up-front disclosure that the centers don't offer abortion, but these laws have been struck down in the courts. California, however, went a slightly different route. The FACT Act simply requires unlicensed centers to disclose their lack of licensing and requires any center that advertises pregnancy-related services "to advise each patient at the time of her visit of the various publicly funded family planning and pregnancy-related resources available in California."
These centers often claim to help women, so it may seem odd, on the surface, that they would object to a law requiring that they simply inform women about their state-supported medical options. In theory, such information might incline some women to choose childbirth, since the state offers prenatal services. But National Institute of Family and Life Advocates and other crisis pregnancy centers object because California also offers financial support for low-income women seeking abortion. So the centers worry that explaining abortion as an option will dilute their efforts to talk women out of having one.
Their arguments become even more ridiculous in light of a growing body of research showing that crisis pregnancy centers generally fail at their ostensible purpose of talking women into having babies.
“Women, at the time they are seeking care, are decided about what they want to do for their pregnancy," Katrina Kimport, a medical sociologist for Advancing New Standards in Reproductive Health, explained to Salon.
Kimport is the lead author on a new study from Louisiana looking into whether crisis pregnancy centers are successfully talking women out of having abortions, as they claim. The answer comports with past research showing that women have made up their minds by the time they reach out to a clinic — or at least to what they think is a clinic. Very few women went to a crisis pregnancy center in the first place, and of those who had, most reported that it had no impact on their choice. Most of the women researchers interviewed, in fact, wanted to have the baby and were just using the center for the free pregnancy testing and ultrasound services.
Another 2016 analysis by Nicole Knight of Rewire found similar trends in the data that crisis pregnancy centers collected themselves, namely that "they largely fail at their mission, persuading less than 4 percent of clients to forgo abortion care."
In a 2014 article in the Journal of Contemporary Ethnography, researcher Kimberly Kelly discovered a number of crisis pregnancy centers issuing reports "lamenting the declining proportions of 'abortion-minded' women visiting centers" and complaining that they "now primarily serve women who would have continued their pregnancies anyway."
It's reasonable to wonder why all this fuss has resulted in a Supreme Court case, if crisis pregnancy centers aren't changing women's minds. But there are a number of reasons why the deceptive practices of crisis pregnancy centers are dangerous, even if they fall short of their stated goals. For one thing, there's the immediate psychic damage women could incur after being shamed and bullied at a place they mistook for an actual medical clinic.
Then there's the issue of delayed care, which is central to this particular case.
As Josh Orton, a legal consultant for NARAL Pro-Choice America, explains it, This case is about the centers' "ability to keep certain timely information from pregnant women." These centers are literally suing for the right to avoid informing women about the availability of not just abortion, but prenatal care and other medical services.
"Women’s pregnancy-related health care services are highly time-sensitive, and unnecessary delay can pose significant risks to maternal and fetal health," explained an amicus brief in support of the FACT Act filed by the American College of Obstetricians and Gynecologists and the California Medical Association, among other health organizations.
But ultimately, this case may be about money. Crisis pregnancy centers fund-raise heavily among anti-abortion conservatives off the idea that they're successfully persuading "abortion-minded" women to have babies. This helps prop up the illusion that the centers are loving and Christ-like, oriented towards helping women and children, which, in turn, opens up pocketbooks and, increasingly, gives them access to multi-million dollar government grants.
So what do crisis pregnancy centers do with the money they get from donors? In large part, they're using it to fund the anti-choice movement's political activities, such as organizing rallies and other public events. Most importantly, many crisis pregnancy centers serve as bases of operations for the harassment campaigns that target actual abortion clinics.
"Our only abortion clinic in the Rio Grande Valley is actually next to the McAllen crisis pregnancy center," explained Ofelia Alonso, a student who lives in Brownsville, Texas, and works with the 1 in 3 Campaign to advocate for reproductive rights. "Their volunteers and employees spend most of their time outside of our only abortion clinic, just yelling at patients, trespassing on property, blocking cars, throwing stuff at people."
"Just the presence of a CPC in the vicinity of an abortion clinic ups the potential for violence," reported Kathryn Joyce in Ms. in 2010. "A recent survey by the Feminist Majority Foundation of women’s reproductive health clinics nationwide found 32.7 percent of clinics located near a CPC experienced one or more incidents of severe violence, compared to only 11.3 percent of clinics not near a CPC."
As Joyce noted, the man who murdered Dr. George Tiller of Kansas in 2009, Scott Roeder, spent his days in front of Tiller's clinic, telling women trying to go inside that they should instead visit the neighboring crisis pregnancy center.
Most donors give to these centers not because of their political organizing, but because of the illusion that the crisis pregnancy centers are talking women out of abortion. The California law threatens that illusion, and with it, the centers' main fundraising pitch.
Unfortunately, Supreme Court justices have been suckered in the past by anti-choice activists who claim to be devoted Christians who just want to help women, rather than mean-spirited harassment troops. In 2014, the court struck down a law that created a buffer zone around abortion clinics, buying the protesters' blatantly false claims to be "sidewalk counselors." Jill Filipovic of Cosmopolitan found instead that the protesters scream vitriolic comments at women and try to intimidate them by taking their pictures. There's a high risk that anti-choicers will pull the same deceit again with this case.
But California has prepared a solid case, arguing that the state's law is viewpoint-neutral and only meant to ensure that women who seek medical care are informed of their options. Crisis pregnancy centers are not barred from lying or using manipulative tactics, either on clients or their donors, as long as they provide women with real information about their options. So the centers will have to argue that hiding basic information from women is somehow "helping" them. One can hope that even the more conservative justices can see through that particular fallacy.