(WOMENSENEWS)–This year, California will be ground zero in the battle over the regulation of crisis pregnancy centers, the estimated 4,000 faith-based facilities across the nation that provide counseling, ultrasounds and other pregnancy-related services but exist primarily to steer women away from abortion.
These centers have proliferated in recent years and are attracting more patients, especially young, low-income women who lack access to medical care and the resources to raise a child.
California‘s Reproductive Freedom, Accountability, Comprehensive Care and Transparency Act, known as Reproductive FACT Act, which took effect Jan. 1, is the first state law that requires health care facilities to post signs in their waiting rooms informing patients that the state offers free and low-cost programs for family planning, prenatal care and abortion.
Signed by Gov. Jerry Brown, a four-term Democrat, the law also requires unlicensed facilities to post signs acknowledging their status and informing women that "the facility has no licensed medical provider who can supervise the patient’s care." The fine is $500 for a first offense; $1,000 for subsequent violations.
Advocates on both sides of the abortion issue are watching closely to see if the
Reproductive FACT Act survives court challenges, which have prevented similar ordinances in Baltimore, New York and Austin, Texas, from being implemented.
If the law does survive, versions of California‘s law may pop up in other state legislatures during the coming months.
Eleven state affiliates of NARAL have conducted undercover investigations, which have revealed numerous abuses by crisis pregnancy clinics in their states.
In Ohio, less than half of the 100 crisis pregnancy centers were candid about their services; 60 percent were unwilling to admit that they were not medical facilities.
In Massachusetts, investigators found that a third of the 24 crisis pregnancy centers they visited overstated the likelihood that an abortion would harm a woman’s future fertility.
And in Montana, staff at 78 percent of the 20 crisis pregnancy centers visited told women that abortions caused serious psychological damage, which has long been disproven.
Surviving Two Challenges
So far, the law has survived two challenges by crisis pregnancy centers in Northern California seeking injunctions to prevent it from taking effect Jan. 1. The centers claimed that the law is a "bully" measure that forces peer counselors to provide a government-mandated message that violates their right of free speech and religion under the First Amendment.
In a 57-page opinion Dec. 23, U.S. District Court Judge Kimberly J. Mueller rejected those claims, stating that the center’s free expression of religious rights were not violated by the law since it requires the centers to provide neutral general information and applied equally to all women’s health providers, not just religious-based crisis pregnancy centers.
Two other suits are pending in Southern California.
In addition to laws such as the California Reproductive FACT Act, public awareness campaigns might also help alert women to the deceptive practices of crisis pregnancy centers, said Joanne Rosen, director of the clinic for public health law and policy at the Bloomberg School of Public Health at Johns Hopkins University in Baltimore.
"States might also use consumer protection laws that ban false advertising and deceptive practices by service providers," she said in a phone interview.
On the national level, Rep. Carolyn B. Maloney, D-N.Y., is seeking support for her bill, the Stop Deceptive Advertising for Women’s Health Service Act, which would make it illegal for crisis pregnancy centers to falsely advertise that they provide abortion services if they do not do so. The bill was introduced in 2011, but like other reproductive health bills, it has faced tremendous opposition in the Republican-controlled House.
"It’s unfortunate that Congress is not likely to act to stop deceptive advertising by crisis pregnancy centers," Maloney said in an email interview. "Far from making progress, we’re fending off relentless attempts to restrict women’s health care. We need more states to follow California‘s lead. That’s the best way to get something done in the near term, but I’m going to continue fighting in Congress to build support and make sure my colleagues know just how damaging the deception from crisis pregnancy centers really is."
A Bright Spot
California‘s passage of the Reproductive FACT Act was a bright spot for pro-choice advocates in 2015, a year in which 17 states enacted 57 new abortion-related restrictions, notes the New York-based Guttmacher Institute, which does research on reproductive health. The number of states considered hostile to abortion has increased from 13 in 2000 to 27 in 2014.
"The California law is a major victory because it ensures that like every medical patient, a woman with an unplanned pregnancy will receive unbiased, scientifically sound information she needs to make the best possible decision for herself and her family," said Autumn Burke, a Democratic assemblywoman representing Inglewood, in a phone interview.
Burke and Democrat Assemblyman David Chiu proposed the bill following a year-long undercover investigation of 45 crisis pregnancy centers by the California affiliate of NARAL Pro-Choice America, the nation’s oldest reproductive rights organization.
Deception was rampant, said Burke. Few women realized the centers were operated by groups opposed to abortion because crisis pregnancy centers had names that were similar to clinics that offer comprehensive reproductive care and were located near hospitals.
Peer counselors wore white coats and conducted free pregnancy tests and ultrasounds in rooms that resembled medical offices.
"The crisis pregnancy centers also promulgated anti-abortion myths," said Amy Everitt, state director of the California affiliate of NARAL, in a phone interview. "Forty-five percent of the crisis pregnancy centers claimed that abortion increases the risk of breast cancer. Thirty-five percent said abortion boosted the risk of infertility."
Worst of all, Everitt said, the crisis pregnancy centers used a "one solution fits all" method of counseling. Investigators who cited serious health conditions like diabetes were told to continue the pregnancy as were women who said they were in abusive relationships or couldn’t support the children they already had.
Each year, about 700,000 women become pregnant in California, the nation’s most populous state. About half of these pregnancies are unintended, she said.
Lack of Access
Ensuring that crisis pregnancy centers provide accurate, unbiased information is imperative because many of California‘s 174 crisis pregnancy centers are located in rural communities and urban areas where women lack access to medical care, said Nourbese Flint, program director of Black Women for Wellness, a nonprofit organization in Los Angeles that seeks to expand health care access and build political advocacy in California and beyond.
"Women’s livelihoods and health care should not be subjected to the biased opinions of strangers who are more interested in pushing an agenda than an individual woman’s health or the health of her community," Flint said in a phone interview. "By the time women who consult crisis pregnancy centers decide to have an abortion, they are often too far along in their pregnancies to have the procedure or it is prohibitively expensive."
Bills to regulate crisis pregnancy centers have faltered in blue states like California as well as red states, so Black Women for Wellness and the California affiliate of NARAL conducted an extensive campaign to win public support of the Democratic-controlled state legislature.
In addition to a letter signed by more than 100 faith leaders endorsing the bill, health professionals testified during legislative committee hearings that the crisis pregnancy centers posed a public health threat because they offered their patients health care of dubious quality.
The strategy paid off: A poll by Tulchin Research, a San Francisco polling organization, found that 70 percent of Californians who were planning to vote in the 2016 presidential election supported the posting of notices; 80 percent were in favor of giving women information about state-supported programs. Catholics supported the measure by a 5-to-1 margin. About 60 percent of conservatives favored passage.
The law was also supported and vetted by Democratic Attorney General Kamala Harris to ensure that it would survive First Amendment challenges that had torpedoed a San Francisco ordinance.