The premiere of HBO’s documentary 12^th and Delaware marked the first time a mass audience got an inside look at a so-called “crisis pregnancy center” (CPC). Like many of you, I watched as the “counselor” at the CPC featured in the film manipulated and misled women in crisis situations. I still can’t get some of the scenes out of my mind, such as the one in which the CPC director tells a woman that going forward with her pregnancy could make her verbally abusive boyfriend change his behavior.

The film gave vivid examples of threats CPCs pose to women’s freedom and privacy, and I am glad it’s starting a conversation in the blogosphere and beyond—but, one thing bothers me. The documentary takes place in Fort Pierce, Florida, across the country from my state of California.

I work as a pro-choice advocate in California, so I often hear from friends that bad things going on in Florida or other parts of the country wouldn’t happen here. I mean, how could a CPC operate in California? It’s the most pro-choice state in the country, right? And if CPCs are here, they must be few and far between.

Well, CPCs are here, and I can relate to the manipulation that many women in the film were subjected to because I experienced it myself right here in my backyard.

During the summer months of 2009, NARAL Pro-Choice California Foundation staff sent volunteers to CPCs around the state.  These volunteers posed as women who might be facing an unplanned pregnancy and who needed both a pregnancy test and knowledge of their options.  As volunteers on the project, they were trained to be unbiased and neutral throughout the investigation in order to ensure accuracy and after each visit filled out a lengthy debriefing form on everything they saw, spoke of, and read in the center.  

Their stories are troubling. One volunteer was told that “women who have abortions have strong reactions when they hear vacuums because they use vacuums to remove the fetus.” Another volunteer was asked if she “wanted to be branded as a loose woman…to have [her] name written on bathroom walls.”  Others’ questions about abortion and contraception were ignored or met with hostility and judgment. If and when abortion was brought into the conversation, CPC employees used delay tactics and graphic images to deter women from seeing abortion as an option. 

The results of this investigation, published by NARAL Pro-Choice California Foundation in its report Unmasking Fake Clinics, demonstrate that the pro-choice state of California is under attack from the “fake clinic” arm of the anti-choice movement.  While only 59 percent of California counties have an abortion provider, 91 percent of California counties have at least one CPC. For women who are young, live in rural areas, or have low incomes, the “counseling” these centers provide may be the only resource available when they are faced with a decision that could affect the rest of their lives.  More than half of centers in this study specifically offer “free” counseling.  More than two-thirds of CPCs represent their counseling as unbiased, when in fact, our report documents that CPCs provided false information to women seeking assistance or information about abortion and birth control.  No matter how a person feels about the question of legal abortion, everyone can agree that women should never be misled when seeking information about pregnancy, birth control, abortion, or sexually transmitted diseases.  

NARAL Pro-Choice California Foundation found that CPCs in California often use propaganda and delay tactics to dissuade women from considering birth-control or legal abortion.  These include misstating statistics about the effectiveness of condoms (60 percent of CPCs in the study advised that condoms are ineffective in reducing pregnancy and the transmission of certain STDs) or providing misinformation about the consequences of undergoing an abortion (85 percent of CPCs in the study advised that abortion increases the risk of infertility and that abortion leads to mental health problems).  Most troubling is that eschewing medical integrity seriously endangers women’s reproductive health, as it ultimately may delay women from seeking appropriate comprehensive medical care. 

NARAL Pro-Choice California Foundation seeks to change this.  Many lawmakers at all levels of government have expressed interest in working on this issue.  Nationally, Rep. Carolyn Maloney (D-NY) and Sen. Robert Menendez (D-NJ) have introduced the Stop Deceptive Advertising in Women’s Services Act, which aims to prescribe rules prohibiting deceptive advertising of abortion services.  Locally, the organization is sharing these findings with community leaders around the state and hopes to work with city-level officials at passing ordinances similar to those in Baltimore and Austin.  Enacting more ordinances like these will help to offset another common deceptive strategy CPCs employ: just like the CPC in 12th & Delaware, many position themselves near or even next to legitimate clinics to confuse women intending to go to the reproductive-health care provider located on the same street.

While CPCs in California are currently not being held accountable for their deception, continuing to expose their practices through reports like Unmasking Fake Clinics provides women with the ability to make healthy decisions and lays the ground work for advocacy that will ensure these centers can no longer use misinformation and delay tactics to discourage women from pursuing safe, comprehensive, and legal options.

What’s happening in Florida, as seen in 12^th and Delaware, is not only happening here in California but all over the country. NARAL Pro-Choice California Foundation’s investigation highlights that though California has long been considered the top state for respecting women’s reproductive privacy, it is not immune to the threats that are being documented around the country.