We have mentioned before that the claim that abortion providers do “abortions on women who aren’t even pregnant,” is a common talking point among the radical anti-choice movement. Recently, activist Abby Johnson came to Congressman Todd Akin’s defense when he repeated this claim, saying that as a clinic director in Texas that was exactly what she saw happen.

Via Buzzfeed:

“In support of Congressman Todd Akin, I can attest that when I served as director of Planned Parenthood in Bryan, Texas, we often scared women into getting services they did not need—including abortion—so we could collect the fees,” Johnson said in a statement released to BuzzFeed on Wednesday by Akin’s campaign. “This included women who were not pregnant and women who were in the process of miscarrying.

The statement continued, “Anyone that would attack Congressman Todd Akin for his factual comments on the House floor in 2008 are misguided at best.”

Performing a D&C on a woman who is miscarrying is of course common medical practice. I should know—I had my own done in 2009 after I discovered I had lost the fetus weeks earlier and my body had never responded by going into labor.

But the idea that abortions were performed on women who weren’t pregnant at all, now that is a totally different story. I had read many of Ms. Johnson’s interviews about her time at Planned Parenthood and the organization’s alleged zeal to up its abortion numbers or other plots to increase revenue, but hadn’t seen her claim about the practice of pushing abortions on women who weren’t pregnant before.

I asked Ms. Johnson via email if she could clarify how abortions were performed on women who weren’t pregnant, and she was happy to explain:

I was, of course, a fan when I worked at Planned Parenthood. We often performed abortions on women who were nearing the end of their miscarriage. We would convince them it was necessary in order to collect the $400 … since they were there anyway and we had already done an ultrasound. With these women, the fetal tissue had passed … we were basically just suctioning out a few cc’s of blood. Totally unnecessary for the patient, but necessary for our bottom line.

Although many reproductive health professionals would likely consider miscarriage management like that to be fairly routine (and, as a woman who has been through the drawn out process of likely retained tissue that caused months of spontaneous bleeding and an elevated hCG level, frankly, rather welcome), I was still more interested in the “not-pregnant” women, which Ms. Johnson explained further.

There were times where nothing was visualized in the uterus and we would perform the abortion anyway. Turned out the woman had an ectopic pregnancy. Once, the woman almost died in the ER from a ruptured tube. We paid her off to keep her quiet. That wasn’t the only time something like that happened. Planned Parenthood is not allowed to diagnose ectopic pregnancies, so many times abortions are performed on a non-pregnant uterus and the woman is sent home. Those were my personal experiences.

Ms. Johnson also mentioned the experiences of Carol Everett, the clinic worker in the ’70s who brought the “abortions on women who aren’t pregnant” concept to the religious right. I asked how likely it would be that such a thing occurs today, when pregnancy tests are available in every grocery store and gas station, and the vast majority of women go into a clinic already knowing whether or not they are pregnant.

That is true. But I have read in multiple places that 25 percent of women misread pregnancy tests. And I can tell you that we had women come in all the time who swore they had a negative test at home, but were indeed pregnant. I’m sure it was because of a misread … or possibly denial. Abortion clinics don’t perform pregnancy tests before performing abortions. And they certainly don’t draw quantitative beta HCG’s. So, I can see how the things that Carol Everett talked about could still happen today.

It is standard clinic procedure to do a follow-up pregnancy test to ensure that the patient is pregnant, and to narrow down whether she could have an ectopic pregnancy. I received a fact sheet from one clinic that had a list of factors to be considered if a pregnancy doesn’t show on an ultrasound that includes: 1) the patient is not actually pregnant 2) it’s too early to see anything or 3) the pregnancy is not actually located in the uterus, so it won’t be visible in an ultrasound. The suggested follow up is first to take another pregnancy test at the clinic, and, if it is positive, then wait seven to 14 days before returning for a second ultrasound. By that point, the pregnancy should be visible if it is in the uterus. The fact sheet also supplies the patient with warning signs to watch for should the pregnancy be ectopic, such as pain, dizziness or sudden weakness.

California provider Dr. Radha Lewis, a Physicians for Reproductive Choice and Health fellow, disagreed with Ms. Johnson’s assertion that clinics don’t perform pregnancy tests, or will try to pressure women into unneeded procedures. “We give every women who comes in saying she is pregnant a pregnancy test, and if it is negative, we offer them birth control,” Dr. Lewis explained when I asked her the basic steps a woman would go through when getting an abortion.

What if the woman has miscarried already? Do clinics urge her to go ahead and get a D&C just in case?

“If a woman has a missed miscarriage we will present her with options,” said Dr. Lewis.  “She can either receive a D&C to complete it, or continue to wait, or we can give her medication to help the uterus contract to expel the tissue. If she is presenting symptoms such as continued bleeding, we would offer surgery in order to help her stop the blood loss and dizziness, just as an emergency room would do the same. This is the same choice provided to every woman across all clinics.”

Some will choose a D&C in order to simply move on, said Dr. Lewis. “She has other children, she is busy. She wants to get it over with and done.”

But force women to have an abortion when she was not actually pregnant? It simply doesn’t happen, according to Dr. Lewis. “There are absolutely no instances of women having abortions performed on them when they are not pregnant and to say so is to assume that women are stupid and physicians unethical.”