No, the Real ‘Abortion Divide’ Is Not Between Patients and Protesters

The abortion divide is between people who need and deserve abortion access and the well-funded movement colluding with lawmakers to push it out of reach.

[Photo: Women's Center volunteers safely escort out a patient seeking an abortion procedure.]
By framing the abortion divide as a battle between highly regulated clinics and crisis pregnancy centers and patients versus people who scream at them on the sidewalk, the film position clinics and crisis pregnancy centers as if they are somehow equivalent. They are not. Vanessa Carr for FRONTLINE

PBS’ Frontline recently premiered The Abortion Divide, a short documentary that examines the experiences of several women facing unplanned pregnancies in Philadelphia as they decide whether to carry the pregnancy to term or have an abortion.

The filmmakers follow the women who choose abortion into the Philadelphia Women’s Center (PWC), where they interview patients and doctors. They also showcase the protesters who gather outside PWC to try to shame and intimidate people on their way in and out of the building. They also film inside so-called crisis pregnancy centers (CPCs).

The Abortion Divide is marketed as an update to the 1983 Frontline episode “Abortion Clinic,” which explored the same subject at Reproductive Health and Counseling Center (RHCC), a Chester, Pennsylvania, facility subsequently forced to close by state legislation that targeted abortion providers with prohibitively expensive, medically unnecessary regulations.

The Abortion Divide got many things right, but also missed the mark in several ways that demand response and clarification. The Women’s Law Project (WLP), where I work, participated in the film by providing background information and arranging interviews. WLP Executive Director Carol E. Tracy and a former board member-attorney, Tom Zemaitis, briefly appear in the film. Dr. Lisa Perreira, one of the featured physicians, is a current board member. WLP has also represented abortion providers in Pennsylvania since 1974, and it provides legal counsel to PWC.

We appreciate that the film clearly showed the compassionate, evidence-based health care patients receive at Philadelphia Women’s Center. Though nearly 1 in 4 U.S. women (as well as transgender and gender-nonconforming people) will have an abortion by the time they are 45 years old, many Americans have never been inside an abortion clinic. It is incredibly important to destigmatize abortion care by inviting viewers to see the clean, professional environment and observe intake staff respectfully assist callers and physicians providing compassionate care.

The film also accurately portrayed sidewalk protesters. They bang on car windows, approach patients without invitation, and yell about “abortion reversal,” a rogue practice the American Congress of Obstetricians and Gynecologists states is “not based on science and [does] not meet clinical standards.”

Unfortunately, that fact-check was not made in the film.

A particularly chilling moment unfolds when anti-choice activist Dr. George Isajiw marvels at how convenient it is for him to treat women with this unethical practice. When explaining all he has to do is call a prescription in to a pharmacy, he exclaims, “You don’t even have to see her!”

It’s a remarkable admission for an activist representing a movement that has long feigned concern for the health of pregnant people as cover for promoting burdensome regulations on abortion providers, such as the kind that forced the clinic featured in the original episode to close.

Harassing behavior, invading unsuspecting patients’ personal space, and espousing false claims about reproductive health are so ingrained as political tools that anti-choice protesters—as the film shows, mostly older white men—seem proud of being filmed behaving this way. They’re so proud that Dr. Isajiw apparently acted out the scenes of him yelling at patients just for the filmmakers though he is not a regular sidewalk protester, according to a PWC statement released after the episode first aired.

PWC objected to the alleged staging of this scene. According to a Facebook post, the clinic said that: “The [producers’] decision to place Isajiw outside our [c]enter and expose our community, patients, staff and police to his vitriol was unnecessary. It was a dramatic display of poor journalistic integrity … ”

Rather than expose patients to harassment for dramatic purposes, Isajiw’s time on camera would have been better spent directly asking him about his 1986 arrest for “storming” the Reproductive Health and Counseling Center, the clinic featured in the earlier Frontline episode.

PWC also took issue with the documentary’s characterization of the depicted events and its work as a “battle.” Its Facebook statement continued: “People who have abortions are not engaging in a battle. Abortion providers are not engaging in a battle. Abortion providers are helping pregnant people with their health-care decisions—in a safe medical facility that is not a battleground for war or politics.”

By framing the abortion divide as a battle between highly regulated clinics and crisis pregnancy centers and patients versus people who scream at them on the sidewalk, the film position clinics and crisis pregnancy centers as if they are somehow equivalent.

They are not. In Pennsylvania, medical facilities that provide abortion care must comply with, at last count, 1,237 pages of statutes, laws, and regulations. “Crisis pregnancy centers” do not need to be licensed and use strategies like luring women in with free ultrasounds as “a tool,” as they say in the film, to initiate conversations to dissuade them from abortion.

According to an American Medical Association Journal of Ethics article that explored the deceptive practices of CPCs, “because the religious ideology of these centers’ owners and employees takes priority over the health and well-being of the women seeking care at these centers, women do not receive comprehensive, accurate, evidence-based clinical information about all available options.”

It was heartbreaking to watch the vulnerable women in the film seek help from crisis pregnancy centers when what they really need is prenatal care and social services. As attorneys who assist young people navigate the judicial bypass process for minors’ abortion care in Pennsylvania, we hear firsthand from young women who have been misled and misinformed by CPCs. Just recently a client sobbed as she explained how the CPC staff told her she would likely become depressed and suicidal if she had an abortion, a horrific and cruel suggestion not grounded in science.

Let’s be clear: The abortion divide in Pennsylvania is between citizens who need, deserve, and support abortion access and the elite, well-funded movement working in collusion with lawmakers to push it out of reach for poor women and women of color. After years of state lawmakers passing hundreds of medically unnecessary, politically motivated state restrictions, safe, legal abortion is already out of reach for so many women.

Research shows that women who seek abortion care but can’t raise the money in time or otherwise navigate logistical hurdles to get to a clinic suffer significant harm as individuals, and that politically motivated abortion restrictions correlate with disastrous public health consequences, including unconscionably high maternal mortality. In Pennsylvania, like everywhere else, those disastrous effects are severely stratified by race. As Mashayla Hays wrote for the Inquirer, “As of 2013, from the most recently available data, Black women made up 11 percent of women in Pennsylvania, yet accounted for 31 percent of all pregnancy-related maternal deaths.”

The filmmakers accurately note the number of CPCs has skyrocketed since the 1980s episode, but leave viewers to assume this growth reflects grassroots momentum of anti-choice activists in Pennsylvania. That couldn’t be further from the truth. The reason unregulated “crisis pregnancy centers” vastly outnumber abortion providers in Pennsylvania is because the state government funnels millions of taxpayer dollars into these organizations.

Pennsylvania not only gives away millions of taxpayer dollars to CPCs, but it’s also one of just a handful that diverts TANF funds—temporary safety-net financial assistance that mostly supports single mothers and children in crisis—to CPCs. The state even takes money earmarked for TANF to subsidize the salary of the CEO of Real Alternatives, a Pennsylvania-based chain of CPCs. (In 2017, the Pennsylvania Auditor General investigated Real Alternatives after being unable to account for almost a million dollars due to practice he characterized as “a fiscal gimmick.” That lack of transparency is now the subject of a related open records lawsuit.)

Pennsylvania has long been a bellwether state and a testing ground for anti-choice policies. It’s the state yielded the 1992 landmark U.S. Supreme Court case Planned Parenthood v. Casey, which upheld the constitutional right to abortion but introduced the “undue burden” framework that enabled today’s anti-choice strategy and hundreds of abortion restrictions. But Pennsylvania is also home to robust reproductive rights, health, and justice movements; in January, Pennsylvania abortion providers, represented by WLP’s Susan J. Frietsche, attorney David S. Cohen, Planned Parenthood Federation of America and the private law firm Pepper Hamilton LLP, filed a lawsuit seeking to restore Medicaid coverage of abortion, which was banned in 1985. 

Working in this climate of restriction and resilience, the doctors, staff, and patients are the clear heroes of this film. Due to the stark rise in death threats and harassment of doctors since Trump took office, the sad reality is that the doctors and staff who participated in a high-profile film with the hope of destigmatizing reproductive health care for the greater good risked their personal safety to do so. And it’s hard to fathom the extraordinary courage of the women and patients who shared their stories.

We are so grateful to the patients who chose to participate in the film. As the film shows, the women who had abortions and the women who chose to carry their pregnancies to term both had the freedom to make the decision best for themselves and their families. Showcasing that shared experience only underscored how important it is to preserve that freedom—and not let sidewalk protesters and politicians hand that decision-making power over to the government.