Soon after giving birth to her sixth child, Laurie Bertram Roberts suspected she was pregnant again. She needed a test to confirm the pregnancy and couldn’t get in to see a doctor, so she went to a crisis pregnancy center for a free one.
Bertram Roberts wasn’t considering abortion—if she was pregnant, she planned to continue the pregnancy, and told the center’s volunteers as much. Still, she was made to watch an anti-abortion propaganda video while waiting for her results and was later shamed for not being married despite disclosing she was trying to leave an abusive relationship, Bertram Roberts said.
When the “counselor” finally told her the pregnancy test was positive, Bertram Roberts asked for help getting a crib—exactly the type of item that these centers often claim to provide in their advertisements. What she received instead was an information sheet listing activities she could do to “earn” one, including going to church and watching more videos.
Though the primary purpose of a “crisis pregnancy center” (CPC) is to dissuade people from having abortions—often using misinformation and other deceptive tactics—research finds that many people who visit them do know they are religiously affiliated and not real medical facilities. But CPCs are often the only organizations in a community advertising free services such as pregnancy tests, ultrasounds, and baby supplies. Many CPC clients aren’t seeking abortions at all—they’re looking for help with a continuing pregnancy.
As abortion is banned and clinics close across much of the South and Midwest, the number of people in need of these services is all but guaranteed to increase. Advocates on the ground say there is an urgent need to provide alternatives to CPCs—but funders aren’t investing enough in the idea.
CPCs not only spread misleading and stigmatizing information about abortion, most are also affiliated with evangelical Christian organizations and shaped by conservative ideas about gender, sexuality, and families in general.
“I think we sometimes underestimate the breadth of bias or judgment people encounter when they go to a CPC,” said Parker Dockray, executive director of All-Options. “It’s not just about CPCs being anti-abortion—it’s about all the things that come along with that,” she said, recalling the story of one client who visited a CPC seeking support for a toddler but faced judgment for having an older child who had recently come out as queer.
In addition to its national support line and other programs, All-Options has operated a pregnancy resource center in Bloomington, Indiana, since its 2015 opening. As the name suggests, unlike a CPC, All-Options offer support for pregnancy and all its outcomes, including parenting, abortion, and adoption. A 2016 analysis of All-Options’ intake forms found that 87 percent of clients were seeking free diapers and 44 percent were seeking baby clothes and other items.
“As opposed to the way some CPCs will maybe give people five diapers a week and require people to go to classes to earn ‘mommy money’ or ‘baby bucks,’ we really try to provide what people need in a way that doesn’t make them have to go to every place in town,” Dockray said. “We try to reduce the hustle that’s required for people to meet their basic needs.”
Requiring people to “earn” their resources “is just poverty shaming,” said Bertram Roberts, the co-founder and executive director of Mississippi Reproductive Freedom Fund (MRFF) who’s also a Rewire News Group contributor. “Because I’m poor you think I can’t parent. And a lot of it is racially motivated. You can’t separate racism from poverty and our views on poverty in America.”
MRFF is another powerful model of a reproductive justice-oriented CPC alternative. In addition to funding abortion care, the organization operates a food pantry and a period supply closet. It has been sourcing baby formula during the national shortage and providing water in response to the Jackson water crisis. MRFF also distributes donated air conditioners and furniture, and it connects people with doulas and numerous other parenting resources when possible.
“There is no other group down here that’ll pay for your abortion one year and then the next year, pay for your midwife,” Bertram Roberts said.
One key element of MRFF’s ethos: Services come with no strings attached.
“You don’t have to check back in with us,” Bertram Roberts said. “You don’t even have to be grateful.”
Several abortion clinics in states where abortion is banned are also stepping up to fill gaps in reproductive and sexual health care, expanding their services to offer prenatal care, miscarriage management, post-abortion care, and more. (I Need an A is tracking them at stillopenclinics.org.) However, many of these clinics are struggling to keep their doors open.
“I’ve been disappointed not to see the abortion funder community really investing in those providers,” Dockray said.
Even clinics that do manage to stay open may not be able to compete with CPCs on one critical front: cost.
“You can open up as many abortion-positive health centers as you want, but they’re not all necessarily going to be able to be free,” said Caroline Weinberg, founder and executive director of Plan A, an organization that operates mobile health clinics in the Mississippi Delta.
Plan A does provide all its services for free, but doing so hasn’t been easy. Originally focused on contraception, Plan A “evolved because the world changed, and we realized as a reproductive justice organization that people who are pregnant need help, too,” Weinberg said. For example, even before Roe v. Wade was overturned in June, Plan A’s pregnant patients were having trouble getting ultrasounds. So it bought an ultrasound machine—but actually getting patients their ultrasounds requires more than just that initial purchase.
Weinberg said a new transvaginal ultrasound machine costs between $3,000 and $7,000 and a new abdominal ultrasound is about $3,000.
“And then training is an issue,” Weinberg said. “It’s expensive to take an ultrasound class, and it’s not the kind of thing every person learns in nurse practitioner school or medical school. It all comes down to money.”
CPC vans offering free ultrasounds—often staffed by volunteers with dubious qualifications—are ubiquitous outside abortion clinics. But it’s nearly impossible to get a free ultrasound from a reliable provider.
“If I could wave a magic wand and have a donor run an ultrasound class where they invite people from all over the country, that would have a huge impact,” Weinberg said.
In addition to the steep price of getting new services off the ground, Weinberg said, another challenge is that grants typically come with restrictions on how the money can be spent, making it difficult for small organizations to make necessary pivots. After all, free ultrasounds are just one item on a long list of services needed in states that have banned abortion, and those needs will likely change with time.
Asked what she would say to funders, Bertram Roberts put it simply: “Send your money down here. Don’t forget about the South.”