As a 23-year-old recent college graduate, I was faced with an unintended pregnancy. I was attempting to maintain control of my reproductive health by taking birth control pills, but I missed a few and got pregnant.
I was living in California, which has some of the most liberal laws enabling access to abortions, and I had a provider who discussed all my options with me. She shared medically accurate, unbiased information and helped me make an appointment at a local clinic. There, I received counseling from trained staff and excellent care from licensed ultrasound technicians, registered nurses, and OB-GYNs. I knew terminating my pregnancy was the only option for me.
Sixteen years later, I’m a mother of two and a family nurse practitioner. I see in many of my teen patients what I saw in myself then.
Recently, I interviewed youth in my community, between the ages of 14 and 24, to determine how to fulfill their needs before the launch of my workplace’s new reproductive health teen clinics. I asked if they knew where they could get pregnancy testing. Every single one of them, 85 to be exact, cited a crisis pregnancy center as the No. 1 place they go or have heard they can go.
Sex. Abortion. Parenthood. Power.
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Why? In their own words, “they offer it for free.” “You can walk in.” “You see the sign as you’re walking by/driving by/riding the bus.”
As a pro-choice advocate who’s worked in abortion care for much of my nursing career, I was floored. I knew these fake clinics used free pregnancy tests as a tactic to lure people into their unlicensed facilities, but I didn’t realize how well it was working. Clearly, none of them knew that these crisis pregnancy centers are staunchly anti-choice and will go to any lengths to coerce women to carry their pregnancies to term.
No matter what decision people make about their pregnancies, they should be able to access accurate information and expert health care without deception or delay. The pro-choice movement must fight back with renewed efforts. And fighting back means listening to the teens about how they ended up at anti-choice facilities in the first place. Fighting back means formalizing relationships between primary-care providers and clinics that provide abortion.
First, abortion clinics can be the primary place young people go to get free pregnancy tests. It might sound simple, but if women can receive unbiased, comprehensive, medically accurate care and discuss the full range of options from the beginning, they will have all the information they need to make the right choice for them.
To be sure, some independent abortion clinics may be reluctant for the general public to know where they are for fear of retaliation. And furthermore, offering free pregnancy testing may take away from the funding given to people who are seeking abortions. But the reality is that without appropriate marketing and knowledge of these places and the services they provide, women will continue to go to the places they know and follow the signs they see.
Anti-choicers will always find abortion clinics and continue to harass and intimidate the people who go there. However, as it is, the pro-choice movement and the staff at these clinics are often left to undo the misinformation doled out by anti-choice pregnancy centers. If abortion clinics can offer pregnancy testing that is free, accessible and well-known, these women can make the choices free of coercion and deceit.
Second, work with advocacy organizations in your community to fill the gaps in abortion care. Across the country, advocacy organizations that focus on providing full spectrum doula care—which includes informational, emotional and physical support for patients seeking abortion—are fulfilling the unmet needs of women in many states. As a primary-care provider, I am not able to provide direct complete referrals to my patients seeking to terminate a pregnancy because I work for a clinic that receives funding from the federal government. Normally, when I refer patients to a specialist, our referral clerks help them schedule appointments to provide better continuity of care. However, because we are only able to provide the name, address, and phone numbers of abortion clinics, it is very important to find advocacy organizations that are able to assist these women by helping them make appointments or providing transportation.
Third, form relationships with community health centers to ensure that abortion counseling is part of the services they provide. The Hyde Amendment is applied to federally qualified health centers funded under the Public Service Health Act, and we are restricted from providing full and complete referrals to abortion services, including negotiating a fee reduction for patients, making an appointment for them, or providing transportation. But we are required to provide women with information about the full range of pregnancy options. Most providers don’t know this or think they are restricted from discussing abortion.
Additionally, many providers are not aware of the abortion services available in their communities, and it is often through in-service trainings or informational materials that providers become aware. An in-service training that outlines the requirements and restrictions surrounding abortion counseling and referrals would help identify providers who are pro-choice advocates and also ensure that providers are meeting federal Title X requirements of their profession by providing “neutral, factual information and non-directional counseling to women who request it.”
It’s time that primary-care providers intentionally grow their networks because the retirement of U.S. Supreme Court Justice Anthony Kennedy and a new Trump appointee may mean Roe v. Wade will be overturned. And in a recent 5-4 decision, the nation’s highest court sided with crisis pregnancy centers and ruled in favor of the National Institute of Family and Life Advocates (NIFLA) in their challenge to California’s Freedom, Accountability, Comprehensive Care, and Transparency Act, an act which would have required such clinics with a medical license to post signs detailing where women could receive affordable medical care, including abortions. The act would also have required unlicensed clinics to actually say that they unlicensed.
For years, such centers have posed a real threat to pregnant people seeking abortion care. Unlike abortion clinics which are heavily regulated and receive limited funding, fake clinics are unregulated and well-funded by the federal government and private donors. This means they are can provide the care they want, even if it means lying to women or deliberately not providing all the information they need, which often delays or pushes abortion care out of reach. Often their clinics disseminate false medical information, usually about the supposed physical and mental risks of abortion and even about the effectiveness of condoms and prevention of sexually transmitted infections.
My 20-year-old niece, who is a mother to two kids under age 2, went to a fake clinic twice for pregnancy tests. At the first sign of a positive pregnancy test, they presented her with a pair of hand knitted blue booties for her baby, prayed with her, and congratulated her on her pregnancy. They did not allow her to consider any other options for her pregnancy.
All patients deserve unbiased and adequate comprehensive reproductive health services, including birth control, prenatal care, abortion, and childbirth. All patients deserve the truth to make choices that are right for them.