Yes, the Government Should Regulate Anti-Abortion Zealots Who Pose as Doctors

Originally published March 20, 2018 in Broadly.

The Supreme Court is hearing arguments in a case that pits reproductive rights advocates against faith-based "crisis pregnancy centers," whose sole purpose is to talk women out of abortion, often through deceptive means.

In 2002, Cherisse Scott was facing an unwanted pregnancy at age 28, living in Chicago and working as a paralegal. She made an appointment at what she thought she was an abortion clinic, she later recounted to New York Magazine—but instead of providing her with information about her full range of options, a counselor lectured her about the joys of motherhood, made her watch a graphic video of an abortion procedure, then presented her with a rattle and a onesie and referred her to another facility for a free ultrasound. At this second appointment, the technician told her, “If you have an abortion now, you’ll rupture your uterus and won’t be able to have children in the future.”

Terrified by the prospect of infertility, Cherisse carried the pregnancy to term. Within a year of her son’s birth, she lost her job and healthcare. The pregnancy clinic she visited never followed up, and offered no support beyond the set of baby toys they’d given her on her first visit. Years later, Cherisse realized what had happened to her: She’d accidentally gone to a crisis pregnancy center.

Crisis pregnancy centers (CPCs) are nonprofit organizations that exist for the sole purpose of counseling women out of abortions. They often masquerade as legitimate reproductive healthcare providers by using a slew of deceptive tactics: outfitting their employees in scrubs or lab coats, placing targeted ads online to trick women searching for terms like “abortion” and “pregnant and scared,” and even setting up shop next to actual abortion providers in hopes of tricking their patients into entering the wrong facility. The vast majority of CPCs are faith-baith organizations, and they’re staunchly opposed to contraception and abortion. According to a 2015 NARAL report, “They consider themselves the foot soldiers in the anti choice movement.”

Some CPCs will lie to women about their due date in order to convince them they’re too far along to receive a legal abortion. Some will tell their patients—with no scientific or medical justification—that they might “die, end up in hell, or get very sick” if they go through with an abortion; that abortion can cause a harrowing PTSD-like disorder called “post-abortion syndrome,” despite the fact that no mental health professionals recognize that condition as real; that there’s a link between abortion and breast cancer.

Put simply, CPCs are fighting the FACT Act because it makes it harder to mislead and deceive women, which is the foundation of their business model.

Nationwide, CPCs outnumber abortion clinics three to one. While one might think that masquerading as a medical office and dispensing spurious information to vulnerable women should be illegal, these fake clinics aren’t only legally protected, they are also very often the lucky recipients of state funding. That’s right—your tax dollars fund these religious propaganda centers, under the guise of “family planning” welfare programs; at least 12 states are currently financially supporting CPCs using money that could be better spent on services like child care subsidies.

Each year, millions of public dollars pour into these fake clinics, which barely offer any services to women, if any at all. It hardly seems controversial to argue that women should be legally entitled to accurate, comprehensive, and unbiased medical information with which they can make their own decisions, but many states have been unsuccessful in their attempts to sanction CPCs by requiring them to meet a standard of transparency.

This brings us to a case currently making its way through the Supreme Court: NIFLA v. Becerra, the result of years of legal battles over a California law passed in 2015: the Reproductive Freedom, Accountability, Comprehensive Care, and Transparency (FACT) Act. In a direct attack on CPCs, the FACT Act would require all licensed reproductive health clinics to notify women about affordable family planning and abortion services offered to them by the state, either by handing patients a notice or displaying on on the wall. Any facility without a license would also have to notify their patients that they are not officially recognized as a medical facility. To the average person, this probably doesn’t seem too onerous of a requirement: If you are licensed to provide family planning services, you are legally required to give your patients the full range of information about their options. If you’re not, you have to tell everyone who comes through your door in search of medical advice that you’re not an actual doctor, just a person in a lab coat with a bunch of fetus pamphlets.

Unsurprisingly, a group of religious organizations, including the National Institute of Family and Life Advocates (NIFLA), adamantly opposed the law and sued California Attorney General Xavier Becerra in 2016. These organizations claim that they have the constitutional right to lie and mislead patients in accordance with their religious beliefs, and that informing them about abortion is tantamount to endorsing it.

In reality, the FACT Act does not mandate that pregnancy clinics alter their professional practice, and it does not force them to support abortion or advocate for it. The reason that CPCs are fighting this law is because they know that if women have access to medically accurate information and resources, they will often choose abortion. Put simply, CPCs are fighting the FACT Act because it makes it harder to mislead and deceive women, which is the foundation of their business model.

Critics of the FACT Act have argued that religious reproductive counseling causes minimal harm to women and that it is of paramount importance to protect the “sincerely held religious beliefs” of religious organizations and individuals. However, I would argue that the harm to women is far greater to that of religious groups: When women are lured into CPCs, they are being diverted from legitimate primary care and family planning clinics. This puts their health at risk. When untrained staff members lie to women about their gestational age, it can push them into having a higher risk and more expensive later-term abortion; it can also delay prenatal care, resulting in low birth weight babies and higher infant mortality rates.

Additionally, many CPCs refuse to refer women for contraception, and often tell patients that condoms are ineffective against sexually transmitted infections—a practice that increases the likelihood of unwanted pregnancies, abortion, and the spread of dangerous STIs. Further, calling abortion “murder” during counseling sessions subjects women to additional distress, anxiety, and shame when making critical family planning decisions.

Oral arguments before the United States Supreme Court are scheduled to start today.
If NIFLA wins, California’s transparency law would be unenforceable, and similar laws in other states would likely be overturned, leaving women vulnerable to religious propaganda masquerading as legitimate medical advice. If the law is upheld, conversely, it will provide a path to protect women’s health care access. Let’s hope NIFLA v. Becerra is a way forward, rather than another success for the tyrannical Christian patriarchy.

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