Womens Health

Will Washington Be First State to Hold CPCs Accountable?

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Late last week two bills with the potential to change the way "crisis pregnancy centers" are regulated were introduced in the Washington State Legislature. The Limited Service Pregnancy Center Accountability Act (SB 5274/HB 1366) targets "Limited Service Pregnancy Centers (LSPCs)" (also known as crisis pregnancy centers) for their historically deceitful practices in the state. Cities from Baltimore, MD to Austin, TX have passed laws regulating crisis pregnancy centers but with these bills Washington could become the first state in the country to regulate the centers statewide.

According to Legal Voice, a Washington State group which provides legal advocacy for women, and a key backer of the legislation, there are 46 such centers in 21 counties operating around the state. The centers pop up to offer "pregnancy care" to mostly lower-income women, with no health insurance. The centers target younger women seeking low-cost or free pregnancy testing, and unbiased pregnancy options or counseling. What women receive from the centers, however, is what the legislation aims to regulate.

The legislation, among other efforts, requires that LSPCs provide accurate information about the services offered. LSPCs generally provide pregnancy testing or, notes Legal Voice, "sometimes ultrasound imaging or sexually transmitted infection testing."  Still, it hasn't prevented the centers from positioning themselves as health care providers, luring women in under the guise of "pregnancy care" and then providing false or misleading information about reproductive health care in an effort to steer women away from choosing abortion as an option. To combat these efforts, the bills require centers to disclose that they do not "provide services or referrals for abortion or comprehensive birth control" or "medical care for pregnant women." The legislation would further require the centers to provide pregnancy test results immediately; many such centers delay delivery of pregnancy test results in an effort to delay a decision to have an abortion, or to deny women the option of a safe, legal abortion completely. 

“A woman facing an unintended pregnancy needs to be able to count on some standards for any care she receives, no matter what reproductive choice she ultimately makes,” said Representative Judy Clibborn, the Prime House Sponsor of the bill.  "Delaying access to pregnancy test results and other personal health information only puts women’s health in jeopardy.”

The bills also address the disturbing lack of medical privacy assured or access to medical records for the women who utilize the centers by noting that the centers may not share health information about women seeking care with any other person, entity or organization without express written permission from the patient first. Currently, LSPCs are under no obligation or mandate to keep women's health and medical information private.

These are basic guidelines which, for centers hoping to offer care and services to women in need of pregnancy testing and pregnancy options counseling, should be easy to follow. State anti-choice groups, like Human Life of Washington, are claiming that the legislation stomps on the rights of women and girls, "Women and girls are smart, resourceful and capable of making their own decisions about what agencies they want to go to for help with their unplanned pregnancies," their web site notes. Yet crisis pregnancy centers are notorious for fraudulent practices; setting up shop, for example, right next to a Planned Parenthood health center, attempting to "trick" young women into visiting their center by making the space look similar. In fact, LSPCs have arisen precisely because groups like Human Life of Washington and others believe the opposite - that women are not in fact capable of making their own decisions when faced with an unintended pregnancy but rather need groups to offer a more limited range of options. 

In the face of indecision and vulnerability, LSPCs create an environment which feeds off of young women's uncertainty, fear and lack of access to affordable, high-quality health care. The centers hone in on younger women and women without adequate resources because they are the easiest to target. Offering free pregnancy testing under the pretense that these centers are medical clinics brings young women in the door; feeding women a steady diet of scare tactics and false "facts" about pregnancy, childbirth, abortion care, and even adoption and parenting keeps them there.

In a report released yesterday, Deceptive Practices of Limited Service Pregnancy Centers, by Legal Voice and Planned Parenthood Votes! Washington, the authors note:

Their primary audience is women facing an unintended pregnancy, and, in particular, vulnerable women who are in their teens or early twenties, or who are receiving public assistance. The services they advertise include free pregnancy tests, “pregnancy options” counseling, and assistance in the form of free packages of diapers and baby clothes.

What these centers do not advertise is that they are not medical clinics; that they are staffed primarily by volunteers who lack medical training; and that they are expressly opposed to abortion and any form of contraception other than abstinence and will not make referrals for these services. In some cases, they will withhold a woman’s private records generated during her visit if they believe the woman will later seek an abortion.

After receiving numerous reports from women who visited these centers over the years, more than ten reports in 2009 alone, the two organizations undertook an investigation. Their primary aim was to uncover whether, in fact, there was a systematic effort, on the part of LSPCs, to prevent women from accessing reproductive health services by using deceptive means. What they found became the basis for the legislation currently before the Washington State Legislature.

Employing trained, volunteer testers, the investigation covered 20 limited service pregnancy centers around the state. The range and depth of misinformation or outright lies offered to the testers would shock even the most hardened health advocate; from providing misleading information to women in order to delay a woman's decision, to feeding them blatant fabrications about birth control and sexually transmitted infections. The report is a catalogue of dishonesty. But it is the lack of information which the authors acknowledge first and foremost. The majority of the centers, the report notes, "did not inform the tester that the center did not provide abortion or abortion referrals unless explicitly asked. Even when explicitly asked, two centers failed to disclose that they would not provide or refer for abortions."

One tester told a staff member of Pregnancy Services in Mt. Vernon, WA, outright, that she wanted an abortion. She was not told that the center did not provide abortions but was rather urged to come to the center where they'd provide her with pregnancy results immediately. If there is a reason for lying by omission, aside from an obvious desire to bury legal abortion as an option for women, and not providing potential clients with information upfront that abortion care will not be discussed, information about legal abortion options will not be offered and, foremost, that abortion is not a service provided by the center, it's hard to see what that is.

According to the report, every single center provided false or distorted information about abortion and pregnancy. Some offered written material which included statements like "abortion causes breast cancer" as well as pamphlets warning women of the distinctly non-diagnostic "post-abortion syndrome" - a condition which does not exist and for which there is no credible evidence to support. Others told young women that if they were already pregnant, Plan B (emergency contraception) would harm the baby.

A teenage girl told the authors of the report that she informed a staff member at a center that she was pregnant and planning on keeping the baby. Sara Ainsworth, Senior Legal & Legislative Counsel for Legal Voice and a lead author of the report, told RH Reality Check that the young girl was told she was "too poor" and "wouldn't be a good parent;" she told the authors that adoption was pushed because, the center told her, "a lot of teenagers have unhealthy babies...and complicated pregnancies."

Others did so in order to place barriers between the young women and their legal right to access abortion, purposefully providing incomplete information. A staff member with Care Net in Tacoma told one woman that an abortion could be performed up to the ninth month of pregnancy and another that she could have an abortion anytime "until she went into labor." Other centers, in fact, claimed legal cover as an excuse for withholding pregnancy test results -- telling women that it was illegal for the centers to release the patient's own results if said woman was planning on "using" the results to then obtain an abortion - a blatant lie, notes Legal Voice. 

Another woman (though Ainsworth points out she's far from the only one with whom the authors spoke who had this experience) talked about a center which refused to release her own medical records because the woman told the center she'd be using the pregnancy test to access Medicaid coupons (in Washington State, with a positive pregnancy test, a woman can access Medicaid for insurance coverage of abortion care). A staff person at the center who performed an ultrasound on the woman, told her she should wait until she was 12 weeks along, to see if she'd miscarry first.

Let it not be said, however, that limited service pregnancy centers are simply anti-abortion. In fact, the subterfuge extends to contraception and birth control as well.

Staff members at local centers like Care Net and Life Choices also told testers that condoms were ineffective at preventing against AIDS - that the AIDS virus is "so small it goes right through condoms like a grain of rice through a tennis racquet; condoms do not do anything to protect against STDs."

There are many things the legislation will not do. It will not put LSPCs out of business or force them to provide any services they do not want to provide, or to which they are opposed for any reason.

Ainsworth says, "This will simply require the centers to disclose what they do and don't offer, in terms of services. At least women will understand what they will get when visiting a limited service pregnancy center."

It's a tough year in Washington State for legislation unrelated to the state's current budget crisis. The state faces a shortfall of $6.5 billion over the next two years so much of the current session is being swallowed up by extraordinarily difficult economic decisions, on the part of the legislators. Does Ainsworth think this legislation has a chance of passing, then?

"The great thing about this legislation is that it’s a chance to effect good policy without costing the state anything. And in the end, it helps ensure people’s heatlh – besides being the morally correct thing to do."

With 32 co-sponsors so far, the bills seem to have a good chance of passing. Increasingly, regions around the country are reacting to the disastrous consequences of the thousands of unregulated pregnancy centers providing services to unsuspecting and -- often times -- vulnerable young women. As well, the funneling of abstinence-only money into these centers has provided a federal funding foundation for these centers to keep operating; although Texas has proposed to zero out all funding for its crisis pregnancy centers this legislative session. Holding those centers accountable for providing women with accurate, truthful information about the services provided - and the underlying belief system which fuels those services - is critical to ensuring the health and well-being of women of all ages in Washington State.