Crisis pregnancy centres criticized for 'deceptive' practices

Alarm over the possibility that national reproductive rights in the U.S. could be overturned has revived discussions in Canada around abortion access and the prevalence across the country of counselling clinics that actively do not support abortion, known as crisis pregnancy centres (CPC).

The centres have come under strong criticism among pro-choice groups who say many of them use 'deceptive' and exploitative practices, including hiding their religious affiliations or anti-abortion views, spreading misinformation about abortion, or presenting themselves as neutral reproductive health clinics.

“Over the years, they've become much, much more deceptive in their approach and their language and everything. So the religious emphasis is mostly gone, and it's all about, ‘we can help you with all options, no judgment, help anyone.’ Underneath, to me, they’re mostly still the same,” Joyce Arthur, an abortion rights activist, told CTVNews.ca in a phone interview. Arthur is the founder and executive director of Abortion Rights Coalition of Canada, which has been tracking these centres.

Pro-choice advocates like Action Canada for Sexual Health and Rights note that there are more crisis pregnancy centres than abortion providers, highlighting the inadequate access to abortion in Canada, particularly outside major city centres.

The organization runs a hotline to help those with questions around their sexual and reproductive health and many call specifically seeking abortion services, the group says.

“We speak to thousands of Canadians every year who are looking to access abortion care and either are misinformed or disinformed on the topic, or just cannot find the services that they need. And crisis pregnancy centres are part of the problem,” Frederique Chabot, Director of Health Promotion with Action Canada, told CTVNews.ca in a phone interview.

“These organizations across the country [are] in high numbers that have a mission to divert people from seeking abortion care. That's at the heart of the work that they do, and often they position themselves as legitimate health/social services in their communities.”

Arthur said sexual health centres would be a better comparison for the number of providers than abortion clinics because these centres do not actually provide medical services. But according to her estimates, even sexual health centres are fewer in number: “People might be more likely to end up there because they present themselves like sexual health centres.”

While the number of crisis pregnancy centres has declined in recent years, there are still 148 such centres in Canada today, according to Arthur.

Action Canada data shows that in Western Canada, Ontario and New Brunswick, these centres outnumber the hospitals and clinics that provide abortion services.

“Sometimes it can be the only resource that is available in a community, which makes people believe that this is where you go when you’re facing an unplanned pregnancy, putting them at risk of being delayed if they are seeking to access abortion or completely diverted from it,” says Chabot.

FILLING A GAP OR EMOTIONAL PRESSURE?

Groups like Pregnancy Care Canada, a faith-based Christian organization and the largest umbrella network of these types of centres in the country, said they fill a need in services not offered by others, including post-abortion counselling.

Abortion data does not indicate how many women have felt pressured into an abortion, Dr. Laura Lewis, the executive director of the organization, told CTVNews.ca in an email.

“There is a gap of support that exists for these women,” she said.

Rights activist Arthur says that while the vast majority of people overwhelmingly feel relief after an abortion, some do have difficulties after the event, and that perhaps there is not enough support for those cases.

“It almost falls into the purview of the CPC to do this, which is I think it really dangerous and because they're not coming at it from a healthy perspective,” she said.

Critics say that these centres over-emphasize the physical health risks and the emotional impact of abortions, while ignoring the risks and impact of carrying a pregnancy to term, and that some also spread popular abortion myths around infertility and breast cancer.

“When it's presented as risky, people are scared, people are worried, have a lot of questions, it can be deterred, and that's the goal. It's also an invitation to add more restrictions. So if people believe that abortion is very risky, then it's regulated differently,” Chabot said.

Many centres also provide pregnancy tests and free diapers, which can be used as a tactic to exploit those in financial difficulties, critics add. And despite inclusive language around gender and sexuality, it can be very different in practice.

“They're still coming at everything from this traditional morality-based perspective. So it's all about encouraging abstinence. It's all about the gender binary. There's no services or no recognition of the LGBT community,” said Arthur.

The centres have also been criticized for offering ultrasounds under the guise of providing a medical service when their goal is to get the individual to hear the “fetal heartbeat,” which early in the pregnancy is the result of pulsating cells firing electrical signals within an embryo and not an actual heartbeat.

Ultimately, these centres put emotional pressure and guilt on clients, Chabot said, placing them at more risk when abortions are delayed until later stages of a pregnancy. These centres also do not address the mental and health repercussions on women who end up going through with an unwanted pregnancy.

Because many of these centres are considered welfare groups, community organizations, or have religious affiliations, a large number of them are also considered a charity, with tax exemptions.

In a March 2018 article published in the American Medical Association’s Journal of Ethics, the authors argued that that these centres target the vulnerable.

“In the setting of CPCs, justice is violated when women are not apprised of the availability of abortion services and access to abortion is consequently obstructed,” the authors wrote.

“Moreover, CPCs often target low-income women and women of color, adolescents, and women with less formal education. By impeding access to abortion through delays, expense, or other tactics, CPCs may propagate racial, ethnic, and socioeconomic inequities.”

“A LOT OF MISCONCEPTIONS”

The executive director of Pregnancy Care Canada, which describes itself as non-political and non-partisan, disputes the criticisms and said there are a lot of misconceptions about the organization’s work.

“Our goal is to ensure every woman has the space, information, and support she needs to make her own pregnancy decision. We respect that it is her decision to make, not ours,” Lewis said.

“Pregnancy Care Canada values authenticity and the importance of not exploiting anyone in a vulnerable situation. … As a medical doctor I care that the information we provide is medically accurate. We are strongly opposed to false and exaggerated information.”

Lewis would not comment on the practices of centres outside their group, but says the centres who join their network – there are currently 81 – must abide by the organization’s guidelines and practices, which include denouncing any form of deception, serving clients without discrimination including gender identity, sexual orientation, or lifestyle. They also require prospective clients to read a Limitation of Services form that she said clearly indicates the centre does not provide or assist in arranging for abortions.

Lewis denied that their centres create a barrier or delay to abortion, adding that they provide medically accurate information about abortion, adoption, parenting, prenatal development, and healthy relationships. The primary resource used by their centres is a document called “Abortion Adoption Parenting,” which the organization says has been reviewed by obstetricians, gynaecologists, and medical ethicists, among other professionals.

The booklet provides an overview on fetal development and offers several “options” – abortion, adoption, and parenting. It goes into some detail about the abortion process itself, and the physical and emotional risks of having an abortion, but offers no information on the physical or the emotional impact of pregnancies, like labour and birth trauma or post-partum depression.

When asked why these were excluded, Lewis acknowledged it was “a fair question.”

“We update our content when necessary to ensure both its accuracy and its neutrality. We will look at adding the physical pregnancy risks (the emotional risks are already given),” Lewis wrote.

Lewis believes the centres provide vital support for women looking for alternatives to abortion and is a charitable service that is worth protecting.

“Today, the topic of abortion can divide a room, but there is a bridge that can unite us. Can we come together and agree that no woman should be pressured into an unwanted abortion?” she wrote.

AN IDEA THAT BEGAN IN TORONTO

A number of crisis pregnancy centres websites that CTVNews.ca examined, including those within and outside Pregnancy Care Canada’s network, all use mostly neutral language promising a safe space that offers non-judgmental support and accurate medical information. Some also provide legal support, as well as infant and maternity clothing and supplies. But for those unfamiliar with the centres, it is not always clear that they specifically do not advocate abortion for those with an unplanned pregnancy.

“They started out as mostly explicitly religious places and trying to dissuade women from having abortions. That really was always their primary purpose and still is, but their strategies have evolved over the years too,” said Arthur, adding that it has become harder to determine whether a centre is pro-choice or not.

“You're looking at a website and you're looking for coded words or phrases. It can be really hard to tell … even though they put on this public face of being secular and supportive and professional and everything. Underneath they are still promoting these antiquated views and these anti-choice views that are driving their agenda, their programming, and everything, so that's a big worry. It's very easy to be fooled by these places. Anyone can be.”

Many of the abortion myths perpetuated by some clinics go back half a century. According to Arthur, the first of these anti-abortion centres actually began in 1968 in Toronto by a woman who went on to found Birthright International, a CPC organization that now has centres across Canada, the United States and Africa. The CPC concept has since spread to numerous other countries around the world.