What Happens at a Pregnancy Help Center?

Tests and talking.

Anti-abortion protesters

A new South Dakota law requires women to seek pro-life counseling at a “pregnancy help center” before obtaining an abortion. What happens at a pregnancy help center?

Sonograms, persuasion, and sometimes misinformation. A visit to a pregnancy help center—sometimes called a crisis pregnancy center or CPC—typically begins with a urine pregnancy test. In some centers, the counseling starts during that brief period of uncertainty. In others, they wait for a positive result. A counselor asks what options the client is considering, and what her concerns might be. These talks aren’t necessarily limited to arguments against abortion. Counselors may discuss adoption and services available to the woman should she decide to keep the baby. They talk about pregnancy and the delivery process. In the overwhelming majority of facilities, the counseling is religious in nature, and there may be explicit proselytizing. Well-funded clinics also offer an ultrasound. (Anti-abortion advocates say the procedure is necessary to confirm the positive test. Critics argue that CPCs push ultrasounds because they believe a woman who sees her fetus is more likely to carry it to term.) The visit can be over within a few minutes, or it can last several hours, depending on the client.

This is just a general framework, however. There is tremendous variation among the 3,000-or-so pregnancy help centers nationwide. Most of the facilities are affiliated with one or more of three national groups—Care Net, Heartbeat International, and the National Institute of Family and Life Advocates, all of which are led by mostly evangelical Protestants or Roman Catholics. The umbrella organizations set some loose standards and provide around 20 hours of training to the volunteer counseling staff. But the local affiliates make most of the decisions, and there are philosophical differences among them. Some of the more faith-based centers strongly advise against single motherhood. They counsel the woman to either marry the father or choose adoption. A handful of organizations on the other end of the spectrum won’t discuss religion at all unless the client brings it up first.

Some facilities have even been caught offering bad medical information to pregnant women. In a 2006 congressional investigation (PDF), several centers told women over the phone that abortions would increase their risk for breast cancer and undermine their chances to get pregnant in the future, even though medical studies have debunked these claims. Furthermore, certain local groups have also been accused of questionable practices such as dressing nonmedical personnel in white coats.

Pregnancy help centers have also attracted controversy by showing pictures of aborted babies to their clients. This was common practice in the late 1960s, but many in the movement eventually came to view this tactic as a public relations liability. Today, the national groups advise against springing such pictures on clients without their consent. A handful of facilities, however, still view them as a vital tool.

The move to offer ultrasounds has been the biggest change in pregnancy help centers over the last 20 years. Early facilities were constructed to look like medical clinics—they featured pastel-painted waiting rooms, magazines, and a receptionist to take down your name—even though they offered no medical services. In the late 1980s, anti-abortion groups funneled money to the pregnancy centers to expand their offerings. Focus on the Family, for example, offered to pay 80 percent of the cost of an ultrasound machine if a local center could raise the remainder.

Many centers also offer certain perks, sometimes pegged to continued consultations and class attendance. They distribute maternity or baby clothes, basinets, or car seats to mothers in need. They may also place clients into GED or English classes. These services have caused something of a rift within the evangelical Christian community. Many financial supporters think the centers have drifted too far from their core mission of providing alternatives to abortion, and point to evidence that 80 percent of clients are there for the free services rather than the pro-life counseling.

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Explainer thanks Thomas Glessner of NIFLA, Peggy Hartshorn of Heartbeat International, and Kimberly Kelly of Mississippi State University.