Monday, December 23, 2024

AMERIKA

I visited an anti-abortion pregnancy center. Here’s why experts call for more regulations.

Alexandria Jacobson, Investigative Reporter
December 23, 2024 
RAW STORY

A sonographer technician holds an ultrasound transducer to diagnose the condition of a pregnant woman with a view of the woman's uterus on the computer screen. (Shutterstock)


CHICAGO — The Aid for Women pregnancy clinic in Chicago’s Edgewater neighborhood might be one of the nicest offices I’ve visited for medical advice.

The clinic is located in the storefront of a newly constructed modern apartment building. Its windows are adorned with images of beautiful, diverse women, advertising free pregnancy tests and ultrasounds. With tasteful neutral tones throughout, the lobby has a cascading wall fountain with the nonprofit’s logo and a woman’s silhouette image, creating a peaceful atmosphere.

Yet, the clinic is not a medical office even though medical procedures and tests are offered there. Aid for Women is one of as many as 4,000 crisis pregnancy centers, or CPCs, operating throughout the country that present as healthcare clinics but are typically nonprofits with an agenda to stop women from getting abortions.


Aid for Women pregnancy center in Chicago's Edgewater neighborhood in December 2024 (Photo by Alexandria Jacobson/Raw Story)

A new study from the University of California San Diego published on Dec. 2 analyzed the websites of 1,825 crisis pregnancy clinics, including Aid for Women, and created a database, choicewatch.org, to provide unbiased data about the services provided by these groups.

“We just want to start a policy debate around these issues,” John W. Ayers, leader of the study, told Raw Story. “With the new administration, there's a chance CPCs could be federally funded, and if those federally funded dollars are going to CPCs, under what conditions can they be given to maximize society benefits and reduce the harms?”


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Ultimately, the paper’s authors are calling for greater scrutiny of these clinics, particularly around the services offered, provider qualifications and conformity with regulations and medical best practices. Generally, such pregnancy centers are exempt from the licensing, regulations and credentialing requirements of healthcare facilities.

“When it comes to crisis pregnancy centers, there's a lot of unknown unknowns,” said Ayers, who is an adjunct associate professor of medicine and epidemiologist at the University of California San Diego. “Our study is independent of your position on abortion, and so, we just want to give data and solve this problem of there being no data.”


Doctors like Kristyn Brandi, an OB-GYN in New Jersey, often find crisis pregnancy centers to be “angering” and “annoying," requiring reeducation of patients after visiting a clinic, she said.

The clinics can also be dangerous to women’s health if unsafe and unproven procedures like “abortion pill reversals” are offered (Aid for Women advertises such a procedure on its website). Ayers and Brandi both pointed out that abortion pill reversals are not recommended by medical professionals and put patients at risk for hemorrhaging and sepsis as they involve pumping the body with progesterone after a first abortion pill is taken, even though the process of ending the pregnancy is likely already underway and no longer likely to be viable.



A screen shot from the Aid for Women website about abortion pill reversals


“At crisis pregnancy centers, they are not healthcare centers, and so they aren’t under the same regulations and rules that doctors and other healthcare providers have to abide by, which is really concerning as a healthcare provider knowing that I have many patients that go there first and then come to me for healthcare,” Brandi told Raw Story. “Hearing the stories about what these patients encounter when they go to these centers is really disturbing.”

Susan Barrett, executive director of Aid for Women, did not respond to Raw Story’s requests for comment.
‘Very weird and off’


When I first visited an Aid for Women clinic, I was just shy of five weeks pregnant. Several at-home early detection pregnancy tests came up positive, but I figured it didn’t hurt to have professionals confirm for me as I waited for my regular OB-GYN appointment at 10 weeks pregnant.

But rather than having a doctor or nurse confirm the pregnancy for me, I conducted the test myself at Aid for Women.

Instead of leaving a urine sample behind a mini door in the bathroom for technicians to grab as I was used to at doctor’s offices, I brought my sample back to a meeting room with an advocate and was told that I would be administering my own pregnancy test since there wasn’t a nurse on site at the time to do so.


I used a dropper to apply a sample to my test and had to write down that, yes, I understood my test was positive.

Brandi said typically patients at a medical practice are “not running their own samples” due to regulations requiring that collection and testing is accurate and a “real result” is being reported.

“It's weird for going to a healthcare center and having to do the stuff you would just do at home,” she said when told about my experience.


At the appointment, I spoke with an advocate about my “pregnancy intention,” a question also asked on an intake form where clients indicate whether they’re planning on parenting, abortion, adoption or are undecided.

The advocate made it clear that the center does not offer abortions but did not explicitly express disapproval for those seeking abortions.

However, the 20-plus-page informational booklet provided to me featured several pages on the risks and drawbacks of abortions, alongside photos of depressed-looking women.



Scan of pages in Aid for Women brochure about abortion

Raw Story shared the pamphlet with Brandi, an abortion provider, who said she was “struck” by the language in the brochure and found it to be “very focused on misleading information” and “very graphic depictions” of procedures like a dilation and evacuation surgical abortion, also known as a D&E.

“It was very much leading with all the risks, which I will not say that there are no risks to abortion care, but the risks are incredibly low and much lower than things like live births and C-sections,” Brandi said. “I make sure that when I counsel patients, I do absolutely tell them the risks, but I make sure to balance that information with all the benefits if they seek abortion, what are the health benefits to them versus continuing the pregnancy … there wouldn't be a field of OB-GYN, if pregnancy was always safe.”

Brandi also took issue with other components of the Aid for Women brochure, calling some parts “just very weird and off.”


For instance, the brochure’s timeline of the pregnancy does not reflect the “medically accurate” dating method, she said, and milestones noted such as the beginning development of a baby’s brain, spinal cord and heart at four weeks is misleading, she said.

“Usually at that time we have maybe three or four cells that are cardiac cells that eventually will turn into a heart in some time,” Brandi said. “It's not inaccurate, but it's misleading to say that those things are developed yet when they're definitely not developed in a significant way.”



Scan of pages in Aid for Women brochure about fetal development

Brandi noted that as an abortion provider, she looks at fetal tissue after a procedure, which typically isn’t seen until about 10 weeks pregnant, and it’s not visible to the naked eye at that point. The brochure said “a little face, fingers and toes” appear as early as six weeks and included images.

A first ultrasound experience

After my first visit, I decided to return to the clinic for another free service offered: an ultrasound. I didn’t have to pay hundreds of dollars or use insurance, so I decided to get an early sneak peek before my regular 10-week appointment.

I brought my husband with me to the clinic when I was just shy of eight weeks pregnant, and we heard our baby’s heartbeat for the first time, which was an exciting, emotional moment. I can imagine hearing a heartbeat that early for an unplanned or unwanted pregnancy might evoke upsetting emotions instead.

A sonographer conducted the ultrasound to check for basic criteria of a viable pregnancy such as noting if a heartbeat was present and that the pregnancy was located in the uterus. She produced two ultrasound images that didn’t look like much yet — I’d say the image resembled a small shrimp-shaped blob.

At barely eight weeks, I had a long way to go until the baby had any chance at surviving outside of the uterus. The American College of Obstetrics and Gynecology reports that premature births at 23 weeks have a 23 percent to 27 percent survival rate, which grows to 67 percent to 76 percent by 25 weeks of gestation and continues to go up from there.

I showed my ultrasound to one of my regular OB-GYN doctors, who accurately predicted the sonographer wanted to show me the heartbeat. Brandi reviewed the ultrasound and corresponding report, calling it “similar” to a typical report.

My report was signed off for review by an OB-GYN, Robert Lawler — something Brandi said is rare to find at crisis pregnancy centers.

Lawler was featured in a 2013 article by the Chicago Catholic, the newspaper of the Archdiocese of Chicago, about a new OB-GYN practice he opened in the southwestern Chicago suburb of Downers Grove, Ill., to conform to the teachings of the church.

“I had visions of meeting the Lord at Judgment Day and him saying to me, 'OK, Robert, what part of 'intrinsically evil' did you not understand about contraception?'" Lawler said in the article.

The practice seems to have since closed as it has both an inactive phone number and web domain. A handful of negative Yelp reviews for the practice complain about lack of transparency about Lawler’s religious influence on his practice.

“He lets his personal religious beliefs undermine the health and well-being of the victims he lures into his office,” wrote one reviewer in March 2018.

Lawler appeared on an episode of the “Family Talk” show by Evangelical Christian author and psychologist James Dobson, where he discussed his opposition to a 2017 Illinois abortion bill that “forces pro-life doctors and nurses to violate their consciences and advocate for the murder of babies in the womb,” according to the video description.



As of January 2024, Lawler is now the medical director for labor and delivery at OSF Little Company of Mary Medical Center, a healthcare system in Illinois founded by the Sisters of the Third Order of St. Francis.

Lawler could not be reached at his OSF office in the southwestern Chicago suburb of Oak Lawn, Ill. He did not respond to Raw Story’s request for comment through Aid for Women.
‘Lying to women in vulnerable positions? Let's cut that out.’

For comparison I also visited a Planned Parenthood clinic a mile away from Aid for Women to confirm my pregnancy there as well.

The Planned Parenthood clinic was certainly not as stylish and welcoming as the Aid for Women office. It was located in a small strip mall next to a Dollar General. The waiting room was dark, and front office staff were seated behind plexiglass.

But the experience reflected that of a typical doctor’s office visit, where I entered a room with an exam chair (I was brought to a room that resembled a personal office with a desk, chair, side tables and sink at Aid for Women).

I answered some medical questions at Planned Parenthood and got my test result through a MyChart portal. I was given some informational materials that included statistics and risks of different procedures, and I was told that if I proceeded with the pregnancy to start taking a prenatal vitamin.



Scan from "Abortion Options" brochure from Planned Parenthood



I chose not to go through the ultrasound experience at Planned Parenthood because I didn’t want to prematurely use my insurance benefits before visiting my regular doctor.

Planned Parenthood clinics are regulated as healthcare facilities and must abide by regulations like the Health Insurance Portability and Accountability Act (HIPAA) to protect patient privacy.

When I went to Aid for Women, I asked about HIPAA and was told my information would be protected. I was given a "care and competence" commitment agreement that promised to hold client information in "strict and absolute confidence;" however, there was no mention of HIPAA on the form, and the Aid for Women privacy policy does not mention HIPAA.

"One thing that really worries me, especially in this Dobbs moment, is privacy," Brandi said, referencing Dobbs v. Jackson Women’s Health Organization, the 2022 landmark Supreme Court decision that overturned the right to abortion protected by Roe v. Wade. "I think many people when they go to a healthcare center, they expect that the healthcare providers are not going to like share their information and talk about them to other people because we abide by rules like HIPAA that protect patients’ privacy. Because these centers aren't health care centers — they look like health care centers — but they have no reason to protect your privacy."

Spokespeople for Planned Parenthood did not respond to Raw Story’s request for comment.



A Planned Parenthood clinic in Chicago's Edgewater neighborhood 
(Photo by Alexandria Jacobson/Raw Story)

The intake form I filled out during my visits at Aid for Women had me initial that I understood all questions on the form were optional, but when I didn’t fill in some information, such as my address, I got pushback from staff to include those details.

“I think when people are pretending to be doctors and have no legal liability if something bad happens, that's really concerning and scary to think about, that patients are trusting these centers when they don't necessarily get the health care that they deserve in these moments,” Brandi told Raw Story.

I returned to the Aid for Women Clinic months later at 37 weeks pregnant to learn about what support services the center offered. When I requested my medical records, I was required to give my address and was given a two-page report from my ultrasound, nothing else from the first visit or any other paperwork.

At this visit, like all my previous visits, the advocate asked me about my housing situation and made sure I had support and wasn’t experiencing any abuse. The nonprofit runs maternity homes and offers referrals for healthcare and community support resources.

I signed up to watch videos from the clinic’s "Earn While Your Learn" program to prepare for my impending labor and delivery experience. Clients who complete various tasks such as watching lessons and doing homework, participating in the nonprofit's newsletters and reviewing the center online can earn points to enter a monthly raffle to win essential baby supplies like a stroller or a crib set. The videos were produced by a group called True to Life Productions, who did not immediately respond to Raw Story’s request for comment.

Aid for Women’s nonprofit tax filing is transparent that it’s a pro-life organization, describing itself as an operator of “pregnancy help centers, pregnancy medical clinics and residential programs to assist women in difficult and unexpected pregnancy situations so that they might choose life.” The nonprofit reported more than $2.5 million in contributions in 2023 and paid Barrett a salary of $101,519.

According to the data provided on choicewatch.org, Aid for Women is affiliated with Heartbeat International, an international pro-life group that supports the largest network of crisis pregnancy centers.



A screen shot about Aid for Women from choicewatch.org

While I visited Aid for Women knowing what type of facility it was, clients in crisis might not be aware of its pro-life mission and could be susceptible to misinformation.

“I think what our study does is it shows some of these crisis centers are bad actors, and CPCs can get behind getting rid of them," Ayers said. "Pro-life, pro-choice, lying to women in vulnerable positions? Let's cut that out."

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