Having Your Baby

Austin LifeCare Pregnancy Services is one of several area "crisis pregnancy centers." Whether Austin LifeCare will become part of the Texas Pregnancy Care Network is unknown – at press time, TPCN had not yet provided the state with a list of subcontracting CPCs. LifeCare is a member of the Care Net, an overtly evangelical network of CPCs whose affiliates, like LifeCare (according to the LifeCare Web site) are "committed to sharing the gospel of Jesus Christ." (Photo By Jana Birchum)

The woman who answers the phone at the National Life Center, the national toll-free counseling resource hotline run by the National Right to Life Committee, sounds eerily like a South Florida retiree – let's call her "Gladys" – and she has a special affection for the word "hon." The caller tells counselor Gladys that she is a 17-year-old girl from Austin – call her "Jane Doe" – who has recently found out that she is pregnant, and she's scared – she's never been pregnant before, she hasn't told her parents, and she doesn't know where to turn for advice or for information on her available options. "You can have the baby," Gladys says helpfully. "You could put the baby up for adoption or put the baby in foster care and take the baby back later when you're ready."

But what about abortion? Can Gladys offer any information about that option? Jane tells Gladys that she knows little about abortion and wonders if it's safe.

Gladys says that while she can't refer Jane to any agency that provides abortion services or even referrals for services – because, she says, "We're pro-life" – she can confirm that abortion is a risky procedure. "Yes, it is very dangerous; that's why we don't recommend it," she says. "You may not be able to have babies later. ... Also there is the possibility of miscarriages and emotional problems further down the road from thinking about what you did."

"Wow," Jane says cautiously.

And there's more, Gladys says. "When you go do the operation, it could perforate the inside when they're trying to get the baby out. They could accidentally tear you to the point that you couldn't be repaired, and you wouldn't be able to have babies anymore." But the "highest risk" in having an abortion "is of guilt and emotional problems. Women call and say, 'I had an abortion 30 years ago, and I still feel guilty,'" Gladys says. "Unfortunately, this is what the clinics don't tell you – they say you can just have this done and go on about your life."

In parting, Gladys offers the number of a local crisis pregnancy center and wishes the caller luck in making her decision.

Tales of Terror

As it turns out, the information – or misinformation – Gladys offered this pseudonymous caller from Austin is very similar to that collected by congressional researchers who, at the request of Rep. Henry Waxman, D-Calif., were tasked with finding out exactly what kind of information various crisis pregnancy centers (or "pregnancy resource centers") across the country are offering female callers. Since 2001, CPCs have become increasingly prominent players in the politics of women's reproductive rights, bolstered by nearly $30 million in federal funding – monies either earmarked for abstinence-only sex-education programs or diverted from other federal programs including, prominently, Title X, Temporary Assistance for Needy Families welfare program funds that traditionally provided cash assistance to poor families to pay for basics such as child care. Indeed, in the last state legislative session, Texas lawmakers, at the behest of Sen. Tommy Williams, R-The Woodlands, set aside $5 million in Title X funds over the biennium to fund Williams' "alternatives-to-abortion" services program – using CPCs, unlicensed and unregulated "support" centers that offer no medical services whatsoever – to implement a "statewide program for women seeking alternatives to abortion focused on pregnancy support services that promote childbirth."

CPCs do not typically employ medical professionals or offer any real medical services, and they are, by and large, run by openly pro-life organizations. Many lawmakers and reproductive-rights advocates question CPC counseling strategies and wonder if the information dispensed is actually medically accurate – and what benefit taxpayers will reap from Williams' abortion-alternatives program.

For the Waxman-requested study, released in July, female investigators with the Special Investigations Division of the Committee on Government Reform, posing as pregnant 17-year-old girls, contacted 23 federally funded CPCs to request information and advice "regarding an unintended pregnancy." The results were striking: 87% of the centers "provided false or misleading information about the health effects of abortion," according to the report. "Often these ... centers grossly misrepresented the medical risks of abortion, telling the callers that having an abortion could increase the risk of breast cancer, result in sterility, and lead to suicide and 'post-abortion stress disorder.'"

As with the information Gladys imparted to the Chronicle's teen caller, "Jane," the congressional investigators were fed scary information about the potential for "permanent damage" that would prevent a woman from bearing children in the future (a "common" problem, one center told investigators), about how an abortion will increase the likelihood of contracting breast cancer, and about the lasting psychological stress that comes with abortion. One center told Waxman's investigators that post-abortion stress is "much like" the stress experienced by soldiers returning from the Vietnam War and that it's "something that anyone who's had an abortion is sure to suffer from."

Unfortunately, none of the information is medically accurate. Abortion does not cause infertility; neither the American Psychological Association nor the American Psychiatric Association recognizes "post-abortion syndrome" (rather, the report notes that there is a scientific consensus that abortion rarely causes any psychological harm); nor is there any statistical or causal link between induced abortion and an increased risk of breast cancer – although pro-life groups continue to use scientifically ancient and discredited studies to suggest that the question remains open for debate. In 2002, the Bush administration edited a National Cancer Institute Web page to suggest there might be a link. When Waxman complained, the NCI convened a panel of medical experts that reviewed all the available data – some 50 years of research – and concluded that it is "well-established" that "induced abortion is not associated with an increase in breast cancer risk."

Nevertheless, many CPCs and other pro-life groups continue to claim a link – as does the state of Texas in its "A Woman's Right to Know" pamphlet, created by the Health Department pursuant to 2003 legislation authored by Rep. Frank Corte, R-San Antonio, which requires "full disclosure" of health risks associated with abortion and pregnancy.

In short, Texas is spending tax dollars to disseminate incorrect medical information. "This [information] may advance the mission of the pregnancy resource centers, which are typically pro-life organizations dedicated to preventing abortion," reads the Waxman report, "but it is an inappropriate public health practice."

Money for Nothing

Sarah Wheat, executive director of NARAL Pro-Choice Texas, isn't surprised by the information collected by Waxman's investigators. CPCs use "alarmist scare tactics based on mythical and bogus medical information" to dissuade women from choosing abortion, she says. "We've made calls [to local CPCs] with real basic questions about safe and legal abortions, and this is standard operating procedure." Wheat says she is encouraged by the Waxman report, which she hopes will serve as an "alarm bell" for federal and state lawmakers. "This is a terrible offense to women's health," she says. "It is an incredible misuse of taxpayer money and a sign of deep disrespect." The timing of the report couldn't be better, she says, coming just weeks before Texas' federally funded alternatives-to-abortion services program will begin offering counseling services. The Waxman report offers a glimpse of "just where we're headed with this [program]."

On Aug. 6, the alternatives-to-abortion services program will officially begin its statewide mission of "promoting childbirth." At the helm is the Texas Pregnancy Care Network, which formed last summer in response to the new funding opportunity and won Health and Human Services Commission approval to administer the multimillion-dollar contract. TPCN is responsible for recruiting subcontractors, individual CPCs across the state that will do the direct counseling. In the first year, TPCN expects to have 20 subcontracted CPCs in the statewide counseling network; TPCN will monitor the information the counselors provide and reimburse the individual centers.

Although the contract was signed in March, the TPCN-coordinated program hasn't yet begun serving clients, yet the HHSC reports that the organization has already been paid close to $600,000. What the state has gotten for its money isn't clear, but it appears that the TPCN is already outspending its proposed budget. According to its HHSC proposal, from March to August the group estimated a total cost of just more than $350,000 to run the program – including nearly $132,000 to reimburse individual CPCs. Since there hasn't yet been any program-related counseling, not a dime of that $600,000 has been spent on the program's stated purpose.

According to HHSC acting spokesman Michael Jones, TPCN has been given funds for start-up costs – including office and equipment rentals and costs associated with program "automation," seemingly related to the proprietary operations model designed by Pennsylvania-based Real Alternatives, a CPC powerhouse that runs that state's equivalent program. Jones says that RA is "actually going to help guide the development of this whole program" and will continue to "give support" to TPCN. (Without RA's involvement, it is unlikely that the TPCN would've been able to meet the HHSC requirement that bidders have relevant experience; among TPCN's board of directors are an oil and gas man, a NASA doctor, and an assistant attorney general – none of whom list any clearly relevant experience in their submitted résumés.)

The fact that the state has already forked over so much cash to TPCN before it has served a single client infuriates Wheat, who notes that the money would otherwise be spent providing comprehensive family-planning and reproductive services for low-income women. There are more than 1 million Texas women in need of such services, and only about 250,000 are served under current funding models. "That's outrageous," she says. "Had [Williams] not made [the alternatives program], women would be getting medical care right now. Now they're getting nothing."

What women will be getting instead, once the TPCN starts services, is also unclear. TPCN board Chairman James Wolfskill of Bellville (who apparently heads a "manufacturers' representative firm providing sales and services to the power-generation industry within Texas and Oklahoma") did not return phone calls requesting information for this story. But under the HHSC contract agreement, TPCN is supposed to be running a statewide toll-free counseling and referral hotline (888/LIFE-AID) and making all its educational materials available for HHSC review, to ensure that providers are giving standardized and medically accurate information. Yet TPCN has not yet provided any materials to HHSC for review, nor has it provided the agency with the names of its subcontracting CPCs.

According to Jones, at the end of July, having already spent $600,000, TPCN was still recruiting providers. If they plan to deliver information of the sort routinely provided by the National Life Center and its local colleagues, neither the women in need nor the state of Texas will be well-served.