Update on Alternatives to Abortion in America

Part I: The Task of the Modern CPC

By Randall K. O'Bannon, Ph.D.

NRL-ETF Director of Education and Research

While it's obvious to even the most casual observer that pro-life legislation and education have had a serious impact in reducing the number of abortions performed annually in the U.S. from 1.6 million in 1990 to just over 1.36 million in the most recent statistics, another significant factor has been the tireless work of America's crisis pregnancy centers (CPCs).

Now offering practical help and support to women facing unplanned pregnancies in all 50 states, the staff and volunteers of America's three to four thousand crisis pregnancy centers, maternity homes, and adoption agencies have been effective at changing hearts and minds on a one-on-one basis. They offer the critical personal, financial, and spiritual support that, thousands of times a year, has made the difference between life or death for a frightened mother's baby.

What makes the difference between a woman's choosing life or death for her unborn child? How have women's attitudes towards unplanned pregnancy changed since Roe became entrenched in society? How have America's crisis pregnancy centers adapted to those changes? Finally, what are the challenges today's CPCs face and what are some of the innovative ways they are trying to meet those challenges?

In the past nine months, the National Right to Life Educational Trust Fund has conducted a national survey of American CPCs and initiated a series of interviews with national leaders of the abortion alternatives movement in the U.S. to try to determine the answers to some of these questions. While results of the survey are still being compiled and will be featured in later issues of NRL News, the interviews conducted with the leaders of these national groups still provide an excellent overview of the issues faced by today's CPCs.

This first article will introduce some of the major national crisis pregnancy groups and some of the factors changing the way they select and market their services.

Beginnings and Background

There have been "homes for unwed mothers" and similar institutions for over a hundred years or longer. But several organizations offering alternatives to abortion came into being as a response to legalization of abortion in the late 1960s and early 1970s in individual states including Colorado, California, and New York.

Birthright, perhaps the earliest, began in Toronto in 1968 and gradually expanded to include several U.S. centers. It now includes nearly 500 offices in the U.S. and Canada dedicated to the proposition that "It is the right of every pregnant woman to give birth and the right of every child to be born."

The National Life Center, which has operated a national hotline for over 25 years and now has affiliates scattered throughout the United States, dates its inception to 1970 in Woodbury, New Jersey. Through its 24-hour, seven-days-a-week hotline, it refers women not only to its approximately two dozen 1st Way Life Center affiliates, but to any pregnancy help center convenient to the caller.

Alternatives to Abortion International, now Heartbeat International, began in 1971 and currently lists over 500 affiliates in 47 states and 15 foreign countries.

Other organizations and centers came into being after the Supreme Court legalized abortion on demand nationally with its infamous 1973 Roe v. Wade decision. CareNet, originally known as the Christian Action Council, was founded in 1975 by Dr. Harold O.J. Brown, with advice and encouragement from the Rev. Billy Graham and the late Christian evangelical theologian and pro-life apologist Francis Schaefer. CareNet now forms a network of some 450 pregnancy care centers and churches offering both practical and spiritual help to women facing unplanned pregnancies.

WELS Lutherans for Life opened its first pregnancy counseling center in 1979 and now operates 25 such centers across the country and a maternity home in Denver, Colorado. Several Sources, a network of shelters in New Jersey offering a broad range of services to women with crisis pregnancies, began in 1981.

There are interesting stories behind the initiation of many of these organizations. The Rev. Jerry Falwell, known originally for his leadership of the Moral Majority, founded the Liberty Godparent Home in 1982. Dr. Falwell was challenged by a reporter at an airport press conference who asked him, "Is it enough to stand against abortion when you aren't doing anything to help pregnant girls who have no other way?"

Mary Cunningham Agee, a Harvard Business School and Wellesley College graduate who served as a vice president in two Fortune 100 companies, founded The Nurturing Network in 1985 to address the same basic issue.

Changing Approaches to Meet Changing Needs

While the basic mission of these centers has not changed, some of the dynamics entering into a woman's decision to abort or bear her baby have. As a consequence many of these centers have begun to modify their approaches and expand their offerings.

Renaming the CPC. Fewer centers today call themselves "crisis pregnancy centers." While they still offer assistance and support to women dealing with the "crisis" of an unplanned pregnancy, the name is "off-putting" to many potential clients.

Dr. Peggy Hartshorn, president of Heartbeat International, for example, said that many clients, despite their dire situations, "don't see the pregnancy as a 'crisis,' even though that's what they are." Clients like to think that they are "in control," said Hartshorn, which to such women is inconsistent with the notion of "crisis."

A 1997 survey and focus groups conducted for the Family Research Council (FRC) by Wirthlin Worldwide found that the term "crisis" evoked a strong negative reaction, especially among women of upper socioeconomic classes. The message it seemed to convey, according to the FRC report of the study, Turning Hearts toward Life: Market Research for Crisis Pregnancy Centers, was that "We know you have messed up your life. You cannot handle things on your own. Now, let us help you."

Women in the survey had a much more positive view of names such as "Women's Resource Center" and "Loving Care Pregnancy Center," though some of the women from the upper socioeconomic brackets did not like the "Loving Care" label.

More centers now use terms like "pregnancy care center" or "pregnancy help center" to identify what they do.

Different clients, different needs, different approaches. Years of experience and observation have shown that different approaches seem suited to different sorts of clients. "A woman chooses to abort her child because it is the path most convenient for a variety of reasons," said Pastor Robert Fleischmann, national director of WELS Lutherans for Life. "Many of those reasons are quite personal in nature. For that reason, generalized alternatives seem to have relatively small impact on each decision."

One size no longer fits all. For example, while the crisis pregnancy center offering the baby clothes, diapers, and other material necessities still plays a crucial role in many of the country's neediest communities, centers in other areas have found incentive programs, in which the pregnant mother is able to "earn" points or "mommy and me dollars" to "buy" cribs, etc., at the center "store," to be quite popular. "Clients love it," said Heartbeat's Hartshorn. It makes them "feel proud of themselves."

One thing that the 1997 FRC research revealed was differing desires and expectations of pregnancy care centers according to women's economic class and social situation. Not surprisingly, those of more modest monetary means found the offer of housing, legal and financial aid, and job training most appealing. These women, focus groups showed, also tended to be more pro-life at the beginning. Their primary worry was the health of the baby and how their lifestyles, prior to their discovery of their pregnancy, may have affected their child.

By contrast, women in the higher socioeconomic levels had a much different perception of their needs. What appealed to women in this focus group were medical services, free pregnancy tests, and counseling.

Rather than the health of the baby, these women were focused on their own health. Their chief concern was the abortion procedure and what it might do to them. This group was much more likely to discuss an unexpected pregnancy with the baby's father than were those of the first group, who assumed the father would have no permanence in their lives.

All of these factors affect how a center structures and markets its services. While the poorer client looks for assistance and a friend who can help them through the pregnancy and after the baby is born, the middle- or upper-class client looks for information from a competent, caring professional.

Centers must decide, then, whether to focus on meeting the needs of one particular group or whether to try to broaden their offerings and approach to address the different expectations of each group. Considering the costs involved, this can be an expensive proposition.

Offering medical services. In attempting to increase and broaden their clientele, many centers are now offering their own medical services or partnering with sympathetic doctors or obstetrical clinics. The addition of ultrasound to a center's offerings serves a dual purpose: giving the centers a medical component that attracts the middle- and upper-class client, and giving women a visible reason to preserve the life of their children.

That sense of connection between a pregnant woman and her unborn child is important. Denise Cocciolone, head of the National Life Center, said that present-day clientele "seems to be much more 'street oriented' and less concerned with mores. Almost none of them cry upon learning of their pregnancy, as they once did."

Julie Parton, the manager of Focus on the Family's Crisis Pregnancy Ministry, said that "in previous years, clients were largely unaware of the facts of fetal development. Now it seems that more are aware and simply don't care-'it's my choice, my body, my right'".

Ultrasound, said Donna Warner, the director of center development for CareNet, helps a woman "to come through denial and connect with her child." Facts are just facts until a woman actually encounters her living baby. Ultrasound, said Warner, is "a wonderful way to help her connect to this child whom she may not yet be able to see or feel or see, and so from whom she can easily disengage from her decision."

"When they see the baby's heartbeat, when they see movement," said Frederika S. Tameling, director of Lifeline for Bethany Christian Services, "they know it's a child."

The addition of medical personnel to a pregnancy care center staff also helps doctors feel better about referring their pregnant patients. According to Heartbeat's Dr. Hartshorn, referrals of patients to abortion-performing "women's centers" were often made less out of ideology than out of a doctor's discomfort in counseling women facing crisis pregnancies and a lack of awareness of any qualified medical alternative.

Several centers now offer not just pregnancy but post-abortion counseling. In addition to adding to the credibility of the movement, this has helped serve an important educational function. Because "post-abortive women are speaking out a lot more," said Tameling, "people are more aware that abortion is not doing women a favor."

That is crucial information. If more people learn about abortion, about how the clinics are largely unregulated, about how often women don't even know their abortionist, about how abortion is legal all the way right up to birth, Tameling claimed, "a lot more people would be against abortion."

Next Issue: Funding & Other Challenges Faced by CPCs