By Michael Alison Chandler
Washington Post Staff Writer
Saturday, September 9, 2006
On June 6, Cheryl Smith took her last $600 and drove her teenage daughter from Baltimore to Severna Park to get an abortion. When they got there, a receptionist told them the clinic had changed hands. The abortion provider had moved a few miles away, she said, but the new clinic would offer a pregnancy test and sonogram for free.
The Smiths stayed. After they saw a picture of the fetus at 21 weeks with arms and legs and a face, their thoughts of termination were gone.
"As soon as I seen that, I was ready. It wasn't no joke. It was real," Makiba Smith, 16, said. "It was like, he's not born to the world yet, but he is inside of me growing."
With its ultrasound machine and its location, the Severna Park Pregnancy Clinic demonstrates two of the most important tactics in an intensifying campaign to woo women away from abortion clinics. Antiabortion organizations in recent years have added medical services to hundreds of Christian-oriented pregnancy counseling centers nationwide. Many of these antiabortion clinics have opened in or near places where women go to end pregnancies.
The new Severna Park clinic's operators say their strategy is akin to a business plan. "Just like McDonald's and Starbucks look for competitors to be next to," the pregnancy centers look to set up "where women will be seeking abortions," Pam Palumbo said.
Palumbo is executive director of the Bowie Crofton Pregnancy Clinic in Prince George's County, one of about 20 antiabortion pregnancy centers in the Washington region and one of the first in the country to offer medical services. She also oversees the satellite Severna Park clinic.
There are at least 2,200 antiabortion pregnancy centers across the country, a nearly 30 percent jump since 1999, according to data from one of the largest pregnancy center networks, Heartbeat International of Columbus, Ohio. The network counts 561 centers that offer medical services, about a quarter of the national total. By comparison, abortion rights advocates estimate there are 1,800 abortion clinics nationwide.
Abortion rights advocates say the proliferation of antiabortion pregnancy clinics is a dangerous trend, confusing vulnerable women by mixing a seemingly neutral clinical environment with a religious agenda.
"They can set up a waiting room and an exam room, but that doesn't mean they employ actual medical practices," said Vicki Saporta, president of the National Abortion Federation, a D.C.-based network of abortion providers.Use of Sonograms
Ultrasound machines, which use sound waves to show real-time pictures of a fetus, are the centerpiece of the pregnancy centers' medical advances. Some antiabortion clinics also offer screening for sexually transmitted infections, and a few offer prenatal care, according to the pregnancy center network. They typically advocate sexual abstinence until marriage and do not help women obtain contraception.
By many accounts, the ultrasound exams have proven effective in convincing women to stay pregnant. A 2005 survey by Care Net, a Sterling-based network of about 1,000 antiabortion pregnancy centers in the United States and Canada, found that 72 percent of women who were initially "strongly leaning" toward abortion decided to carry their pregnancies to term after seeing a sonogram. Fifty percent made the same choice after counseling alone.
Such results have led antiabortion forces to buy more ultrasound machines, which can cost as much as $50,000 each. In the past 2 1/2 years, the evangelical organization Focus on the Family, based in Colorado Springs, estimates it has helped 200 pregnancy centers buy the machines.
Some funding is also coming from taxpayers. About 20 states have designated funding for antiabortion counseling centers, according to the Chicago-based law firm Americans United for Life. Last year, Minnesota appropriated $5 million and Texas $2.5 million for centers that encourage women to carry pregnancies to term. About a dozen states, including Maryland, contribute revenue to such centers through the sale of license plates stamped "Choose Life."
A report in July from congressional Democrats found that the federal government has contributed $30 million to antiabortion pregnancy centers since 2001. Most of that money paid for sexual abstinence education. But some was distributed as grants to help pay for ultrasound machines, the report found. For example, Life Line Pregnancy Care Center in Loudoun County received a $50,000 federal grant last year to buy a machine.
The National Institute of Family and Life Advocates, based in Fredericksburg, organizes conferences across the country to train nurses on ultrasounds in antiabortion clinics. Nurses are taught to determine whether a pregnancy is viable and to identify the sex. They are not taught to identify developmental problems.
The institute also helps centers complete paperwork to become medical clinics. In most states, the process is fairly simple. The main requirement is for a licensed physician to become the medical director and supervise medical services, though the director does not have to work on site, institute President Thomas A. Glessner said.
A few states, including New York and California, have more stringent inspection and licensing requirements, according to the institute. Maryland and Virginia are not among them. The institute did not analyze D.C. regulations. But the director of an antiabortion pregnancy center in the District that is seeking to become a clinic described an apparently simple application process.
Abortion rights activists are calling for tighter regulations. They say the antiabortion centers mislead women about the health effects of abortion.
Antiabortion networks reply that the information their centers provide is based on scientific research. "We are very careful that everything we present is 100 percent factual," said Peggy Hartshorn, president of Heartbeat International.
Defending the decision to locate antiabortion pregnancy centers near abortion clinics, Hartshorn said abortion foes are not seeking "to be deceptive or to trick people, but to be right where they are when they are making decisions."Some Feel Deceived
But many women say they have felt duped.
The National Abortion Federation has received hundreds of calls and e-mails from women who say they went into pregnancy centers with vague or confusing names, many of them found under "abortion services" headings in the phone book. Rather than receiving unbiased counseling on all of their legal options, these women said, they found themselves listening to frightening, sometimes false, information.
Last year, Allyson Kirk, 24, of Manassas, a student at Northern Virginia Community College, became pregnant and made an appointment at an abortion clinic in Manassas to talk about her options. When she arrived at the office park where the clinic was based, she saw a sign advertising "free pregnancy test" at a center called AAA Women for Choice. She walked in.
Kirk was given some forms to fill out. A woman took a urine sample for her test. While she was waiting for the results, the woman asked a series of questions about her religious beliefs and then told her about high rates of infection, depression and even death among women who had abortions, Kirk said.
When Kirk was shown a video depiction of a fetus's head being severed during a surgical abortion, she walked out.
"I was outraged," Kirk said. She recalled saying: "This is horrible. I can't believe you do this to women who are lost and looking for help."
The abortion clinic, as it turns out, was next door. Kirk arrived late for her appointment that day and ultimately decided to have an abortion. The decision felt like "a relief," she said, giving her "another chance" to achieve her goal of finishing school and becoming a veterinarian technician.
The Severna Park Pregnancy Clinic moved in the spring into the former offices of an abortion clinic. The new management removed the bulletproof glass from the former waiting room and turned the late-term abortion room into an area for meditation, with Bible verses on the wall and a small blood stain preserved under an area rug. The clinic's director said up to five women a week walk in, seeking an abortion.
For Cheryl and Makiba Smith, ending up at the wrong clinic was a mistake they say they are deeply glad to have made. "God sent me to that clinic," Cheryl Smith said.
In August, they returned to Severna Park for another sonogram, this time with Makiba's 17-year-old boyfriend, Gregory Byrd. In the waiting room, they talked about plans for a baby shower and a day-care schedule so Makiba can finish 11th grade.
In the exam room, her fetus filled the monitor once again, this time 7 months old. The sonogram showed the beating heart, the rib cage, the right hand a tiny fist held close to the face. The fetus yawned, fell asleep, woke up again.
"He's a cutie," the nurse said, taking screen captures of different poses.
"He's fat!" cried Cheryl Smith.
Only the parents-to-be kept quiet. Makiba covered her mouth with her hand and Gregory stared straight ahead. Their eyes were glued to the screen and the moving image of their future.