Christian cen­ters turn to con­tra­cep­tion

Preg­nancy non­profit hopes new model will draw more clients and fund­ing — and help re­brand the an­tiabor­tion move­ment

The Washington Post - - FRONT PAGE - BY SARAH PULLIAM BAI­LEY

austin — When a low-in­come woman searches for re­pro­duc­tive care, she of­ten goes to a Planned Par­ent­hood clinic, where she’s treated as a pa­tient with an ar­ray of med­i­cal op­tions. Or she might go to a Christian preg­nancy cen­ter, where she is coun­seled to carry a preg­nancy to term.

But some Chris­tians now see an open­ing for a third way to reach women — be­fore they be­come preg­nant — that also en­ables them to com­pete for fed­eral money Planned Par­ent­hood has de­cided to re­lin­quish.

Eight in­de­pen­dent Tex­as­based preg­nancy cen­ters merged ear­lier this year to form a chain called The Source. With Christian women’s health cen­ters in Hous­ton, Dal­las, San An­to­nio and Aus

tin, the non­profit or­ga­ni­za­tion plans to of­fer a full ar­ray of med­i­cal ser­vices, to in­clude test­ing for sex­u­ally trans­mit­ted dis­eases, first-trimester pre­na­tal care and con­tra­cep­tion choices.

That model is sim­i­lar to that of hun­dreds of Planned Par­ent­hood clin­ics. About half of the or­ga­ni­za­tion’s 600 clin­ics pro­vide abor­tion di­rectly; the rest of­fer med­i­cal ser­vices but re­fer pa­tients to out­side providers for abor­tion.

Planned Par­ent­hood an­nounced in Au­gust its plans to forgo about $60 mil­lion in Ti­tle X fam­ily plan­ning funds rather than com­ply with new Trump ad­min­is­tra­tion rules that ban par­tic­i­pat­ing clin­ics from re­fer­ring pa­tients for non-emer­gency abor­tions and re­quire fi­nan­cial sep­a­ra­tion from fa­cil­i­ties that pro­vide abor­tions. Ti­tle X funds al­ready could not be used to pro­vide abor­tions.

Now the Source group, which will not re­fer pa­tients for abor­tion, plans to vie for the money in 2020.

The de­ci­sion to pro­vide con­tra­cep­tion is a huge cul­tural shift for Christian cen­ters that, for reli­gious rea­sons, do not nor­mally of­fer birth con­trol. But it rep­re­sents what some in the an­tiabor­tion move­ment say is a much­needed re­brand­ing for preg­nancy cen­ters — away from em­pha­siz­ing end­ing abor­tion and to­ward plac­ing women’s health care front and cen­ter. Many younger con­ser­va­tive Chris­tians, in par­tic­u­lar, are con­cerned with how the move­ment treats women.

“Even within the pro-life com­mu­nity, there’s a lot of nu­ance in what we think we should be of­fer­ing to women,” said In­grid Skop, an ob­ste­tri­cian-gy­ne­col­o­gist who joined the Source board. “It helps to show that not ev­ery pro-life ac­tivist says, ‘Put an aspirin between your legs and don’t have sex.’ ”

Skop said she be­lieves the Source sites can pro­vide a model for preg­nancy cen­ters na­tion­wide. But Sarah Wheat, chief ex­ter­nal-affairs of­fi­cer for Planned Par­ent­hood of Greater Texas, is skep­ti­cal that the ex­pan­sion into med­i­cal ser­vices will take hold else­where, given that many an­tiabor­tion lead­ers, es­pe­cially Catholics, op­pose con­tra­cep­tion.

“I’ve seen the re­brands,” Wheat said. “So far, I haven’t seen health care.”

Sev­eral large preg­nancy-cen­ter net­works re­cently banned their af­fil­i­ated cen­ters from pro­vid­ing con­tra­cep­tion, be­cause of the be­lief that it en­cour­ages sex out­side mar­riage. By con­trast, the Source cen­ters will all of­fer pills; in­jec­tions; in­trauter­ine de­vices, or IUDS; and other con­tra­cep­tive meth­ods be­gin­ning in March, a move that Source chief ex­ec­u­tive Andy Schoonover said will help re­duce un­wanted preg­nan­cies by pre­vent­ing them be­fore they take place.

“Preg­nancy cen­ters are re­ac­tive. You come with a plan, and they try to talk you out of hav­ing an abor­tion,” he said. “Hope­fully we can keep you from hav­ing an un­planned preg­nancy. If you do [have one], let’s walk through the op­tions.”

Adding con­tra­cep­tion

Among a col­lage of fam­ily pho­to­graphs on his of­fice desk in Austin, Schoonover dis­plays one of his baby, Grace, who died in 2015, just 10½ hours af­ter she was born. Schoonover said he and his wife were ad­vised by their doc­tor to have an abor­tion and try again af­ter the baby was di­ag­nosed with a fa­tal birth de­fect when his wife was 12 weeks preg­nant. In­stead, they de­cided to carry her to term.

Schoonover, who has busi­ness de­grees from the Univer­sity of Vir­ginia and Stan­ford, said he ini­tially de­clined when he was first asked to di­rect the Austin cen­ter two years ago. But guided by his faith, he said, he re­con­sid­ered. He said he un­der­stands — to the ex­tent that he can as a man — what women are told by some doc­tors dur­ing preg­nancy.

“I’ve got a lit­tle bit of skin in the game,” said Schoonover, who was raised Catholic and now at­tends a South­ern Bap­tist church.

He said he ini­tially balked at the idea of pro­vid­ing con­tra­cep­tion, be­cause he feared donors would not ap­prove. He was fi­nally per­suaded af­ter talk­ing with his med­i­cal di­rec­tor, Cather­ine Browne, an ob­ste­tri­cian-gy­ne­col­o­gist. One of the big­gest mis­con­cep­tions Browne said she faces is from peo­ple who think pro­vid­ing con­tra­cep­tion will en­cour­age women to be­come pro­mis­cu­ous.

“If I, as a doc­tor, tell peo­ple, ‘Lock up your guns,’ I’m not en­cour­ag­ing vi­o­lent be­hav­ior,” Browne said. “Let’s em­power peo­ple with ed­u­ca­tion.”

The cen­ters will not pro­vide emer­gency con­tra­cep­tive pills such as the Plan B “morn­ing af­ter” pill, be­cause Schoonover said they con­sider the drugs to be a form of abor­tion.

The Source’s new med­i­cal ap­proach is the lat­est at­tempt by the an­tiabor­tion move­ment to re­brand it­self, said Laura Hussey, a po­lit­i­cal sci­ence professor at the Univer­sity of Mary­land Baltimore County who will pub­lish a book about the ef­forts of preg­nancy cen­ters to be­come more women-cen­tered.

In the mid- to late 1990s, the older “cri­sis preg­nancy cen­ters” be­gan to get li­censed as med­i­cal clin­ics be­cause they were adding ul­tra­sounds, Hussey said, but most of them still do not of­fer the range of ser­vices Planned Par­ent­hood pro­vides. She said plans by the Source sites to of­fer con­tra­cep­tion “might cre­ate a ten­sion with other preg­nancy cen­ters.”

“Not ev­ery­one agrees with the need to com­pete with Planned Par­ent­hood,” she said.

The vast ma­jor­ity of the na­tion’s roughly 2,750 preg­nancy cen­ters do not pro­vide much in the way of med­i­cal ser­vices. Most pro­vide coun­sel­ing and baby sup­plies, and an es­ti­mated 70 per­cent pro­vide ul­tra­sounds, ac­cord­ing to the Char­lotte Lozier In­sti­tute, a re­search group that op­poses abor­tion. About a quar­ter of­fer test­ing for sex­u­ally trans­mit­ted in­fec­tions or dis­eases, and 5 per­cent pro­vide pre­na­tal care, ac­cord­ing to CLI.

Chuck Donovan, pres­i­dent of CLI, said the in­sti­tute did not ask cen­ters about con­tra­cep­tive pro­vi­sion, which he said would be a “rare phe­nom­e­non.”

Many preg­nancy cen­ters are man­aged by boards filled with Catholics and evan­gel­i­cal Chris­tians, many of whom have qualms with birth con­trol. The Catholic Church teaches that ar­ti­fi­cial con­tra­cep­tion is sin­ful. Most evan­gel­i­cal de­nom­i­na­tions teach that birth con­trol should be re­served for mar­ried cou­ples. Just a small per­cent­age of parish­ioners in both groups, how­ever, be­lieve con­tra­cep­tion is morally wrong, ac­cord­ing to the Pew Re­search Cen­ter.

Kris­tan Hawkins, pres­i­dent of the an­tiabor­tion group Stu­dents for Life of Amer­ica, said she op­poses the idea of a preg­nancy cen­ter dis­tribut­ing con­tra­cep­tion, be­cause she be­lieves us­ing it fun­da­men­tally trans­forms the act of sex.

“The con­tra­cep­tive men­tal­ity is what has led to abor­tion in Amer­ica to­day,” she said. “Lov­ing a woman and em­pow­er­ing her is not putting her on a drug.”

How­ever, she said, the “pro-life move­ment” must show that it cares more for women, not just ba­bies. “We have a dam­aged brand,” she said.

Some in the an­tiabor­tion move­ment say women who come to the Source cen­ters for med­i­cal ser­vices, in­clud­ing con­tra­cep­tion, when they are not preg­nant may feel more com­fort­able turn­ing to the cen­ters for help if they be­come preg­nant un­ex­pect­edly.

“I think there can still be a bar­rier for [an­tiabor­tion ac­tivists] who are sin­gu­larly fo­cused on sav­ing the baby and haven’t yet un­der­stood how car­ing for mom is so in­ex­tri­ca­bly linked to sav­ing the baby,” said Kelly Rosati, a for­mer vice pres­i­dent at Fo­cus on the Fam­ily, a con­ser­va­tive Christian min­istry. “Among younger donors, there’s pas­sion for real in­no­va­tion and mov­ing into health-care sys­tems.”

Shift for preg­nancy cen­ters

Many preg­nancy cen­ters have for sev­eral decades used a mo­mand-pop shop model, run­ning in­de­pen­dently from one an­other. But by merg­ing eight cen­ters un­der one um­brella, the Source group has been able to raise $2 mil­lion, mostly from pri­vate donors, to pro­vide the new med­i­cal ser­vices, even as each cen­ter re­tains its own small bud­get. The chain hopes to some­day over­take the num­ber of Planned Par­ent­hood clin­ics in the state, which is 40.

Sand­wiched between a ra­dio sta­tion and a hos­pice cen­ter just off a Cen­tral Texas high­way, the Source cen­ter in Austin sits in the neigh­bor­hood of Her­itage Hills, a largely His­panic, work­ing-class area with ranch-style homes and apart­ment build­ings.

Small Bi­bles and “Our Daily Bread” de­vo­tion­als are strate­gi­cally placed on ta­bles through­out the cen­ter, which is dec­o­rated with mid-cen­tury mod­ern fur­ni­ture. Staffers must sign a state­ment of faith, al­though be­cause of gov­ern­ment fund­ing re­quire­ments, em­ploy­ees are to dis­cuss faith only if a client brings it up. A small box la­beled “prayer re­quests” sits next to the in­take win­dow.

The cen­ter re­cently at­tracted lo­cal me­dia at­ten­tion be­cause it moved into a build­ing that pre­vi­ously housed a lo­cal abor­tion provider. In Au­gust, some­one spray­painted “liars!” on the cen­ter’s ex­te­rior walls. Many abor­tion rights ad­vo­cates ar­gue that preg­nancy cen­ters present de­cep­tive mes­sages in their coun­sel­ing.

To make sure the Source cen­ters main­tain cred­i­bil­ity, Schoonover said he has hired “se­cret shop­pers,” peo­ple who call the cen­ters and ask whether they per­form abor­tions, to en­sure staffers do not pre­tend that they do. When women ar­rive at a Source site, they must sign a dis­claimer say­ing they un­der­stand the cen­ter does not pro­vide abor­tions or re­fer­rals for them.

When a preg­nant woman comes into a cen­ter, coun­selors try to be “non-di­rec­tive” in their ap­proach, said Mary White­hurst, the Austin cen­ter’s ex­ec­u­tive di­rec­tor. They present the woman with a pam­phlet pro­duced by the state with im­ages of a fe­tus’s stages of de­vel­op­ment, which Texas re­quires all women con­sid­er­ing abor­tion to re­ceive. Then the coun­selors of­fer a folder from the cen­ter with three op­tions — adop­tion, abor­tion and par­ent­ing — and will give ad­di­tional in­for­ma­tion as re­quested, White­hurst said.

“We are in­ten­tional to not un­der­mine that rea­son she came,” she said. “If I know she’s there be­cause she wants in­for­ma­tion about abor­tion, I’ ll let her self-di­rect it. I’m not go­ing to talk to her for 15 min­utes about adop­tion.”

Right now, the Austin cen­ter sees about 150 women a month, a num­ber Schoonover said the cen­ter ex­pects to in­crease once it pro­vides more med­i­cal ser­vices. The Source’s San An­to­nio staff be­gan of­fer­ing some med­i­cal ser­vices, such as test­ing for sex­u­ally trans­mit­ted in­fec­tions, three years ago and sees about 500 women a month.

On a re­cent Oc­to­ber af­ter­noon, Amna Ba­tool, 31, came to the San An­to­nio cen­ter to ask ques­tions about birth con­trol six weeks af­ter hav­ing her third baby. She even­tu­ally re­ceived an IUD from her ob­ste­tri­cian-gy­ne­col­o­gist be­cause of her health in­sur­ance, but she made her de­ci­sion based on the con­ver­sa­tion with a nurse at the Source cen­ter.

Roseanna, a 35-year-old who asked that her last name not be used, ar­rived for her 20-week pre­na­tal ap­point­ment. She was there with her 16-year-old daugh­ter, who was 24 weeks preg­nant and also re­ceiv­ing med­i­cal ser­vices at the cen­ter.

“They have an an­swer for ev­ery ques­tion, or they will find a so­lu­tion,” Roseanne said.

Danielle Dirkse, 24, said she had planned to re­lin­quish her twins for adop­tion when she first started re­ceiv­ing med­i­cal care at the Source cen­ter in Austin. But af­ter she mis­car­ried one in the sec­ond trimester, she said, see­ing the ul­tra­sound im­ages at the cen­ter mo­ti­vated her to keep the other twin.

“I needed a sign I wasn’t go­ing to do adop­tion,” she said. “It was the best de­ci­sion ever.”

On a week­day evening in Oc­to­ber, Dirkse took notes dur­ing a class on “par­ent­ing hacks” while she held her daugh­ter, Braeleigh Masters, who was born in Au­gust, on her chest. In ex­change for her class at­ten­dance at the cen­ter, she re­ceived points she could use on di­a­pers, clothes and other baby gear. Dirkse said she plans to keep re­turn­ing in the fu­ture for well­woman check­ups and con­tra­cep­tion.

ILANA PANICH-LINSMAN FOR THE WASH­ING­TON POST

Danielle Dirkse, 24, at­tends a class with her daugh­ter last month at the Austin-based Source cen­ter. She said she had con­sid­ered adop­tion for her child be­fore see­ing an ul­tra­sound at the cen­ter.

PHOTOS BY ILANA PANICH-LINSMAN FOR THE WASH­ING­TON POST

ABOVE: Nurse prac­ti­tioner Penne Jaster ex­am­ines a preg­nant pa­tient last month at a Source cen­ter in San An­to­nio. Eight Texas-based preg­nancy cen­ters merged to cre­ate the Christian non­profit, which plans to vie for Ti­tle X fam­ily plan­ning funds in 2020. BELOW: Andy Schoonover is the chain’s CEO.

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