Crisis pregnancy centers are on the rise in the US. These centers, which currently outnumber abortion clinics three to one nationwide, often provide false information and scant medical services to those seeking abortions or other reproductive health services. Crisis pregnancy centers are also funded in part by the pro-life movement and use religious messaging to dissuade women from engaging in premarital sex or utilizing contraception. At least 11 state governments, including Arkansas and Mississippi, have allocated millions of dollars to these centers in recent years. During her yearlong investigation of crisis pregnancy centers, Meaghan Winter uncovered a complex network of donors, lobbyists, and lawyers behind the proliferation of crisis pregnancy centers across the country. In her reporting, Winter also talked to women in the South who had visited these centers as well crisis pregnancy center staff members. — June Jennings
June Jennings: This is The Backstory. I'm June Jennings, and I'm here with Meaghan Winter. Meaghan reports extensively on abortion and reproductive rights, and most recently published a piece in Cosmopolitan about the rise of crisis pregnancy centers in the US. In your article, you say that crisis pregnancy centers currently outnumber legitimate reproductive health clinics three to one.* What exactly are crisis pregnancy centers, and what sparked your interest in them?
Meaghan Winter: Crisis pregnancy centers, or pregnancy resource centers — people within and outside the pro-life and reproductive rights camps use different terms — are centers that often advertise themselves as comprehensive health clinics, but they're usually targeting or hoping to reach what they call “abortion-minded” women or “abortion-vulnerable” women. Those are women who may be considering abortion, they may need an STI test, they may need a pregnancy test, and most often these centers are really fronts for the pro-life movement because they're hoping to dissuade women from accessing contraception or abortion. In many cases I've found that they're trying to convert the women or to get them to stop having premarital or extramarital sex. So it turns out it's about much more than abortion, and, in many cases, it's about encouraging people to live a certain kind of Christian life. And in terms of how I got to this story, a few years ago — sometimes I write these pieces for New York Magazine where I just interview people about taboo topics — the editor assigned me to do one on abortion, and I knew nothing about abortion. I had once accompanied one of my friends when she had the procedure, but other than that, I was very passively pro-choice. But I grew up Catholic, so I really didn't understand the current political or social landscape around abortion at all. [laughs] I now know. So I just took this story, and I interviewed women about their abortions — many of them, maybe 40. And I think 26 ended up in the story. And I learned a lot doing that.
A number of the women who I spoke with told me that they had been to these crisis pregnancy centers, and I'd never heard of them. I grew up in the New York area, I was raised Catholic, and sometimes there are Catholic pregnancy centers, but increasingly in recent years they tend to be Evangelical. It was not something I was familiar with, so I was really curious about these places because things the women had told me were, frankly, disturbing or troubling. I wanted to see what they were, and I did some poking around and it seemed like they were part of this bigger network, not just these one-off, kindly mothers in isolation, working in a vacuum. So I wanted to better understand that, and I applied for an Investigative Fund grant (the New York editor had suggested I do that) and here I am.
JJ: In your article, you talk a lot about the strategies that crisis pregnancy centers staff use to attract women seeking abortions or other contraceptive services to their centers. Did any of their tactics of attracting “abortion-vulnerable” women that you speak of, surprise you? Was there anything they did that was really shocking?
MW: Yeah. What surprised me throughout this reporting was the extent to which the pregnancy centers intended to deceive women. Once I understood what some of the general practices were — and those practices have been documented for, like, thirty years — very little did I find shockingly new. What really surprised me is I went to a conference for the Heartbeat International, which is a major umbrella organization for pregnancy centers. It frankly shocked me how transparent they were in terms of their intent to deceive, or their intent to, attract women under false pretenses, in terms of presenting themselves as comprehensive health clinics or even abortion providers. One woman I spoke to in Arkansas — this is not at the conference, just doing other reporting — went to a center where there was a woman wearing a pin that said “abortion specialist” and scrubs. And I know that, in fact, that center does not provide abortions or even contraception. In terms of designing their websites, all the marketing, and even the way that they speak to women, I was surprised by how transparent it was — or not transparent but transparent about their goals when they were amongst one another and behind closed doors.
JJ: You also got to talk to women who actually went to these centers seeking an abortion or counsel on adoption. Can you talk a little bit about how you found these women and how you went about interviewing them about such a personal topic?
MW: I actually found, doing that first story I did when I interviewed women about their abortions, that women actually want to tell you about their abortions if you're open to hearing whatever they have to say. People are so eager to talk about it, which is something I didn't understand. I think there are very few spaces in which people feel comfortable having someone that's not their friend ask them open-ended questions. So that's one thing.
It was really hard to find women to go on the record to talk about this. It took me about a year to find the women that I interviewed for, I think, a number of reasons. Many physicians, for example, especially abortion providers and OB-GYNs in the South, told me that they encounter women who had visited crisis pregnancy centers pretty routinely, like, several times a month. But of course patients have protections and HIPAA, so physicians can't just give you the names of these women. They can't do that ethically and they don't want to; I understand that completely. So you have to go try other avenues.
I also wanted to find someone current. The women I previously interviewed who told me about this, unprompted, had done so several years before. I wanted to find someone who had been to a center within recent years. I can't even describe how many center directors I asked whether I could speak with a woman who had been to the center but all of them declined. They cited similar HIPAA protections, and, on one hand I understand that, on the other, most of these centers are not actually covered by these medical guidelines because they're not actually licensed medical centers. But I understand why they wouldn't want to give me a client's name.
In any case, when I went to Arkansas to interview a center director there, but she declined to give me the name of someone. I even asked people who may have had a wonderful experience or positive experience and still nothing. So I made a flyer and I went to Wal-Marts and passed the flyers out in Wal-Mart. And I just went up to people like a crazy person [laughs] and — it's the South, people are very welcoming and nice — I met a woman who was applying for a job in the hotel where I was staying, and she had been to a crisis pregnancy center.
She was a wonderful person actually. I didn't end up using her in the story because she didn't want me to use her name, but she really helped me understand; she was very smart and so capable of explaining social dynamics in the South, which I'm unfamiliar with, and we drove around together for a while. So that was one way, just going out into the street and passing out flyers. That worked to some extent in terms of finding people to speak to in Arkansas, but none of those women ended up wanting to be on the record.
So I reached out to a lot of different organizations, like abortion funds. I didn't realize what a huge network there are of organizations that provide funds for women who can't afford to have an abortion but want one or need one. I reached out to them because they work with a similar demographic to crisis pregnancy centers, in terms of low-income women, young women, women who may not have resources or may not have access to other resources. And the crisis pregnancy centers are very clear that — they said this directly at the conference I attended — the women that they're working with or trying to attract — or they would say “serving” — are people who are afraid to talk to other people and don't have other resources. So it's kind of the last resort. And they know that and in some cases are taking advantage of that. I've called different organizations, and I think that's how I found most people. I found one of the women through a general listserv for women — working women in the South. Some of it was reaching out to different reproductive rights networks, and some it was reaching out to just general groups. I've been thrown off of Meetup.com — for spamming too much.
JJ: For women who are willing to go on the record, how do they understand that they will be in the piece, in this particular way?
MW: Oh, I mean, I tell them directly. Especially when you're writing about someone's health or emotions, I directly would tell them. I asked each of them, I think, like, 40 times “Are you okay with this?” Which is part of the reason that I took so long to find people, right? One of the women in the story went by her first name only, no last name, and one of them went by her middle name, and one of them went by her full name. So I just tell them I'm doing this story — and ask if they would be okay if I use their names? Sometimes, at first, I'll say “you don't have to use your name, we can discuss that later.” But then that opens you up to spending all this time interviewing someone, and then she doesn't want her name used.
MW: So depending on how you do it. But yeah, you have to be really upfront with people, and that helps them trust you too, I think.
JJ: You also write that crisis pregnancy centers tend to represent themselves as grassroots organizations, kind of like the “grandma shop” you were talking about earlier, and were actually part of the larger, well-funded anti-abortion movement. And I was just curious about how you reported on that aspect of the story. Was it more of a paper trail or were there other sort of tactics involved in solving that?
MW: That's a good question. I think that was the part of the reporting I was least prepared to do, just based on my own work history and experience. Sarah [Blustain, of The Investigative Fund] was amazingly helpful in terms of basically teaching me how to do that. I think I was inefficient in how to do that. It was mostly a paper trail in terms of looking at different contracts, realizing there was a lobby history, especially in Pennsylvania. I called several former lobbyists for the Catholic Church and for the Pro-life Caucus through the seventies and eighties, and in part it was looking at contracts and that kind of thing. I mean, just going to the Heartbeat Conference and realizing that there was this huge infrastructure and the people who are in charge of this are law degrees, PhDs. They are really professional people who are kind of shaping the framework in which these other foot soldiers are working within.
And something that I learned in this, that is probably the most troubling and, frankly, sad thing I've learned is that people have known what crisis pregnancy centers are. And the government did a report on this — I think it was 2006. People have known for years. I came across a newspaper article that was in the New York Times in 1987 that outlined very similar practices to the practices I'm outlining in my story, and I just find it so demoralizing that people know what these centers are, and there are, like, legal and financial and structural barriers to basically people filing lawsuits in part because — this is not entirely — but in part because their practices affect women: mostly poor women, and mostly women of color, women who haven't completed their education. And it's not like there's a major interest group that has the funding to somehow lobby against these places or file suits.
JJ: What makes filing suits against these organizations so difficult?
MW: That's an excellent question. That's something I wondered too, and there's a number of things. One is that these pregnancy centers operate in sort of a limbo zone: some of them are medical centers, some of them are not. They often offer their services for free, without asking for a payment, so that means that they're noncommercial. So that means they're in a whole kind of separate realm in terms of how they can be prosecuted. Another thing that's tricky about them is, as I've said, it's hard to find women who are willing to go on the record. So let's say someone goes to a crisis pregnancy center and she's told that abortion is going to give her depression for the rest of her life or breast cancer. In order to file a suit against that center she would have to then have access to a lawyer, and she would have to go tell someone that she was thinking about having an abortion. So basically, she would have to go up against a huge cultural barrier in terms of talking about this stuff that's very fraught and emotional. In many of these situations people perceive that they're gonna be judged. And then — two — she would have to have access to a lawyer but not any lawyer, but someone who is willing to take on this cause maybe for free. So that, I think, is honestly the biggest barrier. And there are other kinds of more technical things that in the limbo zone that these places operate in, which is, not quite a medical center, not quite a counseling.
JJ: So, many of your sources for this piece, as you said, are pro-life or anti-abortion activists. And as a writer who is interested in reproductive rights, how do you approach and interview someone who is a staunch opponent of abortion?
MW: I haven't figured it out yet. [laughs] I'm not quite sure. I think it depends on what you want out of the interview. In my mind — and maybe this is wrong — but there's the interview where I'm trying to get someone's personal experience, and then there's the interview where I'm trying to get hard information about how a program works, how people lobbied, something more concrete. So I try to approach those two somewhat differently, right?
I teach a writing class, and something I have told my students, and I try to remember for myself, is even if you disagree with someone, you have to find something in them to respect because we can all sense when someone doesn't respect us, right? So trying to do that just in my own head, I think, can translate into helping to create a rapport with someone. But it is really tricky. One of the things I've thought a lot about this, and I don't have an answer, is that this kind of reporting raises all kinds of almost philosophical questions in terms of where we draw the line when we disagree with someone and decide that they're wrong. When is someone saying something that objectively is troubling and not just for people on two sides of a polarized political conversation, but just in general? I don't really have any particular answers about that. I think that I would focus not on a bigger question that as a society we don't have the answer to maybe, or we have a lot of disagreements about, but something like how a lot of these centers are really advertising themselves to be something they're not. Or something that is much easier to agree on: what's legal and what the best practices are or what's safe for people.
JJ: So in your piece, you visit a crisis pregnancy center run by a woman you you met through the Heartbeat conference that you talked about in a 2014 investigation. How did people at the conference react to your presence, and how integral was attending that conference in building relationships and cultivating sources for this particular piece?
MW: That's a really good question. I'm really glad I went to the conference. I think it changed everything, in terms of my understanding of many pregnancy centers' goals. I really can't say enough that the focus of the conference was about ending abortion, but it was also really about “advancing the kingdom of God.” That's what people said over and over again. It was way more about an evangelical view of the world than I could have ever understood. So that's one. I don't know if Vikki Parker, who runs the center in Arkansas — she may have welcomed me even if I hadn't met her. I can't answer that in terms of that. And people were still reluctant to speak to me even after I'd met them so I don't know. It was really stressful being at the conference. And I — Sarah had told me I had to and I did — tell people when they asked me I had to tell them I wasn't a center director and they asked me about my personal, political, and religious beliefs, and then I would have to say that I'm personally pro-choice. But they were so nice to me. One of them told me that Jesus gave me a brave heart if I was willing to be there. And it showed me the extent to which, if I was a pregnant teenager, I probably would have listened to anything these women said if I was afraid to speak to my mother, which I would have been as a pregnant teenager. It was also very strange to be surrounded by people who — like, hundreds of people — who were all repeating the same myths, and then in my own head — you start to question. So I'm thinking to myself, I do not come from that framework whatsoever. I have read a lot of medical science, you know, use various forms of contraception, and know that it's healthy and fine, and even then in my head to still hear people repeat myths over and over, it really taught me something that I wouldn't have been able to understand beforehand why these women go into these centers and accept whatever is told to them, even if they are, of course, smart, rational-thinking people who may not even agree with that religious framework.
JJ: So, what kind of responses from sources or people you've met at the conferences or in other settings, people who are pro-life advocates you've met along the way, like, after your work is published, have you gotten responses about it?
MW: Oh, yes! That is a great question. So I get two kinds of responses generally. No, well…so Heartbeat International released a press release that had information that was incorrect about me and my reporting, and I asked the…um, this was about the web piece, I should say, the conference piece, and the PR person declined to make changes and then at the same time published an open letter to me, um, which was confusing, and I didn't understand the full…what he was…what the press release was all about. Um, so I also have gotten many — you know, when I did the New York abortion piece, the New York Magazine abortion piece — uh, several websites said that I was…that I had written the piece just to make myself feel better about my own abortion, and that was on the Internet, and I've never had an abortion. So on one hand, I mean, I just let that go. But it's just… it's…and then I get a lot of, um, I get random…I mean there's always people who are going — like the trolls — they're always going to say weird, hateful things. I wish it didn't hurt my feelings, but it kind of does. Or just, like, knowing people can lie about you, and it's just what happens on the Internet. So one day maybe my skin will get thicker.
So that's one kind of response. Although I have to say yesterday I interviewed a, um, a… pro-life or anti-abortion — however you want to say it — lawyer for another story, and he was so nice to me. And I've found that… and he said that he had Googled me and read my stories and that he appreciated that I spoke to people on both sides of the divide. So I think it really depends on the individual and people's…um…yeah. I mean, I've learned in this that there are reasonable people in both parts of the divide, and there are people who will react in a kneejerk way, or in the Heartbeat case, honestly, very calculated. Their response was clearly, um, to me it seemed channeled through a lawyer or a PR person or both. So that's a different thing. So…
JJ: So you've written, um, extensively on feminist and reproductive issues for a variety of outlets, including both mainstream and literary magazines, so do you ever change your approach to writing or reporting depending on the publication? And specifically when it comes to abortion, like, what does it take to reach, like, mainstream audiences basically?
MW: Um, what do you mean by that? Like, in terms of reaching? Like is there…?
JJ: So is there, like, do you take a different tack when you're writing for, say, New York Magazine talking about abortion versus something that may be a little more, um…
MW: Right. I see what you mean…
JJ: A little bit more, like, of a niche audience, like, for the work.
MW: Yeah, I think so. I think you have to do that no matter what you're writing about. So, honestly I just do what editors tell me to! [laughs] And I hope I get more chances to write about this stuff in ways that are as nuanced as possible, and kind of as wonky and weird as possible because I think that's what the topic demands. Um but then of course I'm so excited about this Cosmo story because I'm so excited that women are going to read it who don't necessarily define themselves as reproductive rights people or who are just, you know, young women in every part of our country. I'm so excited about that. So definitely when writing something you want to keep in mind: okay, who's my audience? Is it a twenty-year-old in Oklahoma whose, like, sneaking this at work? Does she know what it even means? I don't want to be condescending — maybe this is internalized sexism — but does she know about the lobbying or the law or a Supreme Court case? I didn't know a lot about this stuff either, and I think that maybe that was helpful because I'm learning as I go — I know that I have to explain it to other people in — I don't want to say simple terms — but not taking a lot for granted.
JJ: Well, thank you for sitting down with me today. This was really great.
MW: No, thank you.
JJ: Is there anything else you would like to say about the reporting process for this particular piece or other similar pieces that you think that listeners of The Backstory would want to know?
MW: Yeah! There are two interrelated things which I've been thinking about a lot. When I was in Arkansas, for example, I was speaking to this woman who I met through the woman who I met handing out the flyers. So, I'm in Arkansas speaking to this woman who has three children. I'm 32, she's probably my age, but she has three children. She's a black woman, she works at Denny's during the day and at Wal-Mart at night, and it…yeah…it struck me. There were moments in this reporting when I was thinking to myself: when someone's in that situation, and you're asking about one particular thing, like these crisis pregnancy centers, there were a few moments where I was thinking to myself: what is the point of these questions? This seems to missing the larger point, the much larger context of this woman's life, which is that she's working extremely hard, harder than probably I've ever worked, and she's still struggling to support her children. She had a — and not that this should matter, but it does matter — a very active partner who was also working, and this family was really struggling to make it. So there were definitely moments when I would question how this story fits into that bigger problem of how do people support their children.
But taking a step back, the thing I've learned here during this reporting is that — which is so obvious, and feminists have been saying it since the fifties, sixties, seventies — if women don't have a full range of reproductive choices, and they can't control their fertility, they have very limited control over their finances. And if you have limited control over your finances, you have very little control over your life. And this woman was very strongly pro-life and was very taken by the ideas presented to her at the centers, which is why…that's part of the reason she had these children and did not use contraception. And so, that's fine, if that's how she wants to live. But anyway, thinking about all this stuff in terms of economics is, I think, the most important to think about, and I've come to a lot of realizations about my own life. I'm able to do work that I find very meaningful and I'm grateful for a lot of things in my life. And if before doing this reporting you asked me why that's possible, I would have maybe talked about class privilege or my education, and those things are true, but contraception and my ability to control my fertility is a major part of that that I cannot separate from my education. So, I'm very grateful to have grown up the way I did and the time that I did, and that is something I just didn't get. And I think it's partly generational, but speaking with so many women from different parts of the country, and just seeing that that's something that we have in common and, depending on what happens to us, it's important. So that's it.
JJ: Thank you so much!
MW: Thank you.
*Specifically, crisis pregnancy centers outnumber clinics that offer abortion services 3 to 1.
This interview has been edited and condensed for clarity.