In a conference room at the Embassy Suites in Charleston, South Carolina, Laurie Steinfeld stood behind a podium speaking to an audience of about 50 people. Steinfeld is a counselor at a pregnancy center in Mission Hills, California, and she was leading a session at the annual Heartbeat International conference, a gathering of roughly 1,000 crisis pregnancy center staff and anti-abortion leaders from across the country. Her talk focused on how to help women seeking abortions understand Jesus’s plan for them and their babies, and she described how her center’s signage attracts women.

“Right across the street from us is Planned Parenthood,” she said. “We’re across the street and it [their sign] says ‘Pregnancy Counseling Center,’ but these girls aren’t — they just look and see ‘Pregnancy’ and think, Oh, that’s it! So some of them coming in thinking they’re going to their abortion appointments.”

Last year’s Heartbeat conference took place in March 2014. This year’s is scheduled for April 7 to 10 in St. Louis. Pregnancy centers — often called “crisis pregnancy centers” (CPCs) — are anti-abortion organizations that advertise to pregnant women by offering free pregnancy tests, ultrasounds, and “options counseling.” And it has been widely reported that staff at the centers often try to dissuade women from using contraception or having abortions by presenting incomplete medical information and ideas about the “negative consequences” of sex outside marriage. The centers themselves vary — some consist of small rooms piled with baby clothes, and others resemble medical clinics where nurses in scrubs “show women their babies” through sonogram images.

An estimated 3,000 of these centers are scattered across the country, far outnumbering abortion clinics, and with 1,800 affiliated centers, Heartbeat International is the biggest pregnancy center network in the world. It’s an umbrella nonprofit that offers pregnancy centers behind-the-scenes support like legal education and staff training in exchange for membership dues. Heartbeat’s “life-saving vision,” according to its website, is to “to make abortion unwanted today and unthinkable for future generations.”

For decades, reproductive rights advocates have accused pregnancy centers of shaming or scaring women out of using contraception and having abortions. In 2006, Representative Henry Waxman of California published a report detailing how pregnancy centers used deceptive marketing and provided inaccurate health information. And just this March, NARAL Pro-Choice released the results of its own investigation, showing how CPCs misled and misinformed women. “Women are entitled to accurate, comprehensive and unbiased medical information with which they can make their own decisions,” NARAL said in a report on CPCs this January. Still, the federal government and at least 11 states currently fund pregnancy centers, including Heartbeat affiliates.

In her workshop, “How to Reach and Inspire the Heart of a Client,” Steinfeld told her audience about her mission to convert clients: “If you hear nothing today, I want you to hear this one thing,” she said. “We might be the very first face of Christ that these girls ever see.”


The theme of last year’s Heartbeat conference was “Love Is Our Language,” reflecting the tone of a gentler anti-abortion movement. Within the pregnancy center movement, aggressive tactics and graphic imagery like posters of bloody fetuses have not disappeared entirely, but they are becoming increasingly passé as anti-abortion campaigners rebrand themselves as advocates for women. Just as many of the abortion opponents who stand outside clinics now refer to themselves as “sidewalk counselors” rather than “protesters” and talk about wanting to help the women, staff at pregnancy centers say they’re protecting their female clients.

“The sole purpose of every pregnancy help organization is to provide the love and support every woman deserves in an unexpected pregnancy,” Peggy Hartshorn, Heartbeat’s president, said in a press release in response to NARAL’s report. “No woman should ever feel so alone, coerced, or hopeless that she ends her child’s life through abortion.”

  • I don't think it's disrespectful to shout, 'You're killing your baby,' she said. That's not saying, 'You dirty whore.'

Over the course of the three days of the conference, I chatted with a few dozen pregnancy center workers. Multiple women told me it was their job to protect women from abortion as “an adult tells a child not to touch a hot stove.” Another oft-repeated catchphrase was, “Save the mother, save the baby,” shorthand for many pregnancy center workers’ belief that the most effective way to prevent abortion is to convert women. In keeping with Evangelicalism’s central tenets, many pregnancy center staff believe that those living “without Christ”— including Christians having premarital sex — must accept Christ to be born again, redeem their sins, and escape spiritual pain. Carrying a pregnancy to term “redeems” a “broken” woman, multiple staff people told me.

One conference attendee, a center volunteer in her early 30s, told me that she has protested outside her state’s only surgical abortion clinic for several years. “I don’t think it’s disrespectful to shout, ‘You’re killing your baby,'” she said. “That’s not saying, ‘You dirty whore.'” But she prefers counseling at the center: “When I started, I remember thinking, This is so awesome! I don’t have to feel mean, but I can still talk to women!”

  • Nowhere to Turn

    Read more from our series, “Nowhere to Turn,” which explores the expansion of anti-choice ‘Crisis Pregnancy Centers’ as abortion clinics are shuttering under the pressure of new state restrictions.

Throughout the three-day conference, hundreds of middle-age women wearing colorful blazers or sweater sets and a few dozen of their younger, ponytailed counterparts smiled and chatted as they hurried between some 80 workshops. A Christian author spoke about her own abortion publicly for her first time, she said. The women sitting near me explained she knew she wouldn’t be judged. In the crowded exhibition hall, the mood was festive and welcoming as vendors smiled, waved hello, and offered mini chocolate bars. Two RVs were parked in the exhibition hall, one beside a poster that said in all-caps letters, “We seek to empower every abortion-minded mother to choose life and to share with them the good news of Jesus.” Across the country, anti-abortion groups drive the RVs into neighborhoods and offer women ultrasounds.

During mealtimes, attendees sat together in the ballroom. Practiced at exuding kindness, women poured each other iced tea, traded self-deprecations, and left their purses in each other’s care. Before we ate, we waited for at least 20 minutes as speakers blessed the food by invoking God in the battle to make abortion illegal.

The website for Heartbeat International’s call center, Option Line, offers to connect women with a pregnancy center that “provides many services for free.” It encourages women who are curious about emergency contraception to call its hotline to speak to a representative about “information on all your options.” On the Option Line website, there is no mention of Christ, no religious imagery, no talk of being saved. But visit the website of Heartbeat itself and you’ll find very different language. “Heartbeat International does promote God’s Plan for our sexuality: marriage between one man and one woman, sexual intimacy, children, unconditional/unselfish love, and relationship with God must go together,” it says.

The belief that a personal God commands faithful Christians to save others from Satan’s fallen world pervaded the Heartbeat conference. Attendees referred to their centers as “ministries.” In the ballroom, a doctor said he’d performed abortions until he heard the prayers of all the souls of the babies he’d killed. During prayer sessions, hundreds of women raised their arms together in song. Kirk Walden, an anti-abortion fundraiser, repented, saying he’d previously underestimated pregnancy centers as just “nice work doing nice things.” During his morning keynote, he shouted across the ballroom that pregnancy centers are, in fact, “the key God is using to build the wall of hope to make abortion obsolete in this country and around the world.”


Laurie Steinfeld speaking at the Heartbeat conference.Image: Heartbeat International/Facebook

In her talk, Steinfeld explained how she tells girls who are “14, 15, 16 years old” that “He wove us together in our mother’s womb.” Yet she encouraged her audience to think carefully about the words they use when talking to clients. “Notice that I haven’t mentioned abortion,” she said at one point in her talk, after detailing how she tries to make the girls feel comfortable by listening to their fears and talking about God’s unconditional love, even for “the adulterous woman.”

“We’re just starting to build up knowing who she is in Christ, just laying the groundwork. Once she believes He had a plan for her life, then she would also have to believe He has a plan for her baby’s life,” Steinfeld explained.

“This is the time when we start to tell our personal story,” she said, and then described how she tells women about her own struggles during an unplanned pregnancy and how she got through it even though it was hard.

She emphasized gentleness: “We try to forget the ones that make us feel shame, but we all remember the ones that gave us love. We’re guiding her on that road to do the next right thing. About then is when we usually do the ultrasound.”

Beyond the religious messaging, at least 10 conference sessions focused on the “risks” of premarital sex, contraception, and abortion. During the panel “What’s So Bad About Abortion?” Janet Morana and Father Frank Pavone, of the organization Priests for Life, asserted that abortion causes an array of spiritual, psychological, and medical problems.

Pavone said, “Abortion poisons everything” because after an abortion, a woman thinks, “Others can’t possibly esteem me, child-killer that I am.” Those women, he said, suffer a “failure to bond” with future children, often thinking, “I killed one child; I’m afraid that something bad will happen to the next one.” He and the other speakers in the session said abortion increases a woman’s risk of miscarriage, cancer, substance abuse, suicide, and domestic violence, among other problems.
“The fact that [abortion] dismembers a child, the fact that it goes against everything the human body and human psyche are meant to do when a woman is pregnant is the cause, is the root of all of these other physical, emotional, psychological and spiritual problems,” Pavone said.

According to the Guttmacher research institute, less than 1 percent of all first trimester abortion patients in the U.S. experience major complications, and one 2012 study found that legal abortion is much safer than childbirth. Despite abortion opponents’ claims, the American Cancer Society has also said that “scientific research studies have not found a cause-and-effect relationship between abortion and breast cancer.” And the American Psychological Association Task Force on Mental Health and Abortion said in a report in 2008 that “it is clear that some women do experience sadness, grief, and feelings of loss following termination of a pregnancy, and some experience clinically significant disorders, including depression and anxiety. However, the TFMHA reviewed no evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors.” A study last year found that denying abortions to women in abusive relationships actually keeps them in those relationships.

Pavone grounded his claims in research conducted by Dr. Philip Ney, who he described as an expert on abortion research. Dr. Ney is an anti-abortion psychiatrist who regularly contributes articles to the anti-abortion organization Life Issues Institute’s website, where he wrote that “abortion survivors” have “confusions and dilemmas … similar to those who survived Auschwitz and other death camps, only worse.” Georgette Forney of the organization Silent No More — which publicizes confessionals from women who regret their abortions — also spoke during this session and said the brochure that encapsulates the ideas in Pavone’s talk is the most requested by pregnancy centers. That brochure claims that after an abortion, women find themselves with an “increased use of drugs and/or alcohol, reoccurring insomnia and nightmares, eating disorders, suicidal feelings, and attempted suicide.”

The importance of framing abortion and contraception through “risks” also came up in the talk given by Bri Laycock, the director of Option Line. In her session, “Answering the Hard Calls and Tough Questions,” Laycock recommended that staff answer callers’ questions about medical and surgical abortions by saying, “Both options can pose risks to your health,” without saying the center is against abortion. She recommended pregnancy center staff present select medical information and disclaimers from the fine print on pharmaceutical packaging to present using contraception as a high-risk gamble. When callers ask about emergency contraception, for example, even if there might be an opportunity to prevent an unwanted pregnancy, Laycock said staff can just say it’s “not 100 percent effective.” She recommended telling callers, “You might not be at a fertile time in your cycle, and it’s not worth taking hormones for no reason.”

Throughout the conference, I asked at least a dozen pregnancy center staff if seeing so many unplanned pregnancies ever tempted them to suggest birth control pills or IUDs. Again and again, they mentioned claims, which have been debunked, that abortion sterilizes and birth control pills cause cancer. “All those chemicals can be dangerous,” one staff person told me, and she seemed to believe it.

Of course, in order to deliver any message — religious or secular — to women, you have to get them through your doors. And at the Heartbeat conference, speakers and vendors made it clear that attracting “abortion-minded” clients through technology and other marketing practices was a priority — and that it was sometimes helpful to downplay their anti-abortion mission. In an exhibition hall crammed with booths offering medical malpractice insurance and pregnancy tests wrapped in blue and pink felt storks, several booths offered tech services that help centers appear in Internet searches for terms like “abortion.”

“They’re going to Google ‘abortion,’ or they’re going to Google ‘abortion services’ or ‘pregnancy help,’ and that’s why we want to focus on our websites,” said Lauren Chenoweth, Heartbeat’s media specialist at the time. Later she said, “We want to be strategic in getting them to our centers.”

In her session, “Do I Really Need Two Sites?” Chenoweth explained that, yes, in fact, pregnancy centers do. She recommended that centers operate one that describes an anti-abortion mission to secure donors and another that lists medical information to attract women seeking contraception, counseling, or abortion. An audience member offered that her center swapped out an anti-abortion-seeming name for Pregnancy Options. “That is an excellent point,” Chenoweth replied. “Use a more attractive name to someone who is seeking services.”

Other Heartbeat speakers echoed Chenoweth’s advice. In her talk, “Competing With the Abortion Industry,” Abby Johnson, an anti-abortion activist, urged a packed room to allow women to book appointments online. “A lot of centers are doing this, and it’s working out beautifully,” she said. “They’re booking online for what a lot of centers are now calling ‘Pre-Abortion

She told her audience that many callers ask if her center provides abortions. They call and say that, right?The crowd nodded. She recommended telling callers the center provides free ultrasounds that “the abortion clinic is going to do anyway,” without mentioning its anti-abortion goals. A middle-age audience member interjected, saying her clinic doesn’t try to get clients to think they’re going to perform abortions or make referrals. Instead, her staff tells women about the services they can provide, like a free pregnancy test, STD screening, or ultrasound. “We do tell them the truth,” she said. “We don’t do abortions, nor do we make abortion referrals, but this is something that we can do.”

  • Every abortion doctor has to say...'It's a separate, whole, unique living human being.'

“That’s good for you if that works for your center,” Johnson said in response, “but I can tell you that’s not the way we’re going to do it at my center, and that’s not the way we have seen other centers really evolve into seeing more and more abortion-vulnerable and abortion-minded women.”

Johnson said centers should invest in “professional signage” and a web designer as well as advertising on college campuses and public transportation. She recommended targeted Facebook ads that can zero in on women in specific regions and age brackets, and suggested running focus groups to better understand how to reach young women, Spanish-speaking women, and men.

Johnson said “half of the battle” is keeping women out of abortion clinics. “But they might not even know that we exist if we don’t have good advertising,” she said.

She emphasized that waiting rooms should feel like “professional environments” instead of “grandma’s house,” and discouraged crucifixes, fake flowers, and mauve paint before showing slides of Planned Parenthood waiting rooms and encouraging staff to make their centers look just as “beautiful and up-to-date,” especially if they have a “medical model,” meaning they offer sonograms and other medical services. Johnson also said pregnancy center staff should mirror Planned Parenthood’s language.

“We need to use whatever language [women] are using, are comfortable with, and that they have been sold on,” she said. Throughout the conference, speakers and attendees used “Planned Parenthood” and “the enemy” interchangeably.

Few women I spoke with defined their work in strictly political terms. More often they called themselves “servants” of Christ. Heartbeat speakers, though, seamlessly united personal, religious, and political struggles. In her talk “Lasting in Leadership: Staying Called, Not Driven,” longtime anti-contraception activist Leslee Unruh said it’s been easier to pass anti-abortion bills since she began inviting South Dakota legislators “up to the lake” in the summer. One such “win for God” is an enjoined law that requires women seeking an abortion in South Dakota to receive counseling at either Unruh’s Heartbeat center in Sioux Falls or another evangelical center in Rapid City.

“When you hear South Dakota’s winning — no, it took 30 years. It wasn’t easy,” Unruh explained. “We did the informed consent law, the 72 hours waiting period, we’ve done that every abortion doctor has to say to a young woman, ‘It’s a separate, whole, unique living human being,’ to every woman who goes into the abortion clinic.”

Across the country, states are expanding their support and funding of pregnancy centers. Michigan, for example, approved a $800,000 budget for pregnancy centers in 2014, and a bill in Texas, slated to be decided April 7, proposes almost doubling that state’s pregnancy center program budget, from $5.1 to $9.1 million. In 2013, Ohio budgeted $250,000 for pregnancy centers, and abortion opponents are expected to ask for $1 million this year. Centers that receive government funds are generally not monitored by government employees. Instead, private anti-abortion contractors or pregnancy center directors themselves are often wholly responsible for supervising their counseling and education programs.

Some of those pregnancy center directors sat in the Embassy Suites ballroom when Kirk Walden, the anti-abortion fundraiser, promised that the anti-abortion movement “will not be defeated.” “We are the body of Christ,” he called out, “and the body of Christ does not come in second.”

The morning after the conference, four young women from Kentucky invited me to their hotel room for breakfast. I’d met one of them in Laurie Steinfeld’s talk Thursday afternoon, and that night, they made sure I didn’t sit alone at dinner. In the hotel room, they told me, “No one will ever love you the way Christ loves you.” A soft-spoken blonde wearing dangly cross-shaped earrings said she’d deprived her husband of something because she wasn’t a virgin when they married. She spoke with quiet but firm conviction. She didn’t emphasize any one of her claims — that premarital sex is a mistake or abortion is murder — but presented a whole worldview where all beliefs are interlocked. For almost an hour, the women described how feeling Christ’s love carried them through moments of darkness like loneliness, family turmoil, struggles with self-esteem, and loss. One woman, a nurse, explained, “Christ’s love is always there. It’s unconditional. I never feel lonely.”

I imagined them offering the same explanation to women looking for help with their unplanned pregnancies.

This article was reported in partnership with The Investigative Fund at The Nation Institute, now known as Type Investigations.