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Stones unturned: A search for health care answers raises questions about Oldham women's options

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By Rae Hodge

In Kentucky and across the nation, crisis pregnancy centers (CPCs) now outnumber reproductive health care clinics.

Facing criticism from reproductive rights advocates both nationally and locally, CPCs often are accused of misleading their target audience: vulnerable women facing an unplanned pregnancy.

Recently the Era was contacted by Oldham County’s own CPC, Crossroads Pregnancy Resource Center of La Grange, and invited to interview staff members and explore the facility.

Crossroads board member and Special Events Committee Chair Angie Pryor, and Crossroads Executive Director Denise Myers are celebrating the second year of the facilities operation by hosting a fundraiser, which they hope allows them to expand programs and eventually bring on licensed medical practitioners.

CPCs are ften federally or state funded. People for the American Way reports “between 2001 and 2006, CPCs received approximately $30 million in federal funds.”

The Guttmacher Institute notes “seven states included line items in their budgets related to CPCs. For example, Texas provided more than $5 million over a two-year period for CPCs, while Ohio included $250,000 for CPCs in its 2013 budget. Abortion-rights opponents in Ohio are expected to increase their state budget request for the centers to $1 million this year. Ohio and almost two dozen other states sell license plates that say ‘Choose Life,’ with the proceeds from sales going to CPCs”.

Myers said the center, which is funded by a combination of private and public grants, saw 62 clients last year, who made a total of 613 visits to the center to put those programs to use.

“We’re here to educate our clients on all of their options. There’s three out there: parent, abortion, or adoption. We want to give precise, accurate information on all three,” said Myer.

ADOPTION  EDUCATION

Although they haven’t had any clients go the adoption route, Crossroads has already established relationships with three separate pro-life adoption agencies, which they say are ready to work with prospective birth mothers to find families for children

“They would take you into their services as a personal client and they child wouldn’t become a ward of the state or anything like that. They would take you in as a personal client and then work with the families that usually they already have that are looking to adopt. Most states, and Kentucky is one of them, has open, semi-open, and closed adoptions.”

Most agencies handle costs said Myers, who previously worked at a CPC in Dallas said in her experience, “usually there is minimal, if any, cost to the birth mother with the agencies we refer to.”

An adoptive parent herself, Myers said her family covered all the costs, “They covered everything. They paid for her doctor’s appointments. They paid for school.”

“Which is why,” Pryor said, chiming in, “It’s so costly for the adoptive parents. They absorb a lot of the costs.”

“It’s so important to listen to the things that a woman is saying like ‘I can’t give my child this,’ or ‘I wouldn’t be able to give my child that.’ If that’s truly your heart’s desire is to give those things to your child then adoption gives your child that opportunity,” Myers said.

“The agencies that we work with you can literally go through and say ‘I want a family that can provide this for my child’. And you just control that. It can be very empowering as a mother to be able to make those decisions for your child for things that you can’t give right now.”

Myers cautions that none of these choices are easy, “but to make out an adoption plan for your child can feel very good and loving. There’s still a pregnancy loss, but the agencies are skilled with helping moms’ transition through that.”

Even with parenting, it may seem impossible to parent… and if you’re single it’s really all about you. It could be that, ‘I probably could stop going to Starbucks every week if I needed to because if I look at how much that adds up…’ or ‘Maybe I eat out a lot…’ or ‘I don’t have the help I need’ and maybe that’s true, but maybe it’s true because you’ve never really had to ask for help because you’ve always been able to manage things yourself

PARENTING

“If you didn’t have a family physician, we’d usually just refer you to the local Health Clinic,” said Myers, pointing out that for women and girls below the poverty line, the health department can assist pregnant residents with securing Medicaid and state-funded childcare.

“The health department can be a one-stop shop for getting you enrolled in those services,” Myers said, offering that Crossroads “helps with diapers and we help with wipes and household items and educational classes. And there’s a group of women that are going to surround and support you. Walking in here is just the tip of the iceburg and the more you come the more you see there’s so much more”

Crossroads offers a parenting program, and encourages parents to enroll in “Earn While You Learn.” The program allows mothers-to-be to attend parenting and relationship classes classes. The classes cover introductory domestic topics that are as simple as changing a diaper or cleaning a house and as complex as establishing healthy communication channels with between parents during a stressful crisis pregnancy.  

When parents attend the classes, they earn “Resource Cash” for learning and applying parenting concepts. A resource dollar is only a green piece of paper, with lines on the back meant for writing in the salable activity, but each dollar may be used to purchase items from the overflowing stock of family- and child-related goods out of the room next door.

The Resource Room is an adjoining room where towering stacks of diapers, in every age-fit imaginable, are organized by the wooden shelves which line the walls. High chairs, cribs, unused car seats—all organized into manageable sections, butting up against rack after rack of baby clothes. It’s a Resource Cash jackpot that Myers seems eager to spread around.

“Some of the lessons have really easy homework, things that you would go home and apply right away, like on safety, where you would go home and begin to look around your house and see which plugs need covers, and check the lines. Crawl around on the floor and see what you need to move. Is the TV going to fall over.”

“If you come to a class then we give you three dollars in Resource Cash. One of the classes we offer now is a Shaken Baby Class,” said Myers. The class is taught on how to manage overwhelming anger as a parent, and to demonstrate the effects of Shaken Baby Syndrome on infant brains.

“You can personalize your own parenting plan,” said Myer, who works with other staff to pair new mothers and fathers with same-sex mentors, other experienced parents who lived to tell the tale of how a crisis pregnancy became more manageable.

“We want to work with families,” said Myer, who hopes that Crossroads will become an option for those parents who are mandated by courts to receive parental counseling.

CPCs have also begun to expand their public subsidy via state legislatures. Nebraska did this in 2010 by requiring women seeking abortion services to first receive counseling at a CPC. South Dakota did the same in 2013.

The Idaho state legislature tried to to pass similar legislation in 2012 and was struck down by the state supreme court. Both South and North Dakota laws continue to be battled in state and federal courts.
 
ANOTHER  OPTION?

“It should be clear that we are not a medical facility,” Myer said firmly, adding that she’d like to see the center become one in the future so a licensed practitioner can offer ultrasounds and medical advice on site.

A 2007 Congressional report found that deceptive practices were common among CPCs. Staff sometimes assumes pseudo-medical appearances in an attempt to gain credibility with clientele. Staff members at CDCs don lab coats despite having no medical qualification, or use facility names similar to actual reproductive health clinics. Many set up shop near actual clinics.

Deceptive practices among CPCs are not limited to in-person experiences. Blowback against online CPC advertisements recently caused both Google and Yahoo to not only pull the ads but to retool search results after it was found that some CPCs were manipulating the search engines in order to display misleading advertisements to people searching for actual health care providers.

The consulting rooms of Crossroads’ office suite have more in common with a living room than a waiting room, though. Staff eschewed any lab coats in favor of stylish, office-friendly outfits. Brightly-colored plush toys were strewn around the floor and tucked into bins near a cozy loveseat.

But dealing with so many questions about pregnancy means that Crossroads staff must find a way to navigate health concerns of pregnant women who are looking for information about all options, including abortion.
Myers said instead of offering medical advice, she first asks whether a client would like to receive information about her options, then offers pamphlets which explain abortion to the client. The two most popular are called “Choices” and “Unpregnant is not a word.”

“I just read it to them as it says, so I’m not adding anything or taking anything away,” she said. “Most women, if they look it up online, and of course they can, just don’t know the procedures.”

“Anyone up to seven weeks would be looking at the abortion pill RU 486.” Myer explained, pointing to the text in the pamphlet.

This is true. RU 486, also known as mifepristone, is only FDA-approved for use up to seven weeks, although evidence shows to be effective for pregnancies up to nine weeks. The Royal College of Obstetricians and Gynaecologists holds that the medical regimen using Mifepristone in combination with another abortifacient pill, misoprostol, would be a safe and effective alternative to surgery for women undergoing abortion at nine to 13 weeks, with risk for later treatments only increasing slightly.

“The other surgical method from six to 14 weeks is the suction and aspiration,” she said. “This is what we educate our clients on when they are considering abortion because most people when you ask them ‘What do you know about abortion?’ they may not know some of the procedures involved and may not know what the abortion pill is, how does it work.”

In a classroom section of the office, several rows of tables are facing a large monitor. No less than 40 different types of pamphlets line the walls in stacks. Some have names like “Practical Fatherhood: Role Models,” while another shows a birth control compact with a skull and crossbones on its cover and is titled “The Deadly Side of Free Birth Control.”

A sizeable chunk of one wall carries what might be 100 or more copies of one specific video, “Crossroads of the Heart.”

Myers distributes these to pregnant women, who come to consult. During her interview with the Era, however, Myers played an animated video which provided medical information on how RU 486 works.

The animation’s narrator tells viewers “First, an ultrasound is needed to confirm how long you’ve been pregnant and the type of abortion you can have,” referring to a transvaginal ultrasound, a hard plastic wand of ten or more inches which is inserted through the vaginal canal and into the cervix.

This is misleading.  While some states have mandated that women electing to abort must undergo transvaginal ultrasounds, a loud majority of doctors have agreed publicly in the last several years that unless symptoms are present to indicate complications like an entopic pregnancy, transvaginal ultrasounds are not medically necessary.

The FDA has issued guidelines which emphasize physicians should exercise prudent use of ultrasound devices.

“Although there is a lack of evidence of any harm due to ultrasound imaging and heartbeat monitors,” said FDA Biomedical Engineer Shahram Vaezy, “Ultrasound can heat tissues slightly, and in some cases, it can also produce very small bubbles (cavitation) in some tissues… Therefore, ultrasound scans should be done only when there is a medical need, based on a prescription, and performed by appropriately trained operators.”

The video then shows viewers an animated sequence of a cartoon fetus being cut up with scissors, repeating a warning that abortion leads to severe emotional problems.

Myers told the Era about her own experiences with abortion.

“I just didn’t have all the information. And I made decisions without supervision, without information. And it cost me dearly,” she said. “So I believe that its important and that you give people the information and educate both men and women on what their options are and they’ll come up with a decision.”

So the Era asked Myer what kind of accurate information the center could provide if a client came up with a decision to abort, Myers said. “We don’t refer to abortion clinics. We let them research and find that.”

What are some of the most crucial things a woman should know about abortion before she opts to abort?

“I think if someone is seriously considering abortion I think it’s important to let them know what the fetus goes through,” said Pryor.

Since information and resources on adoption and parenting support has been provided by the center, what kind of support can be provided by the center for women who abort?

ABORTION AND CANCER?

In “Crossroads of the Heart” a woman tells viewers that she’s had an abortion and “there ars 20 studies linking breast cancer to induced abortion. I’ve already had two lumps removed from my left breast.”

The scene cuts to Alveda King (whom the movie repeatedly recalls is the niece of Dr. Martin Luther King Jr.). She hints at a previous abortion, then describes brushes with both breast and cervical cancer.

Likewise, the pamphlet, which Crossroads staff read to clients says “27 studies from multiple countries have linked induced abortion with breast cancer. These studies suggest that abortion abruptly stops cell development and interrupts the natural process of breast maturation, in which breast cells are protected against cancer when allowed to develop through a full-term pregnancy. According to these studies, abortion may remove the protection against breast cancer that is gained through carrying a pregnancy to term.”

Pregnancy does not protect women from breast cancer, according to the National Cancer Institute. And the information being presented does not include a single source citation.

Passing along this kind of information is consistent with other CPC actions nationally, which are known to perpetuate the myth that abortion causes breast cancer. It remains a central tenant in many anti-abortion arguments outside of CPCs, despite multiple authoritative denouncements.

Take the American Cancer Society for example. It denounces the myth plainly: “scientific research studies have not found a cause-and-effect relationship between abortion and breast cancer.”

As does the National Cancer Institute, which says “rigorous recent studies demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk.”

Just like the Journal of the American Medical Association in its finding that “results provide strong evidence that there is no relationship between incomplete pregnancy and breast cancer risk.”

The Journal of the American Medical Association has also debunked it: “neither induced nor spontaneous abortion was associated with the incidence of breast cancer.”

The Susan G. Komen Foundation echoes the stance, “Research clearly shows no link between abortion (also called induced abortion) and breast cancer risk.” The foundation goes further in questioning the commonly cited
The foundation adds, “Prospective cohort studies are much more likely to give accurate results on the topic of abortion. These studies gather sensitive information before women are diagnosed with breast cancer. This helps limit biased reporting. The results from cohort studies show abortion does not increase the risk of breast cancer.”

The “Unpregnant” pamphlet also adds: “Other studies have failed to find a link between abortion and breast cancer.”

It may be referring to the above-listed studies debunking the myth, or it may be referring to the 2003 National Cancer Institute summit on March 3 when more than 100 experts from around the world convened and found that “abortion is not associated with an increase in breast cancer risk.”

POSSIBLE INFERTILITY?

CPC literature and videos usually include information suggesting that women who elect to abort experience long-term infertility afterward.

Queue the whole cast of “Crossroads of the Heart”, who can be seen on screen crying, one after another, saying their abortions made all of them barren.

None of the cast mentions that the UK’s National Health Service has affirmed that while some women may experience inflammation, “most women who have an abortion don’t have any complications and their fertility isn’t affected.”

Or that the British Pregnancy Advisory Service says, “There is absolutely no evidence that safe, legal abortion will lead to infertility.”

The most glaring oversight of this segment is its failure to include what has been arguably the largest study of long-term fertility of women who have undergone abortions.

Released in 2007, nearly 12,000 Danish women participated in a study lasting several years, whose data consistently demonstrated that unless the women had other untreated health complications, a medication-induced abortion did not cause long-term fertility problems. The research also included those women who had surgical abortions.  

AFTER IT’S OVER

In “Crossroads of the Heart,” four women in succession tell the viewer how abortion damaged their mental health.

One woman describes an attempted overdose and tells us, “No one tells you that you want to kill yourself after an abortion.”

The screen next shifts to another woman who says, “I wish I had talked to someone who had an abortion that could tell me what the side effects were: that I would not like myself anymore… that it wasn’t worth living anymore… that I would hate myself.”

The video’s “Suicide Depression” segment ends with another woman, who says, “Having had that abortion turned me into a crack-head whore and no one told me that would happen.”

These video testimonials reenforce an abortion-is-trauma narrative that is prevalent across nearly all CPC marketing. For Crossroads, that narrative has a name.

At cprcky.org/abortion-recovery/ readers can find Crossroad’s list of “Common features of Post-Abortion Stress Syndrome (PASS),” along with an offer to prospective clients: “If you are experiencing any of these signs, an abortion recover program may help you.”

PASS was created in 1981 by anti-abortion advocate Vincent Rue, which the Journal of the American Medical Association also calls a “myth.”

The term gained popularity in 1989 when then-President Ronald Reagan directed his U.S. Surgeon General C. Everett Koop to create a report lending veracity to Rue’s opinion that women who obtain abortions are likely to suffer an abortion-specific mental illness. After reviewing over 250 studies on abortion and mental illness, even Coop, an Evangelical anti-abortion advocate, couldn’t do it.

By 2003, The Journal of Psychiatric Practice described the PASS phenomenon in these terms: “Currently, there are active attempts to convince the public and women considering abortion that abortion frequently has negative psychiatric consequences. This assertion is not borne out by theliterature: the vast majority of women tolerate abortion without psychiatric sequelae.”

Then in 2009, a study in the Bioethics Academic Journal found “there is no such thing as post-abortion.”

Some argueing for the veracity of PASS have cited a 2009 study by Priscilla Coleman called the “National Comorbidity Study,” asserting a link between increased depression and abortion.

In 2010, academic journal Social Science and Medicine published a study from Julie Steinberg and Lawrence Finer, which found that Coleman’s results were not only impossible to replicate using her own data, but suspiciously disproportional.

“Their findings were logically inconsistent with other published research—for example, they found higher rates of depression in the last month than other studies found during respondents’ entire lifetimes,” the report reads. “This suggests that their results are substantially inflated.”

In a 2010 issue of the Washington Post Brenda Major, Stanford fellow and psychology professor at University of California Santa Barbara wrote:

“Rigorous U.S. scientific studies have not substantiated the claim that abortion, compared with its alternatives, causes an increased incidence of mental health problems.”

An American Psychological Association task force, an independent team of scholars at Johns Hopkins University, and even a teen-specific study from Oregon State University found the same.

Despite the debunking, CDCs in every state continue to advertise that PASS is not only real, but that they—staff which are often medically unqualified—can assist clients in recovery from PASS.

BIRTH CONTROL

Several pamphlets were found in the center which denounced the efficacy of birth control, providing off-target numbers for condom failure rates and even included one which condemned birth control as a cancer-causing abortifacient. Across the board, the pamphlets failed to provide accurate instructions on the use of birth control, instead arguing for an abstinence-only approach.

Some reports findings have been verified repeatedly. For example in 2009 researchers at the University of Washington in Seattle found that “There was no evidence to suggest that abstinence-only education decreased the likelihood of ever having sex or getting pregnant,” and that  “teens who received comprehensive sex education were 60 percent less likely to get pregnant or to get someone pregnant than those who received no sex education.”

By 2010, those states with abstinence-only education consistently had the highest number of unintended pregnancies. Further research from the Guttmacher Institute shows that abstinence-only education can even deter teens from using contraceptives if they change their minds about chastity.

And yet, in Fiscal Year 2010, Congress devoted a full $50 million to Title V Abstinence-only programs.

NO JUDGEMENT

“It's non-judgmental. We’re not here to pass any judgment.” Both Myers and Pryor repeated this sentiment multiple times over the course of the interview.

But despite their insistence that Crossroads is a center free from judgment or shame, the videos they hand out to women seeking their counsel do not reflect this intent.

“Crossroads of the Heart” concludes with the following lines spoken to viewers from the four women who have appeared throughout the film.

•“It’s so unnatural for a woman to take the lives of her own children.”
 
•“I never thought that I would do this. This is not the type of person I want to be.”

•“(Adoption) is different psychologically, but it’s definitely a better choice.”

•“I pray she will never have an abortion. It will destroy her life. At that point, she will be destroyed.”

•“By going to have an abortion, it’s adding to the problem. Its not a solution.”

 •“It could be the next Rosa Parks or Martin Luther King.”

•“Just have your baby. It’s worse if you don’t.”

•“The side effects are forever. Whatever they are, they are forever.”

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“We spend a lot more time researching phones and cars before we purchase them and sometimes make really rash decisions with a pregnancy when its just worth looking at all the options,” said Myer.

“You’re a reporter, so you know what kinds of questions to ask,” Pryor told the Era, “but I think a lot of girls, especially the younger girls, they just don’t even know what to ask. They don’t even know what to research.”