“I wasn’t considering abortion. I wasn’t considering adoption, or parenting, or childcare. I wasn’t even pregnant, and I definitely wasn’t scared — at least not at first.”
So writes Caitlin Bancroft, a legal intern with NARAL Pro-Choice Virginia and a George Washington University Law School student, in her article about going undercover to several crisis pregnancy centers in Virginia. She is overwhelmingly critical of her informal study of these clinics, which she calls “the foot soldiers in the war against women.” She writes,
These anti-choice non-profits pose as women’s health clinics then use lies and manipulation to dissuade pregnant women from considering their full range of reproductive options (ie: abortion and birth control).
Her description of one visit in particular does reveal sad ways in which crisis pregnancy centers fail women. “So you do have some scruples about you,” the counselor says at one point in reference to Bancroft’s low number of sexual partners. Such a comment is not only inappropriate; it fails to recognize the dignity of the woman who has come into the clinic looking for help. Bancroft also tells a story about getting drunk such that she was unable to consent to the sexual act that followed. The counselor responds, “Oh so he took advantage of you. Well, just don’t do it again sweetie; just don’t do it again.” Bancroft says it is clear that the counselor’s comment reveals that she thinks it is Bancroft’s own fault. I don’t think so, but I do think the counselor’s comments inappropriate. What a woman needs in this situation is to be listened to and helped without judgment. Moral evaluations about a woman’s character or her sexual choices (or non-choices as the case may be) are counter-productive and contrary to the goal of the crisis pregnancy center to respect the unborn and the woman in question.
Bancroft also discusses the counselor’s decision to lecture her on the dangers of birth control, particularly with regard to its very questionable link to certain types of cancer.
I was told the pill could cause breast cancer, that condoms are “naturally porous” and don’t protect against STIs, and that IUDs could kill me. She lectured and lied to me for over an hour before I even received the results of my pregnancy test.
Again, this is inappropriate. There is a time and a place to discuss the often-undiscussed problems with birth control, but a crisis pregnancy center is not one of them. A woman who has come to a crisis pregnancy center should not be subject to having her entire sex life scrutinized. She has come for help with an unintended pregnancy, and this alone should be the goal of the CPC counselors.
What is worse is that this barrage of lectures occurred before the results of her pregnancy test were delivered. The results of such a test can be delivered within minutes. There is no reason to keep a young girl whose future literally may depend on the results of the test needlessly waiting for even a second longer than needed.
All this being said, I disagree with Bancroft’s understanding of the “blatantly manipulative” tactics, as she describes them, of the counselors in offering alternatives to abortion. In the first center she describes, the counselor asks a number of personal questions (Bancroft calls them invasive): “What is your relationship with your parents like?” “How is your financial situation?” “Have you told the father?” “What is his religion?” “Are his parents religious?” “How many people have you slept with?” “Would your parents be excited about a grandchild?” Bancroft argues that the questions were asked to find out how best to manipulate her. It’s possible, but it is is also possible that these precise questions are the sort of questions young girls facing an unplanned pregnancy don’t think of.
Bancroft is even more critical of another clinic after she produced a positive pregnancy test. The counselors try to convince her that she could care for a baby with no job, that she could handle the stress of pregnancy and parenting, and that her parents could provide help. Again, Bancroft sees this as blatant manipulation and bullying.
I don’t know the intentions of the counselors and it is possible that they were trying to bully a vulnerable woman, but it is also possible that they were simply offering relevant advice and asking relevant questions to the serious decision as to whether to continue with the pregnancy. In the very fine textbook on healthcare ethics, Benedict Ashley, et. al. write
. . . The physician’s primary responsibility is to help patients make good health decisions, which requires a counseling process. People cannot make good decisions about how to care for their health unless they have the required information. . . More is involved than [the physician playing the role of the teacher], however, as the information required is not abstract biological truth but a concrete assessment of personal health and the possible ways of dealing with the problems this assessment presents. This form of guidance is required of a physician, and it engages the physician in a special type of counseling (211).
In other words, the job of a health care provider is not just to provide the straight biological facts, say, the positive pregnancy test, but to also care for the patient broadly and help her see the spectrum of possible responses to the biological data. In this regard, the counselors were doing their job. Now, there is a fine line between presenting relevant information (and asking relevant questions) and trying to convert the patient to the counselor’s own value system, the latter being a grave violation of justice and autonomy. Ashley et. al. argue that “it is more important that persons do what they sincerely believe to be right at a given stage of their moral development than that they do what is objectively right” (243). But, in cases where a patient’s decision is clearly injurious to another person, “the counselor may judge that it is necessary to confront the [person] with the challenge inherent in the decision that has to be made. Thus the counselor must raise disturbing questions that ultimately go beyond the ethical level to the spiritual level of the person’s value system” (243).
What this means is that Bancroft, facing the possible decision to end the pregnancy (if it existed) and end a life deserved comprehensive counseling that strives to help her make a subjectively sound decision that was in accord with her own value system. Helping her determine whether her parents might want a grandchild and be willing to help is a means to helping her make a conscientious and autonomous judgment, not necessarily manipulation. Now, ultimately the decision lies with Bancroft as to what to do, and the counselors must respect this. Again, the line between counseling and manipulation is a fine one. But Bancroft is wrong to assume that her right to make a “deeply personal reproductive health decision” does not require a level of counseling that does something else besides tell her that abortion is the solution.
In the end, Bancroft seems prone to be offended by anything the counselors in CPCs do that isn’t flat out giving a woman an abortion if that is what she asks for. She is right to argue that the decision regarding an unplanned pregnancy is a deeply personal one, but this does not mean that it is a decision made in vacuum, nor does it mean that if a woman comes in initially wanting an abortion she is necessarily making an autonomous and informed decision. In offering alternatives to abortion while respecting the autonomy of women even to make wrong decisions crisis pregnancy centers play a vital role in promoting the well-being and health of women. Bancroft’s article, however, does provide the opportunity for those working in CPCs to do an examination of conscience to see if they really do have the woman’s best interest at heart, or if their attempts to help her make a subjectively sound decision might border on cruelty and manipulation.