By Kate Patterson
Crisis pregnancy centers (CPCs) are non-profit organizations established by anti-abortion advocates that attempt to convince pregnant people to carry their pregnancy to term. There are more CPCs than abortion clinics in the U.S., and CPC Care Net of Puget Sound’s Tacoma clinic, located at 19th and Cedar, is closer to campus than Planned Parenthood. Several aspects of CPCs often elicit concerns: frequent lack of licensed medical staff, insufficiency of privacy regulations, misinformation and their general ethos toward abortion and autonomy.
Many CPCs are accused of portraying themselves as medical clinics while not staffing licensed medical professionals. In Washington, only one third of CPCs say they have a registered nurse on staff and only one tenth have a staff physician; the national trend is similar.
In this respect, Care Net of Puget Sound is somewhat unique. It is designated as a healthcare facility, defined by state law as “a hospital, clinic, nursing home, laboratory, office or similar place where a health care provider provides health care to patients.” Director of Communications at Care Net of Puget Sound Amelia Graham says the organization has two licensed OB-GYNs (obstetricians and gynecologists) serving as medical directors, with a total of about 30 licensed medical professionals serving in their clinics.
CPCs frequently face accusations of conveying misinformation. Graham spoke about the organization’s responsibility to provide accurate information as a medical facility. “All the information that we share in any of our clinics, we ensure it is research-based, medically accurate, any medical information that we’re providing is reviewed by a licensed medical professional for accuracy, cited with proper studies and with sources,” she says.
Contrary to Graham’s assurances, Care Net of Puget Sound promotes several pieces of misinformation online. Care Net’s website claims that women who have an abortion “are 81% more likely to experience mental health problems,” which is not true according to the American Psychological Association (APA). Additionally, Care Net’s website advances the myth of abortion pill reversal, or that a medical abortion (taking the abortion pill) can be reversed by taking progesterone. The American College of Obstetricians and Gynecologists says this claim is not supported by science and that attempts to reverse an abortion may be dangerous. A 2020 study on abortion pill reversal ended early when three people were taken to the hospital in response to severe bleeding.
The website also implies that abortion is a risky procedure. On a page titled, ‘Is the Abortion Pill Safe?’ they list five risks of medication abortion without answering the question: that, yes, abortion is a safe procedure and has a low complication rate. In fact, the mortality rate for carrying a pregnancy to term is 14 times as high as the mortality rate of abortion. Decisions about whether to carry a pregnancy to term are high stakes. Carrying a pregnancy and giving birth pose serious health risks, especially for high-risk groups like Black women. Additionally, being denied an abortion is associated with worse physical health, mental health and economic outcomes than seeking and receiving an abortion, according to the APA. Crisis pregnancy centers are much more common than abortion clinics and may advance misinformation about abortion or take an anti-abortion stance. The misinformation CPCs promote threatens the ability of pregnant people to make the best decisions for their lives. Making an autonomous decision about one’s health necessitates access to accurate health information.
Privacy is another concern at CPCs, where individuals share information about their health history. Since most CPCs aren’t licensed medical clinics, they aren’t subject to HIPAA (Health Insurance Portability and Accountability Act) — regulations that protect the privacy of health information. The Care Net intake forms do report that the organization follows HIPAA. However, one sentence reads, “The privacy practices described in this notice are voluntarily undertaken and ARE NOT INTENDED TO CREATE ANY CONTRACTUAL OR LEGAL RIGHTS ON BEHALF OF CLIENTS.” This casts doubt over the legitimacy of Care Net’s adherence to HIPAA. Graham disagreed, saying, “This section doesn’t imply that clients don’t have the legal right to their information. We protect PHI (personal health information) like any other medical facility and patients always have full access to their records when requested.” Regardless of the specific practices of Care Net, the protection of patient health information is extremely important, especially around vulnerable information about sexual health.
I went to Care Net’s Tacoma clinic for a pregnancy test at the end of March as research for this article. I knew I was not pregnant; I had gotten my period the previous week, and more importantly was not concerned that I could be pregnant.
For my pregnancy test at Care Net, a staff member walked me to a bathroom, provided a urine test cup, and showed me the door in the wall where I would submit my sample. The bathroom had several informational posters and two framed quotes. One read, “Be brave. You may just surprise yourself” while the other read, “Beautiful girl, you can do amazing things.”
After producing my sample and washing my hands, I returned to the hallway where the staff member led me to a room. Here, she asked me about my health history and the circumstances of my suspected pregnancy. I told her about the medications I take and about my life. I shared about being in a time of transition with graduation approaching and having plans to study abroad in Guatemala in the fall. She asked about my support network and sexual history. Several questions were about how my support network would respond to the news of my potential pregnancy.
After talking about my assumed pregnancy, the staff member ran the pregnancy test. Upon return, she quickly showed me the test with only one line and assured me she had run a backup test to be sure and that it was also negative. When she showed me my test results, she remarked that I would still be able to go to Guatemala! This memory of and connection to what I had previously shared about my plans to study abroad represent a focus on relationship building and supportiveness that was clear throughout my appointment.
My visit to and research about Care Net surprised me in several ways. When I told the staff member that the father wasn’t someone I was in a relationship with, she reacted nonjudgmentally. I had been emotionally prepared to be slut shamed. Before leaving, I asked for birth control recommendations. Knowing that Care New does not prescribe birth control, I wasn’t expecting any substantive recommendation. I was handed a list of clinics with the heading STD/HIV Testing – Pierce County and was directed towards two organizations in particular, which she circled. One of these was Sea Mar Community Health Centers’ Tacoma clinic, which does prescribe birth control. Care Net of Puget Sound’s commitment to health by having licensed medical staff caring for patients sets them apart from some CPCs. Their volunteers and staff seem to be dedicated to building relationships with women and showing them genuine care and affirmation. However, those seeking abortion care should be aware of reports that these clinics’ opposition to abortion may shame or misinform those seeking these services. However, for those who want to continue their pregnancy, the supportive environment and affirmation of dignity and worth may be very positive. “It is the heart that I see, even though I’m in admin, I see amongst the admin team and I see in our advocates and in our nurses and in our providers who are meeting with our patients and with our clients, that we truly care about every individual that we serve, and so I think that’s one of the strengths,” Graham says.
Between pre-appointment paperwork, checking in, my test, and the conversation, I saw the same staff member. The staff member who helped me was kind and caring, sharing about her own daughter and the unconditional love she had for her.
Though I wasn’t pregnant when I visited Care Net, some people come in with an unexpected pregnancy hoping for support in learning their options and making a decision based on that information. There is a clear conflict when an organization that fundamentally objects to abortion promises to help you “explore your options in a safe, confidential environment so you can make a pregnancy decision with confidence.” Graham spoke about how the organization thinks about the autonomy that patients hold. “Something that we affirm is every woman at the end of the day, it is her decision, you know, what she does, that is her decision, and so our heart for her is going to be that she does carry to term, but that’s not the decision that we can make,” she says. Unlike some CPCs, Care Net discloses on its website that they don’t perform or refer patients for abortions.
Though they can show genuine care for patients, it’s important to know that a CPC is different from Planned Parenthood and know what to expect ahead of time. Planned Parenthood’s Tacoma clinic is located in downtown Tacoma at 15th and Martin Luther King Jr Way and provides reproductive healthcare — including abortions — six days a week.