Centers increasingly look just like doctor's offices with ultrasound rooms and staff in scrubs. Yet they do not provide or refer for contraception or abortion. Many pregnancy-center counselors, even those who provide medical information, are not licensed. And even some workers who are licensed, such as nurses and ultrasound technicians, repeat myths about abortion and contraception. Last year, I attended Heartbeat International's annual conference, where nurses told me that birth control "introduces too many chemicals into your body" and that women "never recover" emotionally from abortion.
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All of this is supported by tens of millions of federal and state dollars. At least 11 states now directly fund pregnancy centers, according to state contracts and contractor websites. Many states refer low-income pregnant women to anti-abortion centers on health department websites, as well as in "informed consent" materials that abortion providers distribute to patients.
Few states, however, have any laws regulating how pregnancy centers interact with women. Unlike other mental-health providers, center counselors are generally not bound by professional standards or malpractice laws. In many cases, the anti-abortion organizations that run the centers — not state employees — monitor their own work.
South Dakota has gone the farthest. As part of its 2011 legislation, the state required all women seeking an abortion to first visit one of two state-approved anti-abortion centers. One is the Care Net in Rapid City — the center that Nicole visited. The other is the Alpha Center in Sioux Falls, run by a longtime anti-contraception and anti-abortion activist. A district court has put the law on hold and is deciding whether the state has the right to force women to visit anti-abortion centers. As the judge evaluates the arguments, women across the state — and country — walk into pregnancy centers in search of free medical services. Some, like Nicole, are savvy about the centers' true goals. They also know they have no better option.