Women and their access to health care has been in the news these past few months, as the plan to replace the Affordable Care Act (ACA) made headlines for, among other things, what it potentially leaves out of women’s health care coverage. Under the bill passed by the U.S. House known as the American Health Care Act, it’s quite possible that insurance companies could revive their old rules that treated sexual assault, domestic violence, postpartum depression, pregnancy, and Caesarean sections as “preexisting conditions,” and thereby charging women who have experienced them more or denying coverage entirely.
Here in North Carolina, the news been similarly discouraging as lawmakers have mostly abandoned the idea of taking affirmative public action to promote women’s health. Remarkably, this is true despite the presence of data showing a number of poor health outcomes for the women of North Carolina as compared to other states.
Unfortunately, one “women’s health” initiative the North Carolina General Assembly has managed to find money for is the anti-abortion ministry of so-called crisis pregnancy centers (CPCs).
In 2011, the state created a “choose life” license plate, with proceeds going to CPCs (there is no corresponding plate that shows support for reproductive rights). In 2013, when sales of license plates weren’t generating enough funds, lawmakers budgeted $250,000 to fund these mostly religious centers that lure in patients who may think they are going into a reproductive health care clinic.
In 2015, despite making cuts to social safety net programs that many North Carolina women and children depend on, lawmakers managed to increase this funding to $300,000. And in this year’s budget, it appears they are appropriating $1.3 million in state general funds for CPCs, in addition to $400,000 in federal maternal health grant money.
What does this money do for the women of North Carolina? Little, if anything, that benefits their health.
The main goal of these “life-affirming ministries” (as they refer to themselves) is to stop women from getting abortions. They’ve been known to present a long list of untruths and half truths about the safety of abortion and the efficacy of birth control. I’ve personally been told the lie that “you have plenty of time to make a decision – one-third of all pregnancies end in miscarriages anyway” when stopped by CPC volunteers on the way to a clinic.
They also may try to convince the clients – again through lies and deception – that all non-procreative sex is wrong, pushing a certain conservative religious view of sexuality. And the state continues to give them our tax dollars to do it.
The CPC services, including providing home pregnancy tests, are usually free to the client, allowing the CPCs to target low-income patients with few resources to adequately navigate an unplanned pregnancy. Many of the CPCs don’t say up front they are opposed to abortion, nor do they mention they aren’t necessarily staffed by medical professionals or paid staff. They like to use the incentive of a “free ultrasound” to lure in patients, and that is in part what this $1.3 million in this year’s budget is supposed to do – “purchase durable medical equipment”, presumably ultrasounds. And because these are not medical facilities, there seems to be little oversight for how they use this equipment, what medical information they provide to clients, and what they do with any private health information they collect from clients.
North Carolina still struggles with relatively high rates of poor birth outcomes, and the state ought to be investing in programs shown to help improve those outcomes. Having little oversight or reporting requirements, there hasn’t been much evidence to suggest CPCs are part of this solution. The factors that go into pre-term and low-weight births are numerous and complicated, and we need to hold the programs we fund to higher reporting standards that reflect actual evidence a program is addressing these factors.
With approximately 20% of reproductive age North Carolina women still uninsured; the potential loss of quality labor and delivery units; and almost a third of North Carolina counties without a practicing OB/GYN, there are many ways the state can invest in healthy pregnancies, rather than diverting tax dollars to conservative religious counseling organizations that don’t offer actual medical care.
Rather than invest in CPCs, the state should use that money to better fund public health departments, rural health centers, maternal health programs, contraception access and comprehensive sex education programs that provide medically accurate information on all reproductive health options. CPCs have been around for a long time, and they have a right to exist. They just don’t need to get our tax dollars.