‘A well-kept secret’ : How pregnancy counseling centers influence choice

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By Akshay Seth, Managing Arts Editor
Published April 1, 2014

“We can see, currently, several hundred visitors a year — something like 300 or more, and me only being here 18 months, I personally think we’re a well-kept secret,” responded Iris Proctor when asked about Arbor Vitae, a pregnancy counseling center, and its relatively low level of notoriety.

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Arbor Vitae is tucked away — almost hidden — in plain sight, down a flight of stairs in the basement of the building shared by the Starbucks on East Liberty. The center has been in its current location since 2008, starting off as the Problem Pregnancy Help, Inc. — PPH — in 1972 and working out of Ann Arbor’s Father Pat Jackson House, a still-active Catholic social-services establishment that supports pregnant teens.

The assistance that Arbor Vitae offers doesn’t include contraception or a morning-after pill. Instead, the center acts as an outlet to those seeking advice, and advocates taking a pregnancy to term before deciding to move forward with other options, like an abortion. At the outset, PPH doesn’t profess to offer any medical assistance, opting only for counseling sessions and free material goods.

“We were started by a mom (Patricia Kay) with five kids who had never worked outside her home,” said Proctor, Arbor Vitae’s executive director. “She wanted to be able to support women who she knew were going to be making a difficult choice, and she wanted to help women who were going to choose to parent knowing that they may be on their own.”

Gradually, PPH expanded into a newer location on Packard Road and became known as the Pregnancy Help Center. On Packard, the organization began to see a gradual increase in visitors until, finally, its board of directors decided to move to its current location, closer to the University’s campus, in order to respond to the need for crisis pregnancy intervention. In the new space, the center adopted its current name.

“We started out primarily giving out free material goods, and before we moved here, we realized women needed medical information to make that decision,” Proctor said, referring to the decision to terminate a pregnancy. “So we became a medical-based women’s health organization, hence having medical professionals on staff and offering ultrasound for all the hours that we’re open.”

However, many groups who advocate for the access to abortion believe these ultrasound services exist to convince women not to terminate their pregnancies.

Proctor went on to clarify that Arbor Vitae exists to empower women.

“We simply think having more information before you make such a significant choice is really important,” she said.

“Being in a safe environment with qualified counselors and being able to come to your own, mindful decision is empowerment.”

The staff of nurses at the center are trained to use the sonogram, and must have received medical training in order to be hired as volunteers. However, the center is not allowed to refer its patients for an abortion.

“We really do believe, as an organization, one of the healthiest things you can do for a woman who has a positive pregnancy test, is she can carry a child to term,” Proctor said. She added that clinics that provide abortions have “excellent marketing,” and Arbor Vitae would never change its policies to allow abortion referrals.

When asked whether or not the center also offers advice that advocates abortion or takes a stance in the right-to-choice debate, Proctor was quick to point out that rhetoric such as “debate” and “argument” doesn’t enter Arbor Vitae’s office space.

“Every woman has her own journey, and politics has no place in it,” Proctor said.


Arbor Vitae
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The abortion debate has been in the national spotlight ever since the beginning of the 20th century, coming to a boiling point near the 1960s. By the end of that decade, consensus emerged that many of the health concerns associated with the procedure were exaggerated. All the while, the women’s rights movement grew, with the right to choice becoming a rallying point for those who believed women should not be bound by government regulation in questions concerning their own bodies.

In a 1967 pamphlet distributed by the National Organization for Women and currently archived at the Bentley Historical Library, activists who sought legalized abortion stated “a woman’s right over her own body deserves greater precedence than the rights of an unborn fetus, and any attempts to manipulate that woman’s access to safe abortion is a mechanism of sexism.”

The landmark 1973 U.S. Supreme court decision in Roe v. Wade mandated that women, under the protection of their due process rights, are able to get an abortion under certain guidelines. An added clause required that all abortion practices are balanced against the state’s responsibilities to protect the life of the baby and the mother.

Activists who advocate against access and the legality of abortion, often with the backing of various religious organizations, saw the ruling as an infringement upon the sanctity of human life.

“It is in God’s name that we must strive forward to protect the lives of those too young to protect their own,” read a 1974 memo drafted by Right to Life of Michigan — accessible at the Bentley Library.

Proctor was quick to point out Arbor Vitae doesn’t endorse any religious or political agendas when offering counseling services to its patients, stating that there is absolutely no religious context to the information they provide.

“It’s about her. This is not a debate. It’s not political. It’s about her,” she said.

“That’s just not true,” said Public Policy junior Carly Manes, former president of the University’s Students For Choice chapter, of Proctor’s claim.

Manes said that while there are around 2,000 abortion clinics in the nation, there are more than 4,000 crisis pregnancy centers, like Arbor Vitae. In many cases, these CPCs started with religious backing and continue to staunchly adhere to those religious beliefs.

“They market themselves as a place where they have free services for women who are sexually active and who might be pregnant,” Manes said. “And yes, they have these free services and they have pregnancy tests and ultrasound testing, but the whole point is to get you in there to convince you to not have an abortion.”

Manes described how the pregnancy tests used at the center are no different than ones available at a local CVS. The staff of nurses at the center are trained to use the sonogram, and have to have received medical training in order to be hired as volunteers — but there’s a catch.

Though Proctor described how Arbor Vitae strives hard to look past the “debate” raging outside the doors of its office space, religion has a history within the counseling center. On its website, Arbor Vitae links to a story specifying the struggles of a mother who faced pressure from a doctor to carry out an abortion when the procedure wasn’t warranted.

Throughout the account, the author references God and Christianity, including verses from the Bible. Ultimately, the doctor in the story informs the mother she will have to deal with a lifetime of health complications if she decides to go to term with the pregnancy.

The 1,000-something words show how both religion and medicine have an influence on women across America.

Arbor Vitae’s dissociation with abortion can be partly explained by the makeup of its board of directors. The two licensed doctors Arbor Vitae has on its board, Dr. Phillip Fleming and Dr. William “Rusty” Chavey, both have many ties to religious and medical groups that oppose abortion. The pair served on the board of directors of the Catholic Medical Association, with Chavey running a call-in radio program called Vital Signs where listeners could call in to discuss the science surrounding the Catholic Church’s position on various medical practices including abortion.

“I think it’s great they give out free pregnancy tests and what not, but they’re never really telling the women that they’re a religious organization,” said Sydney Gallup, a recent LSA graduate who was a former president of the University’s Students For Choice chapter and currently oversees interns for South-East Planned Parenthood.

* * *

From a historical perspective, the number of abortions in Michigan has been dropping ever since the introduction of the practice in the early 1970s. The year-to-year drop-off rate peaked in the ’80s, and continued to increase rapidly until 2000, before stabilizing around 23,000 abortions per year. Though theories about why this rapid fall occurred over this 20-year period are widespread, the obvious answer is the increase in quality and availability of contraceptive techniques.

“There’s no question about it — birth control played a major role in the fall,” said Ed Goldman, an associate professor in the Department of Obstetrics and Gynecology.

Within the OB/GYN Department, Goldman oversees the program on sexual rights and reproductive justice, and in May 2013, hosted an interdisciplinary conference on international reproductive rights.

Goldman believes birth control, which Arbor Vitae does not provide access to, is the single most important point of the reproductive rights debate.

Around the early 1970s and ’80s, doctors started developing “morning-after” pills that allowed women to avoid the risk of unwanted pregnancy after unprotected sex. Usually, the pill or “regimen” requires women to take small doses of estrogen over the course of a few days in order to delay ovulation.

Studies conducted overseas found these new techniques — namely the Yuzpe regimen — to be highly effective, but the FDA stalled approval. The delays occurred because of pushback mainly from advocates against the legalization of abortion — factions that claimed using a morning-after pill was equivalent to getting an abortion, or in worst-case scenarios, the regimen could be abused to harm pregnancies in their later stages.

In a 2012 studypublished in Obtetrics & Gynecology and carried out near the St. Louis metropolitan area, 9,000 women, ages ranging between 15 and 45, were provided free birth control. Researchers then monitored the number of women who chose to terminate their pregnancies over the course of two years and saw a drastic decrease in abortions inside the city. Nearby Kansas City, where contraception wasn’t handed out, showed no significant changes. Critics of the study have suggested the free availability of contraceptives can cause riskier sexual behavior. In the long run, it may even lead to an increase in unplanned pregnancies and abortion because of access to the contraceptives the study identifies as not very effective.

Despite numerous reports showing a clear difference between morning-after pills and ingestible abortion pills, many advocates against access and legality of abortion still consider emergency contraception to be a diluted or indirect form of abortion.
Rather, the availability of regimens such as Yuzpe, has been shown to reduce the need of induced abortions in traditional clinics.


Arbor Vitae
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In the case of women who have already gotten an abortion, Proctor said Arbor Vitae is willing to provide free counseling services for women struggling with after-effects. In fact, while looking for volunteer counselors, Arbor Vitae only hires candidates who self-identify as people advocating for access and legality of abortion — “pro-abortion to the degree that they would have an opinion on the subject should a woman walk through the door,” Proctor said.

According to Proctor, people vehemently against access to abortion would be unable to provide proper guidance due to the risk of patient interactions getting too political.

Goldman explained how, over the last few decades, the proponents against the legality of abortion have modified their stance to become more effective in accomplishing their goals. He noted how closely these modifications follow the principles of economics.

“At first, they tried to work with the demand side of the equation, adding mandatory waiting periods before getting the abortion, forcing patients to look at ultrasounds — a lot like what Arbor Vitae does,” Goldman said. “That didn’t work. The number of abortions didn’t really change because women still wanted them.”

“So now, they’re trying to pass new laws that mess with the supply side,” he continued. “Clinics in Texas are closing because of these policies that require them to be a certain size or be a certain distance from hospitals.”

In Michigan, new policies — namely a bill passed in 2014 — now require women to buy an additional insurance rider to be protected from the costs of abortion. The law, in many cases, goes as far as to nullify already existing policies, making it increasingly difficult for women in poverty to get the services they need.

“It’s the type of system that always sees the poorest people suffering,” Goldman said. “No one looks after the women sleeping under bridges.”

* * *

As she gave a tour of the florally scented, windowless office space, Proctor stopped to show off the fully functional ultrasound machine. A few minutes earlier, she had explained how the center exists for the women who have a difficult time after getting an abortion, in which cases they provide free counseling.

Proctor emphasized that her role at Arbor Vitae is to prioritize people through such counseling, rather than external debate.

“It's a big topic in our culture ... this question about abortion,” she said. “Often, my questions revolve around (focusing) on people. A lot of people come through those doors. Each story is different. Each woman is different. And as you draw her out — and again, not every woman — but there are some that need the support to know their own strength."