There’s a new sort of being pregnant middle on the block
Savannah Marten is a pro-life activist who thinks like a missionary. When she became director of the Greater Toledo Pregnancy Center in 2016, she was frustrated with the suspicion that the community had no idea that she existed. So she set up her office with trendy furniture and prints of handwritten Bible verses and left immediately.
"We can only emerge and serve so far that we understand the people who walk through our doors," said Marten. She brought a neighborhood role to the local laundromat, started talking to patrons, got to know the families in the neighborhood, and spread the word about the center.
She started hopping nearby in the church. She networked with local organizations, shared common concerns for Lucas County, and offered to work with or work on their boards. She worked with hospital systems to provide direct access to the center with more than a dozen women so that pregnant clients could see obstetricians earlier in their pregnancy – a proven factor in combating child mortality.
It's been a few years, but Marten estimates that she still spends about half of her working time outside of the center. Although she was not new to advocacy for life or the Movement of the Pregnancy Center when she took up the job as a director, she was willing to listen to her community and try new strategies. This approach was a critical part of the center's success – it has seen a 22 percent increase in customer numbers last year alone – and could be the key to making pregnancy centers more effective for a new generation.
The Greater Toledo Pregnancy Center opened in 1984 as part of a wave of centers that have emerged across the country in the past decade after the Roe Supreme Court ruled against Wade. After the landmark abortion verdict, "We were attacked by the pro choice side and said," You don't care about women, "said Roland Warren, current CEO of CareNet, one of the largest networks of pregnancy centers in the United States the recoil changed the Christians who stood up for life from protests and reactions to services and actions.
Pregnancy centers – sometimes referred to as "crisis pregnancy centers" or "pregnancy resource centers" – made up a large part of this response. Her original mission was profound, but straightforward: to save babies. The philosophies were different in the 80s and still do. Some centers face evangelism, while others keep their faith in the background. Some offer certain medical services, but most rely on a voluntary guidance model.
Over the decades, these pregnancy centers – now more than 2,000 in the United States – far more than abortion clinics – have cared for hundreds of thousands of women and babies despite external controls and legal challenges. Critics have accused them of being misleading (because they do not provide abortion recommendations), of being forced or proselytized. They have also borne the brunt of criticism of the pro-life movement as a whole, which focuses solely on saving lives in the womb, rather than addressing the factors that lead to an unplanned pregnancy at all.
The narrow focus was something that frustrated Angie Weszely and Denise Stein when they ran a center in Chicago. The expectations led to too much baggage between the consultants and their customers. They saw well-meaning Christian volunteers who were in the fog of their pro-life checklists: will she keep the baby? Have we shared the four spiritual laws?
A wave of new leaders is realizing that some of the best strategies for pregnancy centers – opening a gospel tract or printing a sonogram – may not be as effective as they or their predecessors thought. With many of the founding generation directors retiring, younger Christians have begun testing new ways to care for women and reduce the demand for abortion.
This shift may be due in part to the need. Last year, a New York study in rural pregnancy centers found that only 4 percent of the women they visited gave instructions on whether to have their baby or have an abortion. A majority, the magazine said, wanted social services and pregnancy tests required to sign up for Medicaid.
Some centers adjust their offerings and offer pregnancy tests, screenings for sexually transmitted diseases and even contraceptives. Others stick to pregnancy counseling, but adapt their language and facilities to a different clientele.
The landscape has challenged the Pregnancy Center movement to take a closer look at its mission of prioritizing spiritual salvation or abortion prevention and how far it should go to achieve it. At the end of abortion, many Christians look for factors that can plunge pregnancy into a crisis: poverty, social isolation, inadequate medical care, and the lack of a committed partner.
Weszely and Stein were co-founders of the ProGrace Ministry to separate abortion from politics – especially the pro-life and pro-choice labels – and to equip churches to support women in crisis pregnancies before they go to a clinic. Other Christian organizations that are inspired by their beliefs about life and family use resources that go beyond what a pregnancy center could offer.
Overall, the church's response is becoming more strategic, holistic, and inclusive – a joint venture that goes well beyond a center itself.
In Toledo it started with color.
When "a bunch of middle-aged white women who don't live in the neighborhood" made all the decisions, "it looked like Joanna Gaines had set up the center," said Marten. "But what we heard from our customers was that it felt like a hospital."
Marten was a stylish, fast-talking 30-year-old with a pixie cut and a big smile. The cultural struggle did not prevent him from reaching women in need. She hired leaders from Toledo’s African American and Latin American communities to serve on a cultural literacy advisory committee.
Picture: Eli Lindauer
The members agreed to a two-year term in which they would advise the center on everything from facility to paperwork. The counselors did not have to be Christian or friendly. They just had to understand that the center was both and willing to help.
On her recommendation, the center is now based on the colorful wall paintings in the neighborhood, and hardly two walls have the same color. The lobby is a peaceful forest green. In one of the customer rooms there is a huge, multi-colored flower picture, which was painted by students of the Toledo School for the Arts. Others have modular neon furniture and inspiring prints on the walls ("You're a great woman!").
The committee also advised the center to clear out the chairs in its cozy lobby – women who live in poverty often need to protect their personal space and may feel uncomfortable sitting near someone else. The center switched the documents for admission to mobile-friendly online forms and postponed the questions based on the feedback from the consultants.
"We found that we asked about the baby's father before we asked about rape and sexual abuse," said Marten. The center's documents now ask about abuse. Marten said it helps counselors see whether it is appropriate to raise partner support or marriage, or whether a counselor could instead encourage a woman to speak to the police.
The small changes make a big difference. In 2019, the center saw an increase in appointments by 22 percent, performed 200 additional ultrasound exams, and increased participation in parenting courses by 8 percent. A larger proportion of the clientele came back on several visits to enable employees to develop deeper relationships – and to give them more chances to show them love for the gospel.
Over 500 women who came through the doors had a baby last year, and the staff only know 8 who have had an abortion.
For the second time this year, Marten is bringing what she learned in Ohio to a national CareNet conference and encouraging her colleagues to add their own cultural skills consultants.
Racial Health Distortions
Down in Dallas, Cessilye R. Smith started Abide Women's Health Services for colored women. In an area south of downtown that some call South Dallas, some call Fair Park, and some, like Smith, call "the hood," she has undertaken to expand the movement's work for a near-life pregnancy center by targeting infants and mothers applies mortality to colored women.
According to the Centers for Disease Control and Prevention, black babies in the U.S. die almost twice as often before their first birthday as white babies, and African American and Native American women die almost three times more often than white mothers during pregnancy or after childbirth.
Combating racial prejudice in healthcare is a top priority for Abide, and Smith believes that this must be a larger part of the entire pregnancy center movement. She said that if black women show up in hospitals to give birth after failing to see an obstetrician regularly during their pregnancy, doctors may make assumptions that affect their standard of care. For example, they might think that black mothers are not so interested in breastfeeding and do not provide robust breastfeeding support, or that they are addicted and reduce their pain relievers.
Photo: Brianna Davila / Courtesy of Cessilye R. Smith
Since Abide opened its doors in 2017 and offered free birth preparation courses, self-help groups for young mothers, and breastfeeding education, 90 percent of its customers have been black or Hispanic. Most of the employees are also colored women, and the 25 women who volunteered last year started training with implicit bias, cultural humility, and diversity.
Smith has changed her own approach to pro-life activism. It no longer repeats the statistics on black abortion rates. Instead, she points to the factors behind it and to the racial differences in care by campaigning for Christian justice such as the And campaign for maternal justice.
"When the public sees that the pro-life movement is struggling to end abortion without looking to the roots, you always get the side eyes of the black community," she told Catholic theologian and ethicist Charles Camosy.
The aim of both is to open a free maternity health clinic next year and eventually create a birthplace for women in color. In the meantime, Smith – whose birth inspired her to become a doula – offers scholarships for books, classes, and even bills for black students who want to become licensed midwives. The involvement of midwives and doulas (non-medical job assistants) correlates with better birth outcomes, but women with skin color have far less access to such support. Black and Hispanic women currently make up less than 5 percent of licensed midwives in the United States.
Care after nine months
Tammy Abernathy also has a personal relationship with the women she wants to look after at the Hope Women’s Center in Phoenix. After raising her own children as a single mother, she became involved in the ministry to better support women in similar situations.
In 2013, she led a network of four regional centers that moved away from the medical offerings highlighted by others in the movement (think of ultrasound technicians and referrals from doctors) to instead provide a wider range of counseling support.
"Women came up with so many other coexisting things they were dealing with," said Abernathy.
Her team is trained in trauma-informed care and works with women and adolescent girls who deal with poverty, domestic violence and unwanted pregnancy – often all at once. Because of Hope's broader scope, Abernathy is returning to a higher percentage of customers for ongoing support than she did in her previous work at a more traditional pregnancy center, she said.
Picture: Steve Craft
Hope is part of the ProGrace network, which focuses on long-term contacts so women have a place to go both during and after pregnancy.
ProGrace founders Weszely and Stein work with eager churches with pregnancy centers. They are clear in their belief that while the organization is not campaigning for an abortion and declaring that "God's plan for pregnancy was to connect a woman and a child," they believe that "Christians need a way to do it." the church is a safe place to respond that is outside the debate, ”said Weszely.
For churches, this means that pastors must recognize that women in their congregations are very familiar with abortion – this is not just "outside" of the church – and that Christians who are against abortion do not see politics as the only solution. For centers affiliated with ProGrace, this means no "pro-life" or "pro-choice" talk, no marches, no supporting candidates. For Abernathy, the ProGrace paradigm allows her to focus on the women in her centers, not the surrounding politics, she said.
The question of evangelism
Evangelicalism has historically dominated the pregnancy center landscape, and the vast majority of today's centers are linked to Protestant networks and churches. But even among Christian centers that share basic beliefs, networks can have different approaches when and how to receive the gospel.
CareNet, with its network of more than 1,130 Christian pregnancy centers, uses the mantra to be not only for life but also for life in abundance. Their leaders want families to be transformed through their relationship with God and the Church. However, partners are not required to share the gospel with every customer. The hope is that it would come organically.
There are no Christian symbols or Bible verses in the public space of Marten's center in Toledo. But her office is full of it ("Be quiet and know that I am God," it says in a print above her desk). Her conversations are peppered with scripture in a way that sounds less like a script than more like the wisdom she received from a friend.
"The gospel is so deeply rooted in everything we do," she said. "But for us the form is as important as the message." Marten shares the CareNet philosophy: do not start by opening a tract. First meet the women.
The same applies to another network, Heartbeat International. The 2,500 member organizations list relationship building as a prerequisite for spreading the gospel and train volunteers to "listen and learn" first.
On the other side of the debate is Hope National, an association founded by the co-founders of the National Institute for Family and Life Lawyers (NIFLA), Jim and Pat Dundas. Hope National's handbook reads, “In some voluntary pregnancy center training programs, the instruction was to make the gospel of minor importance and / or to advise the client. This is in direct contradiction to the teaching of Christ. "
In certain circumstances, focus on evangelism can cost federal funding for pregnancy centers through the Title X Family Planning Program if more are looking for a partnership with state maternal health programs. Some Title X centers violate Dundases' approach to comply with federal guidelines: they wait until after a customer's visit to ask permission to spread the gospel.
Believe in the background
Whether centers give priority to evangelism affects other aspects of their work, including the use of contraceptives. Christian pregnancy center networks have traditionally avoided this and fear that it implicitly supports sex outside of marriage. However, some who act as an alternative to planned parenthood believe that it can reach more women.
The Source, a network of eight Christian pregnancy centers in Texas, made headlines late last year when it announced plans to offer hormonal and other birth control services at its centers.
Source CEO Andy Schoonover said the strategy is designed to reduce unplanned pregnancies (and thereby reduce the demand for abortion). "Women who are sexually active and who do not use contraceptives have an abortion about eight times more likely than women who use contraceptives," he said, citing CDC data.
The network also sees the use of contraceptives as a way to build relationships with women in their local communities.
"If you don't get it from us, you'll go somewhere else to get it," said Schoonover. "Do we want to develop and maintain this relationship with the patient, or would we prefer another organization that is most likely not ideological to develop this relationship?"
In New York City, where the abortion rate is twice that of the rest of the country, a pregnancy center called Avail strategically distances itself from evangelical pressure and expectations. Avail calls itself a non-profit organization "with a Christian focus," but says its goal is to provide women with a supportive place where they can take a breath and make a decision – without fluctuating towards or from a specific outcome.
"If you are facing an unexpected pregnancy, you may fear being judged or put under pressure," says Avail's website. “At Avail you will find the opposite. Our employees and volunteers strive to treat others the way they want to be treated and are not judgmental, respectful and supportive. “The strategy is designed to make women feel welcome in what is possibly the most progressive city in the country. (The ProGrace team gave personal training at Avail last year.)
In the offices in Times Square, Avail also invites men to participate in the decision-making process for unwanted pregnancies. Male counselors meet individually and offer support after an abortion. This approach is also used nationwide through CareNet, which now offers male reach in 65 percent of its centers. After the research found that the biggest influence on a woman's decision to have an abortion was often the man who made her pregnant, CareNet's Joseph Project partnered with the National Fatherhood Initiative to help more men get parenting courses and mentoring to win.
Abortions next door
The Greater Toledo Pregnancy Center also runs an abortion counseling center called Haven House. Like the center, the Haven also strives to work with its neighbors – even though it is next to Toledo's only remaining abortion clinic and only a narrow parking strip in between.
Others may not have the same situation with the location, but it is easy for Christians in pro-life services to feel surrounded by the right to abortion movement. Abortion clinics close at record rates, but Americans are becoming increasingly supportive of abortion.
Some pro-life activists have focused their efforts on the legal area or protests against the remaining clinics. But like those who moved to Roe v. Wade has launched, the heads of the Pregnancy Center today feel deeply called to improve the lives of women facing unwanted pregnancies and in urgent need of help.
They want to do more than bring a woman in and show her an ultrasound or offer her a gospel tract. (Most customers, Marten emphasizes, are already mothers and know the reality of the beating heart in them.) The ministries ask these women bigger questions like "What do you need?" and come in to help.
The pregnancy center movement is increasingly not just about the baby or even about the baby and mother, but about the whole family, the neighborhood and the community.
Every now and then an ignorant woman comes to the port in Toledo to look for her abortion date next door. In the interest of honesty and maintaining a positive relationship with the abortion clinic, Haven employees reluctantly forward these women to the building across the parking lot.
"But we also tell them we don't think they accidentally went through our doors," said Marten, who has made some progress in pro-choice circles and was named Woman of the Month by a feminist group in Toledo last year has been .
Before the erroneous woman leaves the port for her appointment, she is asked if she wants to talk about anything and is invited back.
Marten and her team seriously pray to see them again. They pray that they have done enough to earn their trust. And like former and current employees of pregnancy centers, they mourn every lost baby and every woman changed forever.
Maria Baer is a CT author and lives in Columbus, Ohio.
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