By Elizabeth Thompson

Texas’ ‘near-total’ abortion ban sent shockwaves throughout the country after the Supreme Court rejected emergency requests to block the law. Implementation of Texas’ SB 8 is calling into question whether the access to legal abortion decided in Roe v. Wade would be put to the test in other states’ legislatures.

In North Carolina, advocates say legislatures aren’t only taking action against abortion through “heartbeat” bills like the one in Texas. North Carolina is one of 14 states that sends taxpayer dollars to “crisis pregnancy centers,” facilities that offer pregnancy tests and ultrasounds but also seek to dissuade pregnant people from getting abortions.

This year’s North Carolina House budget includes about $9 million in funding to crisis pregnancy centers, compared to the Senate budget which allocates about $3 million.

Advocates, providers and some Democratic politicians have criticized the allocation of funds for further eroding reproductive health care, while Republicans and anti-abortion advocates argue the funds bolster community programs that help pregnant people.

Medical providers?

Most crisis pregnancy centers are religiously affiliated, and some studies have found that they give inaccurate medical information when it comes to the risks of abortion.

“Crisis pregnancy centers exist for one purpose: to prevent a person from obtaining a safe, legal abortion,” Planned Parenthood’s North Carolina Director of Public Affairs Susanna Birdsong said in an August press release. “They intentionally spread misinformation and outright lies to confuse and manipulate people facing an unwanted pregnancy. They are generally unregulated and unlicensed and target people with low incomes.”

The organizations themselves argue that they give someone who’s pregnant access to information and resources to make the choice of whether to continue the pregnancy or not, with the goal of preventing that person from getting an abortion.

Amy Bryant, assistant professor of obstetrics and gynecology at UNC Chapel Hill School of Medicine, said even though crisis pregnancy centers may look like legitimate clinics, Bryant’s research found that many are not licensed, something she concluded was “unethical.” 

“They want to be medical centers that offer free health care and all the support,” Bryant said. She noted CPCs can’t be legally held to the provisions of the Health Insurance Portability and Accountability Act (HIPAA) and they are mostly staffed with volunteers who are not medical professionals.

”They’re not regulated like regular health centers are, and they are protected under the First Amendment to be able to say what they believe,” Bryant said in an interview. “They get to have it both ways.”

While many of the earmarks for crisis pregnancy centers are direct grants that do not specify what exactly what the money will be used for, some funds allocated in the House budget for crisis pregnancy centers specify that they are to purchase ultrasound equipment, such as the $400,000 in appropriations that would go to the Cabarrus Women’s Center and $255,000 to the Salem Pregnancy Support Center, Inc., also known as Salem Pregnancy Care Center, for renovations and equipment.

The biggest budget allocation for a crisis pregnancy center found in the House budget is a provision for a total of $6.4 million in funds to Texas-based Human Coalition toward the statewide expansion of the Continuum of Care Pilot Program, which is designed in part to “support childbirth as an alternative to abortion,” according to the budget. The Senate budget allocated $2.4 million to the same program. 

The News & Observer previously reported that the North Carolina Department of Health and Human Services could not recommend allocating more money to Human Coalition in 2019,  since the group did not provide the information needed to determine the effectiveness of expanding the model it used at a Raleigh clinic.

The funds allocated in the budget will go to using licensed nurses to assess pregnant patients’ needs and the “provision of medically accurate, pregnancy-related medical information to program participants,” both budgets say.

The program will also refer patients to “appropriate local resources, including State and federal programs and local charitable organizations” and assist patients in applying for those programs.

“These funds shall be used for nonreligious, nonsectarian purposes only,” both budgets say of the funds allocated to Human Coalition.

In response to State Rep. Julie von Haefen (D-Apex) calling the centers “fake health care facilities” in a tweet, Sen. Joyce Krawiec (R-Kernersville) who chairs the Senate Health Care Committee told her to look again.

“No money goes to fake healthcare clinics like Planned Parenthood,” Krawiec tweeted.

North Carolina Health News reached out to Krawiec, as well as chairs of the House committee for Appropriations for Health and Human Services and Speaker of the House Tim Moore for further comment over several days, but did not receive a response from them by time of publication.

North Carolina was also one of 10 states that used money from the federal Temporary Assistance for Needy Families (TANF) program, known colloquially as welfare, to fund crisis pregnancy centers, The Guardian first reported based on investigative research by the accountability group Equity Forward.

Access to reproductive health care

North Carolina has “severely restricted access to abortion,” according to NARAL Pro-Choice North Carolina, and abortions are only available in a handful of cities. While there are 15 abortion clinics in the state, there are 83 crisis pregnancy centers, according to the online Crisis Pregnancy Center Map.

Von Haefen, who has been pushing to reduce the state funds to these centers, said the state could better spend the money it’s putting in them, in an interview with NC Health News.

“These unintended pregnancies result in billions of dollars in healthcare expenditures,” Von Haefen said. “By averting unintended pregnancies, we can actually save money and health care. If we really want to look at healthcare spending, the better way to do it is to prevent the pregnancy on the front end rather than dealing with it on the other side.”

While there are many pregnant people who are not considering abortion who could receive help from a crisis pregnancy center, Bryant said they “shouldn’t be privileged over other providers who actually provide comprehensive health care, like Planned Parenthood and other providers.”

As budget deliberations continue, nothing is quite set in stone. Moore and Senate President Pro Tempore Phil Berger continue to negotiate on a compromise budget which they hope to show to Gov. Roy Cooper in the fall.

The state limits the funds that can go to abortion providers, such as Planned Parenthood, in both the House and Senate budgets. An innocuous budget provision, which first appeared in the 2015-2016 budget and is included in this year’s House budget proposal,  prevents any provider that performs abortions from receiving contracts for health education, teen pregnancy prevention services and Medicaid reimbursement.

In the past, Gov. Roy Cooper has vetoed several anti-abortion bills. Most recently, he vetoed a bill that would ban providers from performing an abortion due to a Down syndrome diagnosis. Putting funding for crisis pregnancy centers in the state budget is likely the only way to have that funding signed into law.

Even though North Carolina has not passed Texas’ “heartbeat” law, Von Haefen said she fears “a constant chipping away at our reproductive rights.”

“Abortion is still legal in North Carolina, but the fact is it’s extremely difficult to access,” Von Haefen said.

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Elizabeth Thompson is our Report for America corps member who covers gender health and prison health topics. Thompson is a UNC Chapel Hill graduate who has covered Texas politics for The Dallas Morning...