Reprinted from Gender & Society February 17, 2022

In 2021 the movement to oppose abortion rights experienced a banner year. By the midpoint of 2021, according to the Guttmacher Institute, state legislatures or municipalities enacted more abortion restrictions than in any other year since Roe v. Wade. In September, the United States Supreme Court declined to block Texas Senate Bill 8, a law that effectively bans abortions in Texas after six weeks and institutes a bounty system that enables private citizens to sue anyone assisting a patient seek or obtain an abortion. Beginning in December 2021, the Supreme Court will hear oral arguments for Dobbs v. Jackson Women’s Health Organization to consider the constitutionality of a Mississippi law that bans abortion after fifteen weeks of pregnancy. Widely viewed as a referendum on Roe v. Wade, the Court’s decision may drastically alter women’s rights to reproductive healthcare.

Amidst these legal rollbacks, a larger, quieter faction of the antiabortion movement works “to overturn Roe v Wade in hearts, not just the courts.”

Pregnancy centers—also termed crisis pregnancy centers (CPCs) or pregnancy resource centers (PRCs)—are non-profit, faith-based organizations that provide, in their words “alternatives to abortion.” While centers desire, in the words of one network organization, “to make abortion unwanted today and unthinkable for future generations,” they stay largely out of the legal fray. Instead, they position themselves as ministries that, like in Texas, are ready to help women when clinics that provide abortions empty. It is this concept of ‘ministry,’ that I write about in an article* recently published in Gender & Society.

What are Pregnancy Centers?

Pregnancy centers offer free resources like urine pregnancy tests, options counseling, limited obstetric ultrasounds, and material services (e.g., diapers, infant clothing, and car seats). They can provide confirmation of pregnancy that helps clients enroll in Medicaid and many refer to a network of social service providers and offer parenting classes. Some offer STI testing, medically unfounded “abortion-pill reversal” services, and unsubstantiated “post-abortion counseling.” Centers are increasingly professionalizing and medicalizing (estimates hold that approximately 70 percent now offer ultrasounds under the licensure of a physician). However, most are led, staffed, and supported by evangelical Christian women and only offer services that align with their religious worldview. Thus, they do not provide nor refer for contraceptive or abortion care, instead advocating for abstinence outside of marriage and ‘natural family planning’ within marriage. More troubling still is evidence provided by a variety of studies that pregnancy centers disseminate medical misinformation about abortion and contraception, and craft websites that obfuscate their services and mission. Though pregnancy centers are not full-spectrum healthcare providers, some receive state and federal funding.

These centers comprise a distinct movement within the broader antiabortion movement that is uniquely evangelical and gendered. While the patriarchal ideology that infuses conservative evangelical Christianity tends to keep women out of positions of power in churches and other evangelical groups, pregnancy centers are led by women who use this gendered ideology to articulate and defend approaches to abortion opposition that focus on women’s presumed needs. This approach is popular. Pregnancy centers, draw more volunteers who put in more hours than any other part of the moment. Indeed, with somewhere between 2,500 and nearly 2,800 centers across the United States they outnumber, by a wide margin, facilities that offer abortion. Despite this vast reach, most women cannot distinguish between a pregnancy center and an abortion provider and new research conservatively estimates that approximately 13 percent of pregnant people visit a center during their pregnancy. My research sheds light on these centers, by focusing on the concept of ministry and how it shapes centers’ tactics and performance of care.

Ministry Not Manipulation

Pregnancy centers identify as “faith-based” and, most centers, like the two that I studied over the course of three years, are seeped in evangelical Christianity. Centers’ founders, leaders, and supporters—most of whom are evangelical Christians—describe their work as a ‘ministry.’ And, as is typical of centers in the U.S., they affiliate with large, evangelical network associations (like Care Net, Heartbeat International, or NIFLA) that define the goals and strategies of affiliates. A key part of their ministry? Evangelism.

For instance, Care Net holds that the primary mission of the pregnancy center is to share the gospel of salvation with clients, while Heartbeat International promotes centers as an “unparalleled opportunity for relational evangelism” giving  “young women in the throes of perhaps her most trying time…a thoroughly gospel-saturated response, pairing a Christ-centered offer of hope with a real-world commitment to walk alongside another.”

Given these endorsements, imagine my surprise when I did not see Bibles handed out, tracts dispersed, or staff sharing personal testimony with clients. “Ministry not manipulation” was an oft repeated phrase in centers and at trainings that staff unpacked in in-depth interviews. They painted a portrait of relational evangelism that is uniquely gendered, a process I refer to as feminizing evangelism. In learning to practice feminized evangelism, staff—who avowedly hate abortion—come to empathize with women considering abortion on the basis of shared, gendered experiences. They articulate a unique ministry that they hope is more effective than other approaches to evangelism. However, staff consciously work to realign their deeply felt religious beliefs with practices that require them to put the Bibles away and to avoid conversion conversations.

Feminized evangelism gains more widespread support and client trust. In removing overt ‘God talk’ from appointments, centers produce a narrative of care that is grounded in social welfare and wrapped in the language of ‘empowerment’ and ‘trauma-informed care.’ While staff emphasize that they don’t hide their faith, most clients in my study did not realize the pregnancy center they visited was “faith-based” prior to their first appointment. Over the course of my fieldwork, both organizations gained secular and nonsecular supporters across the political spectrum, and solicited referrals from various secular organizations (including, unsuccessfully, a local Planned Parenthood). Pregnancy centers are not held to the same regulatory and credentialing requirements as healthcare facilities, Further, their religious orientation restricts the range of services provided and shapes how they deliver them, information that most women want to know. When that worldview is not transparent, clients cannot give informed consent to services.

Supporting people with resources that enable them to build families if, when, how, and with whom they want should be a priority for our country. Excluding contraceptive and abortion care from reproductive support does the opposite. Pregnancy centers believe that providing limited economic resources and empathetic counsel enables meaningful choices but the ability to make unconstrained reproductive choices depends equally on access to a full range of healthcare services, including abortion and contraception.

The Supreme Court’s decision on Dobbs, not expected until 2022, may restructure the landscape of abortion care. Pregnancy centers are ready to fill the void and patients. If they do, patients with few resources—those who are low income, underinsured, live in rural areas or conservative states, or women of color—will bear the consequences of religiously-based healthcare restrictions.

*This is freely available to read, download, and share through Open Access.

Kendra Hutchens is a research associate at Circle A Productions and a lecturer at the University of Colorado Boulder. Her academic research explores crisis pregnancy centers and Americans’ abortion attitudes. In the public sector, her research focuses on deinstitutionalization for individuals with intellectual and developmental disabilities.