As the legislature muddles its way through another contentious and lengthy budget process, one thing that remains painfully clear is that comprehensive reproductive healthcare — including affordable access to contraception and pre- and postnatal care — is still not a priority for some elected officials. This unfortunately seems to be what we can expect from a gerrymandered legislature that continues to treat this vital form of healthcare, especially for women and people who can get pregnant, as a political and ideological issue rather than an issue of health, safety, and economic security for families across the state.
As one of only 12 states that still stubbornly refuses to expand Medicaid, North Carolina received a “D” on the status of women’s healthcare in a 2019 report, with 13% of women in the state uninsured and the 11th highest infant mortality rate and 10th highest sexually transmitted infection rates in the country. Our state also has lost at least 10 labor and delivery units since 2013, particularly in rural areas, during the decade that our legislature has not meaningfully addressed the lack of access to affordable healthcare.
There has long been a clear and pressing need for access to quality, affordable reproductive health and maternity care in the state, but for the last decade legislative leadership has focused on:
- Defunding reproductive safety net healthcare providers,
- Attacking comprehensive sex education, and
- Restricting access to both abortion and contraception.
One consistent budget allotment that makes clear the legislative leadership’s view of reproductive healthcare is the increasing amount of public dollars that have been funneled into anti-abortion fake clinics, otherwise known as “crisis pregnancy centers” or CPCs. While it’s often couched under the generic euphemism of “helping women,” the purpose of these fake clinics is unmistakable — toend access to all abortion by spreading anti-abortion and anti-choice propaganda and harmful myths and inaccuracies about sexuality, family, pregnancy, and gender roles.
CPCs deliberately misrepresent themselves as healthcare clinics, despite typically offering few substantive healthcare services. Having been provided direct funding from our state for almost a decade, it’s still unclear if or how they contribute to improved maternal and infant health outcomes. Their own reports to the state have often included broad, vague, and inconsistent metrics like the number of people seen, “educational events,” and referrals made; or generic “employee expenses” or the number of products and trainings purchased from anti-abortion organizations. Despite their claims, there is little evidence we’ve seen from these publicly funded fake clinics that they are improving actual healthcare outcomes.
Their websites often provide no additional evidence of their healthcare activities. While stating they provide “non-judgmental care,” what typically follows are pages of medically inaccurate information about abortion, pregnancy and contraception and language designed to shame people who have had abortions. While CPCs sometimes offer people access to baby care items, often used as incentives for their programs, these are not a substitute for quality prenatal and postpartum care. Coercing and shaming people into not accessing abortion or contraception, an obvious goal of CPCs, has no place in an equitable and patient-centered healthcare system.
One concrete number you may see from CPCs is how many people they claim to have diverted from accessing abortion. In addition to not knowing anything about how that outcome is measured, such actions do not constitute healthcare and tells us everything we need to know about CPC priorities – priorities they expect us to fund through our public health dollars. There is a longstanding and urgent need for affordable access to services for people in North Carolina who are experiencing an unplanned pregnancy, particularly people who have not had access to affordable and consistent quality, comprehensive healthcare. Surely the money being diverted to CPCs could be better used funding evidence-based, proven healthcare and safety net services.
Our goal as reproductive healthcare advocates is to make sure all people have the information, resources, and support they need to make decisions that are best for themselves and their families, including the decision to have an abortion. CPCs operate from an opposite stance. These fake clinics don’t take reproductive health any more seriously than the anti-abortion, anti-equity leaders at the legislature. Whether it’s false or co-opted narratives of reproductive oppression, misleading claims of providing actual healthcare, or moral justifications for the harm of deceiving or blocking people from seeking abortion, access to reproductive care is just one more political football anti-abortion lawmakers use to gain and keep power, creating a state that is neither responsive to the needs of its residents nor representative of its constituents’ priorities.
Tara Romano is the executive director of NARAL Pro-Choice NC.