I am sitting in a room full of rubber uteruses and ultrasound pictures, next to a woman who wants me to carry this baby to term, waiting for the nurse to come back in and tell me that I'm not pregnant. I'm a patient at ZoeCare.
Recent headlines about the Ravalli County Commission's refusal of Title X money that would fund essential healthcare for 400 Montanans have once again turned our sight to the changing landscape of healthcare—and especially women's healthcare—in the United States. This most recent maneuver, which will deplete the coffers of the already under-funded Ravalli County Health Department, is just one of thousands of skirmishes being fought nationwide over women's healthcare. These tidings coincide with the news that Dr. Susan Wicklund's abortion clinic in Livingston will be closing its doors, leaving only five clinics offering abortions open in the state.
While the War on Women is being waged in towns across the country and in the U.S. Congress, one type of pregnancy care is thriving, including here in Bozeman. A growing trend worldwide, "crisis pregnancy centers" (CPCs) are non-medical or slightly medical facilities that offer free pregnancy tests, ultrasounds, and limited options counseling for women.
Unlike clinics such as Planned Parenthood or Bozeman's BridgerCare, which offer information about abortion, adoption, and parenting, crisis pregnancy centers are "fake clinics run by people who are anti-abortion. They have a history of giving women wrong, biased information to scare them into not having abortions" (source: Planned Parenthood) Bozeman's own CPC, ZoeCare, is supported by Heartbeat International, a Christian organization that works, according to their own website, to intervene in the lives of women "who are at risk for abortion," persuading them to carry their pregnancies to term. Their "Life-Saving Vision is to make abortion unwanted today and unthinkable for future generations."
ZoeCare, like many CPCs, puts out the public image of being a women's healthcare clinic. Indeed, many college students at Montana State University are unaware that ZoeCare is funded by religious groups and doesn't provide the same services as Planned Parenthood or BridgerCare. It bills itself as a facility "committed to providing you with accurate, current information and options," these options being parenting and adoption. Their other website frankly states, "We do not offer, recommend, or refer for abortions or abortifacients but we are committed to offering accurate information about abortion procedures and risks… All staff, volunteers, and medical referrals agree with the Sanctity of Life and pro-life issues."
This basic claim common among CPCs, that a staunchly anti-choice staff even could provide "accurate information" about abortions, has been widely criticized by watchdog organizations. Lobbyist group NARAL Pro-Choice states, "CPCs recognize that if they are upfront about the limited nature of their services and their ideological agenda, they will lose this constituency.” One could reasonably assume that constituency to at least include and at worst be intended for vulnerable and scared young adults without access to normal medical care. NARAL goes on to say, “While CPCs may claim they exist simply to empower women in carrying their pregnancies to term, in reality, an overwhelming body of research indicates these centers fail to provide honest, comprehensive, and non-directive information about reproductive health.”
To uncover what it would be like to seek help from a CPC as a potentially-pregnant young woman, and to provide a picture of a ZoeCare office visit for the Bozeman community, I called ZoeCare claiming that my period was two weeks late, and a few days later found myself trepiditiously approaching their West Lincoln Street office for a free pregnancy test and options counseling.
The clinic's advocate checked me in at the plexiglass-encased counter, smiling at me encouragingly as she passed me a clipboard. I settled into the lobby, which was decorated with vaguely Western art and wheat grass arrangements. Country music played from a stereo over mismatched furniture, while copies of Better Homes and Gardens, Montana Outlaw, and an anti-abortion/ pro-abstinence teen mag were arrayed neatly on side tables. I was the only patient.
The intake form was unlike any other I've encountered. After filling in the usual birthday and address lines, I was asked to supply my religion and to rate my current fear level on a 1-10 scale. On the backside, there were a number of statements that I was to read and initial, including a statement that ZoeCare is religiously affiliated and does not provide abortion services or referrals for abortions. Nowhere on the form were questions about my medical history or if I'd been pregnant before.
After a brief wait, Robin Cory, RN, ZoeCare's white-coated nurse, ushered me into the clinic's spacious bathroom for the provision of a urine sample. Afterwards, while Cory performed the dipstick test, the advocate led me into an airy room reminiscent of a garden-themed sitting room, decorated with a hodgepodge of reproductive organ models. One wall of the space was adorned with framed color pictures of fetuses alongside information about when fingernails and heartbeats develop in pregnancy, prompting in me a memory of the film "Juno," when the protester's statement about fetuses having fingernails led Ellen Page’s character to decide against an abortion. A bulky examination table sat underneath these pictures, flanked by an ultrasound machine. Although there were several framed certificates on the wall, I didn't want to be caught examining them too closely for fear of exposing myself as a journalist.
Before the test results came back, the ZoeCare advocate, a neatly dressed woman in her 40s, asked me about my feelings surrounding this pregnancy, about this baby. Throughout all of my conversations with the advocate, and later with the nurse, the nonexistent bunch of cells in my uterus was referred to as a “baby,” not a zygote or an embryo. The advocate’s questioning seemed to be feeling out if I was "abortion-oriented." I played along, manufacturing a detail about a boyfriend who had broken up with me several weeks previously. When asked, I said that I was a student at MSU. For the most part, I said little, allowing the other women to lead the conversation, saying, when pressed, that it wasn't a good time for me to be pregnant or have a baby, and that I was worried about continuing my education in light of this potential pregnancy. I never directly said that I would want an abortion, but rather expressed my fear of being pregnant.
As Cory entered the room with the news that I was not indeed pregnant, I found myself actually being relieved, despite rationally knowing this all along. The conversation shifted at this point, the two older women inquiring into how I would have reacted if the test had been positive, and how I should change my behavior so that I couldn't become pregnant again. Rather than discussing options for safer sex, the advocate and the nurse began listing the many reasons why sex is never safe, at least not outside of monogamous matrimony.
Cory stated that condoms are 87% successful at preventing pregnancy, when most authorities put the numbers closer to 98% with correct use. According to my research, the 87% statistic comes from a 1999 study that appeared in Family Planning Perspectives which statistically analyzed the results from 25 published studies on the effectiveness of condoms in preventing HIV transmission during heterosexual sex. To quote the abstract, “the condom's efficacy at reducing transmission [of HIV] may be comparable to or slightly lower than its effectiveness at preventing pregnancy.” ZoeCare's citation of this number in regards to pregnancy is a misapplication of this statistic.
It should be noted that condoms are the most easily accessible and inexpensive form of birth control, and they are highly effective at preventing the spread of sexually transmitted infections (STIs) and HIV. By casting doubt on the effectiveness of condoms, the only form of birth control I said I sometimes used, it was clear that ZoeCare wanted me to decide that sex was too risky and choose abstinence, rather than empowering me to make safe, medically-sound decisions to protect myself.
Despite their questionable information about birth control, they did offer me free STI testing, should I want to come back at a later date. After inquiring about STI symptoms, the nurse told me about several of the more common diseases. Although I'd been privately skeptical of their information so far, this part of my visit contained, to the best of my knowledge, scientifically sound information. My cursory tour of their three-ring binder of STI information revealed no obvious inaccuracies. I was surprised to see that their handouts on gonorrhea and chlamydia are from the Center for Disease Control, which although admirable that this information is from a reputable source, could lead someone to believe that the rest of their information has similar roots in peer-reviewed scientific literature.
The advocate leaned forward, relaxing her posture, drawing me into a more casual conversation about why I was at ZoeCare in the first place. Assuming the attitude of your best friend's mom dispensing wisdom, she told me that "just between us girls," boys my age are pretty much hormonally-driven creatures, interested only in relationships so far as they extend to sexual activities. Sex was something that men coerced women into giving up, and there was an underlying ethos that women don't want or enjoy sex. She asked me what my mother, father, and grandmother would think if they knew I was taking a pregnancy test. As the conversation shifted from sexuality to relationships, the advocate told me that God wanted me to be in a respectable relationship, one in which sex was reserved for matrimony. According to the ZoeCare staff, although I'm not a virgin, it's never too late to turn back to God.
The overt Christian background in ZoeCare's messaging doesn't offend me. Pregnancies can be deeply spiritual experiences for some people, and finding an environment full of like-minded confidants could be incredibly soothing for a pregnant person who definitely wants to carry their pregnancy to term. However, although generous, the promise of free pregnancy tests appeals directly to people with few resources, people who should be empowered by knowing all of their options—parenting, adoption, and abortion—when facing an unexpected pregnancy. Beyond the ethics of abortion access, I am a sex-positive feminist, and I found myself during my 40-minute appointment being made to feel ashamed. I cannot imagine the influence of their rhetoric should a pregnancy test turn up positive.
My visit to ZoeCare drove home the feeling that these high-level debates on reproductive health care do affect real people, even people in Bozeman, Montana. There's a pattern here, a common thread connecting the Ravalli County Commissioners, the five remaining abortion clinics in Montana, and CPCs like ZoeCare, a thread that does not bode well for women's bodily autonomy.
All images were taken from ZoeCare's literature.