It need only be 8 1/2 inches by 11 inches, written in at least 22-point type.
Posted in a “conspicuous place” in a waiting area, it would alert visitors that “California has public programs that provide immediate free or low-cost access” for family planning, prenatal care and abortion. At the bottom, they would find the telephone number for the county social services office.
The sign, mandated by California lawmakers this year for any licensed facility providing pregnancy-related services, may be small in size. But nothing is ever small in the enduring political battle over abortion.
As the national debate has once again been inflamed by restrictive new laws in many states and a controversial series of videos released this summer about Planned Parenthood’s practice of selling fetal issue, supporters of abortion rights have pushed back with fresh scrutiny of crisis pregnancy centers.
The sign requirement is a direct shot at these clinics – faith-based organizations that cropped up as alternatives to abortion providers and largely counsel women to carry their unplanned pregnancies to term. Abortion-rights advocates argue they pose a threat to public health by providing incomplete medical information early in women’s pregnancies.
It has already set off a legal challenge over compelled speech and religious freedom that has many of the state’s crisis pregnancy centers defending their existence.
“I always feel like we’re misrepresented,” said Marie Leatherby, executive director of the Sacramento Life Center, one of a handful of such clinics in the region. “We are just here to be a resource for women who are pregnant and have needs.”
Crisis pregnancy centers have existed for decades, but they took off in the 1990s as the anti-abortion movement shifted from increasingly extreme and unpopular protest tactics to a more moderate, “women-centered” approach, according to Kimberly Kelly, a sociologist at Mississippi State University who has studied the clinics.
Crisis pregnancy centers in California, according to a legislative analysis
There are now as many as 3,000 of the centers nationwide, Kelly said, the vast majority affiliated with evangelical Protestant umbrella organizations like CareNet and Heartbeat International. A legislative analysis found at least 228 in California.
Kelly said the centers generally present themselves as women’s health clinics, offering services like ultrasounds and free STD testing, then try to convince clients to have their babies by giving them material support, such as clothes and formula, and warning them about health risks associated with abortion that critics charge are medically inaccurate.
“They truly believe the information that they are giving women is correct,” Kelly said. “This isn’t just a cynical strategy all the way through, but they do prioritize preventing abortions above all else.”
Last year, NARAL Pro-Choice California conducted an undercover investigation of 43 centers in 19 counties. Its report blasted the clinics for buying online ads on abortion-related search terms, shaming women for having sex outside of marriage and falsely linking the procedure to breast cancer and depression.
The young woman who visited the centers described appointments in which she expressed interest in obtaining an abortion to keep her college plans on track and was told to put school aside and move back home to get help raising the baby.
“Women don’t get all of their options. They get an agenda,” NARAL state director Amy Everitt said. “These are very well-trained soldiers in the anti-choice movement.”
According to Assembly Bill 775, the sign must state: “California has public programs that provide immediate free or low-cost access to comprehensive family planning services (including all FDA-approved methods of contraception), prenatal care, and abortion for eligible women. To determine whether you qualify, contact the county social services office at [insert the telephone number].”
The investigation became the impetus behind Assembly Bill 775, the sign requirement, which was sponsored by California Attorney General Kamala Harris.
Harris, who is running for the U.S. Senate, declined an interview request to discuss why she thought the regulation was necessary. In a statement released after its passage, she said she was “proud” of the bill, “which ensures that all women have equal access to comprehensive reproductive health care services, and that they have the facts they need to make informed decisions about their health and their lives.”
Crisis pregnancy centers immediately pushed back on the law. In October, a day after Gov. Jerry Brown signed AB 775, two clinics in Marysville and Redding jointly filed federal suit against Harris asking for an injunction before it goes into effect Jan. 1.
The religiously affiliated clinics contend that a mandate to post the signs is compelled speech. The notices direct women on where and how to obtain abortions, they argue, which runs counter to their faith-based missions and violates their First Amendment right to freedom of religion.
“This is an ideological message,” said Kevin Snider, chief counsel for the Pacific Justice Institute, a Sacramento-based legal organization that is representing the clinics in their lawsuit. “When the government forces someone to start a conversation with a certain premise, that’s unconstitutional.”
Snider added that the clinics owe no obligation to the government, regardless of potential public health implications in the message it is trying to spread. He pointed to similar efforts in Baltimore and New York City that have already been struck down in federal court.
The government cannot tell Taco Bell to put up a notice that there are also burgers and fries available at Burger King and where to find them.
Kevin Snider, chief counsel for the Pacific Justice Institute
“Our clients are religious nonprofits. They don’t receive one penny from the government,” he said. “The government cannot tell Taco Bell to put up a notice that there are also burgers and fries available at Burger King and where to find them.”
Through a spokeswoman, Harris said, “We will vigorously defend the state law in court.”
NARAL’s Everitt dismisses the notion that it might infringe on the clinics’ constitutional rights.
“They still are able to say everything they want to,” she said. “We can’t regulate free speech. If we could we would, but we can’t.”
But she does hope the signs will send a message to women who find themselves in the lobby of a crisis pregnancy center: “Run. This is not where you want to be. Run.”
It irks Leatherby of the Sacramento Life Center, who believes politicians should focus on improving the few “bad players” rather than targeting all crisis pregnancy centers.
She’s well aware of the perception that they are a faith-based effort to steer women away from abortions. The familiar argument practically makes her sigh with weariness.
“We don’t steer. I hate that word. We just don’t,” she said. “We’re life-affirming.”
Marie Leatherby, executive director of the Sacramento Life Center
Founded in 1972, the Sacramento Life Center provides “compassion, support, resources in the community, and free medical care” for about 2,000 pregnant women each year, many of them low-income and without health insurance, according to Leatherby.
Though it’s supported financially by the Diocese of Sacramento, she said the clinic is not affiliated with the Catholic Church and does not proselytize to patients. It approaches its work from a “morality standpoint” opposing abortion, she said.
“We respect life, in the womb also,” Leatherby said. “If we have a chance to help both mom and babies, then we’d like to do that.”
The clinic employs nurses and a doctor to run pregnancy and STD tests, ultrasounds and well-woman exams. It also teams up with about 40 other local nonprofits to connect women with resources they may need. Recently, Leatherby said, they helped a woman get her abusive husband into treatment, a different kind of support that she didn’t expect an abortion clinic would offer.
“Mostly, we just give them tons of information so they can make the best decision for their own lives,” she said.
Leatherby estimated that 90 percent of the women who visit the Sacramento Life Center end up carrying their pregnancy to term.
“We want to empower them with what they would need if they decide to carry,” she said. “Not because we guilted them or we shamed them, but because they could see a light of the end of the tunnel.”