By Mary Fitzgerald
LONDON – In Europe, if you go to a public hospital seeking medical advice, you expect accurate, science-based information. You expect the staff attending you to be professionally trained and certified. You’d have similar expectations on university campuses, in schools, women’s shelters, or other state-run facilities, right?
Think again. In a new report, the global news site openDemocracy reveals how women and girls are being given “misinformation and manipulation” on an extraordinary scale in “crisis pregnancy centers” (CPCs) around the world.
Supported by powerful American activists who claim to have close ties to President Donald Trump’s administration, and often made to look like health clinics, many of these centers claim to offer pregnant women unbiased “advice.” In fact, staff are trained to dissuade women from having legal abortions, and in some cases, from accessing contraception.
In the first investigation of its kind, openDemocracy mapped the global spending, networks, and activities of two influential anti-abortion groups based in the United States, Heartbeat International and Human Life International. Together, they have spent $13 million around the world since 2007 and have funded and trained hundreds of organizations globally.
We sent undercover reporters, posing as vulnerable pregnant women, into Heartbeat-affiliated CPCs in 18 countries across Europe, Africa, and Latin America, where they consistently received wildly misleading and false information. Abortion causes cancer. A woman needs consent from a partner to have one. Hospitals will not treat medical complications. Women will suffer from a widely debunked “post-abortion syndrome.”
We also sent a reporter to get Heartbeat training, available online or in-person globally. Our reporter was taught to encourage women to delay abortion and emergency contraception. In these trainings, they also claim that condoms don’t work, and to tell women that abortion increases risk of abuse of other children and could “turn” partners gay.
In the US, there are thousands of CPCs. In the wake of the US Supreme Court’s 1973 Roe v. Wade decision legalizing abortion nationwide, both Heartbeat and Human Life expanded a model that began in the 1960s in response to liberalization of state abortion laws. Their CPCs have been repeatedly challenged in the US for presenting themselves as neutral health facilities, while hiding their anti-abortion and religious agendas from women seeking help. But, until now, the global scale of these activities had not been mapped.
The power and influence of US religious conservatives in Latin America and Africa is well known. As a result of the draconian anti-abortion restrictions they have backed, women have been jailed for having miscarriages and thousands die from unsafe abortions every year. In Uganda, our reporter was told she could never “truly” love and care for any children after an abortion, and might have difficulty conceiving again. In Argentina, a reporter who said she was in an abusive relationship was told: “Now, you’re a victim, but an abortion would make you part of that violence since you will be violent.”
But the scale of these operations in Europe has shocked lawmakers, doctors, and health experts. We found 410 Heartbeat-affiliated CPCs in Italy alone – and dozens more in Spain, Croatia, Serbia, Romania, and Ukraine. At a CPC inside a Lombardy hospital, our reporter was told that having a baby can cure leukemia. In Spain, our reporter was given books and articles claiming that abortion causes mental health problems, sterility, and heart attacks. She was also warned that women who have an abortion are “99% more likely” to abuse any other children they have, and that having several abortions increases this risk by 189%.
The organizations that run these centers have both received Heartbeat funding and participated in in-person training. They also receive public funds and political endorsements: in Italy, from the far-right leader Matteo Salvini; in Spain, from the far-right Vox party.
Neil Datta, Secretary of the European Parliamentary Forum for Sexual and Reproductive Rights, finds it highly “disturbing” that foreign groups are “proactively attempting to deprive women of their legal rights…by deliberately deceiving them.” He calls it “a rule of law issue.” No policymaker, whatever their position on abortion, should stand by while “their country’s laws are being circumvented through disinformation, emotional manipulation, and outright deceit specifically targeting pregnant women.”
What can be done? It’s instructive that openDemocracy’s reporters were not fed such extreme falsehoods when they visited CPCs in North America. In the US, Heartbeat has a “Commitment of Care” which promises that women will always receive “accurate information,” including on abortion and contraception, and to advertising and communication that are “truthful and honest and accurately describe the services we offer.”
While many of Heartbeat’s global affiliates clearly don’t follow these rules, it appears that legal pressure and greater scrutiny in the US have had some effect – despite America’s robust free-speech protections. That means there is surely room for more ambitious action in the European Union. It cannot be right that most EU countries require a license to sell vitamins, but not to offer a pregnant woman an ultrasound. All of the countries we investigated have laws or regulations prohibiting false or deceptive advertising of goods or services, yet we found no evidence of legal challenges against CPCs under these rules outside of the US.
There are obvious steps to be taken in countries like Italy, where national and regional lawmakers must urgently ban CPCs from public hospitals and – critically – improve provision of accurate, science-based advice, education, and health-care services for women and girls. The catastrophic lack of such services in Italy has created a vacuum, which religious conservatives have deftly filled. Notably, many of the clients our reporters saw at Italian CPCs were Roma and migrant women; similarly, in Spain, we observed Latin American migrants in financial difficulty.
Other countries have made some efforts. In 2017, France made it a crime to provide women with false information about abortion, although no cases have yet been brought under this law, and rights groups question its effectiveness. The same year, Ireland tabled proposals for a new law to regulate counselors, after journalists found staff at a CPC telling women that abortion causes cancer, among other falsehoods. But these legislative proposals have now stalled.
There is, rightly, much discussion in Brussels and across European capitals about how to combat fake news online and rein in the power of Big Tech. But the toxic spread of misinformation offline is arguably even more insidious and influential. Are you more likely to believe something you’re told in a hospital or by a trusted member of your community, or an ad on Facebook?
What openDemocracy’s investigation found is likely just the tip of the iceberg. Heartbeat and Human Life International are part of a larger universe of anti-abortion evangelists targeting vulnerable women and girls globally. We have found evidence pointing to hundreds more CPCs in other countries, from the Czech Republic to Kenya. The model is cheap – often relying on well-meaning volunteers – and easy to replicate. It is misinformation on a global scale. Europe must lead the way in putting a stop to it.
Fitzgerald is Editor in Chief of openDemocracy.