BBC Panorama on Crisis Pregnancy Centres shows how little has changed

Lisa Hallgarten, Brook’s Head of Policy and Public Affairs reflects on the recent Panorama programme uncovering coercive practice at “crisis pregnancy centres” and how little has changed over the last ten years.

Bodily autonomy is a fundamental right. As is the right to decide when and whether to be pregnant and have children, and to choose the number and spacing of those children. They are rights we actively support at Brook.

Through our education work in the RSE curriculum and beyond, we address how, when and why people choose to have sex and the importance of consent in that process; how to prevent pregnancy; what the pregnancy options are; and how to make a decision about an unintended pregnancy. Through our clinical work, we provide contraceptive services to help people manage their fertility, and can support someone’s access to abortion or signpost them into ante-natal care depending on their decision and needs.

Evidence-based information about the different pregnancy options, and impartial non-directive support to weigh up the pros and cons of these options, is the foundation of good practice in pregnancy decision-making. High quality support for those who want it has positive public health outcomes.

Those who are able to make an informed decision are more likely to be satisfied with their decision, whatever they choose.

The benefits of early access to abortion are also well established. Abortion is safer the earlier in pregnancy it takes place, there is likely to be a greater choice of abortion method and less need to travel. Expediting access to the chosen service without delay should be a key criterion of counselling services.

Sadly, we know that some services that advertise support with pregnancy decision-making provide none of these. In fact, as the Panorama programme on ‘crisis pregnancy centres’ (CPCs) reported, some are doing the exact opposite. They are using shaming and stigmatising approaches and providing misinformation and biased views on abortion, in their attempts to delay, obstruct or prevent access to abortion services. Delaying access to abortion is unethical.

Coercion in pregnancy decision-making is associated with negative emotional outcomes.

This is not a new phenomenon. Ten years ago, three years after I first reported on this phenomenon, Brook published a comprehensive report on crisis pregnancy services based on undercover/mystery shopper investigations in a third of CPCs in England. Services were often deliberately marketed at younger more vulnerable women seeking abortion, and those who are undecided about their pregnancy. We discovered multiple examples of bad practice including wildly overstating or completely inventing risks associated with abortion. We found workers in the services providing personal anecdotes about abortion – the opposite of good counselling practice.

Centres then, as now, varied widely in their practice from those where abortion services were – albeit reluctantly – signposted to, to those more egregious examples where access was deliberately obstructed. The only difference now is the widespread use of ultrasound which is openly discussed in the anti-abortion movement as a useful tool for generating ambivalence towards abortion.

A lack of regulation or oversight of these services means that the only action open to challenge them is through advertising standards. These actions have the limited scope to prevent advertising, not to shut down services that may be deceitful and actively harmful. Some have changed names multiple times over the years to circumvent this issue. Only this week the Guardian reported on the use of Google Ads to direct people seeking abortion (or information about abortion) to anti-abortion sites.

Following our report in 2014, the national network linking up and promoting crisis pregnancy centres was dismantled. In conversations with its chief executive they acknowledged that it was not possible to enforce quality standards across a large and dispersed number of independently run centres, often staffed by volunteers, mainly by people who are actively opposed to abortion. However, new networks and helplines have sprung up in its place.

It is so disappointing that nothing has changed.

Things may be set to get even worse with well-funded US organisations like Stanton making inroads into the UK and no investment in the statutory and voluntary sector services that can provide high quality, impartial decision-making support.

Another thing that hasn’t changed are our recommendations. We still need better regulation of these services, stricter application of rules around false advertising, and for legitimate bodies like local authorities and the NHS to ensure they never inadvertently promote unethical and harmful services via their signposting.

Many people don’t need or want outside help with pregnancy decision-making.

Most are already sure of their decision by the time they approach a healthcare professional. But for those who need support to explore all the many factors that can inform a pregnancy decision, we would urge them to seek support from a service that genuinely believes in choice: community sexual and reproductive health services like Brook, abortion providers like bpas and MSI, and prochoice organisations like Abortion Talk.