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When seeking family planning services, Baltimore women deserve to know which options are, and are not, on the table

Searching for a Baltimore ZIP code on the national pregnancy help website, "Options Line," generates a list of several pregnancy centers across Baltimore. While the site claims to provide "information on all your options," something is clearly missing: None of the pregnancy centers listed offer abortions; many do not even offer contraception counseling.

These pregnancy centers instead use purposely vague advertising to target women who may be considering an abortion or inaccurately portray the availability of abortion services, directly interfering with women's access to services. A 2006 study found that up to 87 percent of centers provided false or misleading information on the health effects of abortion in their written materials, websites and counseling. In Maryland, this false information has ranged from linking abortion to breast cancer to claiming that abortion is legal through all nine months of pregnancy. These statements are unscientific and/or inaccurate and may encourage women to delay seeking abortion services until it is too late.

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Shouldn't this intentionally deceptive advertising and information for women who are pregnant or who could become pregnant be against the law? The Baltimore City Council thought so. In 2009, the council passed an ordinance to require all "limited-service" pregnancy centers to tell clients up front if they do not "provide or make referral for abortion or birth-control services." However, this common sense provision, which has been tied up in litigation since 2009, was recently struck down in U.S. district court.

As OB/GYNs in Baltimore City, we are deeply concerned about the effects this recent ruling will have on the health and well-being of Baltimore's women, particularly those who are most vulnerable.

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Without the protections of this ordinance, women are left susceptible to false advertising and deceptive counseling. When pregnancy centers do not truthfully inform consumers about the scope of provided services, women who are young, poor and less educated suffer the most. These women are more likely to experience an unintended pregnancy and often do not have an established relationship with a health care provider or the health care system. As they seek help during a stressful life event, they are easy victims for misleading advertising.

Teenagers are also particularly vulnerable to deceptive options counseling. We know that teenagers often take longer to suspect pregnancy than adult women and longer to confirm a pregnancy once suspected. When they come to crisis pregnancy centers, teenagers are more likely to be farther along in their pregnancies, leaving little time to make an informed decision about their health and future. Family planning services are time-sensitive, and delays in accessing information can lead to increased health risks and poorer health outcomes.

In many pregnancy centers, women are also kept in the dark about contraception. Nearly half of pregnancies in the U.S. are unplanned, but many pregnancy centers fail to offer contraception counseling and services, missing a critical window of opportunity to help women prevent future unwanted pregnancies. Other centers offer contraception counseling but include false information about the efficacy and health effects of various contraceptive options. Women deserve to know whether contraception services will be offered when they walk in the door for a pregnancy test and that the information provided will be medically accurate.

We should be clear: crisis pregnancy centers can provide a variety of valuable services to women, including spiritual counseling and parenting classes. But women seeking contraception, options counseling or abortion services should be empowered to understand what is — and is not — offered at these centers and, like any other consumers, have all the information to make an informed decision.

Informed consent is a deeply held ethical framework in the medical field. It involves ensuring that every patient knows what his or her options are, has an opportunity to ask questions, and can opt-out of a medical procedure if they desire. This is no different.

Women deserve to receive accurate information about which options are on the table and to make choices that reflect their priorities and unique situations. Without these protections, experiences of dishonesty and coercion can damage a woman's relationship with the health care system for life.

Baltimore City needs to be able to protect our women and their right to make fully-informed, autonomous decisions about family planning and pregnancy-related care.

Dr. Carolyn Sufrin (csufrin@jhmi.edu) and Dr. Stacey Leigh Rubin are OB/GYN's with the Johns Hopkins University School of Medicine.

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