Signing a petition outside the Southwestern Women's Surgery Center in Dallas in November, after a federal appeals court ruled that the state's new abortion restrictions could take effect. Rex C. Curry/AP

AUSTIN, Texas — Betsy Garcia hovers nervously outside an abortion clinic in McAllen, Texas. After accepting a pamphlet from someone on the street, she goes to a different building where a woman in a white coat greets her with warmth. The woman offers to show Betsy a graphic video about abortion, then the two pray in front of a crucifix before the teen exposes her belly for an ultrasound. "God is going to bless you in a tremendous way with this child," says the woman as she presses a rosary into the girl's hands. The final scene shows a radiant Betsy dandling her 6-month-old daughter on her lap. So goes the promotional video for the McAllen Pregnancy Center, a crisis-pregnancy facility established in 2008 to dissuade women from having abortions. The video was released in April, when there was still an abortion clinic to lure women from. Today there’s a major change in town. While the McAllen Pregnancy Center continues to operate, Whole Woman’s Health, the only abortion provider in McAllen, stopped being able to provide abortions. A controversial Texas law that went into effect in November requiring abortion physicians to have admitting privileges at nearby hospitals has caused a third of the abortion clinics in the state to close. Abortion opponents say the law makes abortion safer, while providers and medical groups, like the American College of Obstetricians and Gynecologists (ACOG), counter that admitting privileges have no impact on the safety of the procedure. Regardless, women in McAllen seeking to terminate unplanned pregnancies must now travel 170 miles to the nearest clinic. Alternatively, they could walk the two blocks to the McAllen Pregnancy Center for help. But that could prove risky.

A laissez-faire climate

While center staffers donning white coats and offering sonograms could easily be mistaken for health professionals, there’s nothing medical about the services they provide. A McAllen Pregnancy Center counselor reached by phone told Al Jazeera that the center does not employ a doctor because the ultrasounds it conducts aren’t for diagnostic purposes but for “seeing the baby.” Medical experts, like the American Institute of Ultrasound in Medicine and the ACOG, take a dim view of such practices. They warn that women could be falsely reassured about their health or that of their fetus, and if abnormalities are discovered, there’s no guarantee that pregnant women will receive the follow-up care they need. Though it might not be obvious to Betsy that she isn’t receiving medical treatment, the McAllen Pregnancy Center isn’t behaving like a rogue operator. Unlike abortion clinics, sandwich shops and nail salons, crisis-pregnancy centers in Texas don’t have to comply with state or federal safety standards. The state health department does not inspect the clinics, not even the ones that offer ultrasounds and call themselves pregnancy medical clinics. (The McAllen Pregnancy Center doesn’t call itself a medical clinic because it says its ultrasounds are nondiagnostic.) Even the Texas Medical Board, which is responsible for the good conduct of licensed physicians, shrugs at its doctors’ activities. It doesn’t require physicians to report where they serve as medical directors, and it investigates only if someone files a complaint. So far, no one has. Such a laissez-faire climate means that anyone can set up shop and call it a pregnancy medical clinic. The anti-abortion powerhouse National Institute of Family and Life Advocates (NIFLA) sees this as a ripe business opportunity. As NIFLA says on its website, “Ultrasound opens a window to the womb where the mother is first introduced to her unborn child. By allowing this connection to happen, medical (clinics) experience dramatic increases in the percentages of their patients that choose life.” NIFLA advises would-be medical clinics that only California, New Jersey, Massachusetts and New York have rigorous regulatory requirements for medical clinics. In any other state, a crisis-pregnancy center needs to have only a licensed physician to serve as medical director. Accordingly, NIFLA provides legal advice and staff training for crisis-pregnancy centers that want to “go medical,” advising that ultrasounds be performed only by physicians, sonographers or nurses because “the provision of ultrasound services is the practice of medicine.” The group reassures members that the extra effort to become a medical clinic is worthwhile because the ability to confirm pregnancies and establish viability will increase their client loads. Accordingly, more than 70 crisis-pregnancy centers in Texas have gone medical.

Feted by Texas politicians