“What’s the use?” Sara Ahmed notes, is a question that is meant to gesture to the pointlessness of something. But Ahmed also demonstrates that “use” as a word and concept can enable epistemological and political possibilities. Following around use to consider the work that use does can be quite, well, useful. The question of use, Ahmed says, “implies that some things we do, things we are used to, things we are asked to get used to, are in the way of a feminist project of living differently.” Feminist scholars—such as Lauren Berlant, Lynn Morgan and Meredith Wilson Michaels, and Janelle Taylor—have followed around fetal imaging, noting that while it is something that we have simply gotten used to, its effects are no less political, dangerous, or coercive. It is no stretch to say that fetal imaging, and the sonogram that enables it, contributes to the personification of the fetus—and thus is something that can get in the way of feminist projects to live differently. In this essay, I reflect on the paradox of anti-abortion activists’ use of sonograms, suggesting that, in this case, the sonogram is both utterly useless and also the very mechanism through which these activists constitute their social usefulness.
Crisis pregnancy centers (CPCs) are religiously-motivated nonprofit organizations whose goal is to prevent women who are experiencing an unintended pregnancy from obtaining an abortion. Reproductive justice activists often refer to them as “fake clinics” because CPCs work to make themselves appear as if they are medical facilities when they are not. While critics have made this point repeatedly, noting that it is precisely CPCs’ undisclosed religiosity that allows them to appear “neutral,” little has been said about how CPCs weaponize the sonogram in the service of reaching their anti-abortion goals. Here, I expand on previous critiques of CPCs and the little discussion of CPCs’ increasing use of sonograms to suggest that the sonogram is the very mechanism through which CPCs articulate their usefulness, and in so doing, make themselves appear both more medical and also less religious than they actually are. Put otherwise, the technology’s medical valence enables the largely evangelical CPC network to operate under a secular guise while allowing them to advance their religious motivations.
While we do not know the precise number of CPCs in the United States, estimates range anywhere from 2,500 to 5,000. By contrast, there are just 743 abortion clinics in existence in the US today. In the 1980s these numbers were reversed—a trend that explains why those of us committed to reproductive justice ought to be concerned with crisis pregnancy centers. Abortion-rights supporters have pointed out that CPCs’ approaches are dubious, and include: using names that suggest they offer abortions; setting themselves up next to abortion clinics to confuse, and thus, intercept, those seeking abortion; and giving out false medical information. Researchers found, for example, that 80 percent of CPC websites include false information about abortion, including that abortion is linked to breast cancer, mental health issues, and infertility. Researchers have disproven each of these claims and various health organizations—including the American College of Obstetricians and Gynecologists, the American Psychological Association, and the Mayo Clinic—have issued statements to this effect. Unfortunately, such clear scientific evidence has not deterred CPCs from continuing to spread false claims—which are, of course, given additional credence due to the ostensibly medical technologies utilized in conjunction with the dispersal of such claims.
Feminists have pushed back using a variety of tactics, including comedy. In April of 2018, John Oliver’s exposé on crisis pregnancy centers went viral and became a rallying cry for feminists concerned with reproductive justice—in part because it increased public consciousness around an anti-CPC case that was scheduled to be considered by the US Supreme Court later that same summer. Oliver begins his takedown of fake clinics by sharing a CPC commercial that features a white, heterosexual, teenage couple presumably facing an unplanned pregnancy. A peppy voiceover comments: “Before you make the decision about a pregnancy that comes at a less than perfect time, get jelly on the belly! Come to Sunrise Women’s Clinic…where our nurses specialize in early pregnancy options.” Oliver responds in his quintessentially hilarious way: “‘Jelly on the belly’ is a pretty childish way to describe an important medical procedure. I’m not sure that I would trust a doctor that referred to colonoscopies as looking for cooties in the booties!” Both the Sunrise Women’s Clinic and Oliver are, of course, referring to CPCs’ use of sonograms. Later in the episode, Oliver covers CPCs’ use of mobile units and shows an image of a van decorated with the words “Free Sonograms: You’ve Got Options!” CPCs “increasingly,” Oliver notes, “offer free ultrasounds. Which can sound appealing. It’s free. But often they’re not performing them so much for health care but for emotional manipulation.”
Not surprisingly, pro-CPC activists responded to Oliver’s claims with outrage. Conservative political commentator Steven Crowder, for example, became particularly animated when responding to Oliver’s critiques of CPCs’ use of sonograms.
When these crisis pregnancy centers offer free…ultrasounds, women take them. Here’s why [Oliver is] so pissed off about ultrasounds and why Planned Parenthood has fought ultrasound laws. Studies found that 78 percent of women chose to keep their baby after seeing an ultrasound. Without government funding, all they’re doing is providing an ultrasound for free . . .We talk often about wanting to provide health care to the poorest among us . . .[John Oliver] is literally complaining about people offering free health care voluntarily. To you its offensive to provide a free ultrasound.
The misinformation Crowder spews here is, as in the rest of the twenty-three minute segment, rampant: CPCs do, in fact, take government funding (in 2013 alone, 34 states funneled money to CPCs); the so-called “study” Crowder references, which was based on numbers CPCs provided themselves to an organization that serves as a CPC support network, has been proven false; and abortion rights groups have not fought laws that require women to get an ultrasound prior to an abortion because ultrasounds successfully convince women out of abortions, as Crowder claims, but rather because they are medically unnecessary and place an undue burden on those seeking abortion (a point supported by the American College of Obstetricians and Gynecologists). Even by CPCs’ own admission, the ultrasounds they offer are “limited” and are only meant to test if a pregnancy is viable—though, considering that an investigator getting an ultrasound at a California CPC was told her IUD was a fetus, we should be wary of CPCs’ ability to accurately predict viability, or anything at all for that matter.
Despite Crowder’s claims, a peer-reviewed study shows that just 1.6 percent of women who looked at their ultrasounds during their visit to an abortion clinic decided against having an abortion. We might ask, then, what’s the use of sonograms for CPCs?—particularly considering that they are not intended for medical purposes and that evidence suggests that they do not actually help CPCs reach their intended goal of convincing women out of abortions. In many ways, a sonogram is the precise object that allows CPCs to change their image and potentially expand their reach; the sonogram is understood as a medical device and so is viewed as something that would be available at a medical clinic but not at a religiously motivated and unregulated anti-abortion nonprofit organization.
In some cases, CPCs have used the sonogram as justification for changing their name to include the word “clinic.” This was the case in Rutland, Vermont, where First Step Pregnancy Center changed its name to First Step Pregnancy Clinic. David Wilkerson, the executive director of the CPC and a pastor, spoke to this point: “By adding a medical procedure like ultrasound, we transitioned to becoming a medical clinic…We have trained nurses in ultrasound to do the pregnancy testing as well as the ultrasound exam. Since those are medical procedures we’ve decided to change the name to a pregnancy clinic to reflect that we are now doing those procedures.” The Rutland CPC will be sharing its sonogram with other CPCs in the area, including the Pregnancy Resource Center of Addison County, which is in Middlebury, Vermont, the small town where I live.
I recently reached out to the Middlebury CPC via their chat function on their website to ask what kinds of training they require their ultrasound users to have. I was forwarded to their national organization, Heartbeat International, which, I was informed by the chat line worker, does not require that those performing sonograms in its facilities have any training, licensure, or medical certification for using sonogram machines—though CPCs certainly do not make evident that those performing ostensibly medical tasks are not actually medical professionals. Furthermore, it is important to recognize that those volunteers at CPCs who are medical professionals are not required to follow the same standards or regulations as they would be while working at an actual clinic or hospital—precisely because CPCs are not medical facilities.
Sonograms have become precisely the object through which CPCs extend their deceptive practices, including obscuring their religiosity, and, in the very same moment articulate their social usefulness by claiming to provide medical care. To be clear, I am not merely advocating for restricting CPCs’ use of sonograms and fetal imagery, working against laws that require those seeking abortions to obtain an ultrasound, or fighting against CPCs calling themselves “clinics.” Nor am I merely arguing for laws that require CPCs to make clear that they are religiously oriented, do not provide abortion services, and are not held to HIPAA standards. And I am not merely advocating that state and federal funding should never go to CPCs and that they should be prevented from providing abstinence only sex education in schools. I am arguing that scholars and activists committed to reproductive rights and justice must center addressing CPCs in our work and, ultimately, for the usefulness of ending fake clinics altogether.
Original banner art by Rayn Bumstead, a sociology and studio art double major at Middlebury College. All rights reserved.