Life and new life

Since beginning her career as an OB-GYN in the 1980s, Dr. Sandy Christiansen has performed hundreds of obstetrical ultrasounds. 

She knows the drill: “We try to explain what we’re seeing.” At her Frederick, Md., pregnancy center, she applies transducer gel to the patient’s abdomen and talks the woman through the ultrasound procedure: “Here you can see the uterine wall, and inside the uterus is the gestational sac, which appears black. Can you see the white bean-shaped structure? That is the embryo. Do you see the flickering? That’s the baby’s heart beating,” She points with her finger or the monitor’s arrow to the pixelated grays and whites on the screen.

During these 15- to 20-minute show-and-tells, Christiansen sees reactions varying from shocked silence to jaws dropping in amazement. The sonographic images bring others to tears: “I’ve had dads faint … crumple to the ground.” Even the ultrasound footage that can’t show the embryo in detail, but only depicts the flickering light representing a heartbeat, is enough to help some frightened mothers and skeptical fathers connect with their unborn children.

“For the person who feels this [pregnancy] is just the worst thing that’s happened to them … it’s a terrible shock to them,” said Christiansen, national medical director for the pro-life group Care Net. She described that moment of seeing an unborn baby: “We desperately want them to understand that yes, you’re in this crisis moment, this moment where this feels impossible, but we want to try to help you see a bigger picture … to be able to look back on that decision and say, ‘Yes … it was tough, but I am so glad that I had this child.’”

Helping parents see that bigger picture has been a central function of ultrasound technology since its introduction for clinical use in the 1950s. The first pro-life pregnancy center to provide ultrasounds opened in 1985. In 2009, 52 percent of Care Net’s 1,113 affiliates offered ultrasounds. A decade later, that number had grown to 77 percent of that year’s 1,055.

English OB-GYN Ian Donald, who pioneered the use of ultrasound in obstetrics after serving as a medical officer for the Royal Air Force in World War II, saw his legacy clearly. “If I have done nothing else in my life,” he said in a lecture given in the last decade before his death in 1987, “I have killed that dirty lie that the fetus is just a nondescript meaningless jelly, disposable at will, something to be got rid of.”

I talked with staff and volunteers from more than a dozen medical pregnancy centers across America. When I asked them for their best tool in helping abortion-prone women choose life for their unborn babies, most named ultrasounds right away, or at least as one of the top two. But all of the centers I spoke with acknowledged that some who see an unborn child bouncing and moving still choose abortion. Ultrasound technology by itself is important but not sufficient: Pregnancy centers are considering how to address spiritual topics with clients.

THE ALTERNATIVES PREGNANCY CENTER sits in a business park tucked back from a busy street in Sacramento, Calif., an 11-minute drive from a Planned Parenthood that performs surgical abortions. The center sees clients ranging from women already parenting to homeless women to college students pregnant for the first time.

Nicole Manners, the client services manager, still prays for one mid-30s woman who came to the pregnancy center last year, wearing paint-spattered overalls and a beat-up ball cap. She had just helped a friend paint his trailer and was planning to abort that day, since that was when she had a ride. At the time, the Planned Parenthood was only performing abortions and often sent clients to Alternatives to confirm their pregnancies before the appointment.

Alternatives provided this woman with a pregnancy test and offered her a free ultrasound. She was in a hurry but still agreed to the sonogram. The almost masculine woman surprised Manners by silently weeping as she lay on the table, looking at the ultrasound image of her first-trimester baby. But later, sitting in the client room’s brown leatherette love seat, she told Manners, “It doesn’t matter what I saw, and it doesn’t matter that my heart is broken. I’m going to get an abortion.”

At least one pregnancy center worker I spoke with said ultrasounds’ effect on pregnant women has probably changed over the last few decades. Most women today have never known a pregnancy without ultrasound images. Some grew up seeing sonograms of themselves on the fridge. Perhaps that has desensitized them to sonographic depictions of unborn life—but ultrasounds have never guaranteed a choice for life.

Alofa Porter was a 19-year-old college student in Knoxville, Tenn., when she missed a period in early 2000. After taking about five pregnancy tests that all came out positive, she told her boyfriend and started researching abortions. Keeping the baby never seemed like an option: She didn’t know how she could keep working two part-time jobs to pay her way through college. Porter and her boyfriend worried about the future their child would have. She was also afraid to tell her mother, who put pressure on Porter to be an excellent example for her 17- and 12-year-old sisters. Porter looked up the local abortion facility in the phone book and called to find out the price: around $400. She decided to drive there to get more information.

Seemingly by accident, she ended up at the Hope Resource Center across the street. There, she took another pregnancy test and had a free sonogram. While lying on the table in the ultrasound room, she looked at the screen and saw her little bean-shaped baby. The sonographer pointed out the flutter of a heartbeat. She had seen an ultrasound image before, but tears still ran down her cheeks. After she realized during counseling that the center didn’t perform abortions and that she was in the wrong place, she left as soon as she could without changing her mind.

“I saw that it was life,” Porter remembers. The center had even offered her help and information about adoption. “But I think that fear overtook me.” Within two weeks, she aborted her baby at the facility across the street. Porter felt instant regret. She sobbed in the parking lot. As her boyfriend drove home, she sat slouched in the passenger seat with her head on the window and her face wrapped in her sweater.

PREGNANCY CENTERS OFFER resources and free services, but center staffers reach a point where that help makes little difference to some women. Manners said the woman in the paint-spattered overalls knew about the center’s free parenting classes and complimentary obstetric care, but that didn’t sway her. “What can you do at that point?” said Manners, remembering her client. “There’s nothing we can offer.”

Christiansen said the choice some women make can weigh heavily on counselors: “We feel so responsible if somebody doesn’t choose to carry. At the end of the day, I’m not in control of that. I’m not.” Christiansen compared the experience to a person’s decision to trust Christ: Whether or not the person makes that decision is not up to the evangelist. Like becoming a Christ-follower, the decision to keep an unplanned pregnancy relies on the work of the Holy Spirit: “We do what we can … and then God will do the rest.”

That’s why many pregnancy centers incorporate spiritual discussions into their interactions with clients. Some include it as an add-on to their sessions with women and say bringing up the gospel is a secondary concern when women come to them in a crisis. A common concern is that sharing the gospel with women in crisis pregnancies can come across as pushing an agenda. But, for other centers, it’s a central function of their work.

“We want to save the babies, but we also want to save the mom eternally. That is an equally important mission,” said Christina Hagan, partner relations manager for ICU Mobile, a nationwide fleet of pro-life medical units. The ICU-Cuyahoga unit serves women in parking lots and on roadsides around the Cleveland metro area. From the outside, the converted 30-foot RV parked down the street from the Preterm abortion facility looks like a standard medical unit. The blue signs on the sidewalk and one-way street advertise free ultrasounds. Inside, that’s what patients with a positive pregnancy test will get, along with referrals to local organizations that can help them during their pregnancy.

But Michelle Grenig, the unit’s enthusiastic operations manager, said she wants women to hear not only about the life in their wombs but also about the eternal life they could have. Depending on the client, Grenig will touch on the good news of Christ’s sacrifice either by sharing her own testimony, explaining what Jesus did for sinners, or just telling the woman God loves her. She also offers to pray for the women before they leave. In her two years with ICU-Cuyahoga, only one person has turned her down.

To Grenig, who has spiky red hair, the image of the ultrasound and the truth of Scripture work in tandem. She tells women, “You know what? This is a perfect time in your life. You have a new life and a new beginning inside of you, and what better time to start off with God … and raise this child to know the Lord?” As the women leave, Grenig gives them a purple plastic bag of books—sometimes a New Testament devotional or a title by Max Lucado. She sometimes recommends local churches.

Some centers put their volunteers through training to help them address spiritual needs. First Life Center for Pregnancy, a center in the heart of Orlando, Fla., uses Focus on the Heart, a Hope National curriculum that teaches an approach based on use of Scripture and reliance on the Holy Spirit to change the woman’s life. First Life director Carmem Carmo sees how this gospel focus complements the use of ultrasound technology: “Just to show them it is a baby doesn’t bring the peace they need to move forward with the pregnancy. That can even overwhelm them even more.” An ultrasound image can show the reality of unborn human life, but the women need to know God’s love for them.

Carmo said her center’s goal is to make the fears they’re dealing with smaller and their hope in Christ bigger: “The problem is not the pregnancy. The problem is not the baby. The problem is, where is her heart? Where is her focus? So when Jesus gets ahold of her heart, her life changes.”

The Alternatives Pregnancy Center also tries to prioritize the gospel in its interactions with clients. When and how to present the gospel varies, depending on whether a woman has given staffers permission to talk about spiritual things. But client services director Manners knows the gospel is crucial: “Generally, women who recognize their forgiveness and recognize their Savior are going to see their children in a different light.” Sometimes, that change in perspective happens without the help of an ultrasound machine.

Manners remembers one woman who visited Alternatives in the past year: an older mom who already had teen children and called herself a Christian but was adamant that she would get an abortion. The woman was unmarried and knew the shame of what she had done. Manners asked her to consider what God thought of her decision to abort. The woman said she knew it would be wrong to get an abortion but refused to pray about it and wouldn’t watch the educational video that explains an abortion procedure.

During the ultrasound, the woman jerked her head to the side and covered her face with her hands. After the sonogram, she didn’t want to take home prints of her unborn baby or any of her paperwork. But she did allow Manners to pray for her back in the client room. When the woman left, Manners didn’t expect to hear from her again, anticipating that she would get an abortion. But a few weeks later, the woman returned. Still pregnant, she was asking for guidance about pursuing adoption because she had chosen to continue her pregnancy. Since she hadn’t looked at the ultrasound and had been so unreceptive to any other help the center initially offered, Manners asked what had changed her mind. “It was just you guys,” said the woman. “It was you guys praying for me.”

She ended up miscarrying, and Manners said the mother was heartbroken. But the decision to keep her baby seemed to mark a turning point in her spiritual life: “She did say she’s seeking the Lord much more deeply and in fellowship with her church community.”

AFTER ALOFA PORTER’S ABORTION in early 2000, the image of her bean-shaped baby on the ultrasound screen replayed in her mind. Getting a positive pregnancy test was one thing, she said, but the ultrasound confirmed without a shadow of a doubt that the thing inside of her was a baby.

“I knew how wrong it was,” said Porter. “But I don’t understand why I couldn’t see that beforehand, even with—like—an intervention.” It wasn’t until after her abortion that the reality of that ultrasound image struck her fully. She said knowing she had seen that ultrasound made her guilt even worse: “Leading up to [the abortion], I wish it had affected me more. I don’t know why it didn’t. I mean, that’s all I can say: I had total blinders on.”

Porter doesn’t recall if the pregnancy center she visited in Knoxville discussed spiritual things with her during her unplanned visit, and she didn’t return there after her abortion. She married her boyfriend. Now they have two teenage children. Even though she attended church regularly as an adult, it wasn’t until she went to a post-abortion recovery retreat in July 2017 that she realized Christ had taken the penalty for her abortion upon Himself too: “Understanding that I’m forgiven in Jesus Christ … ultimately, that’s the only thing—the only thing—that has gotten me on the other side of it.”