The New Front Line of the Anti-Abortion Movement

As rural health care flounders, crisis pregnancy centers are gaining ground.
woman looking at crisis pregnancy center
Crisis pregnancy centers have used deceptive techniques to attract clients.Illustration by Ben Wiseman

On the door of a white R.V. that serves as the Wabash Valley Crisis Pregnancy Center’s mobile unit are the stencilled words “No Cash, No Narcotics.” The center, in Terre Haute, Indiana, is one of more than twenty-five hundred such C.P.C.s in the U.S.—Christian organizations that provide services including free pregnancy testing, low-cost S.T.D. testing, parenting classes, and ultrasounds. Sharon Carey, the executive director of the Wabash Valley center, acquired the van in January, 2018, for a hundred and fifty thousand dollars, after finding a company that retrofits secondhand vehicles with medical equipment. That May, Carey began to dispatch the van to rural towns whose residents often cannot afford the gas needed to drive to the C.P.C. or to a hospital. Carey has selected parking spots in areas with high foot traffic, so that prospective clients can drop in to learn about the C.P.C.’s services. In Montezuma, she chose the lot outside a Dollar General. In Rockville, she discovered an I.G.A. supermarket frequented by the local Amish community; the van parks next to the hitching post where Amish shoppers tether their buggy horses. Driving straight up to the Amish farms would have been the wrong approach, Carey felt. The community is insular, and was unlikely to welcome outsiders offering their teen-agers free pregnancy tests or screening for chlamydia and gonorrhea.

In Brazil, which is one of the poorest cities in Indiana, Carey chose the parking lot of the Church of the Nazarene, across from a Circle K convenience store and not far from House of Hope, a Christian drug-rehabilitation center whose residents rely on the van for S.T.D. testing. On a recent Wednesday morning, Libby Butts, the manager of client services for the mobile unit, who wears her hair in a long braid, and Mary Hargis, a sonographer, came aboard. Hargis, who is fifty-six, had on a pink lab coat over a T-shirt featuring an image of a sewing machine and the words “Quilting in My Veins, Jesus in My Heart.” She opened a silver wheelie bag containing a new ultrasound machine, and disappeared into the van’s makeshift examining room, which contained a sink, a table with stirrups, and a large TV screen on which the ultrasounds would be shown.

Hargis began volunteering at the C.P.C. in 2005. “I think, if women are fully informed, most would choose life for their child,” she told me as she assembled the machine. “Maybe I’m naïve, but from what I’ve read, and hopefully accurately, I’m not sure they’re always informed.” On the wall was a rack of pamphlets with titles such as “Before She Decides” and “Intentional Abstinence for Singles.” Like much of the literature dispensed by C.P.C.s, the brochures presented carefully selected facts in order to make a case against abortion (“A small number of women have died from infection”) and contraception (“You can be infected with any S.T.D. even when using condoms 100% of the time”).

The C.P.C. movement took off in the late sixties, as states considered repealing laws criminalizing abortion. Robert Pearson, a Catholic carpenter, founded one of the first centers, in Honolulu, and then set up a foundation for C.P.C. owners, providing them with training sessions, pamphlets, and slide shows, many of which featured gory images of fetal remains. C.P.C.s employed various deceptive techniques to attract women, often advertising themselves as abortion providers. Centers were sometimes established next to abortion clinics and were designed to resemble them. Until the seventies, abortion had mostly been a Catholic issue, but following Roe v. Wade, in 1973, evangelical Christians began to join the pro-life movement. In 1978, the Southern Baptist pastor Jerry Falwell partnered with the conservative activist Paul Weyrich in an effort to register and organize religious voters, and they seized on the issue of abortion as a mobilizing cause.

In the eighties, some pro-life activism became associated with violence, when groups such as Operation Rescue staged sit-ins at abortion clinics and incited attacks against abortion providers. Several doctors were assassinated. C.P.C.s, under increasing scrutiny, were hit with a wave of lawsuits. Following a congressional investigation in 1991 that condemned C.P.C.s for committing consumer fraud and for publishing misleading advertising, the national anti-abortion organizations Heartbeat International and Care Net standardized C.P.C.s’ training and materials, attempting to transform them into institutions that offered advice and support. In 1991, the Wabash Valley center was among the first C.P.C.s to hire part-time medical providers and to purchase ultrasound equipment. Like many other centers, Wabash Valley also began to run abstinence-only education programs in public schools. In 1996, President Bill Clinton’s welfare-reform act allocated fifty million dollars a year to abstinence-training programs, giving C.P.C.s an infusion of federal funding. In 2003, President George W. Bush increased that funding by thirty-three million dollars. In 2009 and 2010, the Wabash Valley C.P.C. received twenty-six thousand five hundred dollars to teach abstinence to public-school students in surrounding Vigo County.

These days, as few as four per cent of the women who visit C.P.C.s are pregnant and undecided about whether to have an abortion. Most come for social services, including the pregnancy verification required to sign up for maternal and infant Medicaid. In the past decade, C.P.C.s, which are at the forefront of the grassroots anti-abortion movement, have identified a new sense of mission and authority as rural health-care providers have struggled with a lack of funding. (In the U.S., more than a hundred rural hospitals have closed in the past decade.) This dynamic was particularly evident in Indiana under the governorship of Mike Pence, who grew up as a Catholic and became an evangelical Christian as an adult, and has praised C.P.C.s for “telling the truth about the cause of life.” In 2007, as a member of Congress, Pence sponsored the first federal bill to defund Planned Parenthood, which did not pass. In 2014, the year after Pence became governor, he signed a bill prohibiting private insurance plans from covering abortions in most cases. In 2015, he launched an investigation of Planned Parenthood’s fetal-tissue-disposal practices. (The investigation found no wrongdoing.)

That year, Pence gave $3.5 million to Real Alternatives, a Pennsylvania-based anti-abortion organization that supports C.P.C.s. The funding was diverted from Temporary Assistance for Needy Families, a state-run federal program intended to clothe and feed children and to create initiatives that help prevent “non-marital childbearing.” Indiana has some of the lowest payouts to TANF recipients in the country. The Real Alternatives contract stipulated that the organization and its subcontractors must “actively promote childbirth” and must not refer clients to abortion providers or promote contraceptives. To date, the state has allocated $11.25 million to Real Alternatives. In early 2016, Pence signed into law an array of bills that restrict abortion, including one measure, which was recently upheld by the Supreme Court, requiring that fetal remains be buried or cremated.

As Vice-President, Pence has attempted to reshape the country’s reproductive-health-care policies according to his religious ideology. He staffed the Department of Health and Human Services with several people he knew from his time in Indiana, including Alex Azar, a pharmaceutical executive and lobbyist in Indianapolis; Jerome Adams, a former Indiana health commissioner; and Seema Verma, who worked on the redesign of Indiana’s Medicaid program. In July, 2017, H.H.S. said that it would terminate the contracts of eighty-one organizations receiving pregnancy-prevention grants, and issued new rules that favored groups promoting abstinence-training programs. The National Campaign to Prevent Teen and Unplanned Pregnancy had found in 2002 that abstinence-only programs led to “no significant changes in participants’ initiation of intercourse, frequency of intercourse, or number of sexual partners.” The Trump Administration also announced that it would ban organizations that provide abortion referrals from receiving funds from the Title X Family Planning Program, a federal grant that offers services including contraception counselling. As a result, Planned Parenthood withdrew from Title X funding, which it had used to provide more than 1.5 million women with services such as pregnancy testing and birth control. In March, H.H.S. designated $5.1 million of Title X money for the Obria Group, a largely Catholic organization that subsidizes C.P.C.s in Southern California.

“Looks like you’re not the only one wearing impractical shoes in the woods.”
Cartoon by P. C. Vey

In response to C.P.C.s’ growing influence, the national campaign #ExposeFakeClinics invited visitors to its Web site to review C.P.C.s online, to report false advertising, and to “take it to the streets.” Last year, the advocacy organization NARAL Pro-Choice America conducted an undercover investigation of forty-five crisis pregnancy centers in California, finding that C.P.C. employees very often presented misleading information, claiming that “having an abortion was linked to an increased risk of breast cancer, infertility, miscarriage, and/or the made-up ‘post-abortion depression’ that results in suicide.” Amy Bryant, a gynecologist at the University of North Carolina School of Medicine who has written about the medical ethics of C.P.C.s, told me that the centers, which are ideologically driven, violate the Hippocratic oath. “They do not have the well-being of the woman seeking care from them as their primary interest,” she said.

Since the Wabash Valley C.P.C.’s founding, thirty-one years ago, its annual budget has increased from twenty-one thousand dollars to four hundred and seventy thousand dollars. Most of this has come from donations from individuals and churches, but last spring it was awarded seventy-six thousand seven hundred dollars as part of a $4.5 million federal program called the West Central Indiana Healthy Start initiative; the program aims to combat Indiana’s infant-mortality rate, which is the seventh highest in the country. The C.P.C. has spent the funds on a five-year subscription to a curriculum designed by BrightCourse, a video-streaming service often used by such centers, and on the part-time salary of a teacher for parenting classes. It also used the grant to buy the portable ultrasound machine, for thirty-eight thousand dollars, and to pay the part-time salary of Mary Hargis, the sonographer. Whereas ultrasounds at an abortion clinic are for doctors’ use, and at a medical center are studied for detailed information about the health of the fetus, the purpose of the sonograms at the C.P.C., Sharon Carey told me, is “to educate these women on what’s going on in their bodies.” She added, “We don’t tell them, ‘These are the arms, these are the legs.’ We just let them see the pictures and they go from there.” Hargis said that, showing ultrasounds to pregnant women, “You can see some of the change from ‘abortion-minded.’ You can see some of the change in their countenance.”

C.P.C.s’ use of sonograms is controversial. Betty Cockrum, a former C.E.O. of Planned Parenthood in Indiana and Kentucky, described the use of federal funds for ultrasounds that serve no medical purpose as “a scam.” “What do they have to do with infant mortality?” she asked. (Hicham Rahmouni, who directs the Richard G. Lugar Center for Rural Health, at Union Hospital, in Terre Haute, which is distributing the federal grant, said that Healthy Start is in the process of hiring a nurse-practitioner who will travel in the Wabash Valley mobile unit so that the C.P.C. can provide diagnostic ultrasounds.) Steven Holman, the C.E.O. of Union Health, an integrated health system in Illinois that serves a rural population of two hundred and eighty-six thousand people, and the primary recipient of the grant, told me that the Wabash Valley C.P.C. was uniquely well positioned to reach women who otherwise would be unable to access prenatal care. “The C.P.C. is doing that by taking their van and going out to these moms where they’re at,” he told me. “Yes, they park at churches sometimes. That’s where these moms may go.”

Next to the highway outside the Church of the Nazarene, the R.V.’s driver, Stan Dugger, a member of HonorBound, a Pentecostal motorcycle ministry, set up a sandwich board advertising walk-in appointments. Butts, the C.P.C. manager, drew black curtains over the R.V.’s windshield, transforming the driver’s seat and the passenger seat into an improvised counselling area. Amber, a twenty-five-year-old with freckles and glasses, wearing sweats and a neon-pink tank top, stepped into the R.V. with her mother, Jackie, who had been smoking outside. Jackie plunked herself down on a narrow black bench. “I need one of these,” Jackie joked, about the van. “If I get mad at my husband, I can sleep out in here.”

After an earlier visit, Butts had texted Amber some prenatal videos to study. Amber, who was six months pregnant, was doing some babysitting work and lived with Jackie in a cramped house in downtown Brazil. The pregnancy was the result of “a one-night stand,” Amber said. She was going to parent the child with Jackie’s help. “I was up until 2 a.m. doing my homework,” Amber told the women, presenting a black-and-white composition book. Butts led Amber into the back of the R.V. to take her through a series of worksheets about breast-feeding. The lesson was practical, and Butts was patient. “You’re going to get real familiar with your breast during that time, so don’t feel any shame,” she said, noting that her daughter, who’d recently had a baby, had had trouble with latching. A breast-feeding consultant had helped immensely, she said, and if Amber signed up for the Healthy Start initiative she would be eligible for one. Participants would also be assigned a primary-care provider and a health-care “navigator,” who could connect them to local organizations for help with housing, addiction treatment, and courses. Signing up required home visits. The two women returned to the front of the R.V., where Butts asked whether Amber would like to join the program.

“Remember what I said,” a nurse named Carol Lucas told her. “They’re not there to judge you. They’re there to help you.”

“I’d rather not,” Amber replied. She didn’t want the government snooping around in her home, she said, and was afraid that officials would find a reason to take her baby away.

“Can we pray with you before you go?” Butts asked Amber. Amber agreed, and Dugger, who was sitting in the driver’s seat, swivelled around. Amber squeezed her eyes shut and lowered her head. “Lord, we first and foremost ask for a healthy baby and for your hand to be in it,” Dugger said. “And to bless this baby not just physically and emotionally but spiritually. And, Father God, nurture this baby to grow up and come to know you, and to be with this family in a mighty powerful way.”

Many of the C.P.C.’s clients or their partners struggle with drug abuse. According to one study, Indiana has the seventh-highest rate of drug use and drug addiction in the country. In 2015, the worst outbreak of H.I.V. in Indiana’s history took place in Scott County, where the last remaining H.I.V.-testing facility, a Planned Parenthood clinic, had closed in 2013, owing to funding cuts. Pence, who was morally opposed to needle exchanges on the ground that they promoted drug use, has been criticized for waiting more than two months after the outbreak was detected before issuing an executive order allowing syringes to be distributed. According to Matt Brooks, the president and C.E.O. of the Indiana Council of Community Mental Health Centers, the state’s drug problem is the result of a history of incarcerating addicts rather than treating them, and also of a lack of coverage for rehabilitation under Medicaid. Indiana is ranked forty-eighth in the nation for public-health spending. “We’re getting the results we’d expect to get because of a historic lack of investment,” he said.

That afternoon, a twenty-year-old woman and her eighteen-year-old boyfriend arrived for their first ultrasound. They were unemployed and lived with the man’s mother, a precarious situation that the C.P.C.’s employees saw as making the woman “abortion-vulnerable.” The man, whose pupils were dilated and who slurred his speech, wore a wristful of rubber bracelets stamped with names and dates—family members and friends who had died from overdoses, he said. The woman went into the examining room and, a few minutes later, emerged clutching an ultrasound image. She stared down at it, and mumbled reasons for not staying for a parenting class. She said that she was, however, willing to sign up for the Healthy Start program, as long as the paperwork wouldn’t take too long.

After the couple left, I asked Butts why she hadn’t asked to pray with them, and she explained that the woman, on a previous visit, had said she wasn’t interested, and so the nurses, worried that she wouldn’t come to her appointments, had stopped talking to her about God. “Right now, since she is wanting to carry, our main concern is that she carries a healthy baby,” Butts said.

Terre Haute, a faded industrial town, is the seat of government for Vigo County, which has voted for the winning President in almost every election since the eighteen-nineties. In 2015, with $1.5 million in donations, the C.P.C. moved from a small house in a poor neighborhood into a facility that occupies the entire ground floor of a new five-story brick-and-glass dorm for Indiana State University, a minute’s walk from the main campus. Governor Pence visited the facility soon after it opened, and a photograph of him posing with seven female members of the C.P.C.’s staff hangs on a wall in a conference room, below the words “To God be the glory / Great things He has done.” The waiting rooms of many C.P.C.s are decorated with Biblical sayings and images of smiling babies, but Sharon Carey, the Wabash Valley center’s executive director, chose photographs of frostbitten leaves and local rivers. With the exception of a cornerstone to the left of the entrance, etched with the Bible verse “Draw near to God and He will draw nearer to you,” the space resembles a dentist’s office. On a busy September afternoon, young men and women, many of them students from the university and a local high school, sat in the sunny waiting room, flipping through copies of Terre Haute Living and Parents magazine.

Carey, an earnest sixty-four-year-old with violet eyes set in a round face, has worked at the center since its beginning, when it shared an office with a Christian counselling service. Carey attended Liberty University, in Lynchburg, Virginia, which was founded, in 1971, by Jerry Falwell. In 1977, when she was a junior, she met Paul Carey, a freshman whose family had known Falwell for a long time, and she and Paul got married the next year. In 1979, when Sharon was pregnant with their first daughter, she attended a sermon by Falwell in which he spoke of the scourge of abortion. He had recently opened a home for pregnant women in Lynchburg, which later became Liberty Godparent Home, and he told stories of their difficult lives from the pulpit. Sharon realized that helping such women was her life’s calling.

In 1981, Paul Carey became the pastor of an independent Baptist church in Terre Haute. In 1988, Sharon, now the mother of three young children, met a well-off local man who was interested in opening a C.P.C. The evangelical organization Care Net sent employees from Virginia to help the pair set up the Wabash Valley Crisis Pregnancy Center as a nonprofit. Two years later, when the C.P.C. opened a satellite in Brazil, Carey became its director. A Biblical counsellor, she was prepared to encourage women not to end their pregnancies. But she discovered that many of them needed other kinds of help. Some were victims of abuse; others couldn’t afford food for their children. With assistance from a local nonprofit and the police department, she helped women find safe houses and apply for maternity benefits.

Over lunch recently, Paul and Sharon explained that they felt that their faith had anchored them through a difficult time. In 2002, their younger daughter, Autumn, then twenty-one years old and recently married, told Sharon and Paul that she was deeply unhappy and wanted to leave her husband. Autumn filed for divorce, and the deacons at Paul’s church voted to rescind her church membership. When the Careys publicly supported their daughter’s decision, the deacons asked Paul to resign. “We left in shame, basically,” Sharon told me. Paul, an empathetic, humorous man, grew serious. “I won’t lie,” he said. “Sometimes I struggle with bitterness.” Sharon told me, “We know what it’s like to be betrayed,” noting that many of the young women she sees at the C.P.C. feel abandoned by a family member or a partner.

Autumn Carey went to Liberty University, where she met her second husband, Eddie, who was studying to be a pastor. She has since become a successful Christian radio host and an author. In 2005, Paul started a church, New Life, in a friend’s basement. In the past fourteen years, New Life’s congregation has grown from twelve to a hundred. The Careys often say that, although they “vote pro-life,” they oppose the politicization of abortion. Sharon told me that she has never used manipulative techniques to persuade women to continue their pregnancies. “Of course we want them to carry,” she told me. “But we know the decision is theirs to make, and we want them to know, whether they choose parenting, adoption, or abortion, they’re all hard, and we’ll be there for them.” Kimberly Kelly, a sociologist at Mississippi State University, who has studied C.P.C.s for the past thirteen years, has written about a “paradox” in the C.P.C. movement: that, while garnering “impressive support among evangelicals,” it has “only limited success meeting its primary goals,” of promoting marriage and persuading women not to have abortions. She writes that “it is not uncommon for unsuccessful religious movements to reframe failure as evidence of society’s dire need for their efforts,” noting that the main function of the C.P.C. movement is the maintenance of a “collective evangelical antiabortion identity.”

One recent Tuesday afternoon in Terre Haute, I sat in on an Earn While You Learn class with four pregnant women, including a mother of six. For attending the class, the women would earn “baby bucks,” which they could spend at the C.P.C.’s boutique on baby clothes or larger items such as home furnishings or a stroller. The teacher was Cary King, whose father pastored a local megachurch, Maryland Community Church, which is a donor to the C.P.C. King leads an abstinence program for all junior-high and high-school students in Vigo County, called Creating Positive Relationships, or C.P.R.; the Healthy Start grant was now covering part of her salary. Even though all the students in the parenting class were pregnant, and the federal grant specified that the classes were to teach them parenting skills, King seemed intent on sticking to the C.P.R. formula. “Things can get out of balance when physical touching is involved,” she said, opening the abstinence pamphlet that she uses with her high-school students. “Until marriage, it would be the healthiest choice to draw that boundary after the kissing.” (King said that she includes the C.P.R. curriculum in the parenting workshops because “part of being a good parent is that it’s important to have healthy relationships, and a lot of times they can get into unhealthy relationships which then leads to becoming a parent.”)

After the class, Audrey, a slight eighteen-year-old in jeans and blue Crocs, who was five months pregnant and had signed up for the Healthy Start program, told me that she had taken the abstinence classes in high school, where kids who weren’t religious considered them a joke. Even the religious kids, like her, were only half listening, she said. The classes could have damaging effects. “It’s not normalized to use a condom, because of all of this abstinence training,” she said. “That’s why there are so many S.T.D.s.”

“There’s food in the fridge, and clues about the state of our marriage all around the house.”
Cartoon by Sofia Warren

Another afternoon, a petite, visibly pregnant thirty-five-year-old woman whom I’ll call Holly, who was wearing a red headband and matching Puma slides, walked into the waiting room with her mother, her sister, and a friend. Hargis greeted her and led her back to a windowless counselling room. Holly explained that she already had three children. In the past, she had gone to Planned Parenthood to receive the pregnancy verifications she needed for Medicaid, but, in 2016, the Planned Parenthood in Terre Haute closed. After taking a pregnancy test, five months earlier, she had hoped she would have a miscarriage. “I’ve been smoking cigarettes and marijuana the whole time,” she said. Hargis explained that sonograms showed clearly that pregnant smokers had thinner placentas than nonsmokers had. She told Holly about a program in which mothers who quit tobacco received free diapers each month. Holly nodded politely.

After Hargis administered the pregnancy test, she asked Holly whether she believed in God. “It didn’t feel right praying high or drunk,” Holly said. Hargis reassured her, “You don’t have to wait until you get your life together to pray. All you have to do to be forgiven is to pray and ask.”

Holly had learned that the C.P.C. offered free sonograms, and she asked if she could have one. Hargis agreed. As Hargis explains to all her patients, the sonograms at the C.P.C. are not meant to be “diagnostic,” and she stressed to Holly that she should also have an ultrasound at a doctor’s office, which could give a detailed picture of the fetus’s health. Hargis is not qualified to tell a woman much more than if the fetus has a heartbeat. Holly went to fetch her mother, her sister, and her friend, and the three women squeezed into the examining room, along with Hargis, a nurse, and me. Hargis smeared clear gel onto Holly’s belly, and began sliding a wand over it. She stopped as the baby’s spine came into focus and the underwater thud of a heartbeat filled the room. “Everything look O.K.?” Holly’s mother asked Hargis.

“We’re not doing all the diagnostics and tests they do at the doctor’s office,” Hargis replied curtly. “You need to go to the doctor.” Holly’s mother, who had been hoping to learn the sex of the baby, glared at Hargis and left the exam room, along with Holly’s sister, as Hargis printed out a picture for Holly to take with her. The nurse handed Holly a month’s supply of prenatal vitamins, and Hargis offered her a basket of rubber models of twelve-week-old fetuses. “Would you like to pick out a bootee?” Hargis asked. Some elderly volunteers had crocheted bootees for the rubber models to fit inside. Holly deliberated, then picked a red one.

In the course of my visits to the Wabash Valley Crisis Pregnancy Center, Sharon Carey introduced me to several women whose stories she felt illustrated her staff’s success. One was Jessica Harkness, who had come to the C.P.C. in 2012 to attend a parenting class in the hope of earning a crib for her baby. At the time, she was living in a tent in her stepfather’s yard, at the edge of a cornfield. For six years, she had served in the U.S. Army as a Patriot-missile operator and a mechanic, but she had been discharged, she said, for consuming alcohol. At the Terre Haute employment office, a veterans’-affairs officer noted her military experience and suggested that she apply for training as a truck driver. During a routine physical for the training, Harkness learned that she was pregnant. She suspected that the father was a soldier with whom she’d had a brief relationship.

Harkness, who was not religious, expected that the services at the C.P.C. would come with a lot of talk about Scripture, but, she said, “I was willing to put up with it to get what I needed.” In exchange for coupons that she could spend at the center’s boutique, she signed up for whatever classes were being offered. At the end of each class, Harkness’s mentor, an elderly woman named Connie Elkins, asked if she could pray for Harkness’s baby. To her surprise, Harkness found this comforting. If there was a God, she recalled thinking, she hoped that He was paying attention.

Harkness confided in Elkins about her rough childhood in the Florida Everglades. She said that her mother, a crack addict, had allowed her to be sexually abused. (Her mother could not be reached for comment.) Harkness also talked about her discharge from the Army, where she believed that she may have been drugged and assaulted. Elkins listened. “She liked me even when I thought of myself as unlikable,” Harkness told me. In August, 2012, Harkness started going to church with Elkins and her husband. The women at church held a baby shower for her. Word spread that she was looking for housecleaning jobs, and she began to earn a steady income. Harkness moved between temporary housing arrangements until the next summer, when someone at the church put her in touch with a landlord who had a two-bedroom house that she could afford.

In June, I visited Harkness in the house, where she lives with her son, Mickel, who is now six. Every Wednesday, she has dinner with the Elkinses, who treat Mickel as a grandson; for a few years, she attended Maryland Community Church with them, but now she goes to a smaller church. The pastor at Maryland once preached about Harkness’s story, pointing her out in the sanctuary. The C.P.C., Harkness told me, had offered her a family, a community, and a way of life. “The Christian values helped me realize that I liked Trump, so I was brave and voted for him,” she said, showing me a sketch of the President on the wall—she had bought it from the far-right Web site Infowars—while Mickel, sitting on the sofa, watched a nature documentary.

Sharon Carey also introduced me to another woman, who asked to be called Ray, a twenty-one-year-old psychology major from Illinois who’d come to the C.P.C. after having an abortion, and had dropped out of school to try to pay off her student loans. Beth DaCosta, who has volunteered at the C.P.C. for more than twenty years and is one of Carey’s oldest friends, said that, in March, when Ray came to the clinic after her abortion, she was suffering from “post-abortion syndrome.” For a year, almost every week, Ray had attended Bible-study classes with DaCosta, making a decision to give her life to Jesus. I spoke to the two women in a conference room at the C.P.C. Ray was warm and expressed gratitude to DaCosta for listening to her while she was experiencing an overwhelming grief after her abortion. “It was eating me up inside,” she said. Still, she added, she did not regret her decision, and she would not try to persuade anyone else not to terminate her pregnancy. “I would just want her to know she wasn’t alone,” she said. DaCosta looked surprised, explaining that she would discourage anyone from getting an abortion for any reason. “I would try to change her mind,” she said.

A week later, Ray and I went to dinner at a Panda Express in a nearby strip mall. She had recently finished a shift at Staples and was wearing the store’s uniform polo shirt. Afterward, she took me back to the third-floor walkup where she lived with two roommates. The C.P.C.’s illuminated sign was visible from her bedroom window. She had stopped going to the Bible-study classes at the C.P.C. and had begun ignoring some of DaCosta’s text messages. “I’ve been kind of wanting to be left alone to figure myself out,” she said.

Late this summer, she wrote to tell me that she was moving into a house with a porch swing and a yard. She had bought a husky puppy with crystalline eyes, which she’d named Blue. When I returned to Terre Haute in September, she was waitressing at Denny’s three times a week, on the graveyard shift, and was about to pick up another job, at a Hilton Garden Inn. She was enrolled in college classes online and had plans to become a therapist. Taking care of a puppy had proved too much, so she’d sent Blue to live on a farm. As we talked, sitting on her bedroom floor, we played with her new thirteen-week-old kitten. ♦