Health authorities in Ecuador and Costa Rica have promised to open formal investigations into US-backed ‘crisis pregnancy centres’ following an openDemocracy special report.

Women’s rights activists in both countries described these promises as “important” – but warned that their governments have poor records implementing policies based on human rights, and that this could only get worse during the coronavirus pandemic.

As part of a recent global investigation, undercover reporters posing as vulnerable pregnant women visited anti-abortion ‘crisis pregnancy centres’ in Ecuador and Costa Rica.

Backed by two US Christian right groups, Heartbeat International and Human Life International, the centres the reporters visited had advertised themselves online as pro-choice support groups for women considering abortions.

In person, however, staff at these centres gave the reporters misleading and incorrect information, including, for example, that abortion increases the risk of getting cancer. In Costa Rica, a reporter was also told that after having an abortion a woman’s life would “become hell”.

Abortion is illegal in most cases in both countries, but women still terminate pregnancies and there have been campaigns to change the law to widen access to legal, safe abortion.

In a letter to openDemocracy, Ecuador’s health ministry said it had “no knowledge of the activity or existence” of such centres prior to our investigation – and that government authorities would “carry out corresponding monitoring” of these places.

On 12 March, the government agency overseeing the quality of health services confirmed that “the detailed information [revealed by openDemocracy’s investigation] was sent to the office in charge” and said that a statement from this office is forthcoming.

Meanwhile, Costa Rica’s ministry of health said in an email that it “will send the charges [of our reporting] to the responsible offices to proceed with investigation”.

‘It must act more seriously’

Ana Vera, an Ecuadorian lawyer and sexual and reproductive rights expert, said: “It’s important the ministry is ready to take action, but it must act more seriously than in the past”, because similar questions have been raised about such centres before, with no results.

Larissa Arroyo, a lawyer in Costa Rica, added that her human rights organisation Acceder will “check this promise by the government because these centres have been here for years. They even advertise in newspapers.”

She said her group is “interested in following this up”, and that while “now it’s all about coronavirus […] the right to health care is constitutional” and can’t be suspended.

The Ecuadorian and Costa Rican governments’ responses follow other calls for action from lawmakers around the world who expressed alarm at openDemocracy’s investigation.

Neil Datta, secretary of the European Parliamentary Forum for Sexual and Reproductive Rights, should “every politician” should be concerned about the examples of “disinformation, emotional manipulation and outright deceit” revealed by our reporters.

The centres in Ecuador and Costa Rica visited by reporters are part of a regional network called Centro de Ayuda para la Mujer Latinoamericana (Latin American Women’s Aid Centre, or CAM), which has a partnership with the Christian right-wing group Heartbeat International, a pioneer of ‘crisis pregnancy centres’ in the US.

The CAM network is further connected to a second US anti-abortion group, Human Life International (HLI), whose founder once called contraception a “moral cancer”. CAM was founded after an activist attended an HLI conference, and its website carries HLI’s logo.

In Mexico City, where abortion is legal, another reporter was told – incorrectly – that she needed the consent of her partner or a relative for an abortion – and that no hospital would treat her if she had any serious complications, which is also incorrect.

In response to our findings, Mexico City’s secretary of health, Oliva López, told openDemocracy that her department had received complaints about ‘crisis pregnancy centres’ before, and that it would review their activities and potentially sanction them.

In Argentina, parliamentarian Mónica Macha, a member of the ruling coalition, called on authorities “to investigate whether [such centres’] practices are fully legal”.

On 1 March, Argentinian president Alberto Fernández said he would shortly introduce bills to legalise abortion and protect pregnant women – though this has not yet happened.

Delaying action

The Ecuadorian government letter, signed by the under-secretary for the promotion of health and equality, reaffirms that the country is “secular” and must provide and regulate contraception and post-abortion care, even though abortion itself is illegal in most cases.

The country's National Plan on Sexual and Reproductive Health, it adds, also considers that information and access to modern contraception as “fundamental rights of men and women”, which enable their “right to decide” if and when to have children.

But Vera, the Ecuadorian lawyer, who directs the sexual and reproductive rights group Surkuna, contrasted her country’s laws on paper with what happens in practice. She said health authorities have known about ‘crisis pregnancy centres’ for at least a year, but have done nothing.

“They knew. Now there are new authorities [in office], but the facts were there,” said Vera, who is also pessimistic about quick action during the current public health crisis. “During coronavirus, they will do absolutely nothing,” she predicts.

She said she has provided legal advice to numerous women who have visited CAM centres and “were left terrified, describing their experiences as torturous”, but were reluctant to denounce these centres. “If they got an abortion, they wouldn’t say it to authorities.”

Last year the public prosecutor’s office opened a preliminary inquiry into ‘crisis pregnancy centres’ in Ecuador following an investigation published by the local feminist media outlet La Periódica, but none of the women Vera spoke to would testify.

In Costa Rica, lawyer Arroyo said that her group has also received “lots of calls from girls who visited those sites and were left scared and without knowing what to do”.

Neither HLI nor CAM responded to questions from openDemocracy about our investigation’s findings. Heartbeat International defended its federation of affiliates around the world. It said they must follow “basic principles”, but are otherwise autonomous.

“Public mischaracterisations of Heartbeat-affiliated pregnancy help centres have consistently not withstood scrutiny when brought into a court of law,” it added, and “a recent survey of pregnancy help centre clients revealed a 99% satisfaction score.”