“They’re really the darlings of the pro-life movement. That ground level, one-on-one, reaching-the-woman-where-she’s-at approach.” This is how the vice president of external affairs for Americans United for Life Jeanneane Maxon described crisis pregnancy centers in a 2013 New York Times article.[1] Yet such words of praise have historically been harder to come by for the “service-based arm” of the pro-life movement. Those who started “emergency pregnancy services” (EPS) in response to state-level efforts to liberalize abortion laws saw pregnant women in need as their primary concern. Providing “alternatives to abortion” to pregnant women acknowledged and aimed to alleviate the stigma of unplanned pregnancy, and advocates believed that such services were the only way to enable women to “choose life.” Rhetoric and laws would do nothing to help women struggling with an unplanned pregnancy that, in the absence of alternatives, gave women “little choice but abortion or forced marriage.”[2] They had difficulty, however, garnering support from other arms of a movement that believed “fetus-centered, rights-based” arguments would win the battle over legal abortion.[3] Looking at the early efforts of those dedicated to EPS not only emphasizes the diversity of opinion within the pro-life movement regarding how best to combat Roe, but also shows that such opinions were not of equal importance despite a shared opposition to abortion.[4] Such insights help complicate the abortion debate, which, whether as historical narrative or popular opinion, is too often told solely in binaries.

In 1970, a group of pro-life activists met in Chicago to discuss how such services could begin in the US. Organized by Louise Summerhill, the founder of the Canadian organization Birthright, the meeting drew those interested in a service-based approach to combating liberal abortion laws. It was here that Dr. John Hillabrand, Lore Maier, and Sister Paula Vandegaer would meet and found Alternatives to Abortion International (AAI). The founders aimed to create a “world federation of emergency pregnancy services” that would eventually form a vast network of support for pregnant women across the globe. Maier, while no more dedicated than her co-founders, often conceived of AAI’s role in the most grandiose of terms. She wrote: “In a way, I envision AAI and EPS centers as a global entity, much like the Red Cross. While the Red Cross enters in where there are catastrophic natural plights, wars, or other man-caused mishaps that affect the multitudes, AAI in contrast deals with individual and personal crises where the life of the unborn and the healing and well-being of women and families are at stake.”[5]

While the infrastructure AAI aspired to create was significant, the emergency pregnancy services that existed upon the organization’s founding in 1971 were at best trying to keep up with clinics and non-profits that offered abortion referrals. By this time, a handful of states had liberalized their abortion laws, resulting in a visible and legal network of abortion referral. To counteract this new resource, groups established EPS hotlines so that women could locate sympathetic pro-life services. In 1971, The Value of Life Committee (VOLCOM) in Boston created the “Pregnancy Guidance” hotline—it encouraged women to “give their baby a chance for life” by calling the advertised number. Lifelines of Western Massachusetts operated a similar referral system.[6] Yet after four and half months of operation, VOLCOM had received only thirty calls, compared to the 613 women Pregnancy Counseling Service saw in the month of July alone. Lifelines was similarly under utilized, and members of VOLCOM concluded that pro-life agencies were failing to “make even the initial point of contact with the overwhelming majority of these pregnant and troubled girls.” They urged the Massachusetts Conference of Bishops to increase support for “a positive well-advertised and well-packaged program of care for women in pregnancy as a sound alternative to abortion.”[7]


Client protection, however, was not only about anti-discrimination. It also extended to AAI’s strict stance on abortion.


Other early hotline operations were more optimistic. Women mobilized by California’s abortion reform bill eventually began an operating service called LifeLine in 1971.[8] With the help of social service providers working for Catholic Charities, the initial group received training in principles of “non-judgment and client determination” and began to train other interested volunteers.[9] A second hotline serving the San Fernando Valley was established a couple of months later, and the network of trained volunteers eventually reached even further across Southern California.

Concerned advocates continued to form networks of pro-life service providers in hopes of making abortion irrelevant. But it was not until the formation of AAI that “emergency pregnancy services” began to take a recognizable shape nationwide. The organization understood itself to have a primarily coordinating function—it tried to harness the energies of existing or fledgling centers by requesting their affiliation. In return for affiliation dues, AAI provided centers with advice on how to counsel women facing unplanned pregnancies and a copy of the annual AAI affiliate directory. It also connected those in the field by hosting an academy on abortion alternatives every year. AAI aimed to provide “loose” organization of its affiliates and encouraged them to tailor their approach to the specific needs of a given area.[10]

Adherence to AAI’s six pro-life principles was the one requirement affiliates had to fulfill for membership. These principles made up the philosophical underpinnings of the organization and aimed at ensuring client protection. Centers, for example, had to promise not to discriminate on the basis of “race, creed, color, national origin, age, marital, or socioeconomic status” and to maintain client confidentiality. Client protection, however, was not only about anti-discrimination. It also extended to AAI’s strict stance on abortion. AAI’s sixth principle forbade centers from referring “abortions or abortifacients” to clients. As AAI’s affiliates increased and the organization became more visible, this principle would make federal funding all but impossible until the mid 1990s.

In addition to these official affiliate services, AAI bolstered the EPS movement in other large and small ways. Sometimes AAI would connect potential clients to centers in their area. RB, a seventeen year old with a six-month-old son, wrote in hopes of finding “moral and financial support” from a local EPS. “My son’s father left me when I became pregnant. And not having no one to turn to besides my parents I was in a sense of the word forced to have and keep my child…Please don’t get me wrong I love my son very much and far from regretting having and keeping him.” AAI co-founder Sister Paula instructed the center Friends of Life in West Palm Beach to get in touch with RB and “give her whatever encouragement and support you can.”


While explicitly non-sectarian, those involved in emergency pregnancy services early on were largely Catholic. As a result, the founders desperately sought recognition and support from the National Council of Catholic Bishops.


Time was also spent reporting on the successes of AAI’s affiliates. EPS advocates in Montana had twenty centers by 1973, leading Maier to conclude that the state “is alert and doing something about it.”[11] Centers in Geauga County of Ohio reported that they had received funds from the State Mental Health Board to cover psychiatric consultant fees offered by their centers and declared the development a “breakthrough in the area of securing public funding for Pro-Life EPS Centers” and an “acknowledgement of the fact that these centers do perform a service which contributes to the improvement of mental health in those persons who are distressed by pregnancy.”[12]

By 1975, AAI boasted of having over 700 emergency pregnancy services affiliates in the U.S., all of which provided services free of charge and without any financial support.[13] The number of EPS operations affiliated with AAI more than doubled between August of 1972 and December of 1973, a period that spanned both the lead up to and year after the Supreme Court’s decision in Roe v. Wade.[14] Recognizing this growth, the 1975 January issue of Heartbeat News Bulletin was dedicated entirely to “Starting a Pro-Life Emergency Pregnancy Service Center” in response to the “numerous inquiries received from many new groups planning to establish Emergency Pregnancy Services, and as a service to all the newly formed E.P.S. centers within the last year.”[15]

Yet despite the influx of letters, annual academies, and the creation of Heartbeat Magazine, a publication dedicated solely to emergency pregnancy counseling, AAI did not have the prominence it desired within the pro-life movement or on the national stage. While explicitly non-sectarian, those involved in emergency pregnancy services early on were largely Catholic. As a result, the founders desperately sought recognition and support from the National Council of Catholic Bishops (NCCB).[16] Financially strained from the beginning, AAI felt overlooked by the NCCB when it came to monetary support. Maier attributed this to the Bishops not taking seriously the promise service held for ending abortion: “In most instances the EPS centers have begun and carried on without support from church or government. In far too many instances, it is because the nature, scope and importance of their programs have not been understood, or have been confused with Right to Life Societies. It is, for example, not too uncommon and it is very frustrating for the service centers to hear, ‘We have already given to you in the last Right to Life Drive!’”[17]

The EPS movement would undergo many changes over the next three decades. Yet this early history shows that the current day “darlings” of the pro-life movement were not always considered central to the movement’s success. They did not follow the dominant approach: these women chose to invest their energies in the situation on the ground rather than in the courts and Congress. In doing so, they inaugurated an approach to pro-life activism that would prove invaluable to the movement’s image and growth by the late 1990s. Their story demonstrates the complexity of a movement often taken as monolithic and speaks to the variety of responses any ethical crisis can provoke.

Sara Matthiesen is a PhD Candidate in American Studies at Brown University. Her research interests include social and political movements, the intersection of gender and sexuality with race and class, different modes of citizenship, and the body. Her dissertation, “Reconceived: Women’s Reproduction after Roe v. Wade,” examines debates between gender-based advocates and state and legal institutions over how to define and best account for women’s “reproductive difference.


[1]Pam Belluck, “Pregnancy Centers Gain Influence in Anti-Abortion Arena,” NYT, Jan 4 2013.

[2]This view was widely held by the original founders of emergency pregnancy service centers, many of whom modeled themselves after Birthright. Sue Kincaid, The Cleveland Press, Dec 14, 1970, p. B6.

[3]Robert O. Self, All in the Family, Hill and Wang, New York, 2012, p. 284.

[4]Scholarship exploring the pro-life movement post Roe has mostly focused on the more radical segments that emerged during the mid-1980s and early 1990s. See Dallas Blanchard, The Antiabortion Movement and the Rise of the Religious Right (Twayne Publishers, 1994); Carol Maxwell, Pro-Life Activists in America (Cambridge: Cambridge University Press, 2002); Carol Joffe, Dispatches from the Abortion Wars (Boston: Beacon Press, 2011); Carol Mason, Killing for Life (Ithaca: Cornell University Press, 2002); Faye Ginsburg, “Saving America’s Souls: Operation Rescue’s Crusade against Abortion,” in Fundamentalisms and the State: Remaking Polities, Economies, and Militance, edited by Martin E. Marty and R. Scott Appleby (Chicago: University of Chicago Press, 1993). Additionally, these studies and others exploring different aspects of the abortion debate rarely mention the EPS movement, and when they do, crisis pregnancy centers are depicted as an outgrowth of the confrontational and violent tactics that emerged on the fringes of the movement.

[5]Letter to Bishop from Maier, Folder Bishop Correspondence, Heartbeat International Internal Records.

[6]“Volcom Speaks…” newsletter, Oct 1972, bMS 404/2, George Hunston Williams Papers, Abortion Collection, Harvard Divinity School. “Statement Before the Massachusetts Conference of Bishops,” Sept 25, 1971, bMS 404/2, George Hunston Williams Papers, Abortion Collection, Harvard Divinity School.

[7]For example, in the Value of Life Committee’s statement to the Massachusetts Conference of Bishops, they sighted Pregnancy Counseling Services’ number of clients as evidence of the fact that despite their attempts with the Pregnancy Guidance hotline, they were not reaching “the majority of these pregnant and troubled girls.” “Statement Before the Massachusetts Conference of Bishops,” Sept 25, 1971, bMS 404/1, George Hunston Williams Papers, Abortion Collection, Harvard Divinity School.

[8]Undated Right to Life training materials, International Life Services Internal Records.

[9]Interview with Sister Paula Vandegaer, On File with Author.

[10]Tailoring services to regional needs also meant being cognizant about prevailing political beliefs when it came to advertising. An early Heartbeat Newsletter advised affiliates that in order for the names of their centers to be effective they should “first engage the attention, arouse curiosity, suggest an element of hope, and preferably, not appear excessively moralistic…many different names might be required to suit the conditions prevailing in various areas and nations,” Heartbeat Bulletin Oct 1971, Vol 1, No 2, BMS 404/9, George Hunston Williams Papers, Abortion Collection, Harvard Divinity School.

[11]Heartbeat News Bulletin, Sept 1973, Vol 5, No 3, BMS 404/8, George Hunston Williams Papers, Abortion Collection, Harvard Divinity School.

[12]Heartbeat News Bulletin, Aug 1973, Vol 5, No 2, BMS 404/8, George Hunston Williams Papers, Abortion Collection, Harvard Divinity School.

[13]Letters to Senators Kennedy and Bayh from Hillabrand and Lore, December 1 and 4 respectively, 1975, Heartbeat International Internal Records

[14]AAI went from having 181 affiliates in 1972 to 467 affiliates in 1973. AAI’s Worldwide Directory of Emergency Pregnancy Services, Aug 1972 and Dec 1973 editions, George Hunston Williams Papers, Abortion Collection, Harvard Divinity School.

[15]Heartbeat News Bulletin, Jan 1975, Heartbeat International Inc. Internal Records.

[16]In a letter to the President of the NCCB and Archbishop of Cincinnati Joseph L. Bernadin, Dr. Hillabrand wrote to ask for a public statement of approval from the NCCB on AAI’s operations. Hillabrand confided in Bernadin that while the organization “makes every effort to protect and maintain its avowed non-sectarian image…It is unrealistic not to acknowledge that the greatest reservoir of strength and manpower in the service effort is found among the committed Roman Catholics.” Letter to Bernadin from Hillabrand, Dec 28, 1975, Heartbeat International Internal Records.

[17]Letter Joseph L. Bernadin from Lore Maier, Dec 4, 1975, Heartbeat International Internal Records.

Image of the Supreme Court from Flickr via Jason OX4


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