Tamra Call recognized an opportunity for her Christian-based clinic to reach more women than ever before.
For months, Ms. Call had been hearing news reports of Planned Parenthoods closing across the country — forced to shutter amid funding cuts from the Trump administration.
Now, the closures had reached her hometown, Ames, Iowa. In just a few days, the Planned Parenthood one block from Iowa State University would close, leaving thousands of students in Ames with few options for reproductive health care.
Obria Medical Clinic — providing care Ms. Call describes as “Christ-centered” and “life-affirming” — was ready to step in.
About 50 of Planned Parenthood’s nearly 600 clinics have shut down this year, largely because of Republican moves to cut the organization off from government money — fulfilling a long-held conservative dream to defund the nation’s largest abortion provider. Already prohibited from using federal funds for abortions, Planned Parenthood had relied on government dollars to provide other reproductive services for some two million patients a year, many of whom are low-income and use the clinics as a health care provider of last resort.
As Planned Parenthood closures mount, a different kind of organization is seeking to fill the void: anti-abortion pregnancy centers. While the typically Christian-based centers have long provided pregnancy tests and counseling for women facing unexpected pregnancies, some have expanded to offer a range of medical services. The founder of the national Obria network, of which the Ames clinic is a member, described Obria as a “medical brand” intended to “attract women out of Planned Parenthood.”
But because the Obria in Ames does not advertise its faith-based approach, patients may struggle to identify the key differences between Planned Parenthood and the Christian-based clinic. Instead of prescribing birth control, Obria nurses teach patients how to monitor fertility by tracking their menstrual cycles. Instead of performing abortions, they provide counseling they hope will persuade women to carry their pregnancies to term.
With abortion numbers continuing to rise three years after the fall of Roe v. Wade, the anti-abortion movement sees the Planned Parenthood closures as an opportunity to stop abortion one community — and one clinic — at a time, offering an alternative model for reproductive health care.
After hearing that the clinic was preparing to close, Ms. Call walked into the Planned Parenthood in Ames with a thick stack of Obria fliers.
“I’d love to leave some information for your patients,” Ms. Call said to the security guard one afternoon in early June. Her fliers pictured women in white coats with stethoscopes, advertising affordable ultrasounds, pap smears and testing for sexually transmitted infections — all services offered by Planned Parenthood.
“We just want them to know we are here,” she said.
Of the towns and cities where a Planned Parenthood has closed this year, about half have a pregnancy center that advertises S.T.I. testing, and about 15 percent have one that advertises some form of prenatal or gynecological care, though the offerings are far more limited than those at Planned Parenthood. Many of the communities also have other kinds of health centers that receive federal funding and offer low-cost reproductive health care.
The Obria network — with 16 locations across five states — received millions of dollars under the first Trump administration, a grant that ended under President Joseph R. Biden Jr. The group is deeply invested in the effort to convert pregnancy centers into medical clinics for low-income patients. Unlike most of the approximately 2,700 pregnancy centers nationwide, which are largely unregulated, the Obria clinic in Ames takes insurance and is staffed with licensed nurse practitioners. It is also bound by HIPAA, the federal law protecting sensitive medical information.
“This is the moment for pregnancy centers to announce themselves to the world,” said John Mize, the chief executive of Americans United for Life, a national anti-abortion group. “There is an increasing awareness that Planned Parenthood is struggling, and we have an opportunity to be what they always promised to be, but really never were — a true social safety net.”
Sarah Traxler, an OB-GYN and the chief medical officer of Planned Parenthood North Central States, stressed that anti-abortion pregnancy centers “are not substitutes to Planned Parenthood.”
“Any time you are providing medical care based in a religious ideology, you are engaging in coercion and paternalism,” she said.
As soon as Ms. Call left the Planned Parenthood building, the clinic manager dumped her fliers in the recycling bin.
“They saw the news and jumped to, ‘Well, we can just take these patients,’” said Lacee Be, who ran daily operations at the clinic before it closed in mid-June. “It doesn’t feel ethical.”
Ms. Call did not see it that way. As a Christian, she said, she felt called to serve vulnerable women who might consider abortion and “let the oppressed go free,” one of her favorite Bible passages. To Ms. Call, Planned Parenthood pushed its patients toward a risky, destructive lifestyle that could eventually leave them broken.
This was her moment to show them another way, she said.
In the months that followed, Obria added a second nurse practitioner, revamped its social media with a new communications coordinator, and started an advertising campaign on the bus system students use to get around Iowa State. Ms. Call and her staff wrote to donors about the closure, asking them to “join us in praying Obria becomes a key provider to fill gaps left by Planned Parenthood’s exit.”
Since the Planned Parenthood closed, records show, the number of patients seeking care at Obria has nearly doubled.
A Campus Health Care Hub
At Iowa State, students knew where to find Planned Parenthood. The one-story brick building was a three-minute walk from campus, tucked between a row of student apartments and a country-rock bar known for its karaoke and crowded dance floor.
Planned Parenthood intentionally integrated itself into campus life, Ms. Be said, with a reputation for confidential services that wouldn’t show up on a parent’s insurance statement. Whenever a student dropped by for a morning-after pill, Ms. Be handed it over, no charge.
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“This is free for any student at Iowa State,” she would say. “Tell your friends.”
Abortions made up about 40 percent of the services offered at the Ames clinic, according to Planned Parenthood, with Iowa law banning the procedure after six weeks of pregnancy. Some patients received gender transition treatment. Most came for contraception and S.T.I. testing.
“I didn’t have a primary care doctor when I was a freshman,” said Jasmine Lambert, a former Iowa State student who stayed in Ames and has gone to Planned Parenthood for contraception for seven years. She knew Planned Parenthood was not “going to be weird about providing birth control,” she said.
Now, Ms. Lambert drives 40 minutes to get her birth control from the only primary care doctor she could find with available appointments.
The former Planned Parenthood office was locked during a recent visit, with blackened windows, the lawn littered with crushed beer cans and a Joker mask from Halloween.
“I feel a loss of sense of security,” Ms. Lambert said.
The Ames clinic is one of four Planned Parenthoods to close in Iowa this year, leaving two open locations, in Iowa City and Des Moines. Another 11 clinics have closed in the neighboring states of Minnesota, Illinois and Wisconsin.
Many Planned Parenthood clinics had already been struggling before President Trump took office. A New York Times investigation earlier this year revealed a network that operated on a shoestring budget with aging equipment and extremely low salaries — sometimes failing to provide quality care.
In Iowa, state lawmakers have targeted Planned Parenthood’s finances for years, said Ruth Richardson, the president and chief executive of Planned Parenthood North Central States. But recent federal cuts were the death blow, she added.
This spring, the Trump administration withheld a nearly $3 million grant allotted to her clinics through a federal family planning initiative. Then came news of Mr. Trump’s sweeping policy bill, which was devised to prevent Planned Parenthood affiliates that provide abortions from accepting payments from Medicaid, the government insurance program for low-income Americans.
According to Planned Parenthood, that defunding provision puts approximately one-third of its locations at risk of closure.
Planned Parenthood officials stressed that their patients still had options: Those in Ames could drive 40 miles to the branch in Des Moines or talk to a provider through telehealth.
But when one sophomore at Iowa State noticed an unfamiliar smell in her underwear a few months ago, she wanted to talk to a medical professional in person, somewhere nearby.
The student health clinic was not an option, the sophomore said, because she worried her parents might ask about medications that showed up on her student bill. If she had an S.T.I., she said, she would never want them to know.
The sophomore, who spoke on the condition of anonymity to discuss a private health condition, searched online for clinics that treated bacterial vaginismus and sexually transmitted infections.
A friend of hers had gone to Planned Parenthood, she said — “but it wasn’t around anymore.”
She went to Obria instead.
‘We Are Ready to Receive These Women’
Before Obria launched its fall advertising campaign, the clinic’s new communications coordinator researched the question that would shape her approach: “Why do women choose Planned Parenthood?”
The same adjectives popped up again and again, said the coordinator, Lauren Britton, who was hired into the new role several weeks after the Planned Parenthood closed. Planned Parenthood patients wanted reproductive health care that was “affordable” and “comprehensive,” she found.
Those adjectives described Obria, too, Ms. Britton said. And so those were the words Obria leaders would splash across the sides of the campus buses — their best opportunity to reach the women of Iowa State.
“We want people to know: Planned Parenthood has closed, but there is still reproductive health care in Ames,” Ms. Call said. “We are ready to receive these women.”
A 10-minute drive from campus, Obria Medical Clinic looks like a doctor’s office, with hard-backed black chairs and houseplants in the lobby. A framed document above the water cooler certifies that the clinic complies with HIPAA, which governs medical facilities, but few pregnancy centers.
The only hint of Obria’s Christian orientation comes from the reading materials selected for the waiting room: Instead of People or Vogue, patients can leaf through HomeLife, a magazine published by the Southern Baptist Convention, or a Bible.
Most patients do not know that Obria is a Christian clinic, Ms. Call said.
“I think there’s just a lot of baggage, for lack of a better word, that can come with an overt message that we are a Christian-based organization,” she said.
At their appointments, some patients are also surprised to learn that Obria does not provide birth control — a position the clinic takes to promote what the staff call a more “sacred view of sex.”
Pregnancy centers began opening in the late 1960s and 1970s as small Christian mom-and-pop shops, often run by volunteers. The movement to provide ultrasounds and eventually other medical services started in the early 2010s, said Andrea Swartzendruber, an associate professor at the University of Georgia who studies anti-abortion pregnancy centers.
Unlike Planned Parenthood, pregnancy centers very rarely have doctors on staff. Medical appointments at the Obria in Ames are handled by two full-time licensed nurse practitioners, with some oversight from a retired OB-GYN who volunteers with the clinic, reviewing charts remotely and occasionally coming in for consultations. The providers, who said they refer patients out to other local clinics or hospitals for complex cases, undergo an extensive credentialing process to take Medicaid and insurance, rather than offering all services for free, as most pregnancy centers do.
While insurance payments yield just 6 percent of the Ames clinic’s $720,000 annual budget, Ms. Call said, Obria considers the process worth the hassle.
“It adds legitimacy to us as a medical clinic,” she said.
The clinic gets the rest of its money from private donors and grants, Ms. Call said. That includes nearly $500,000 over three years from the state of Iowa — which, like other Republican-led states, has directed considerable funding to pregnancy centers since Roe fell.
Many medical professionals remain skeptical of Obria, including one former Obria chief executive who said last year in an interview with Elle that the network was “misrepresenting” itself as a group of medical clinics.
“The movement tried to come up with something to make themselves more legitimate, other than ‘We want to save babies from abortion,’ and found a way to get federal monies,” said Dawn Hughes, who led the group for two years and did not respond to a request for comment. She left after unsuccessfully pushing for the Obria board to start providing contraception, according to two people with knowledge of the events.
Ms. Call reiterated that Obria locations are fully licensed medical clinics, and stressed the clinic’s commitment to transparency. The Obria in Ames does not advertise abortion-related services on its website, a difference from many centers in its cohort that do so to attract women who want to end their pregnancies.
“We have always wanted to be above board and not try to manipulate people in any way,” she said.
When the Iowa State sophomore went to Obria this fall, she was nervous to talk openly about her symptoms, she said during an interview at the clinic shortly after her appointment. “But just being in here and talking was a weight off my back.”
The staff spent time getting to know her, she said. She told them about her Christian parents back home. How she didn’t want them to know she was having sex.
The 19-year-old had no idea she had gone to a Christian-based clinic.
Since her appointment, she said, several friends at school have asked her where to go for their own S.T.I. tests.
She told them about Obria.
David A. Fahrenthold and Katie Benner contributed reporting. Kitty Bennett contributed research.
Caroline Kitchener is a Times reporter, writing about the American family.
The post The Planned Parenthood Closed. A Christian Clinic Seized the Moment. appeared first on New York Times.
