KAISER PERMANENTE: Refers Pregnant Patients To Anti-Abortion Counseling Clinic
A Kaiser Permanente hospital in Oakland for the past year has been referring women who are ambivalent about their pregnancies to a counseling center with strong pro-life ties, California Healthline has learned. Women receiving positive pregnancy tests at Kaiser-Oakland Hospital who said the pregnancies were "not good news," or who weren't sure what to do, were referred to First Resort Inc., a group whose CEO has stated her goal is to make "the San Francisco Bay Area into an abortion- free community." Shari Plunkett, in an Oct. 8 interview in Christianity Today that ran in the Washington Times last week, said, "I think every woman's heart is telling her to carry to term, because God has placed truth in her heart, and the truth is that abortion is never the right answer." Yesterday afternoon, Kaiser temporarily suspended all referrals to First Resort pending a complete review. Kaiser-California's Tom Debly said, "The [CT/Washington Times] interview raises obvious questions in terms of what we were told about being unbiased."
'Is This Good News?'
According to Kaiser-Oakland OB/GYN Service Manager Shirley Dostal, "When people call in for a pregnancy test, generally what happens when it's positive is we ask, 'Is this good news or bad news?' If they respond 'I don't know' or 'it's bad news,' our next series of questions have to do with 'What do you want to do from here?' Women were then offered the choice of counseling within Kaiser-Oakland or through First Resort, which was described to them as a nonbiased clinic. The referrals, which began roughly a year ago, averaged 15 calls and eight to 12 visits to First Resort per month, according to Dostal. Plunkett says her clinic saw a total of 140 Kaiser members. Kaiser Permanente told California Healthline that Kaiser- Heyward Hospital was also involved in sending referrals to First Resort, but Plunkett denied that assertion.
Dostal says that when Kaiser received a referral proposal from First Resort, her department met with representatives of the center and sat in on several counseling visits. "They said they provide pregnancy counseling that offers the spectrum of options on what to do with a pregnancy a woman feels ambivalent about," Dostal said. "We felt some of their information was biased, and we asked them to make changes to make it more neutral." Brenda Cummings, executive director of the Women's Health Rights Coalition, which provides abortion referrals, said the HMO did not do enough to ensure its members received objective counseling. "Kaiser probably did not know what First Response's historical agenda has been and what their current practices are," she said. "But they have a contractual obligation to know that. And they have an obligation to their patients, who trust them for referrals, to know who they're referring to."
Plunkett insists that First Resort can provide objective counseling despite her stated goal of decreasing the number of abortions. In an interview with California Healthline, she said, "Our organizational philosophy and our personal beliefs absolutely never come up in the counseling room. That's one of the issues we specifically train our counselors on. Women leave here and they never know our organizational stance. Our goal in the counseling room is that women received unbiased, compassionate care." However, Plunkett noted to Life Insight, published by the National Conference of Catholic Bishops, that the ultrasounds the clinic provides to pregnant women not only confirm "the viability of the fetus and [determine] gestational age" but have "the power to save lives." She said "when society, family members, partners and career goals scream 'abortion!' our ultrasound machine magnifies the humanity of the child not yet born. Seeing her child helps a woman make one of the most self-sacrificing decisions of her life." First Resort only provides referrals to adoption agencies and offers prenatal care. Cummings said her organization has received complaints about First Resort unrelated to Kaiser in which women said they were unable to get a pregnancy certificate for an abortion and were given "advice that wasn't neutral."
Seeking The Undecided
Kaiser officials insist that women who specifically wanted abortions were not referred to First Resort. However, women were asked their plans immediately after learning they were pregnant -- a point at which few women have chosen whether to terminate their pregnancy -- and Plunkett told Life Insight that she specifically set up the HMO referral for access to women in that situation. She said, "Like other pregnancy help centers, we were prepared to meet a woman's needs. But, mainly, we wanted to inform and counsel as many women who are contemplating abortion as possible." She said in her CT/Washington Times interview that the referral arrangement included women who wanted abortions -- they were told that First Resort provided "pre-abortion counseling." Plunkett also said in her CT/Timesinterview that Kaiser-Oakland "chief of obstetrics" -- who is Dr. Victor Chen -- asked her, "But what about the ones that are having abortions? Do they really know what they're doing?"
Betrayal of Trust
For abortion rights activists, the revelation of the referrals was a rude surprise coming from Kaiser. Cummings said, "There was no way I could see this being Kaiser. They're the ones that are most forthright about abortion being part of a comprehensive set of reproductive health care options." She also said the implications of the case extended beyond Kaiser: "Overall, those of us who are the consumers of health care are increasingly confronted with needing to be incredibly responsible and resourceful for our own needs, because we cannot trust or rely on our health care provider to do what we ask. Because managed care plans have a gatekeeper system, the problem with getting confidential services like an abortion or birth control or HIV testing [is] if the person you go to to get permission isn't comfortable with your interests and needs, they can make things very difficult for you."
California Abortion and Reproductive Rights Action League President-elect Sandy Minell said, "These 'stealth clinics' have historically mislead women by their dishonest, misleading and devious advertising and promotional materials. This is believed to be the first time a major health provider was mislead, however." CARAL said it is "investigating all legislative, legal and regulatory solutions to stop clinics from failing to disclose that they will not provide referrals for abortions and that they actively counsel women against that option."
Blame It On The Press
Plunkett blamed the temporary severing of her Kaiser referral contract on misguided public pressures. She said, "I hope once this blows over, we'll go back to business as usual ... My irritation is with the press for getting in the way of that. The press has inundated Kaiser with calls, and look what happened." In her interview with Life Insight, Plunkett said of her goal of ending abortions in the Bay Area, "If it can be done in San Francisco ... it can be done anywhere." For at least the time being, her efforts will not include any referrals from Kaiser Permanente, the nation's largest nonprofit HMO (Adam Pasick, California Healthline). For additional coverage, see today's San Francisco Chronicle.