Annie Filkowski used to see the signs during her drive to school each morning. "Free pregnancy tests," they said.
So when she feared she might be pregnant at 16, shortly after starting to have sex with her boyfriend, she remembered them. And walked into a center in Fort Myers.
Keisha Walters, saw the signs too, outside an old Tampa home on Armenia Avenue that had been converted into an office. Walters, 32, was pregnant for the first time and had lost her job. She felt alone, far away from her family in the Caribbean islands of Saint Kitts.
"I didn’t even know what to ask for, or what I needed," she said.
Both women had found their way to one of the 105 publicly subsidized "pregnancy support centers" in Florida, part of a network of mostly faith-based organizations that provide emotional support and limited medical services for unplanned pregnancies — while also working to prevent abortions.
But their experiences could not have been more different. Filkowski said she left feeling pressured and duped, while Walters found a welcoming source of help that she continues to rely on today.
The contrast goes to the heart of a simmering debate as Florida lawmakers prepare to make a key decision on the future of the centers: Should the state continue to fund them every year as part of the budget process, or give them a more exalted position by enshrining them in state law as a permanent program overseen by the Department of Health?
Welcome to the latest battleground in a long-running war over state government’s role in the abortion issue.
Many Floridians know of the centers from the now-familiar billboards that have lined the state’s rural highways for years, urging women to find options other than abortion, reminding them that a heartbeat begins just days into a pregnancy.
The centers are part of the Florida Pregnancy Care Network, which has received more than $21 million in state funding since 2007, according to the Florida Department of Health, including $4 million in the current fiscal year. With services that range from testing for sexually transmitted diseases to parental counseling, they are largely unregulated and can vary significantly depending on the location. Some employ nurse practitioners or physicians. Others rely on church volunteers to take ultrasound images, provide medical information with sometimes questionable accuracy and deliver a clear anti-abortion message.
Companion bills in the House and Senate that would make the centers a permanent fixture have drawn heavy criticism from groups like the National Organization for Women and Planned Parenthood.
"The funding for this network umbrella has steadily increased over the years to the tune of millions," said Laura Goodhue, executive director of the Florida Alliance of Planned Parenthood Affiliates, whose members receive no state funding. "Women should have all the medically accurate information they’re seeking, without bias and without shaming. The women who have been to some of these pregnancy centers have felt this way and are later harassed for their decisions."
But Carole Alexander, executive director of the Next STEPP Pregnancy Center in St. Petersburg, said the work they do impacts the lives of many women. The letters stand for "services to those experiencing pregnancy or parenting."
"I know anecdotally that we have better, healthier birth outcomes from the women who come here," Alexander said. "There are less babies in (the intensive care unit) and with other problems because we’re coaching these women on nutrition and other aspects of pregnancy that are so important. This funding goes toward helping that."
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When Filkowski walked into the pregnancy center as a 16-year-old in Fort Myers, she said it looked like a normal doctor’s office but felt like something else. The woman at the front desk wore dangling crucifixes from her ears.
Another woman wearing medical scrubs took her to a private room after she’d taken the pregnancy test. "It looked like a therapist’s office," Filkowski recalls. Posters on the walls described abstinence as the only form of birth control. Bible verses and depictions of Jesus hung there, too.
"This woman told me I needed to think hard about my actions," she said. "Then she asked if I was religious."
Filkowski, now 19, wasn’t even sure she was pregnant. But she told the woman at the center that she didn’t identify as religious, even though she grew up Catholic. When she asked about getting on birth control, the woman told her the pill causes cancer and makes women infertile. She was given pamphlets about Christianity and told she could "still be saved, despite her mistakes."
"After all this she told me the results of the test. I wasn’t pregnant," Filkowski recalled. "But she was going to contact my parents and my school anyway."
At the Foundations of Life Pregnancy Center in Tampa, Walters saw her baby for the first time on an ultrasound screen. She sat by a fireplace in a room with hardwood floors and a couch while the women who worked or volunteered there encouraged her to hold life-like dolls, weighted to feel like a baby during various gestation periods. They encouraged Walters to come back for parenting classes, offered help with day care or adoption services, gave her free diapers and baby supplies.
"And name brand ones. Pampers," Walters said.
They emphasized options other than abortion. She didn’t want one anyway.
Walters’ daughter, Zeeva, is now 6 months old. She still comes back to the pregnancy center for parenting classes because she feels welcome there.
"They want to talk with me. They want to provide what you need," she said. "Anyone can come here. Anyone."
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In November, Filkowski testified before the Senate’s Health Policy Committee about her troubling experiencing at the Fort Myers pregnancy center. Now a political science major at the University of South Florida St. Petersburg, she urged lawmakers to reconsider the bills.
For the hearing, the National Organization of Women encouraged its members to dress like the concubines from The Handmaid’s Tale, a novel-turned-popular television series set in a dystopian society where women are stripped of their rights.
Sen. Aaron Bean, R-Fernandina Beach, a sponsor of the measure, described it at the time as "a choice bill. A choice for life." The centers, he said, are "a place where people can go that fosters life."
He did not respond to questions for this story. Nor did state Rep. Jackie Toledo, R-Tampa, who is sponsoring the measure in the House.
The Catholic Charities Diocese of St. Petersburg, Inc. runs the five Foundations of Life Pregnancy Centers in Tampa Bay. The centers work in tandem with a separate adoption services arm, said Rose Llauget, director of pregnancy and adoption services for the organization.
She said the centers support about 1,400 women a year. They also receive some funding from consumers who select antiabortion license plates at the Florida Department of Motor Vehicles.
Llauget is a fierce defender of what her centers do for women, which she described as mostly education.
"It’s only a short period of time when women can become pregnant during their lifetime," she said. "We want them to take the time and make an educated choice about that baby’s future."
Llauget called Planned Parenthood a corrupt, racist organization "whose sole business is abortions."
In an interview, she produced a document claiming that, due to abortion, "60 million babies have been lost since 1973, that’s 1.1 million per year and 3,000 per day." She said it’s "been known for a long time" that birth control pills are linked to cancer. She doesn’t like using the words "tissue" or "fetus" to describe what she says is a baby in a woman’s abdomen.
And she professed support for Lila Rose, an antiabortion advocate known for her undercover videos at Plannned Parenthood clinics, calling her "a "top-notch investigative journalist."
Llauget is a mother and a former communications saleswoman, with a poised and gentle manner that runs counter to the stereotype of the angry abortion clinic protester.
She is well aware of the image and is trying to change it with a less aggressive approach.
She has stood in front of local Planned Parenthood clinics to try to spark conversations with the women and couples who seek out abortions. "I don’t scream," Llauget says. "I ask to talk to them. I call it sidewalk counseling."
She hands out pamphlets that detail questions women should ask doctors before agreeing to an abortion.
"Just because it’s legal doesn’t make it moral," she says of abortion. "I don’t like women being duped. Which is why we try to educate them about the life within."
If women come to classes at one of the Foundations of Life centers, they earn points they can use to exchange for baby clothes, food and diapers. Volunteers and staff help women find jobs and pair them with mentors who can answer questions anytime during pregnancy. The centers also offer post-abortion therapy.
"I just don’t want women to experience this life-long guilt of what could have been," Llauget said. "A woman can put her life on pause for just a minute and choose to bring a new baby into the world."
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At the Next STEPP Pregnancy Center in St. Petersburg, a photo of an African-American baby is pinned to a bulletin board. Stamped over the image is a message in red letters: "endangered species."
Alexander has been the director of Next STEPP since it was launched more than 20 years ago. Pamphlets for programs like the Healthy Start Coalition, Operation PAR and information about the Zika virus from the health department fill a tabletop near the entrance. The small space doesn’t feel like a medical office, but there is an ultrasound machine in a back room. Alexander said she hopes to hire a qualified medical director to begin offering ultrasound services later in the year.
"Our goal is to promote a culture of life," said Alexander, whose center serves predominantly black communities in St. Petersburg. "This isn’t just about pregnancy. It’s supporting the community we’re in."
But Goodhue with Planned Parenthood says the pregnancy centers masquerade as legitimate medical offices and can do more harm than good. They take patient medical information, but are not bound by the privacy laws that govern doctors’ offices, she said.
"These sham health clinics have been known to mislead, judge and shame women to prevent them from obtaining abortions," Goodhue said. "Worse yet, pregnancy centers are known to withhold essential, even life-saving, reproductive health information."
The contracts that centers must sign with the state health department say they are allowed to offer wellness testing — from high blood pressure screening, to flu vaccines, to cholesterol screening and tetanus vaccines. The contracts say all practitioners must be licensed. But it is unclear how strictly guidelines are enforced outside of submitting monthly reports, a quarterly newsletter and adhering to a compliance manual. For example, the contracts say the centers cannot use state funding to purchase medical equipment or to pay for medical procedures such as ultrasound.
"They are still not under the type of regulation that would be placed on a medical provider," Goodhue said.
During the November health policy committee meeting, senators seemed split on the issue but it passed by a 5-3 vote. More recently, both House Bill 41 and Senate Bill 444 were heard on first reading during the first week of the new session.
In a committee meeting Wednesday, Bean answered questions and responded to pushback from his colleagues, including Sen. Lauren Book, D-Plantation.
"If women report feeling judged or women report feeling threatened, we need to listen. We need to understand the linguistic differences where things can be dangerous," Book said. "I don’t believe that having an abortion will give a women cervical cancer or breast cancer, but these centers hand out materials that say they do."
Bean argued that women should have options.
"It’s 100 percent true that the network only contracts with centers that support child birth and life," he said. "If you want an abortion there are many other places to go."
Contact Justine Griffin at [email protected] or (727) 893-8467. Follow @SunBizGriffin.