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In downtown Honolulu, across the street from the Roman Catholic diocese, sits Pearson Place. With its worn sign and proximity to a closed-down bookstore, the pregnancy resource center can be easy to overlook.

But the words “Free pregnancy test” scrawled in big white letters across the center’s door may cause passersby to double back.

Beyond the doorway, volunteers offer a myriad of resources ranging from peer mentorship to baby formula — all free of charge in the name of providing pregnant women with alternatives to abortion.

Pearson Place is one of several organizations in Hawaii hoping to promote and expand its efforts to keep women from getting abortions following the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization. The decision, issued in late June, and determined that abortion is not a constitutional right.

Abortion is still legal in Hawaii. However, medical providers point to pregnancy resource centers and other anti-abortion organizations as sources of confusion for women facing unplanned or unwanted pregnancies.

Catholic leaders see the situation differently.

“We want to say that, rather than helping a woman choose to terminate the pregnancy, we want her to choose to keep the baby,” said Eva Andrade, executive director of Hawaii Catholic Conference. “There are obstacles that may be in the woman’s life that’s keeping her from making that choice, so we’re going to help her by providing the resources that she needs.”

Promoting The ‘Culture of Life’

At the Diocese of Honolulu, Valerie and Gary Streff aim to eliminate the social pressures and fears they believe push women to receive abortions.

As co-directors of the Respect Life Ministry, their most recent work includes implementing , an initiative that provides support for expectant mothers in parishes across the country.

The Catholic Church has always provided resources, from free baby strollers to temporary housing, to pregnant women and young families. Walking With Moms in Need streamlines these services to support women from the start of their pregnancies to after childbirth. Women do not need to be Catholic to receive the Church’s support.

“The whole idea behind that is, to first of all, give women support so that they choose having a child versus the other choices that are available to them,” said Gary Streff, a Catholic deacon. “We don’t coerce them, but the whole idea behind that is to say, ‘Okay, if you choose life, this is what we can help you with.’”

One of the first steps in promoting what Gary Streff calls the “culture of life” includes the referral of women to pregnancy resource centers — .

Hawaii’s pregnancy resource centers first emerged in response to the state’s decision to legalize abortion in 1970. Susan Duffy, president of the Pearson Foundation of Hawaii Inc., said the centers offer alternatives to abortion by providing women with baby supplies, connections to adoption agencies and even ultrasounds at certain locations.

“We’re a pro-life organization, and we make it very clear.” — Susan Duffy of the Pearson Foundation of Hawaii

In response to the overturn of Roe, Duffy hopes to expand Pearson Place’s outreach and services. As the center is staffed by volunteers, many people are unaware that Pearson Place exists, Duffy added.

As a nonprofit, Pearson Place runs on donations and is deemed independent of the Diocese of Honolulu. Like many other pregnancy resource centers, it does not offer or recommend abortions. It also does not provide contraceptives.

“We’re going to continue to do what we always have done, and we’re going to continue to do outreach to people to let them know that we’re there,” Duffy said.

Garret Hashimoto at Aloha Pregnancy Care and Counseling Center has no plans for expansion — but, like Duffy, he sees his center as a way of supporting the anti-abortion movement.

“We’re just here to provide the same services as we’ve always done,” Hashimoto said. “We’re not shouting hooray or anything yet. We just keep on trying to save as many babies as we can.”

As the president of what he describes as a Christ-centered ministry, Hashimoto said he often consults with women on their pregnancy options. The center never recommends abortion: Hashimoto instead urges women to carry their pregnancies to term before raising the children themselves or turning to adoption agencies.

Providing All Options

But some doctors in Hawaii have serious concerns about what exactly abortion alternatives entail.

Dr. Reni Soon, chair of the Hawaii section of the American College Of Obstetricians and Gynecologists, said the social supports offered by the Catholic Church and other religious organizations are important but are not substitutes for abortion.

“It certainly is great that there are organizations that want to help support people in various other ways, but that is not a reason to take away the option to have an abortion,” said Soon, who also provides clinical and abortion care at The Queen’s Medical Center and Planned Parenthood. “If someone feels that that is the best option, the best decision at that moment in their lives, then only that person can make that decision.”

Like pregnancy resource centers, some abortion-rights groups also provide support to women who are not seeking abortion. For example, the Women’s Option Center helps patients find adoption resources, while birth control and general health care services.

There are over 3,000 pregnancy resource centers, also known as crisis pregnancy centers, across the country. In Hawaii, pregnancy resource centers outnumber clinics offering abortion. While some centers are affiliated with certain churches, others are independently run but still faith-based, Gary Streff said.

In 2019, and the North American Society for Pediatric and Adolescent Gynecology claimed that crisis pregnancy centers fail to follow medically and ethically sound practices.

Pregnancy resource centers often attract women by providing free services, including pregnancy tests and visits with doctors and nurse practitioners, said Tanya Smith-Johnson, the health policy and community-based doula program director at the Healthy Mothers Healthy Babies Coalition of Hawaii. However, Smith-Johnson added, once the pregnancy test turns positive, the centers only focus on keeping their clients pregnant.

“Lots of times, they really just kind of focus on helping people get a pregnancy test and find out whether they’re pregnant,” said Smith-Johnson, who also works as a certified professional midwife. “They tend to really tunnel vision, focusing on, how do we keep you pregnant and maintain that pregnancy.”

Dr. Divya Dethier, a complex family planning fellow at the University of Hawaii, has seen the potential harm pregnancy resource centers can inflict on patients.

Dethier said she was scheduled to meet with a patient who went through an online pregnancy resource center to receive abortion pills. However, when the patient arrived at the emergency department with abdominal pain, she learned that she had likely received false medication from the center and that she was still pregnant — in her second trimester.

Dethier said the patient never came to her scheduled appointment, but if she had wanted an abortion at that point, she would have required surgery.

Concerns Raised

Dr. Marit Pearlman Shapiro, a complex family planning fellow at UH, raised concerns about A Place for Women, a pregnancy center located in Waipio Shopping Center. She said the center has purposely extended women’s pregnancies by scheduling individuals for follow-up appointments and ultrasounds across multiple weeks. By the time patients seek outside advice, they can no longer receive abortions through medication and instead require more expensive procedures, Pearlman Shapiro said.

According to an emailed statement from A Place for Women, the . The center’s website adds that procedures are performed under the supervision of a licensed physician and its workers do not “offer, recommend or refer for abortions or abortifacients.”

“A Place for Women in Waipio is a pregnancy medical center that provides free, HIPAA compliant services to the community,” the center said in the statement. “All women are welcome and supported no matter what they decide.”

Duffy said that pregnancy resource centers don’t conceal their stance against abortion or provide misinformation about women’s pregnancy options. Pearson Place also states on its website that it does not perform abortions.

“We’re a pro-life organization, and we make it very clear,” Duffy said.

Valerie Streff said that pregnancy resource centers honor individuals’ choices, adding that the Catholic Church supports women throughout and after their pregnancy journeys.

“We respect the rights of any individual that comes to the pregnancy center. And, of course, we would love for them to choose life,” Streff said. “However, whatever decision they may make, we respect the dignity of that person.”

Soon said she is unsure if pregnancy resource centers will gain greater popularity following the overturn of Roe, especially considering that abortion is still legal in Hawaii. However, she said, centers may become more aggressive with their advertising and marketing as they work to draw in more women seeking guidance.

“With the overturning of Roe, the people who oppose access to abortion are feeling rather galvanized, and they may focus more attention or try to get more funding for these crisis pregnancy centers,” Soon said.

In the meantime, Dethier said she encourages women with unwanted pregnancies to turn to their OB-GYNs, Planned Parenthood or the Women’s Option Center, where she works to provide a range of reproductive health options.

“Even though I provide abortion care, my motive is not to provide more abortions,” Dethier said. “My motive is to provide the patients with what they need right now and what works for them and for their life.”