When I walked into the Obria clinic in Whittier, California, one evening in July, a woman in a modest floral- print dress or ganizing bundles of diapers in a back room greeted me hopefully. She thought I’d come for a class. Instead, I asked if I had come to the right place for birth control. Furrowing her brow, she walked around a couch and through a cozy waiting room full of baby toys to the front desk. “What sort of services were you looking for?” she inquired. I asked if they dispensed the morning-after pill, the emergency contraception often called “Plan B.” She told me curtly, “We don’t provide that or refer for any birth control here.”
I wasn’t surprised. For most of its existence, this clinic has been known as the Whittier Pregnancy Care Clinic, a religious ministry that offers free pregnancy tests and ultrasounds in the hopes of dissuading women facing an unplanned pregnancy from having an abortion. The clinic provides lots of things: free diapers and baby supplies, and post-abortion Bible-based counseling. What the clinic has never provided is birth control.
When the Whittier clinic was strictly saving babies for the Lord, its refusal to dispense even a single condom was a private religious matter in the eyes of its funders. But today, the clinic is part of Obria, a Southern California–based chain of Christian pregnancy centers that in March won a $5.1 million Title X grant to provide contraception and family planning services to low-income women over three years. Created in 1970, Title X is the only federal program solely devoted to providing family planning services across the country. Congress created the program to fulfill President Richard Nixon’s promise that “no American woman should be denied access to family planning assistance because of her economic condition.” It serves 4 million low-income people nationwide annually on a budget of about $286 million and is estimated to prevent more than 800,000 unintended pregnancies every year.
Historically, federal regulations required that any organization receiving Title X funding “provide a broad range of acceptable and effective medically approved family planning methods.” But as I discovered during my visit to Whittier and other Obria clinics last summer, the organization’s clinics refuse to provide contraception. Nor do they refer patients to other providers for birth control.
Obria’s founder is opposed to all fdaapproved forms of birth control and has privately reassured anti-abortion donors that Obria will never dispense contraception, even as she has aggressively sought federal funding that requires exactly those services. “We’re an abstinence-only organization. It always works,” Kathleen Eaton Bravo told the Catholic World Report in 2011. “And for those single women who have had sex before marriage, we encourage them to embrace a second virginity.”
Mara Gandal-Powers, director of birth control access at the nonprofit National Women’s Law Center, does not think Bravo’s stance “is in line with the intent of the Title X family planning program, but obviously they see it differently.”
Should the Trump administration survive another four years, Obria may represent the future of the Title X program. In 2019, the Department of Health and Human Services instituted a gag rule that banned clinics getting Title X money from providing patients with referrals for abortions. (Federal law prohibits the program from funding abortions.) Seven state governments and Planned Parenthood, which served 40 percent of Title X patients, decided to drop out of the program rather than comply.
But even before Planned Parenthood was squeezed out, the White House had been pushing to redirect Title X and other federal funds to anti-abortion organizations like the Whittier clinic, which juggles its mandates of health care and family planning with pushing abstinence-only sex education, dissuading women from having abortions, and introducing them “to the love of Christ,” as its website says. In July, HHS awarded Obria nearly $500,000 from its teen pregnancy prevention program to provide “sexual risk avoidance” classes.
The Obria grant suggests that the Trump administration’s assault on Title X is not just about reducing abortion access. It’s part of the broader, if largely futile, culture war still waged by evangelical and other Christian conservatives heaven-bent on making America chaste again. Abstinence- only activists now control key posts at HHS and are driving policies that force their views about contraception onto the vast majority of Americans, who don’t agree with them. While Americans’ opinions on abortion are mixed, only 4 percent think contraception is immoral, and 99 percent of women who have had sex have used it. Which raises a big question: Now that Obria has won millions in taxpayer dollars to provide anti-abortion family planning services, will anyone use what they are offering?
Obria is the brainchild of Kathleen Eaton Bravo, a devout Catholic who set out to build a pro-life alternative to Planned Parenthood. “I wanted to create a comprehensive medical clinic model that could compete nose-tonose with the large abortion providers,” she wrote on the Obria Group website. Bravo may seek to emulate Planned Parenthood’s organizational model, but she holds a dim view of it otherwise. In a 2015 interview with Catholic World Report, she claimed Planned Parenthood promoted a “‘hook-up,’ contraceptive mentality among our young people. They teach children as young as 12 that they can have sex without consequences.” She went on: “Today, Planned Parenthood promotes oral sex, anal sex, and S&M sex.”
Bravo did not respond to repeated requests for an interview. But she has said elsewhere that her involvement with the anti- abortion movement began after having an abortion in California in 1980 amid the collapse of a first marriage. Afterward, she remarried, moved to Oklahoma, rediscovered her Catholic faith, and started volunteering at a pregnancy center that tried to convince women to carry unplanned pregnancies to term. Bravo has described driving to Kansas to pray in front of the clinic of Dr. George Tiller, who would be murdered in 2009 by an anti-abortion extremist.
In Bravo’s public statements, there are echoes of the “great replacement” theory of abortion that’s become popular among white supremacists. Abortion, she told Catholic World Report, “threatens our culture’s survival. Take the example of Europe. When its nations accepted contraception and abortion, they stopped replacing their population. Christianity began to die out. And, with Europeans having no children, immigrant Muslims came in to replace them, and now the culture of Europe is changing. The US faces a similar future.”
After moving back to Southern California in the mid-1980s, Bravo took over a crisis pregnancy center in Mission Viejo called
Birthright, whose name she later changed to Birth Choice. Crisis pregnancy centers (cpcs) have been an integral part of the antiabortion movement for more than 50 years. The founder of the first known American cpc, Robert Pearson, pioneered the deceptive practices that would come to characterize their services to this day. He published a training manual that coached activists to set up cpcs to look like abortion clinics and use misleading ads to trick pregnant women into thinking they could get an abortion there. cpcs have a long, well-documented record of using high-pressure tactics on unsuspecting women and peddling misinformation like the myths that abortion causes breast cancer, infertility, and suicide.
Over the past three decades, pro-choice organizations, Democratic members of Congress, and state attorneys general have tried to expose and rein in some of the cpcs’ worst abuses. In 2015, California enacted the Reproductive Freedom, Accountability, Comprehensive Care, and Transparency (fact) Act, which required unlicensed cpcs to prominently disclose that they don’t provide medical care (including abortions), and licensed ones to inform clients that the state offers free or low-cost family planning and abortion services. The cpc industry sued, and the Supreme Court struck down the law in 2018.
Obria’s clinics don’t appear to have ever been sanctioned by any government agencies for deceptive practices, but its Whittier clinic was one of many Los Angeles cpcs that a local public radio station found openly flouting the fact Act before the act was overturned. And Obria’s RealOptions, a Northern California cpc chain that’s a recipient of its Title X grant, was caught using mobile surveillance technology to target ads at women inside family planning clinics.
In 2015, the company hired a Massachusetts-based ad firm to set up virtual “fences” around family planning clinics to target “abortion-minded women,” according to the Massachusetts attorney general. When women entered the clinics, their smartphones would trip the fence, triggering a barrage of online RealOptions ads that said things like “Pregnant? It’s your choice. You have time...Be informed.” The ads, which steered women to the pregnancy center’s site, would continue to appear on their devices for a month after their clinic visit. The Massachusetts attorney general secured a settlement with the ad firm to end the practice in 2017 after alleging that it violated consumer protection laws.
Bravo’s vision for an anti-abortion rival to Planned Parenthood is deeply rooted in the crisis pregnancy center world. Bravo has said she wants to transform cpcs from “Pampers and a prayer” ministries into a network of “life-affirming” clinics that provide many of the services Planned Parenthood does-sti testing, ultrasounds, and cervical cancer screenings, but without the birth control, abortion, or abortion referrals. “I would close my doors before I do that,” she told the Heritage Foundation’s Daily Signal in 2015.
By the middle of 2006, Bravo had expanded Birth Choice to include four cpcs. She got the centers licensed and accredited as community clinics and installed ultrasound machines to increase their “conversion rate” by convincing abortionminded women to stay pregnant. Grants from the evangelical Christian advocacy group Focus on the Family and the Catholic Knights of Columbus paid for the machines. In 2014, she rebranded the nonprofit chain as Obria (a vaguely medicalized name made up by a marketing firm, ostensibly based on the Spanish word obra, meaning “work”) and announced an aggressive expansion plan. Bravo became the ceo of a new nonprofit umbrella organization called the Obria Group and essentially turned the operation into a franchise.
The Obria Group doesn’t provide any medical services or even start new clinics. Rather, it’s a marketing arm that recruits existing cpcs to join the Obria network. Affiliated clinics pay a licensing fee to use the Obria name, but they remain separate legal entities with their own nonprofit status. (Bravo’s Birth Choice clinics are now a separate nonprofit called Obria Medical Clinics of Southern California, and she is no longer employed there or on its board.)
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