New Yorkers boarding subways for their morning commute in 2010 were met with an unusual sight: anti-abortion advertisements, portraying a young, hip woman whose decision to terminate a pregnancy had unalterably marred her future.
“I thought life would be the way it was before,” the ads read, set against a somber portrait of the woman. “I wonder if there was something I could have done to help her,” another one said, showing a man looking solemnly at the floor.
The advertisements, which reportedly numbered 2,000 in the subway system alone in addition to billboards and print ads, all promoted the same website: AbortionChangesYou.com, which offers “healing” to those who’ve been “touched by abortion.” The site features a page where users are invited to read and anonymously write testimonials about the effects of terminating a pregnancy, such as “feeling far away from or angry toward God.”
The ads attracted some light vandalism but otherwise have largely been forgotten. Yet more than a decade after the subway ads began, a federal judge in Texas cited a linguistic analysis of those same website testimonials in a radical order that the Food and Drug Administration’s 2000 approval of the abortion pill mifepristone ― a safe and effective drug ― should be revoked.
“Women also perceive the harm to the informed-consent aspect of the physician-patient relationship,” wrote U.S. District Judge Matthew Kacsmaryk, a Trump nominee known for his anti-abortion views. He cited a study that found “fourteen percent of women and girls reported having received insufficient information” about the side effects of abortion and wrote that “Plaintiff physicians’ lack of pertinent information on chemical abortion harms their physician-patient relationships because they cannot receive informed consent from the women and girls they treat in their clinics.”
That 14% actually represented exactly 14 women who submitted testimonials to the AbortionChangesYou.com project, run by what was then called Life Perspectives and is now the Institute of Reproductive Grief Care.
In 2020, two authors from the Charlotte Lozier Institute presented the referenced “study” of those testimonials.
Neither the Institute of Reproductive Grief Care nor the Charlotte Lozier Institute answered HuffPost’s questions about research methods, including questions as basic as whether there were any procedures in place to vet the authenticity of the anonymous entries. But Michaelene Fredenburg, founder of the Institute of Reproductive Grief Care, stressed in a statement that the study was published “in a peer-reviewed, prestigious scientific journal, and that its data set and goals were very limited and not politically related.” The study was included in the original lawsuit over the FDA’s approval of the drug.
The journey from subway ads to a federal judge’s order illustrates the sophisticated research and lobbying efforts of conservative groups that have spent years seeking to minimize or outright eliminate access to abortion care.
It also may have surprised the creators of AbortionChangesYou.com; the Institute of Reproductive Grief Care told HuffPost the testimonials were not intended to be representative. “No qualitative study can be generalized to the population as a whole; particularly a study like this one, which included 98 anonymous women who self-selected to use the site AbortionChangesYou.com as a means to privately share their personal feelings,” the group said in a statement.
“No qualitative study can be generalized to the population as a whole; particularly a study like this one.”
- Institute of Reproductive Grief Care
Even the researchers who created the study, the statement added, “cautioned against generalizing their findings.”
Later in his order, Kacsmaryk referenced the same study again, falsely referring to multiple “studies,” rather than just one, that he said “show eighty-three percent of women report that chemical abortion changed them and seventy-seven percent of those women reported a negative.” As the study’s authors have repeatedly stressed, this may not be surprising for entries to a website called “Abortion Changes You.”
Critics of Kacsmaryk’s ruling have pounced on the study’s inclusion in his order: The New Republic called the study “completely bogus,” and Adam Unikowsky, who had been a clerk for the late Supreme Court Justice Antonin Scalia, observed, “This is roughly like reporting a statistic that ‘83% of people are fans of Judge Kacsmaryk’ without mentioning that the entire sample consisted of posters on JudgeKacsmarykFanClub.com.”
The federal government has taken note of Kacsmaryk’s thin sourcing. In an emergency appeal of his order, which is on hold as the fight moves to higher courts, Justice Department lawyers said Kacsmaryk based his ruling on “the court’s own interpretation of articles and studies, including many submitted by plaintiffs or their amici [friends] to the court but not to FDA.”
“For example, in concluding that no women should have access to mifepristone because it is harmful to them, the court relied on an article that was based on fewer than 100 anonymous blog posts submitted to a website called Abortion Changes You,” the filing reads.
But Americans needn’t listen to the Biden administration’s skepticism of the study: The authors themselves have repeatedly expressed the limits of their work and their own expertise.
Katherine Rafferty, a communications lecturer at Iowa State University, author of “The Dating Fast” and the lead author of the study, has said in multiple interviews that she’s not qualified to speak about the medical science of abortion pills nor about the regulations surrounding them.
“That is outside my pay grade,” she said during a question-and-answer session with Path of Life Spokane, a Christian conference, in 2021, one of several appearances in which she struggled to pronounce “mifepristone.” “Those specific nuances I do not have the insight on,” she said in response to another question about risks associated with the medication, before adding: “I do know that there are risks to a medication abortion, just like there are side effects associated with any sort of medication.”
Still, Rafferty, who did not return HuffPost’s request for comment aside from an automated message saying she was on leave after the birth of her daughter, has been clear on the purpose of the study.
As she put it on the Catholic talk radio show “Straight Talk” last month: “Looking simply at ‘What are these women experiencing?’ and using this evidence-based research to kind of influence legislation.”
In addition to her Iowa State job, Rafferty is an associate scholar at Charlotte Lozier Institute, the research and education arm of Susan B. Anthony Pro-Life America. She credited the institute for helping “make this study possible” and said the organization was working on “educating legislators on issues like this.” She described the purposes of the study as “showing this voice of the pro-life movement.” For her part, Rafferty has described herself as “pro-life my whole life,” and she signed on to an amicus brief urging the Supreme Court to overturn Roe v. Wade.
Susan B. Anthony Pro-Life America has used the study as anti-abortion advertising of its own.
Ironically, this Twitter post shows precisely how anti-abortion groups can twist research to their own ends: After the study noted that 77% of testimonials, or 75 women, said they regretted their decision to have an abortion, it clarified that “the term regret was rife with contradiction and also included talk about initial relief.” One of the examples included in the figure is a testimonial that reads, “I know I did the right thing for myself and it would be a lot harder for me right now. But I still would give anything to go back in time and keep my baby.”
The individuals associated with AbortionChangesYou.com and its affiliated websites are clear about their anti-abortion agenda, though they often appear apolitical or otherwise focused on “healing” people who’ve terminated pregnancies.
As far back as 2008, Fredenburg debated in favor of a proposed constitutional amendment in California that would require health care providers to notify parents before performing an abortion on a minor. The moderator in that debate, Michael Bernstein, dean of arts and humanities at the University of California, San Diego, described Fredenburg’s group as “a national organization that calls itself pro-life and pro-woman, and advocates safe, holistic solutions to reduce the number of abortions in the United States.”
That same year, an article in Biola Magazine, a publication affiliated with the private Christian university of the same name, paraphrased Gary Strauss, a professor at the university who’d helped write content for the website as well as for Fredenburg’s book.
“One of the strengths, Strauss said, is that the materials are firmly grounded in biblical principles without appearing overtly Christian,” the article read, referring to the website. “That opens the door for people who might otherwise be immediately turned off by the site to ultimately experience God’s true healing.”
In 2010, Fredenburg declined to tell The New York Times who funded her subway advertising campaign, but the Metropolitan Transportation Authority told the newspaper the ad had been bought by the Vitae Caring Foundation, whose website said it sought to “reduce the number of abortions by using mass media education.”
Back then, AbortionChangesYou.com’s “Find Help” section directed Manhattanites to Project Rachel, an anti-abortion group affiliated with the Catholic Church. An article posted on the website of the Archdiocese of Baltimore about the subway ads quoted the Project Rachel coordinator in New York, who commented, “The only way to stop abortion is to heal post-abortion women and men.”
Nowadays, visitors to AbortionChangesYou.com’s “Find Help” page see the new number for the suicide hotline, 988, and two anti-abortion websites: “Support After Abortion” and “International Helpline for Abortion Recovery.”
Under its “Considering an abortion?” section, Support After Abortion plays purported testimony from abortion recipients, including one who says “I was ashamed of what I had done” and another who says they “ended up feeling very deceived by the doctor and nurses at the clinic.” On tax forms, Support After Abortion says its mission is “to end the demand for abortion through healing people impacted by abortion.” (In an email, a spokesperson disputed the “anti-abortion” label and said SAA simply provides support for people who “are struggling after experiencing abortion.”)
The founder of the International Helpline for Abortion Recovery says in a testimonial on the site regarding her own abortion, “I will have regret for the rest of my life and so will my husband.”
The fate of mifepristone access in the United States now lies in the hands of the U.S. Court of Appeals for the 5th Circuit and ultimately, maybe, with the U.S. Supreme Court. If the appeals court doesn’t block Kacsmaryk’s order, it will take effect Saturday.