By Betty McDowell

“Responsibility for learning belongs to the student, regardless of age.” Robert Martin

One of the joys of working at Heartbeat is that I am always learning. I love learning, which is a good thing, especially since I serve in a ministry that is always changing, growing, and being challenged.

Next month is Heartbeat’s annual Institute for Center Effectiveness℠ (Nov. 27–30 in Columbus, Ohio). One of the key principles we teach each year is that we are always functioning in one of two modes: judger or learner.

How do you know which mode you’re functioning in right now? Ask yourself, “What questions am I asking?”

You see, we talk to ourselves on a regular basis, and we’re constantly asking ourselves questions. When you look in a mirror, for instance, you are undoubtedly able to say something about yourself. It may be a derogatory remark about your looks or perhaps “a thumbs-up”, but it might also be a question about what you expect the coming day to bring. If the question you’d ask yourself has to do with your looks, you’re in “judging” mode, but if your question has to do with the upcoming day, you’re in “learning” mode. In other words, your self-talk tells you which mode you’re in. 

Besides self-talk, we are also in one of these two modes when we’re dealing with other people. Do you find yourself thinking, “How can I prove I am right?”, or is the question your asking yourself more of, “How can I better understand what he/she is saying?” The first of these indicates you’re in “judging” mode, while the second shows you’re in “learning” mode.

If you work in a life-affirming ministry, you need to become a student of the clients you serve. Stay in learning mode and you’ll become a better listener, which will put you in a position to be of much more help to another person. Ask yourself inquisitive learning questions, rather than deciding you already know everything you need to know about a person and their situation.

The best leaders are always the best learners.

Like an inquisitive child, start to enjoy the process of learning again. Begin to examine your self-talk and the questions you ask yourself on a regular basis, and begin forming better questions about the people you are talking with and the situations you find yourself facing.

You’re never too old to become a learner.

To think more about this, pick up Change your Questions, Change your Life, a book by Marilee Adams, and attend ourInstitute for Center Effectiveness this November.

by Ellen Foell, Heartbeat International Legal Counsel

This sounds like a trick question a Pharisee might ask to entrap Jesus.

The answer seems fairly straightforward. The patient is anyone who receives medical services from a physician.[1] But then, there is a follow-up question: "When is my patient no longer my patient?" In other words, when does the legal obligation to the patient end?

The physician and the clients who walk through the center’s doors are indispensable to its existence as a medical pregnancy clinic. Without the client-patients, there would be no need for the medical center to exist. Without the medical director, the center has no legal authority to provide any of its critical life-changing medical services, including ultrasounds and sexually transmitted infection and disease testing.

The medical director’s presence in name, policy-setting, procedure, and writing standing orders creates a patient-physician relationship. It runs between the physician and every client who walks through your doors to receive medical service.

However, much like ambulatory care clinics, the relationship between the physician in a medical pregnancy center and patient is limited in time and treatment, so the center must set distinct parameters to avoid confusion for the patient and liability for the center. Failure of the center to be clear in setting and communicating those parameters to the patient can create liability-laden situations.

The best way for centers to avoid liability issues is to be up-front in communicating the parameters of the patient-physician relationship with each client. In the eyes of the law, the physician-patient relationship continues if the following three factors are present, with the third factor posing the most relevance for pregnancy help centers:

1. The client-patient needs follow-up treatment from a physician,
2. The client-patient has a reasonable expectation of continued treatment, and
   
3. The physician has not clearly and explicitly ended the relationship.

It is easy to see how a client-patient could leave a center with the impression that she and the medical director have now established a continuous patient-physician relationship. Treatment and care for a pregnant woman typically involves multiple doctor visits, additional ultrasounds, and can include additional procedures as well.

Further, since many of the women coming to a medical pregnancy clinic may not have an existing relationship with a physician, a client-patient might naturally conclude that the relationship would continue beyond the parameters of that place (the center) and time (the appointment).

That is, the client-patient might have a reasonable expectation of continued services because she clearly requires continued treatment. The question is, “From whom?” That question can and must be addressed in the context of clear and explicit communication to the client that the patient-physician relationship is terminated upon her leaving the pregnancy medical clinic, and—if needed—receipt of referrals for obstetrician-gynecologists, in keeping with standard pregnancy medical center practice. 

If the client is clearly and explicitly informed—verbally and in writing—that no continuing patient-physician relationship continues after the verification of pregnancy and/or ultrasound, then the center and its medical director will have fulfilled their legal duty to the client. In fact, most pregnancy medical centers have a Consent and Release Form for the client to sign, indicating this agreement.

Heartbeat International was recently asked whether giving a regimen of prenatal vitamins or prescribing prenatal vitamins constituted a continuation of the patient-physician relationship, possibly exposing the center to liability. The question was raised for obvious reasons: Prenatal vitamins tend to be something pregnant women take throughout the course of their pregnancy, implying continuing treatment.

Arguably, prescribing the vitamins could be interpreted to constitute action taken pursuant to the patient-physician relationship. Thus, a center will want to ensure that its Consent and Release Form is broad enough to encompass the prescription for vitamins.

Pregnancy help medical clinics daily provide excellent and caring life-saving services. In the event that a client-patient is pregnant, she should be given referrals for other service providers.

Centers should have an attorney draft a Consent and Release Form, which should be given and explained to the client-patient. This paperwork should clearly state that no follow-up care will be provided, and that the patient-physician relationship is terminated.

That form must be signed by both center staff and the client-patient, with a signed copy given to the client-patient and a copy kept in the client-patient’s medical file. In following these guidelines, a center will have fulfilled its obligation to the client-patient, and to the law.

Go and do likewise!

What would you do if a client contacted you and said she had taken the first dose of the RU-486 regimen and now regretted it?

There is help!

Because of the critical time factor involved in attempting a reversal, Dr. George Delgado and Culture of Life Family Services have launched AbortionPillReversal.com.

This website and its associated hotline (877-558-0333) will serve as a means to rapidly connect women who have taken mifepristone (brand name Mifeprex, a.k.a. RU-486) to a nationwide network of medical providers who can attempt reversal of the drug with progesterone.

In a recent presentation to the American Association of Prolife Obstetricians and Gynecologists (AAPLOG), Dr. George Delgado described a series of seven patients where a reversal of RU-486 was attempted. The majority of the babies survived, and were born full-term with no apparent anomalies.

Mifepristone causes abortion because it is a progesterone receptor blocker. Progesterone is an essential hormone during pregnancy, which allows the placenta to grow, flourish, and nourish the baby. Blocking the action of progesterone (as mifepristone does) causes placental failure, which in turn, leads to the death of the unborn baby.

Supplemental progesterone, if given early enough, can out-compete the mifepristone and prevent the progesterone receptor-blocking action. By out-competing the mifepristone on a molecular and receptor level, the progesterone serves as an antidote to the mifepristone.

Since Ella and other “morning after pills” are also progesterone blockers like mifepristone, they also have the potential to be reversed by an emergency progesterone intervention.

The fact is that many women regret their choice to abort their babies. After a surgical abortion, of course, there is no going back. But, when a woman begins the process of a medical abortion and changes her mind, there is a window of opportunity to reverse the effects of an abortion-causing agent.

Please take a look at this website, and keep this information handy, should one of your clients come looking for help.

• How knowledgeable are you about RU-486?
• How much information does your staff have to skillfully discuss RU-486 with a client?
• Are you looking for a great educational piece for a staff in-service or training?

Director of Education and Research for the National Right to Life Educational Trust Fund Randall K. O’Bannon Ph.D and Director of Research and Public Policy for the American Association of Pro-Life Obstetricians and Gynecologists Dr. Donna Harrison have written a duo of fantastic articles that you can read and download in their entirety at http://www.abortionresearch.us/images/Vol24No1.pdf for use in your centers as well as education for your staff.

• The Introduction and Use of the Abortifacient Mifepristone (RU-486) in the United States
• The Introduction and Use of the Abortifacient Mifepristone (RU-486) in the Developing World

Let me whet your appetite with a few excerpts from the 12 page well-referenced articles…

The Introduction and Use of the Abortifacient Mifepristone (RU-486) in the United States

By Randall K. O’Bannon Ph.D,  Director of Education and Research for the National Right to Life Educational Trust Fund

“The discovery of the pregnancy hormones progesterone (1929) and estrogen (1934) opened up whole new possibilities. Gregory Pincus, one of the co-inventors of the oral contraceptive pill, theorized that “anti-progestins should be implantation inhibitors,”

“Etienne-Emile Baulieu visited Pincus in Puerto Rico, where trials were being conducted of the new birth control pill, and came away determined to devote his life to steroid research, believing Chemical contraception central to women’s health and to control of the world’s population (Lader, RU-486, 29-30, Baulieu, 69).

“He returned to France and began working as a consultant to French pharmaceutical giant Roussel Uclaf…”

“Normally in pregnancy, progesterone, produced by the corpus luteum, functions to build and maintain the endometrium, which welcomes and then sustains the developing child in his or her earliest days. As pregnancy progresses, the placenta takes over progesterone production, but those critical first weeks are crucial to the establishment of the child’s nurturing and protective environment.”

“Anti-progestins bind to the same receptor sites as progesterone, but then do not carry out the same tasks. With the progesterone signal effectively blocked, the endometrial lining decays and sloughs off, depriving the developing child of essential nutrients, essentially starving her or him to death as the protective environment around her or him collapses.”

“Ultimately, under what The New York Times termed “sustained political pressure from the Clinton administration, a deal was struck granting U.S. licensing rights to the Population Council of New York in May of 1994. Roussel agreed to turn over all rights and responsibilities connected to the drug to the Population Council for free, hoping to avoid becoming a boycott target.”

“A common medical issue in many of these deaths is how difficult it is, for both patients and doctors, to distinguish between the ordinary side effects of chemical abortion, which are often severe, and the signs of a serious problem like hemorrhage, ruptured ectopic pregnancy, or infection.”

“Women are told to expect heavy bleeding, akin to a heavy period, and understand that the abortion will be painful. When these occur, they assume that they are related to the abortion process. If the pain and bleeding become so substantial that they call the clinic or go to the emergency room, even the medical professional may consider the events to be abortion-related. Brenda Vise called the clinic repeatedly and was told that her considerable pelvic pain was normal. The doctor at the ER did a physical exam of Holly Patterson and sent her home with more pain medication. Both were dead before the week was out.”

“Many abortion clinics are ignoring the FDA protocol, changing doses of the drugs extending the cutoff date from 49 days to 63, eliminating the second visit and letting women take the misoprostol at home (San Francisco Chronicle, 12/5/11), or even going so far as to prescribe the drugs via webcams, eliminating all direct physical contact between doctor and patient entirely (KCCI, 5/1910; Sioux City Journal, 10/8/10). Failures and complications are not only common, but more problematic, as women are farther removed from the careful medical monitoring that is essential to this process.”

“The Guttmacher Institute estimated that in 2008, more than a quarter of all abortions done at 9 weeks gestation or earlier were chemical abortions and both the overall percentage of chemical abortions and the number of clinics offering these abortions have been steadily increasing. If things continue trending as they are, it means that we can expect more women will die, along with tens of thousands more of their unborn children.”

The Use of the Abortifacient Mifepristone (RU-486) in the Developing World

By Donna Harrison, M.D,, Director of Research and Public Policy, American Association of Pro-Life Obstetricians and Gynecologists

“The use of non-surgical (medical) abortion in the developing world has had great appeal for abortion advocates. Surgical procedures in third world countries with poor medical infrastructure, lack of dependable transportation to emergency centers, and even inadequate water supplies pose health risks for patients electing to have a surgical abortion. On the other hand, simply taking a pill to undo the pregnancy appears to be a good solution for third world women. “

“The reality is that surgical abortions are still necessary in a number of cases because the pill fails; medical abortions are being attempted in settings with inadequate backup to care for complications; and hemorrhaging, a common side-effect of RU-486 abortions, is harder to control in third world environments. Unfortunately, there is a tendency to disregard such problems by enthusiastic abortion advocates, eager to expand abortion use in these countries.”

“In a moment of unguarded honesty, an ironic article, entitled Medical abortion: Is it a blessing or curse for the developing nations?, was published in the medical literature in 2011 ... [T]his article gives a rare glimpse into the reality of willy-nilly access to drugs which can end a pregnancy … The abstract opens with this statement:

"Medical abortion is definitely a safer and a better option, but in developing countries, its widespread misuse has led to partial or septic abortion thereby increasing maternal mortality and morbidity.”

“When the medical methods of abortion were launched in developing countries like India it was thought that frequency of illegal unsafe abortions by local dais and unregistered practitioners will decrease to a large extent and it will help in managing such unwanted pregnancies through safe and legalized abortions in peripheral health centres (PHCs), community health centres (CHCs), and civil hospitals. No doubt, though unsafe surgical abortions have decreased largely due to strict legislations but these have been replaced by increasing number of unsafe medical abortions.”

“Because medical abortion is being used increasingly in several countries, it is likely to result in an elevated incidence of overall morbidity related to termination of pregnancy.”

Download both articles in their entirety: http://www.abortionresearch.us/images/Vol24No1.pdf.

Based on biblical principles found in the book of Genesis, The Sexual Integrity Program (SIP) also draws inspiration from on The Theology of the Body and Pope John Paul II's Encyclical, Humanae Vitae.

SIP, designed for use inside the pregnancy help center, teaches women how to walk in sexual wholeness in all areas of their life – physical, emotional, social, intellectual, and spiritual.

Four Biblical Pillars form the foundation of the program.

• Pillar One: A Focus on Relationships (Genesis 1:27)
• Pillar Two: A Focus on Marriage (Genesis 2:24)
• Pillar Three: A Focus on Fertility (Genesis 1:28)
• Pillar Four: A Focus on Wholeness (Genesis 2:25)

Centers that offer SIP have more effective client outcomes. The ability to continue building the relationship with clients week after week by offering them a new way of living leads to a reduction in the number of return pregnancy tests visits per client.

Women who learn about sexual wholeness feel empowered. They have the new knowledge that helps them make healthier choices with their bodies, reducing sexual activity outside of marriage.

Other outcomes that centers see when the use SIP include Evangelization opportunities that increase as centers spend more time with clients sharing God’s blueprint for sexual integrity. The center’s reputation is enhanced as a provider of more complete reproductive health education. Volunteers become more knowledgeable on the major topics related to sexual activity, and, therefore, more confident in their interaction with all clients.

Learn more about what The Sexual Integrity Program can offer your center.

by Jor-El Godsey, Heartbeat International Vice President

“Let’s get the volunteers to do it. That will save a bundle!”

Volunteers are often seen as a supply of labor for almost any task or for the implementation of an action item. Leaders - board members and directors alike - often assume that volunteers are the least expensive option available. Think again.

Many moons ago, our pregnancy help center utilized a team of volunteers to accomplish the bulk mailing of our newsletters and appeals.  Trays of printed material and envelopes along with stickers and labels were distributed. Presto, some two weeks later the mailing had been delivered.

Upon closer inspection, we realized that, in addition to the volunteer time, two staff members had spent ten work hours (a total of twenty staff hours) each mailing cycle to coordinate the assembly, distribution, and postal paperwork for this process.  A local mailing service (also known as a fulfillment house) that had more sophisticated equipment could lower the postal rate and turn the same task around in three working days as opposed to two weeks. Cost comparisons revealed that, for just a few dollars more, we could improve our process, tighten our turn around, and release several volunteers to more personally rewarding tasks.

All leaders recognize the scarcity of resources to accomplish the mission and achieve the vision.  The good leader continually evaluates how to allocate the limited resources available for maximum return on the investment for the ministry and those involved. 

Adapted from DIRECT Well™, Heartbeat International’s manual for directors.

From On the LeaderBoard | Volume 2, Issue 2

(5/10/2012)

Yesterday, the United States Court of Appeals for the Fourth Circuit was the first circuit court to rule on government mandates requiring pregnancy centers to post disclaimers and disclosures, declaring that such mandates violate freedom of speech, a constitutional right.

“The Fourth Circuit Court’s decision is a victory for Centro Tepeyac and other Heartbeat International affiliated pregnancy help centers that are rescuing children who were once at risk of abortion by providing practical help and emotional support to mothers who often have been abandoned and abused,” said Heartbeat International President Peggy Hartshorn, Ph.D. “This decision upholding our freedom of speech affirms the life-saving work of pregnancy centers and the importance of providing alternatives to abortion.”

The first case ruled upon by the court was Centro Tepeyac v. Montgomery County; Montgomery County Council, et al, No. 11-1314 (4th Cir. 6/27/2012) in which the county passed a resolution requiring limited service pregnancy centers to display a sign bearing two statements: “The Center does not have a licensed medical professional on staff. Montgomery County Health Officer encourages women who are or may be pregnant to consult with a licensed health care provider.”

The second case, Greater Baltimore Center for Pregnancy Concerns et al v. Mayor and City Council of Baltimore, et al, No. 11-1111 (4th Cir. 6/27/2012) originated from Baltimore, which involved a city ordinance mandating pregnancy help organizations to post signage in two languages that “the center does not perform or refer for abortions or birth control services.”

The Fourth Circuit Court slapped down both government mandates as violations of free speech, applying strict scrutiny to its analysis of both laws.

The Court applied the same reasoning to both laws:

1. that the pregnancy centers are not engaged in commercial speech;
2. that the Court was obligated to apply strict scrutiny in its review of such ordinances and resolutions;
3. the government did not demonstrate a compelling interest necessitating the laws; and
4. that both laws violated First Amendment.

These rulings signal a strong victory for pregnancy help organizations, not only in Maryland, but across the country, as challenges are raised to similar attempts in other jurisdictions.

One of the most beautiful things about the pro-life movement is its unity. When people come together and pool resources to see a common goal accomplished, the gospel of LIFE is spread throughout the earth.

That’s exactly what took place during Heartbeat International’s Annual Conference last March.

We have the honor of hosting pregnancy help movement leaders from all around the world at Conferences every year, and the chance for those international life-savers to receive training and get equipped can be life-changing. This year, we encouraged our U.S. pregnancy help organizations to bring any foreign coins they may have to our Conference, to be distributed among those outside of the U.S.

We were overwhelmed with the response! We received a multitude of foreign coins that we were able divide up and distribute among our international partners.

Our friends from Centro de Ayuda para la Mujer (CAM) came all the way from Mexico to attend our Conference. We were blessed to be able to give CAM the pesos that we received, knowing that they would be put to good use. And we were right!

The CAM network saves lives from abortion all over Mexico and across Latin America. As it turned out, those donated pesos were spent on baptism robes and gifts for the children who have been saved from abortion by their ministry. It is a thing of beauty to see lives rescued from death now baptized in beautiful garments because of the unity and generosity of the pregnancy help movement.

Thank you for partnering with us as we work to advance the pregnancy help movement worldwide!

By Virginia Cline

I remember my father’s tears on January 22, 1973. It was the first time I had ever seen him cry.

I was 11 years old when I found him crumpled up on the stairs, shuddering, with his folded hands pressed to his face as he sobbed. I will never forget how he was curled up in the fetal position as he wept. It took him no less than 10 minutes to choke out the fact that seven men on the U.S. Supreme Court had decided it should be legal for a mother to abort her baby.

On that particularly bleak Monday afternoon, he cried for the millions of babies he knew would die at the hand of Roe v. Wade.

How could we fail to acknowledge the more than 54 million children aborted in the United States alone since the insidious Roe v. Wade decision on Jan. 22, 1973—the most tragic and unforgettable date in U.S. history?

Since the upcoming presidential inauguration is planned for Monday, Jan. 21, 2013, the 40th annual March for Life was moved to Friday, Jan. 25, leaving the anniversary itself without acknowledgement. Heartbeat International and at least 10 other partnering pro-life organizations—including March for Life—did not want the 40th anniversary of Roe v. Wade to pass by without a national day of prayer and fasting, so RememberingRoe.com was launched.

RememberingRoe.com promotes a day of remembrance and hosts a variety of interactive tools and includes an opportunity to sign up for a national hour of prayer via webcast, led by the National Pro-life Religious Council on Jan. 22, 2013, beginning at 3 p.m. EST.  

The site is also the vehicle for a national campaign that seeks to send 1.2 million red pro-life postcards to the president in honor of the 1.2 million victims of abortion in the U.S. each year. For a small donation, visitors can sign up for a red card—personalized with their name—to be delivered to the White House on Jan. 22, 2013, sending the leader of the free world a positive message about the sanctity of every human life from those he represents.

Forty years of destroying life in the womb is the battle that defines our society. The false “choice” of aborting a child has endangered our very civilization by attacking the dignity of human life and by denigrating motherhood. The escalating evil of abortion calls for a supernatural response, and so we challenge every pro-life individual to kneel together as one nation under God, and call upon Him as we remember, reflect, repent and plead for restoration on the anniversary of this disastrous turning point.

Prayer is the strongest weapon against the evil that is abortion. Our hope is that members of the pro-life movement call upon God—the Giver of Life—in prayer and fasting together as we fight for the sanctity of life in America. As the 40th anniversary of Roe v. Wade approaches, visitors are encouraged to post prayers on RememberingRoe.com, leading to greater unity among members of the pro-life community.

There’s also a place at the site to share your story of how you first heard about Roe v. Wade. Some of us are old enough to remember exactly where we were when we learned about the now-infamous U.S. Supreme Court decision.  Those born after Roe—rightly called “abortion survivors”—are also invited to share reflections on when and how they learned that the Supreme Court had declared it a “right” for every woman to choose to abort her baby.

My pro-life passion was ignited Jan. 22, 1973, after witnessing my father’s heartbreak and hearing his cries: “I could have done more. I should have done more to stop abortion.” 

Imagine if our stories listed online at RememberingRoe.com inspired Christians everywhere to do more to help each mother reject the “choice” to abort her child!

The goal of RememberingRoe.com—and the goal of Heartbeat International—is to make abortion unwanted now and unthinkable for future generations. The Holy Spirit has the power to kindle the fire of compassionate love within us, so that the pro-life movement can renew the face of the earth for LIFE. Let us unite so that we may never forget.