When I call the Kharkiv Pregnancy Assistance Center, I hear a sympathetic woman’s voice in the receiver. Iryna* she introduces herself, as I slowly explain my situation: I am a 20-year-old student and an internally-displaced person who was raped. I am now pregnant and thinking about accessing an abortion, which has been legal in Ukraine since the 1950s.

Iryna’s tone changes. Abortion is not an option, in her view. Instead, she pushes me to turn to religion and tells me to go confess at church. “It is impossible to kill and be happy”, she says, suggesting that even if I got pregnant from a rapist I am still carrying a “child born of God and his blood”.

She said my “ability to love” would also be affected. “It is better to give him life than to get breast cancer or uterus cancer", she added, incorrectly claiming that after an abortion, these are “risks that await you at every corner".

The story I told Iryna was not my own. I’m 39 now, and I called her group’s hotline as part of an eighteen-country investigation from openDemocracy, into how ‘crisis pregnancy centres’ (CPCs) are operating around the world.

Often styled to resemble medical clinics or neutral counselling services, staff at these centres have agendas: to dissuade women from having abortions. Internationally, some even discourage women and teenagers from using contraception. Thanks to support from US religious groups, linked Donald Trump’s administration, they’ve spread across the world.

The Kharkiv centre is based in Ukraine’s second-biggest city, which has also become a main destination for internally-displaced persons since the start of the war in 2014 in Ukraine’s eastern Donbass region.

Its website has a neutral landing page and the simple URL “helpcenter.com.ua”. On the site, it advertises services “regardless of whether you are considering an abortion, bringing up a child on your own or give it for up for adoption”. It even offers an online “test” to tell you if you should have an abortion or not.

Though when you dig deeper, every blog post and article the Kharkiv centre has published about abortion appears to emphasise only negative consequences and psychological and physical side effects. And when I called the centre’s hotline, I was given only one choice: carry my unwanted pregnancy to term.

I couldn’t find any suggestion on the centre’s website that it is a religious group, though the about section of its Russian Facebook page (which has only 600 followers) says it aims “to reduce the need for abortion to zero”. The English version with fewer followers says it reaches people with “the love of Christ”.

On the phone, Iryna initially said: “If you do an abortion, I can’t judge you. This is your choice. You have a difficult choice”. Though she quickly shifted the focus of our call from a discussion of healthcare options towards moral claims, and warned me that having an abortion would also threaten my soul. She spoke a lot about God, and told me “You will never be the same” after an abortion.

A woman in trouble, looking for help, may not realise that the Kharkiv centre has an agenda – or such powerful foreign friends. For years, however, this ‘crisis centre’ in eastern Ukraine has been connected to a Christian right group whose “new friends in Washington” include Trump’s Vice President Michael Pence.

This is Heartbeat International, which was founded in the 1970s and started opening ‘crisis pregnancy centres’ in the US decades ago. Today it says it has a presence on “every inhabited continent” and its online directory lists hundreds of ‘affiliates’ internationally, including the Kharkiv centre in Ukraine.

As part of openDemocracy’s global investigation, many other undercover reporters visiting other such centres in Heartbeat’s network were told remarkably similar things, including incorrect information about cancer risks that was repeated by staff at some of these centres from Italy to Ecuador.

In Ukraine, Ministry of Health guidelines say that “healthcare providers” should “be respectful of the patient and be able to help her maintain her dignity”. Counsellors asked about abortion should only provide information on different procedures and never intimidate, condemn or force women into decisions.

But here’s the catch: the Kharkiv centre I contacted for help appears to fall beyond the ministry’s reach, as it isn’t – and doesn’t have to be – on the list of officially accredited healthcare organisations. This means there’s no state monitoring, or quality assessment, of its services to pregnant women.

Hillary Margolis, Human Rights Watch senior researcher on Europe and Central Asia and women’s rights called our findings “disturbing”.

“These centres prey on women and girls who are often at their most vulnerable”, she said, calling on governments to make sure that their advertising is clear so that “people understand immediately what these centres really represent.”

Kateryna Levchenko, the government’s commissioner for gender policy, said she was not aware of the centre in Kharkiv but that “counselling is a service” that should not be prohibited but regulated by “public organisations, and citizens themselves – if they see that a [government] approved standard is not being met, then they can apply to those institutions that issue a license to operate”.

From the US to Ukraine

Unlike in the US, where there are thousands of these anti-abortion pregnancy centres, they are not at the fore of public debate in Ukraine. Meanwhile, there have been several populist and nationalist political proposals in recent years to change the law and restrict Ukrainian women’s abortion rights.

openDemocracy’s investigation also comes amidst increasing signs of intensifying US Christian right activity and connections in Ukraine – including links to the ultra-conservative World Congress of Families network that holds big annual summits and lists Heartbeat as a previous partner on its website.

Since 1955, women in Ukraine have had legal rights to abortions on request, paid for by the state, through the 12th week of pregnancy (and after this period in cases of rape, incest, fetal deformities and threats to the woman’s health).

A 2017 bill would have limited legal abortions to cases of rape, fetal impairment, or to preserve the woman’s health. A previous 2013 bill tried to introduce criminal liability for abortion and fines for abortion ‘propaganda’. Each of these proposals was met with resistance and was ultimately rejected by parliament.

But January, a new cross-party group of nearly 300 MPs was unveiled under the banner: “Values. Dignity. Family”. One of this group’s leaders, Oleg Voloshin from the party of Putin’s ally Medvedchuk, said he hopes the ultra-conservative World Congress of Families network will hold their next global gathering in Kyiv.

The World Congress of Families is led by the US activist Brian Brown who visited Ukraine last year to participate in an ultra-conservative ‘family forum’ in Kyiv. This March, he met Voloshin and Sviatoslav Yurash, the young co-leader of the “Values. Dignity. Family” group in Ukraine’s parliament.

“We agreed to coordinate efforts in everything, adopt international experience in legislation… and also do everything to prove: that to be part of the modern world there is no need to bury our eternal values under the cover of a rainbow flag, wrote Voloshin on Facebook, posting a picture of himself and Brown.

The World Congress of Families also has significant Russian ties. It was founded after a 1995 Moscow meeting. Alexei Komov, a close associate of ‘Orthodox oligarch’ Konstantin Malofeev, is on the board of the US group behind it.

Olena Suslova, a researcher and human rights activist who founded the Women's Information Consultative Center, says such ties between Russian and US ultra-conservatives are a major driver of anti-abortion initiatives in Ukraine.

These initiatives intensified, she said, after 2010 when President V. Yanukovych entered office and a wide range of church-related NGOs were established.

Success and shame

Founded in 2003, the Kharkiv centre reaches hundreds of mainly “unbelieving” women a year, “who are seeking abortion as a way out of the crisis of an unplanned pregnancy”, its director Elena Batina claimed in 2015.

The Kharkiv centre has no known links to the World Congress of Families but Heartbeat has given it small grants in recent years. In 2016, Heartbeat’s president Jor-El Godsey also praised Batina at a 2016 anti-abortion summit in Atlanta, saying that she “has been instrumental in fanning to flame the work of pregnancy help organisations across Eastern Europe”.

A ‘success story’ celebrated on Heartbeat’s website is about a child it claims was born after Kharkiv centre staff prayed and persuaded her mother to give birth.

Others, however, have questioned the effectiveness of these centres. Halyna Maistruk at Ukraine’s Women’s Health and Family Planning foundation argues that the number of abortions women have will only decrease if more people have access to sex education and contraception, both of which are currently limited).

“We still have Soviet-educated teachers who don’t want to talk to children about such topics and we still have parents who don’t speak to children about them”, said Maistruk. Meanwhile the Kharkiv centre does have programmes for teenagers – teaching abstinence and “true love waits”.

In such contexts, where comprehensive sexuality education is not widely taught at schools, Jaime Todd-Gher, former Legal Advisor at Amnesty International, warned that the activities of ‘crisis pregnancy centres’ can compound “stigma around abortion and women’s sexuality in general, and lead people to feel ashamed and embarrassed to seek accurate information”.

This can cause “unnecessary emotional distress” and for young people without access to other sources of information, consequences can include “increased rates of adolescent pregnancies, unsafe abortions and maternal mortality”.

Silence from Kharkiv?

The Kharkiv centre did not respond to openDemocracy’s requests for comment. Meanwhile, Heartbeat said “we stand firmly by our Commitment of Care” – which commits affiliates to providing accurate information and advertising.

In further emailed comments, it stated that its affiliates “must adhere to basic principles that affirm alternatives to abortion and ensure non-discrimination, but all other matters of policy and management remain under the direction of the centres’ local leadership allowing for autonomy”.

“Our clients have the right to choose an abortion and they also have the right to know more fully what may be at stake in their decision”, it added, saying “a recent survey of pregnancy help centre clients revealed a 99% satisfaction score.”

The World Congress of Families declined to comment.

In response to openDemocracy’s investigation, Fred Matic, the European Parliament’s Special Rapporteur on Sexual and Reproductive Health and Rights, said he believes: “Misinformation and deliberate inaccurate information provided in these centres are undoubtedly a violation of human rights”.

In Ukraine, Jaime Nadal Roig, the UNFPA’s country representative, said he was not aware of the Kharkiv centre but that “the provision of inaccurate information and counselling not in line with official health legislation and protocols should be brought to the attention of the appropriate authorities”.

Such inaccurate information “could lead women to make ill-informed decisions, exposing them to unnecessary health risks”, he warned.