Ciara Guernon was in a troubled relationship and working three jobs when she learned she was pregnant. The 22-year-old began calling people to see if they would lend her money for an abortion. "I didn't think I'd be a good mom," she said.
Guernon ultimately decided to have the baby after a visit to the fervently anti-abortion EMC Frontline Pregnancy Center in Brooklyn, where she was shown her sonogram.
The center, where young women and couples are directed to a room decorated with pictures of mothers to watch videos on prenatal development and abortion, is among a small number of pregnancy service organizations accused by abortion rights groups and city officials of misleading women about their reproductive health options and disguising themselves as medical clinics.
The debate between the centers and the city has renewed focus on the New York City's abortion rate, at 41 percent among the highest in the country.
EMC Frontline Pregnancy Centers promotes itself as "Fighting for life in NYC _ the abortion capital of America." In City Council testimony last month, Joan Malin, Planned Parenthood of New York City's CEO, called the centers "anti-choice organizations masquerading as legitimate reproductive health care providers."
Mayor Michael Bloomberg signed a law last month that mandates all pregnancy centers disclose what services they offer, including whether they have licensed medical staff and what they do to protect the privacy of clients. Abortion rights groups have backed the law.
Several of the centers have filed lawsuits to try to stop the law from going into effect, arguing it tramples on their free speech rights.
Often funded through donations and by charitable organizations and run by anti-abortion volunteers, the centers set up shop near clinics that provide abortions, sometimes even in the same building.
A few hold rallies outside abortion providers' clinics while trying to divert women to their offices. Some advertise in newspapers and on subways with the promise of "abortion alternatives." They provide free pregnancy tests, counseling and sonograms. Their objective is to persuade women to carry their pregnancies to term.
Chris Slattery, who founded the chain of EMC Frontline Pregnancy Centers in 1985, said abortion-rights groups were ganging up on organizations like his with the support of government officials.
"In a lot of other states, there is mandatory counseling, mandatory waiting periods," he said. "We are a substitute for those laws that don't exist in New York."
The city's abortion rate has for years hovered around twice the national average, according to researchers and statistics from the city's Department of Health and Mental Hygiene.
In New York, 41 percent of the more than 225,000 pregnancies in 2009 ended in abortions, said the city's Department of Health and Mental Hygiene. The national average for abortions is 22 percent, according to the Guttmacher Institute, which studies sexual and reproductive health and is cited by both sides in the abortion debate.
Health officials say 61 percent of the city's pregnancies were unintended in 2009, a potential indicator of poor access to birth control, health care and family planning.
Reporting requirements for abortions vary widely by jurisdiction. Philadelphia's public health department reported that 39 percent of more than 39,000 pregnancies ended in abortion in 2008; and Washington, D.C., reported that about 13 percent of nearly 11,000 pregnancies ended in abortion.
New York City's statistics have given fuel to activists on both sides of the debate and to organizations like the one Guernon went to in Brooklyn, with some claiming that the high abortion numbers are a result of an "industry" bent on making money off poor and minority women.
New York has one of the most lenient abortion laws in the country dating to 1970 and provides funding for all or most medically necessary procedures. The city is also where the country's modern-day birth control movement got its start when Margaret Sanger, the founder of Planned Parenthood, opened a family planning clinic in Brooklyn in 1916.
Experts point to a myriad number of possible factors _ social, economic, financial _ to explain the statistics on abortions and unintended pregnancies in the city.
Rachel Jones, a senior researcher at the Guttmacher Institute, said that the procedure is more accessible in the city because there are fewer laws in New York that regulate abortion, state insurance pays for the procedure and public transportation makes it easy to get to providers.
"We are a geographically concentrated area," she said. "It is easy to find a clinic and it is easy to get there."
But while abortion may be more accessible, low-income women especially have uneven access to family planning, such as birth control, health officials said.
"We know that abortion rates are higher for poor women who have lower access to these services," said Deborah Kaplan, the city's assistant commissioner in the Bureau of Maternal, Infant and Reproductive Health.
The city has worked to reduce the numbers of abortions through various public policies, including an initiative funded in 2005 to improve family planning. Kaplan said one outcome of the program had been a delay in subsequent pregnancies. The city also received a five-year grant from the Centers for Disease Control for a program in the Bronx for improving sexual education and services.
Malin said social and economic barriers make it "pretty difficult" for women to get the reproductive services they need in the city _ and that some may not even be able to afford birth control.
"Many of the women we see are leading chaotic lives," she said. "In my mind, it's related to all the factors of poverty that make it more challenging and difficult to get services."
The Rev. Earl Kooperkamp, a pastor at St. Mary's Episcopal Church in Harlem who supports Planned Parenthood, said he had counseled many women with unintended pregnancies and found one underlying theme.
"One thing we are not doing _ we as a city, as a society, as churches _ we aren't doing nearly the job we need to do so that our young boys and girls have the education they need," he said.
He recounted how one young woman came to him astonished that she could get pregnant.
"There is so much ignorance out there," he said.