The Ground is Tilled and the Seed is Planted by the “Greatest Generation”

How did this network start and how has it grown?  What are some of its hallmarks and accomplishments?

The story begins with the push for the legalization of abortion came years before the Supreme Court decision Roe v. Wade.

In 1875, the laws in every state banned abortion. At the turn of the 20th century movements to overturn state bans began.  The most influential was the Birth Control League (now Planned Parenthood), founded in 1917 by Margaret Sanger, whose philosophy also influenced the eugenics movement in Nazi Germany.

By 1960, pro-life physicians and others saw that women would soon feel pressured to have a “safe, legal abortion” and would succumb to that pressure unless they found a safety net of support for choosing to carry their babies to term.

These pioneers began to provide so-called “alternatives-to-abortion” services. Pregnancy testing and counseling were offered out of private doctors’ offices (since pregnancy tests had to be sent to a medical lab).   Phone counseling and support was also provided, sometimes out of the same physician’s office (by his nurse and others), and sometimes this help was supplied out of  homes or small offices opened for that purpose.

One of the first “centers” was Heartbeat of Toledo (Ohio), operating from a small office in conjunction with the medical practice of Dr. John Hillabrand OB/Gyn, with the help of one of his nurses, Esther Applegate, and one of their friends, Mrs. Lore Maier.  Another early outreach was a hotline founded in Los Angeles by Sister Paula Vandegaer, a recently graduated social worker.

At our founding in 1971, Dr. Hillabrand had already enjoyed a 45-year obstetrics career, delivering 8,800 babies without a single maternal death. Devoted to the dignity and sanctity of life, Dr. Hillabrand, at the ridicule of colleagues, had even attempted to save the life of a baby born at 20 weeks of gestation, years ahead of the technology.

Pioneering men and women, professionals and non-professionals, those called most early into this movement, were doing pregnancy help center work from their homes, offices, and out of coffee shops and other meeting places.  They were tilling the ground and planning seeds.  These were the early pregnancy help centers. These pioneers founded the first U.S.-based pregnancy center organization, Alternatives to Abortion, now Heartbeat International, at a 1971 meeting in Chicago, so their organizations could learn from and support each other.

Our founders were led by Dr. Hillabrand and Lore Maier, both now deceased, members of the so called “Greatest Generation” that came of age during World War II.  Some of their early writings and speeches, as they founded our movement, show how close they were to the events of this war and the Holocaust.

In a 1979 newspaper interview, Dr. Hillabrand asked: “Because you can’t see the child, should you kill it? Are they like bomb victims about which the inventor of the atom bomb said, ‘We don’t mind dropping
bombs if we can’t see faces.’?”

Mrs. Lore Maier became our first Executive Director, as a full-time volunteer. German-born, Mrs. Maier was the only survivor of her family of six in Nazi Germany. She was a court recorder during the Nuremburg trials and knew how the killing had escalated, with the “imperfect” being the first victims.

In 1979, Mrs. Maier commented: “Where Hitler compelled people to do the killing, today millions of people choose to abort their babies of their free will. …If we let this go on, what is now a matter of choice could very easily become mandatory…If we are not pro-life, we are against our own survival.”

Operating out of Dr. Hillabrand’s medical office in Toledo, this national, soon international organization, described itself as humanitarian, non-sectarian and non-denominational.  AAI , and other emerging organizations such as Right to Life, thought that if the tenet that each human life is intrinsically valuable was presented as a civil rights issue, rather than a religious issue, it would gain wider worldwide acceptance.

This would also counter the charge that being pro-life was “just” a Catholic issue.  Most of the pro-life pioneers were Catholic, and this was used, successfully at first, to marginalize and discredit the movement. The presumption also was that Americans already held religious beliefs and Judeo-Christian values, so they need not be stated explicitly. As our culture and other factors have changed, so has Heartbeat International, which is now an explicitly Christian organization.

A Generation of Counselors and Helpers Bear Fruit


Our early history demonstrates the medical roots of our movement.  Interwoven with the medical component of services was the counseling component. One of our founders and early Board members was Sister Paula Vandegaer, a member of the religious order of the “Sisters of the Social Service.” Sister Paula now heads the pro-life organization called International Life Services in Los Angeles. Sister Paula, a professional social worker, brought the insights and skills of a professional counselor into the early “service arm of the prolife movement.” As a result, we have made an impact on the fields of counseling and social services for women.

Sister Paula has noted that “crisis intervention” was brand new in the counseling profession at the time our early pregnancy help centers were being founded: “It was our movement that really developed this new area of counseling,” says Sister Paula.  Early affiliates, specializing in crisis intervention, were often called Emergency Pregnancy Services or EPS. The approach was “woman centered” and focused on supporting the mother during her crisis period so that she could then save and nurture her baby.

Sister Paula’s also founded one of the very first “hotlines” of any kind!  Hotlines were a new concept for crisis intervention in the early 1970’s. She wrote the first counseling manual and materials ever used specifically for helping women with unplanned pregnancies, thus launching a new, specialized field for counseling and social work.  She laughingly mentions that she still sees parts of that original manual in many materials published for pregnancy help ministries today!

Sister Paula also noted that it was the faith-based counselors working in our movement who were the first to diagnose (and later name) what is now known widely as “post- abortion syndrome” (PAS). The magazine of our organization called Heartbeat, published by Sister Paula from our West Coast office in Los Angeles, published the first research on postabortion syndrome, including how to recognize it and offer help.  The name of our magazine eventually became the name of our organization in 1992.

Until some states started licensing “counselors,” most of those called into our movement referred to themselves “counselors.” Now we often use terms such as “consultants” or “client advocates,” unless speaking of professional counselors.

The first 20 years of our history were clearly marked with tremendous growth and creativity of those called to serve and to support women in crisis. When our founders retired from leadership in the mid 1980’s, the AAI office moved from Toledo, Ohio, to White Plains, New York (and then back to Ohio in 1993.)  Official affiliates registered about 250, a combination of pregnancy service centers, maternity homes, and adoption agencies.  These people were served by a nearly all volunteer central AAI office. Currently Heartbeat’s central office has over 20 staff members serving thousands of people called to work in over 2,500 affiliated locations in 50 countries.

Among the first of our founders’ stated goals was the publication of a Directory of all the movement’s service providers. In 1971 the Directory was a mimeographed sheet of 75 entries. This year’s Worldwide Directory (on the web and in published form) contains thousands of entries.

The second goal was to hold an annual training conference. The first conference was held on a college campus in Minnesota in 1971. Our 40th annual conference was held in Columbus, Ohio, in 2011.

The third goal was to publish training materials. The first were a series of small booklets published in the 1970’s, along with the Heartbeat magazine. Currently, Heartbeat provides numerous manuals, a distance-learning curriculum via the internet (Heartbeat Academy), a Leadership Institute, along with numerous other training opportunities.

The last goal, to have a “WATTS line” connecting pregnant women with help in their area, was realized 32 years after our founding with the creation of Option Line® in 2003 (in partnership with Care Net), our 24/7 call center that handles approximately 200,000 calls, emails, instant messages, and chats per year, connecting women in need with their local pregnancy help ministry.

All of us owe a debt of gratitude to the visionary and courageous founding generation who laid a strong groundwork for our growth and development into the 1990’s and beyond.

A Generation That Recommits and Unites Christians Working in this Vineyard

In 1992, twenty-one years after our founding, several factors led to major changes for  Alternatives to Abortion International (AAI), now Heartbeat International. First, some of our founding leaders, who had served for two decades as volunteers, began to resign. Two shocks also came from Washington: the Supreme Court’s “Casey Decision,” which reaffirmed Roe v. Wade, and the election of a strongly proabortion president, Bill Clinton.

Pro-life people were discouraged, but determined to try to reduce the numbers of abortion.  Those who were called into “alternative to abortion” recommitted to helping women, vulnerable to abortion, and to saving and changing lives, one life at a time.

The AAI Board had a scheduled meeting two day after the November 1992 election. There they voted to reorganize, recommit, and move from a volunteer model to a “professional” model at the top levels, and to do everything in our power, and in the power of the Lord, to help create an even larger and more effective network of pregnancy help ministries worldwide.  Peggy Hartshorn was Chairman of the Board at that time, and, in 1993, took the position of President, AAI’s first full time professional staff member.

We soon changed our name to Heartbeat International (Heartbeat was the title of AAI’s magazine). A more momentous change was that we described ourselves as an interdenominational Christian association, with Biblically based programs.

This was a radical departure from our early days.  Early on, AAI made a strategic decision to avoid referring to abortion or our work in “religious” terms. The founders believed AAI would be more effective and obtain more support if they described abortion as a “civil rights” issue and their work as “humanitarian.” Partly this was because American culture was still presumed to be rooted in Judeo-Christian values. Also, the “first wave” of the pro-life movement was made up predominately of Catholics, and it was easy to marginalize the entire movement if it was identified as “religious” and “just Catholic.”

Since our founding, the cultural landscape had radically changed. By the 1990’s, it could no longer be presumed that we had a Christian culture and that American non-profits were functioning from a Judeo-Christian perspective. Our programs, especially post-abortion programs, had a Christian basis.  In addition, the “second wave” of pro-lifers had entered the movement in the 1980’s, and they were Evangelical Christians.   The leaders of AAI were Catholics and Evangelical Protestants. Our Christian identity, in a world marked by increasing confusion, needed to be clear. We also believed the Lord wanted to use Heartbeat to continue to bring about greater unity among Christians.  That kind of unity would be essential in fighting abortion and returning our nation to one that respected the “inalienable right to life.”

Our mission remained basically the same—to start and strengthen abortion alternative organizations worldwide, encouraging entrepreneurial and independent local pregnancy help ministries that subscribed to prolife principles and could uniquely meet the needs of those in their community that were vulnerable to abortion.

In 1993, we set up a new Heartbeat headquarters in Columbus, Ohio, using donated space (a walk-in closet!) in the office of our affiliates (now Pregnancy Decision Health Centers), and we purchased a file cabinet and computer. The previous office and its equipment in White Plains, N.Y., was destroyed in a fire. We eventually moved to our own office space as God provided more financial and human resources.

Our programs grew as well. About 100 of the original 250 AAI affiliated centers became new Heartbeat affiliates and other centers began to join. The first Conference planned under our new leadership was held in Columbus, Ohio, in 1993, and our first new manual, published in 1994, was The LOVE Approach, now the centerpiece of Heartbeat International training.

Today, Heartbeat has over 2,500 affiliate locations in 50 countries.  We still hold yearly international training conferences, have instituted many specialized trainings, launched an internet-based training courses through our Heartbeat Academy.

The seeds planted during those transition years have borne much fruit and, for that, we give thanks and glory to the Lord!