Volunteers at a Surrey Christian charity are warning women about risks of abortion that may be common in back-alley operations but are rare in modern Canadian clinics, a CTV News hidden camera investigation has revealed.

Warnings of catastrophically scarred uteruses that would leave a woman infertile are not realistic in a legal abortion, doctors say, but that was one of the risks discussed with a volunteer counsellor at the South Fraser Pregnancy Options Centre.

"Thankfully that's a rare condition in Canada in modern times," medical ethicist Dr. Dan Reilly told CTV News in an interview where the footage was discussed. "It's something you would see more in a place where abortions are being done not in a medical setting."

The South Fraser Pregnancy Options Centre in Surrey is affiliated with the Canadian Association of Pregnancy Support Services (CAPSS), a national Christian charity, which operates about 80 such centres in Canada, serving an estimated 6,800 people a year.

But some providers of sexual health services have expressed concerns that some centres aren't giving women the full story.

To learn more about the advice offered by some centres affiliated with CAPSS, CTV News sent staff member Sheila with a hidden camera to the Surrey Centre to pose as a pregnant woman in her first trimester with some questions.

During her visit, Sheila heard that abortion is associated with risks ranging from breast cancer to depression to fetal body parts forgotten inside the womb.

Staff welcomed Sheila and seemed genuinely concerned about her well-being. They asked about her background, the circumstances of the pregnancy, and if she had been abused. They offered referrals to hospitals for any sexually transmitted diseases and said that she was not alone struggling with a tough decision.

Staff went through a brochure that discussed fetal development, adoption and abortion, and when the option of abortion was brought up, staff members spent a long time discussing the risks. The volunteer brought up the image of a botched abortion where doctors had to return to collect fetal body parts.

"They will check to see the fetus, to make sure all the parts are there," the volunteer said. "Some of it might still be attached to the uterus and you have to scrape it out."

She described infections after an abortion as "very, very common," and brought up the possibility of serious physical harm.

"You're scraping the uterus and there could be some scar tissue," she said.

"It could affect you later when you do decide you would like to have a baby because there's so much scar tissue that the fetus won't have anywhere to hang on to."

Pressed on where an abortion would be available, the volunteer said, "I have no idea where abortion clinics are."

Instead, the volunteer gave Sheila a bag of materials that included a referral to a photographer in an envelope that read, "For a Proud Mom-To-Be."

Sheila also visited the Crisis Pregnancy Centre in Vancouver. That centre is also affiliated with CAPSS, but is not commonly owned or associated with the Surrey South Fraser Pregnancy Options Centre. In Vancouver, staff members raised links between abortion and breast cancer, premature births, and infertility. But Sheila heard no far-fetched health warnings., just an emotional pitch.

"Sadness, anxiety, guilt and suicidal thoughts are the top four that at the centre I see women experience after an abortion," she said. "You are a woman. You have a heart."

South Fraser Pregnancy Options Centre defends volunteer

South Fraser Pregnancy Options Centre staff told CTV News they stood by their Surrey volunteer, who they said was informing one of their 300 clients a year of all the risks of abortion.

"A lot of our clients have concerns about what the physical risks are," said the centre's client service director, Megan-Jane Good.

However, staff members conceded that giving someone interested in getting an abortion an envelope that said "For a proud Mom-to-be" was inappropriate.

"If that's something we can reword and make more sensitive, we will absolutely do it," said South Fraser Pregnancy Options Centre executive director Laura Lansink.

Centre staff said they let visitors know up front they do not do abortion referrals, and denied that they had a hidden agenda to steer women away from abortion.

Lansink said that the centre does hard work to provide counselling, maternity clothes, and other support. Having an unplanned pregnancy can be very tough, she said.

"We believe that what we are offering to these women is real and tangible help at their greatest need," Lansink said.

Doctors differ on risks of abortion

Abortion is legal in Canada, and is covered by provincial health insurance in B.C. People looking for help about what to do with a pregnancy can see a doctor or call services like Options for Sexual Health, which gives some 30,000 patients advice on sexual health, according to the centre's director, Greg Smith.

But Smith said he is concerned about other centres that advertise online as resources for women with unplanned pregnancies. He says patients have come to him complaining that rather than being given objective advice, they were steered away from abortion.

"We hear from time to time that people who have gone to those centres come out enraged," he told CTV News. "They feel they were given a bait and switch."

Doctors recommended by the B.C. Women's Hospital and by CAPSS disagreed about the links between abortion, breast cancer, infertility and the chance of miscarriages.

But they did agree that infection was uncommon in North American hospitals – about one in every 200 cases. As for any perforations to the uterus, studies show that ranges between three in 1,000 to one in 10,000 cases.

And actual scarring that impacts a woman's ability to have children is so rare that meaningful statistics are difficult to come by, said Dr. Wendy Norman of B.C. Women's Hospital.

"Both medical and surgical abortions are very safe," she said.

Scarring to the point of infertility is a mark of an illegal abortion, she said.

"Abortions performed by physicians and accredited health professionals have been shown indisputably to not have these long term effects," she said.

Dr. Reilly, who is a professor at McMaster University and also an obstetrician based near Hamilton, Ontario, said it was ethical to inform patients of the risks they would face in Canada – not risks facing someone in a developing country, or where abortion is illegal.

"You should be talking about the risks in a country where you live," he said.

Updated on April 26, 2012 and July 5, 2012. Originally published on Jan. 17, 2012