The pro-choice movement in America is almost inextricable from Planned Parenthood. The non-profit is not only the largest provider of abortion services in the country, it is also its political leader. Planned Parenthood and its executives are who liberal politicians turn to for endorsement and support. They issue the talking points and they decide the agenda.
Increasingly, abortion seems to be a thing progressives care about only whenever there’s an opening on the supreme court, or when a state we don’t care about or know anyone in closes another clinic, and that is pretty much it. (Even the New York Times, in a recent article about how irrelevant abortion rights seem to young feminists, seemingly couldn’t find anyone outside a major urban area to talk to, someone who maybe didn’t live a short Uber ride away from a clinic and have the $600 on hand to pay for the procedure before the end of the first trimester.)
If Planned Parenthood is one of the leaders, if not the leader, of the pro-choice movement, perhaps it needs to take some responsibility for the movement being in a shambles. Because while many blame Trump for having “emboldened” conservative state governments to pass sweeping legislation challenging abortion access – Tennessee and Iowa being the latest – these challenges have been happening, and succeeding, for decades.
Like many major non-profits, Planned Parenthood seems more concerned with hobnobbing with the powerful, paying the CEOs of its regional chapters salaries in the mid-six figures, making symbolic gestures and coming up with a catchy slogan to sell on T-shirts than with providing care for the people who need their services. They’ll send out a fundraising appeal whenever a new restrictive law is passed, but that fundraising doesn’t often seem to translate into grassroots-level advocacy to make it understood healthcare is a human right, and reproductive justice is a necessity if a person is going to live with dignity and autonomy. The organization doesn’t, for example, endorse Medicaid for All. (Full disclosure: I was a Planned Parenthood employee in the Texas Capital Region chapter for about five years.)
It’s often the national organization that makes the headlines with its celebrity supporters and its adversarial relationship with Washington. But it’s local Planned Parenthood clinics – often incredibly underfunded – who do the work, offering health screenings, birth control, reproductive services and abortion in often difficult environments. Plus, Planned Parenthood’s brand recognition often draws support and dollars away from non-affiliated local clinics operating in rural regions without institutional support.
Instead, Planned Parenthood spends its time talking about “protecting Roe”, a notoriously weak and hobbled supreme court decision that guarantees legality but not access, and there is a massive difference between those two. For large parts of the nation, abortion is simply not accessible – logistically, financially or politically. Six states each have only one remaining clinic, meaning women there must travel extreme distances to access services. Then there are waiting limits, invasive medical tests, “counseling” and other wastes of time they must undergo. These facts are well known in the feminist community, but they are often recited as a head-shaking “what are you going to do?” commentary on how the pro-life movement has us on our heels. Rarely do we use them to indict ourselves on just how many people we are letting down every year.
There’s no choice when the nearest clinic is 400 miles away and you don’t own a car and it’s been 80 years since Amtrak stopped in your town
When I spoke with workers at a clinic in Kansas last year, they informed me that only about half their clients come from within the state. Women were forced to travel from Arkansas, Missouri, Oklahoma and beyond to find providers with open appointments and who could accommodate their particular issues. But there are also an untold number of involuntarily pregnant people who don’t even get as far as the clinic, because of the enormous cost of the procedure itself. Planned Parenthood and other clinics charge $400–$600 (the price varies from region to region and clinic to clinic) for the combination of drugs that induce a medication abortion, despite the fact that the medication only costs about $90 for the clinics. That’s the same amount charged for the surgical procedure – and that’s if you want to experience potential white-knuckling pain during an already potentially emotionally traumatic procedure; if you want pain relief it will cost you much more.
Then there’s that word, “choice”. There’s no choice when you don’t have the necessary funds to back it up. There’s no choice when the nearest clinic is 400 miles away and you don’t own a car and it’s been 80 years since Amtrak stopped in your town. There are small independent funds to assist those in financial need, but there are too many people left underserved. “My body, my choice” is the best our pro-choice leaders can seemingly come up with to protect our rights, which sounds like the argument of a 16-year old trying to convince their parents to sign off on a tattoo of a butterfly smoking weed. They can’t even make clear what is at stake. The state should not mandate parenthood, but that is absolutely what it does under current law.
There’s a T-shirt available in the Planned Parenthood store that reads “I Stand With Planned Parenthood.” I’m sure the people who buy and wear these shirts have the best of intentions. But shouldn’t Planned Parenthood be standing with us? After all, we fund them with our donations. We keep abortion access available with our votes and our screaming voices in state legislatures. We’re the ones who work in clinics for salaries barely above minimum wage. We’re the ones who escort women through screaming protesters. We’re the ones who go to jail or die from self-induced abortions because of lack of access. But that slogan doesn’t seem like it would fit into Planned Parenthood’s media strategy. At least not this year.
Jessa Crispin is a Guardian US columnist. She is the host of the Public Intellectual podcast