The Quandary of Planned Parenthood

Last week, in an abrupt about-face, Planned Parenthood announced that Dr. Leana Wen had been fired as president and CEO, effective immediately. Initially, no reason was given for her ouster, which came only eight months after she joined the organization at the end of 2018.

It quickly became clear, however, that there were myriad reasons for her termination, ranging from her unwillingness to frame abortion rights as a political fight to issues with her management style. Add to that concerns about a lack of morale to match the more than 100-year-old organization’s dwindling fund-raising efforts.

This transition comes as abortion rights are under swift and escalating attack. Planned Parenthood was essentially defunded by the federal government under new Trump administration restrictions that bar providers of abortion from receiving Title X funding, the only federal family-planning grant program. In the first half of 2019 alone, nine states have passed bans on abortion, ranging from eight weeks to six weeks to Alabama’s draconian total abortion ban, which makes performing an abortion a crime punishable by up to 99 years in prison. Every one of these bans is patently unconstitutional, and that’s no accident; they are all meant to be blocked and appealed all the way to the Supreme Court. With Brett Kavanaugh’s appointment last fall, abortion opponents feel that this may be their best shot to finally overturn Roe v. Wade, the landmark ruling that legalized abortion nationwide nearly five decades ago. Barring court intervention, Arkansas is about to become the seventh state to have a single abortion clinic left. The Planned Parenthood in St. Louis, Missouri, the only abortion provider remaining in that state, is barely managing to keep its doors open as it fights with anti-choice state regulators, who continue to try to force it to close.

With all of this as a backdrop, it is no doubt disheartening to see Planned Parenthood in a state of, if not disarray, ill-timed realignment. After all, today, the phrase “Planned Parenthood” is synonymous with reproductive rights, particularly abortion rights. You either stand with Planned Parenthood or you don’t. And those who don’t really don’t.

While Planned Parenthood is the largest single provider of abortion in the U.S., the majority of abortions occur at independent abortion clinics, owned and operated by independent providers.

Planned Parenthood occupies a significant place in the movement for reproductive rights; too much, some have argued. They are not entirely wrong. Because Planned Parenthood has such outsize influence, it often does overshadow many, if not all, of those independent abortion providers who lack the structural support and big-name recognition that Planned Parenthood has. Planned Parenthood certainly overshadows independent clinics in the U.S., who are often left struggling for visibility, begging for meager funding, and fighting against onerous abortion restrictions to keep their doors open and provide basic care.

Against the backdrop of draconian abortion bans like Alabama’s, Kentucky’s, and Mississippi’s, Planned Parenthood fund-raises and positions itself as the embodiment of reproductive rights and freedom while it doesn’t provide abortions in any of those states.

It’s not a good look, admittedly.

Planned Parenthood is not the only abortion provider. It’s not even the leading abortion provider. But, as Amelia Bonow writes at the New Republic, “Planned Parenthood has leveraged its position well, amassing a formidable share of political and grassroots support that has translated into unrivaled power to set the tone of the pro-choice movement.”

This blessing is also Planned Parenthood’s curse, because the minute that it cedes any ground as the face of abortion rights, it loses donors. And for a non-profit, that is never a good place to be.

Because the reality is, Planned Parenthood is, like every other nonprofit organization out there, a business. It needs to make money to keep its doors open. It has to rely on a tiny number of potentially charitable millionaires and billionaires or righteous outrage fueling a mass swell of small donations to stay alive. It has to fund-raise and position itself as the best at what it does because it needs you to donate to them, rather than to an independent provider. And, as legislative and judicial attacks on abortion and broader reproductive rights escalate, it needs more and more money to be protected and insulated so that it can indeed continue to keep its doors open.

Nonprofit service providers emerge to fill a social or political gap, something Planned Parenthood certainly did in its early years and continues to do today. As the government has not only ceded its responsibility to uphold the right to abortion but, in turn, has become a hostile force seeking to upend that right, the role of non-profit service providers and advocacy organizations like Planned Parenthood become even more important, and their needs ever-more dire.

In no way is Planned Parenthood perfect. I myself have called them out before, particularly for their wishy-washy language on abortion rights and their now laughable attempts to appeal to anti-choice Republicans, including then-candidate Donald Trump. And yes, Planned Parenthood takes up a lot of space and can, at times, unfairly appropriate others’ fights to fund-raise and benefit themselves. Independent abortion providers like Red River Women’s Clinic in Fargo, North Dakota, and Whole Woman’s Health have played a critical, pioneering role in providing care in the face of egregious legislative attacks. In fact, it was Whole Woman’s Health, along with the Center for Reproductive Rights, that led the Supreme Court to eventually overturn a Texas “TRAP” law that would have closed all but a handful of clinics in the state. Planned Parenthood didn’t wage and win that judicial fight, but they certainly had no trouble raising money off of it.

What’s important to remember here is that Planned Parenthood doesn’t do this because it’s evil; it does this because we exist in a society in which resources are finite. This means that ultimately, a donation given to another organization makes it seem as if your organization loses out. And if you don’t receive that money, you have less money to provide that desperately needed service.

As Paul Kivel writes in the The Revolution Will Not Be Funded, “When temporary shelter becomes a substitute for permanent housing, emergency food a substitute for a decent job, tutoring a substitute for adequate public schools, and free clinics a substitute for universal health care, we have shifted our attention from the redistribution of wealth to the temporary provision of social services to keep people alive.”

Planned Parenthood exists as a stop-gap to providing reproductive and sexual health care in a political system that not only doesn’t value but actively works to undermine, access to that care. We shouldn’t need non-profit organizations to provide basic services; the government should do that. But until it does, until we radically restructure the way that services are provided and put the onus for providing those services on the government, nonprofits like Planned Parenthood and others will continue to fight for meager funding and elbow each other for visibility because there is no other way.

We shouldn’t need a Planned Parenthood, but we do. Abortion shouldn’t be a political fight, but it is. Until we demand better, this may be the best we can do.