October 15, 2015 — Although Planned Parenthood is the target of many federal- and state-level attacks on abortion care, independent abortion providers also face challenges that usually do not receive as much public attention or media coverage, Color Lines reports.
Integral Role of Independent Abortion Providers in U.S.
Nikki Madsen, executive director of the Abortion Care Network, said while Planned Parenthood is the "national face" of abortion care in the U.S., the organization provides only about one-third of abortion services in the country, Color Lines reports. According to Madsen, independent abortion providers perform 60% to 80% of abortion procedures in the U.S.
Madsen noted that the country has lost more than 150 independent providers over the last four years.
An increase in recent years in the number of state-level restrictions on abortion care has made it more difficult for both Planned Parenthood and independent providers to offer abortion services. Examples of such restrictions include mandatory delays before an abortion, ultrasound requirements, building regulations, hospital admitting privileges requirements for providers and statements that providers must read before providing abortion care.
One independent abortion provider, Whole Woman's Health in Texas, is the lead plaintiff in a case against an omnibus state law (HB 2) that imposes several such antiabortion-rights restrictions. According to a recent report, wait times for abortion care increased up to 20 days for an appointment after parts of the law took effect.
Amy Hagstrom Miller, owner of Whole Woman's Health, said, "We have opened and closed our clinics a number of times since HB2 passed two years ago ... Until we got (an) injunction, we had to close because we didn't have any physicians who could" meet the law's admitting privileges requirement.
Hagstrom Miller added that since the law was passed, her team has had to devote time to telling people that abortion remains legal. According to Color Lines, her organization founded a not-for-profit called Shift that teaches people about the law. "We spend a lot of time explaining the forced ultrasound and the [mandatory delay]," she said, adding, "It's absurd, really, that we end up being the educators and enforcers of laws (we don't support)."
Antiabortion-Rights Video Campaign
In addition, independent providers also reported increased harassment following the release of the misleading video series targeting Planned Parenthood.
For example, Erin Grant, office manager at the Philadelphia Women's Center, said the clinic has seen changes in the culture since Planned Parenthood came under attack. Grant cited antiabortion-rights protests at the clinic, noting, "The debate outside of our doors has become nastier." Grant added, "The language that [protesters] use to intimidate and shame people coming for services has changed."
Further, Grant noted that the political climate has affected the relationship between patients and providers. "Patients are on edge so it turns into a suspect interaction making it feel like everyone is here doing illegal things," Grant said, adding, "We're all working overtime to make ourselves seem more and more transparent, which makes us feel more suspicious."
Separately, Madsen also noticed an increase in intimidation and harassment tactics among local antiabortion-rights protesters. According to Color Lines, ACN recently tried to broaden the social media response to the Planned Parenthood attacks by proposing a new Twitter hashtag, #standwithabortioncareproviders, to use in conjunction with #StandwithPP.
Independent abortion providers also face business challenges, given that abortion is provided at a lower cost compared with other medical services, Color Lines reports.
"Abortion is fascinating when you look at it [in] the context of health care because our fees are the same as they were 20 or 30 years ago," Hagstrom Miller said, adding, "We don't come with a business mind, we come with a human rights and social justice framework. Inflation (of abortion costs) has (only) gone up 11 percent since Roe, when in other health care fields it's been exponential."
Meanwhile, Madsen pointed to challenges that independent providers face affording advertisements and technology to reach more patients. Noting that most patients access abortion care information through handheld devices, Madsen said, "Independent providers are disadvantaged because they don't have the resources to have applications developed, to upgrade their websites to be mobile friendly or to buy Google ads -- things that might bring more patients."
Madsen also noted that low state reimbursements for abortion under Medicaid -- which is only permitted in certain circumstances -- can also create cost concerns. Minnesota, for example, reimburses about $420 for a second trimester abortion that could cost about $2,000, Madsen said.
Noting that independent providers face challenges across states, Madsen said, "Everyone is concerned about how much farther this hostile climate will go, and how much more difficult it will become to find an abortion in this country."
In addition, Madsen expressed concern that the number of options women have for seeking abortion care could narrow as clinics close. "Abortion care cannot become a monopoly," she said.
Meanwhile, Dawn Laguens, executive vice president at Planned Parenthood Federation of America, said, "We fight, often in partnership with groups that represent independent abortion providers, against any legislation that attempts to block women from accessing essential reproductive health care, including abortion. This fight is not just about Planned Parenthood, it's about ensuring that abortion remains a legal and fundamental right in this country" (Zoila Pérez, Color Lines, 10/13).