While Planned Parenthood is synonymous with abortion, the organization also provides basic health care to millions of Americans who have few other options. Financial strains now undermine those services.
A New York Times review found that the clinics have been in decline for decades, undermined by structural and political headwinds and left to make do as national leaders prioritized the fight for abortion rights over finding a more sustainable way to fund health care.
Planned Parenthood’s health care operation has shrunk from a high of 5 million patients served across 900 clinics in the 1990s to 2.1 million patients and 600 clinics today, with staff members complaining that patient care is compromised by low salaries, chronic understaffing, high turnover, inadequate training and aging facilities.
Here are four takeaways from the reporting:
Planned Parenthood may need structural reform
Few people outside the organization understand that there is a significant difference between Planned Parenthood Federation of America, the national office that most people associate with the brand, and the 49 Planned Parenthood affiliates located across the country. The national office does not provide health care. Rather, it funds legal, political and public opinion work that supports abortion rights. The clinics are run by the affiliates, which are stand-alone nonprofit organizations.
The affiliates have been buffeted for years by political challenges that hurt their ability to raise the money necessary to cover procedures that patients cannot afford.
For the past two decades, leaders say they had to prioritize the fight for abortion rights over clinics because the political fight was fundamental to the organization’s ability to operate. They argue that the organization managed to deliver quality health care, despite increasing financial constraints. Yet clinics have degraded over time.
Clinics nationwide face financial problems
While affiliates in more liberal states like New York and California have had an easier time fund-raising than their counterparts in states with a strong anti-abortion sentiment, rising health care costs and the lingering effects of the pandemic have taken a financial toll on all clinics. Planned Parenthood of Greater New York — one of the few places where abortion is still legal up to 24 weeks — said that a budget shortfall would force it to restrict later term abortion services, effectively implementing a 20-week abortion ban.
Planned Parenthood of Northern California made a hard funding choice last March when it ended a prenatal care program that served 200 to 250 low-income women a month. And Planned Parenthood of Northern New England expects to run an $8 million deficit over the next three years.
Patients have felt the effects
Patients and employees said that clinics are operating like “a conveyor belt” for patients, leading to botched IUD placements and abortions, patients prepped for the wrong procedures, and other errors, according to legal filings, complaints and interviews.
Planned Parenthood has been accused of improperly implanting a birth control device and causing nerve damage; inserting an IUD in a woman who was four months pregnant; and failing to upload sexually transmitted infection test results into charts, leading patients to wrongly believe that their results were negative.
Employees are feeling the pressure
Employees said there has been constant pressure to more than double the number of patients seen from the present 2.1 million, to help bring in more revenues, with management asking staff to see more than four patients an hour. That is in line with a trend in health care, widely unpopular with both patients and doctors, to keep primary care visits to about 15 minutes. But clinic staff members said that they needed more than 10 to 15 minutes to care for patients who often face literacy and language barriers, or face social ills like housing insecurity, abuse and poverty.
Staff members who have decried the conditions are beginning to unionize to push back on demands that they say undermine Planned Parenthood’s mission.
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