Tuesday, September 21, 2010

Plight of Feminist Abortion Providers

OK. I think I'm bracing myself to piss off a lot of people with this post. So here it goes...

Am I the only one out there that thinks some of our feminist clinics have changed? Maybe lost of some their feminist qualities? Lost some of those things that make them different from the regular, kinda corporate-like abortion clinics? Despite good intentions, I think they have. Sometimes I feel a bit angry about this, but then I knock myself upside the head and think, “Of course they have. Times have changed.”

Over the years, they’ve had to adapt. Clinics have had flex to external pressures of physicians, state and national law, and medical standards; not to mention meeting the ever-changing expectations of clients and the local community. As independent abortion clinics have adhered and adjusted to these changes, they've lost some of their roots: what makes them who they are. What makes them different.

Why are feminist-based abortion clinics special? They typically were established, owned, and operated by women whose ideals spat in the face of the status quo. They had dreams of women working passionately, cooperatively towards a common goal: demystifying abortion. Breaking the “standard expectations” of women to their very bones; allowing a space for women to feel free, to make their own choices, apart from judgment. A sacred place for women have a voice. A place to rediscover, remember who they are.

Why has this changed? Because administrators are so focused on administrative type things (budgets, appeasing all they need to appease, putting out fires, lobbying, etc.), it becomes difficult to focus on feminist things like: making sure staff earn a sustainable living (see Deliverance's post last week); ensuring that power of hierarchy doesn’t become a poison to morale; and remembering…instilling institutional (gasp!) memory and culture within staff and management, lest they (the organization) forgets who THEY are. Their roots.

There are other reasons they’ve changed, too. Let’s face it: there’s a decrease in abortion. Little clinics are struggling to stay open – just like Sparky touched on the other day. I mean, if not as many people need abortions, you’ve either got to diversify the services you offer (expand them?) or you’re going to simply struggle to provide abortions.

We talk a lot about stupid, restricting new laws that are being conceived and born every day. They’re annoying. So are restrictions by the department of health (like Sparky mentioned last week). But there’s another reason things have changed for feminist clinics. Another reason they’re busy and finding it hard to do feminist things: competition. Okay. Come on. Admit it. Clinics have competitors. Yes. Yes. I know. I spoke the unspoken. (Gasp!) I mean, HELLO. Running a business doesn’t make you less altruistic. And, honestly, it doesn’t take a rocket scientist to figure out that small women-owned and operated, independent businesses, find it hard to stand tall against corporate-like competitors.

It’s super important that access to abortion is increased. We already know nearly all counties in the USA don’t have abortion providers. That is wrong and it sucks. But there’s another side to all of this. Clinics are closing down. Not because of obnoxious, annoying protesters and harassing laws. Not because the department of health is making things difficult (well, except in this instance!). You’re all clever. So I’ll just ask you this: were any of the clinics that closed down recently Planned Parenthoods? Not that I know of. (I could be wrong.) They were all little clinics. And I'm sorry to admit this, but even the pro-lifers wrote an article about this back in February. (And no, I'm not going to provide the link here, because I don't want to give traffic to their site. Yes. I'm being a bit totalitarian about it.)

Who is out there talking about this? Even the clinics shutting down and the feminists don't seem to be making enough noise. Some organizations are out there waving the flag that hospitals should provide more abortion services. Okay. Great. But again, the more hospitals are out there doing abortions, the more corporate institutions are out there expanding their abortion services, the fewer independent providers there will be. It’s just kind of a fact. The way I see it: too many big fish in a small bowl fighting for a service on the decline.

So. Things have changed. Feminist clinics are too busy fighting to keep their doors open because financially, in straight-up business terms, it’s tough. The tides are turning.

I ask this: what happens to the women?


  1. Yay, for saying out loud, "The Emperor has no clothes" --breaking the silence about all the pressures on independent providers. Feminist clinics have a particular history, and today are represented by FAN and they are all not-for -profits. Whether their feminism resembles any other version of feminism is a good question, but they are committed to helping fund poor women. There are other clinics with feminists at the helm who have dedicated their work to making the experience of abortion better-- to understand the complexity of it and to challenge the stigma of abortion. They are for- profit in status only and are endangered too. And you are right, both endangered by PPFA's "forced-abortions-in-every-affiliate-whether-needed-or-not" practice. All the good work of feminists may well go down the tube, and where will women be? Keep asking

  2. This so struck a chord with me - thank you for bringing it to light. As an administrator of an independent clinic, in addition to the above, I also face more extreme anti-abortion harassment (lawsuits, home picketing) that at times does force me away from work that furthers our mission. The important thing that I try to do is surround myself with co-workers who are insanely passionate about providing abortion care - because we have to keep providing the best care to women, no matter what stressors we face, including competition. For us, our competition has only pushed us to provide an even higher level of care to our patients. I've noticed that in some other "commercially feminist" clinics, actual feminist ideals are virtually absent in reality (they won't even speak about their abortion services in public). And yes, they are impacting our survival. There was a time years ago where abortion providers in my community were more collaborative - but I have seen that change. More recently, I've noticed a palpable attack on for-profit independent abortion providers by non-profit, non-independent providers. Don't we share the same mission though? Shouldn't we be collaborating and helping each other on a more global scale? I stubbornly refuse to allow these things to impact health service delivery, however it gets more and more challenging to stay focused. We have to do more to keep morale up and remind ourselves to work from the patient's agenda and why we are all here. ACN has been a great organization to help us do that. My theory has been that the clinics who lose focus on their mission and their patients will eventually self-implode - but I no longer think that I'm right about that. Access clearly needs to expand. If feminist clinics disappear and are replaced by larger, more "corporate-focused" entities, could abortion stigma actually increase? I think that scares me more than the possibility of shutting down.

  3. The other side of this, of course, is that some of the clinics that started out as feminist have become far, far less so. The fact that an organization was founded under feminist principles doesn't always translate into feminist practice 20 or 30 years down the line, unless the higher-ups are willing to continue to learn and grow. On the contrary, having a heavy feminist mission can be used as a cudgel against employees who are being treated unfairly. After all, a good feminist prizes the mission above all else, right? (And no, I won't share details publicly, but suffice to say I speak from experience)

  4. Rachel, agreed, pretty much any place operating with a "social mission" can try to guilt its employees into not seeking any kind of quality of life because We Aren't In It For The Money. Well, no shit we're not, otherwise we would've left a long time ago. (This is why I always laugh when antis outright claim we work in the "abortion industry" for the profit -- completely out of touch with reality.)

    This applies to our need for not only a living wage but also sick time or decent hours -- depending on where you work, you may have one but not another (or maybe none of the above), and it's true that it's hard to give your staff time off when you are already understaffed, but maybe we could hire more people if we could pay them more -- but where is the money going to come from? No government bailouts for us, that's for sure, and I believe that the vast majority of abortioneers do balk (like me) at raising fees.

    We should have a post sometime about all the different kinds of providers that exist: among clinics there's non-profit and for-profit, there's independent and affiliated -- and these combine in all four ways -- and then there's hospitals which might be similar in some ways, and private practice offices... but I don't know about ALL of them!

  5. Also, N.Meg, I'm curious about this sentence:
    And you are right, both endangered by PPFA's "forced-abortions-in-every-affiliate-whether-needed-or-not" practice.

    My best guess is that you're saying PPFA is asking all their clinics to start providing abortions even in places where other clinics are already meeting the need for services? That would be very interesting information, and totally put into perspective something that happened a year or two ago. A clinic owner I'm friends with (it is a for-profit clinic, not officially FAN, but with a mission and practice that I'd consider feminist) told me she was confused and hurt by the local PP's decision to start providing abortions, because for decades they had cross-referred -- PP would refer patients to her clinic for abortion care, and she would refer patients to PP for other gynecology services -- so when PP added abortion services she felt like they were saying they no longer felt her clinic was worth referring to. (For the record, if I were in that state and needed an abortion, hers is the first clinic I would call.) Anyway, if I'm interpreting you right, that would probably explain what happened in this story... Can you explain anything more about it?

  6. @N.Meg - I don't think all feminist clinics are represented by FAN and I don't think it is un-feminist to be for-profit. I feel fortunate to be able to give my employees better wages and benefits than some non-profits can. This work is hard and staff deserve to be paid well. And being non-profit doesn't mean we don't help women get funding either. We simply don't rely on government assistance or donations to provide healthcare services.

  7. Jen - the way I read N.Meg's comment, she was only making a distinction between "official" feminist clinics, i.e. that grew out of the Feminist Women's Health Center umbrella organization and/or are part of FAN, which I think happen to all be non-profit entities, vs. clinics which also are feminist (but not tied into the 'institution' of FWHCs)...and that those that are for-profit are often for-profit "in name only" because it's hard for all of us out there and for-profits don't make all that much profit, either. N.Meg, did I misunderstand?

    Anyhow, Jen, thanks a ton for your very informative and thoughtful comments... We <3 Allentown and really wish you luck with the challenges you're facing down. And for what it's worth, a couple of my favorite clinics are privately-owned with feminist missions :)

  8. On the feminist note, I wonder how much our society's view (often negative) of feminism has also changed what feminsim in abortion care looks like.
    How do you carry the feminist torch while handling all the challenges all independent clinics face (whether non-profit or for-profit)?

    Rachel, I feel it's so sad your experience has been seeing a change with leaders of feminist organization not continue with that mission (if I'm understanding you correctly). Picking up on N.Meg's comment about PPFAs expanding their abortion services (like PS, I think that's what she's talking about) even in places where the services are being met, how many of those clinics ensure their staff are pro-choice?
    I have heard friends tell me about tensions within some PP affiliates when they began offering, say medical abortions, and some staff were pro-life and not happy about the change. By the same token, how do *feminist* abortion providers ensure their staff are passionate advocates and feminists? Because I tend to agree with you, Jen....(your previous theory), that clinics that don't stay focused on their patients/empowering women, will, as you said, "self implode." Though the issues are very complex, truly, if you don't forget the women, you will maintain your unique edge? You will stand apart and patients will refer other patients....and so on and so on....

  9. I also have another question. What *exactly* does FAN do? Where are they in this conversation? What has happened to the feminist abortion provider's voice? Is it loud enough? Why aren't they shouting from the rooftops? Are they too busy trying to survive? Are they shouting, but falling upon deaf ears?

    From my limited understanding, FAN is more of an internal support network, no? Maybe info sharing between the few standing feminist umbrella clinics? Though we've given shout-outs to them before, I don't know honestly what they do. There's virtually nothing on the website.

    And then I wonder... Does anyone care? I mean, it's clear we do. It's obvious we're feminists on this blog. And clearly feminist abortion providers care. And the wome who go there care (but maybe a lot of them don't know it's the feminist philosophy of "trusting women" that makes their experience different than had they gone to a different provider). So who's going to step-up? What's going to give? What is going to change?

    Do thew clinics need to be "rescued?" But oh, the pandora's box that term opens up. Have some feminist clinics tried to be too self sufficient? Too indepedent? Lol

    I also wanted to say to Jen that I admire the obvious passion you have. I am grateful for the hard work you're doing and for what sounds like - ensuring your staff understand and "get" what it's about, while actually *paying* them! It sounds like an amazing place to work.... maybe your passion can inspire those who may have lost some of theirs...

  10. My understanding is that PPFA just adopted (in March) a policy that EVERY affiliate has to provide abortion services and eventually most or all sites--EVEN IF the need is not there. Some cities need prenatal care for poor women, not abortion services which are plentiful and good in their area. This seems to me to be a business decision for PP to compete, and undercut independent clinics, rather than responding to the reproductive needs of women.
    And even tho FAN clinics are only not for profit, a lot of profit (in name only usually!) have deep feminist principles, as Jen has said.
    Thanks for asking for clarification.


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