What coffee and abortion have in common

I don't quite understand the obsession with Planned Parenthod. I LOVE Planned Parenthood. I have friends who have been staff and patients of Planned Parenthood, I have a Planned Parenthood T-shirt, I refer clients to Planned Parenthood, and I would gladly submit my resume to Planned Parenthood. The thing about Planned Parenthood is that it has, at least among people I know, become the generic name for "abortion clinic." Dear friends of mine love and support the work that I do, and they even put out calls for support of abortion. But those calls for support always seem to say, "Make a donation to Planned Parenthood!" "If I won the lottery, the first place I'd give to is Planned Parenthood." They know where I work, and it happens to be an independent abortion clinic. An independent clinic that doesn't receive government funding and that always welcomes donation and support, especially in this economy. And I know of plenty of other similar clinics that have had to close because of a lack of funds.

What I'm saying is that if your BFF worked at Independent Coffee Beanery, would you really suggest that Starbucks needed the money more? That's actually not the best analogy because Planned Parenthood isn't a corporate behemoth, and I respect Planned Parenthood and I do want them to benefit from donations...but sometimes, I want my little clinic that could to benefit from some cash money here and there. (I might be jealous of Planned Parenthood, but I'm also human and I heart my clinic.)

So if you're a little flush or if your rich pro-choice aunt wants to contribute to the cause, maybe think about checking FAN or Abortion Clinics Online for contact info of lesser-known but super-important clinics in your area that might need a little help, especially in this political and economic climate (Also, think about patronizing your independent coffee shop.)

Another One Bites the Dust: Feminist Clinic in Washington State Closes

We need to expand access to abortion services. We all know this. So, the question may now be, within our own Abortionland, what exactly does expanded access mean? How can abortion access expand without crushing little, struggling clinics? Is it even possible for different service delivery models (hospitals, Planned Parenthood, etc.) to expand without hurting independent clinics? And if possible (which I believe it, of course, is), is it realistic? Will providers set aside competition for altruism (increased access)? And at the risk of sounding cynical, should they set aside competition? And....are independent, feminist clinics now obsolete?

These questions are – hopefully – being asked by people besides me. You’ve probably heard all the buzz about another feminist abortion clinic closing down: Cedar River Clinics’ Yakima site (one of three in Washington State) just closed down last week after 30 years. Let me say that again: after 30 years.

I read about this closure on RH Reality Check’s site here. It’s a lovely tribute to the Yakima clinic which appears to have served women from all over the Pacific Northwest and beyond (Oregon, Washington, Idaho, and Montana). The closure also has created a big hoopla – a controversy even – because Cedar River Clinics points the finger directly at Planned Parenthood as the reason for their closure! (Ballsy, I know!) The comments on the article obviously get very feisty. (Pretty fun to read if you’re in the mood for feistiness!)

It seems like there is this clear divide, an us versus them between some independent clinics and Planned Parenthood. If you’re not up on the debate, the issue seems to be the apparent recent Planned Parenthood decision to expand all their abortion services… even in areas where there are already providers. It’s pretty obvious there are many who are uncomfortable with this pointing of fingers, saying that by pointing fingers at Planned Parenthood, abortioneers are unnecessarily feeding into all the negative media that the antis put out against them. (After all, Planned Parenthood does do a lot of good work.) Well, on this blog, we pride ourselves in talking about the things that are hard to talk about. We speak the unspeakable – the unpopular, even – at the risk of antis twisting it however they will (they’ll always twist things around).

Let’s say the independent clinics out there are right: Planned Parenthood plays a role in closing down little clinics (not intentionally, I’m sure). Should people NOT talk about it just for fear of what the antis are going to say? Of course not!! Sure, we’re all in the same boat: we want to provide abortion services to women; but like I talked about here in September, there is, of course, competition. We're only in the same boat up to a point. Abortion rates are down. Clinics still have a business to run. If another provider comes in and offers the exact same services (same gestational limits, for example) as another clinic in town, then that’s direct competition. If a small clinic is already struggling, a direct competitor will surely hurt said struggling clinic. It sounds like that’s precisely what happened in the case of the Yakima Cedar River Clinic and the Yakima Planned Parenthood.

We don't like to talk about competition: it's the big elephant in the room. The reality is, competition exists. The analogy of the big corporate store coming in, causing the little independent store to close is very similar to the small abortion clinic versus a corporate-like Planned Parenthood. I am an idealist at heart, so it's difficult for me to even acknowledge the elephant. I want to tuck myself into a little world of abortion safety where everyone is in it just for the women and the focus is so entirely on that, not politics and competition and business models and strategies and blahblahblah. The harsh - ever so harsh - reality is that when big corporate business comes in and succeeds, it offers a service that customers/clients/patients respond to. They're doing something right. That doesn't mean the small, independent clinic is doing anything wrong...

Or are they? Little businesses often fall prey to "treading water syndrome." They can be hyper-focused internally and don't always invest/have the resources to look externally. For all business - non profit or profit - it's vital to not only scan your external environment, but do an in-depth analysis. The for-profit sector and non-profit sector are not really that different. (Despite how much I'd like to bury my head in the sand and pretend they are.) They compete. And abortion providers compete, too. In the case of Yakima, it appears that Planned Parenthood came up with a strategy that worked for them. You can bet your bottom dollar that Planned Parenthood has the resources to do an in-depth SWOT analysis and probably really researched the opportunities in Yakima (and other places). Did Cedar River Clinics? Like so many small businesses, did they focus too much on putting out fires that they didn't stop to recognize Planned Parenthood as an external threat and then decide what to do about it?

Look, I am a huge fan of supporting local businesses. I support my local book store. Unless....Amazon meets my needs when browsing the internet at 1am. I would go to my independent abortion clinic if I knew it was locally owned. Unless... Planned Parenthood was more convenient (price, location, abortion days/times that fit my schedule) and made themselves more known to me (advertisement). I'm talking about the marketing mix. The Four P's:
- Product
- Promotion
- Place
- Price

Do I wish that Planned Parenthood could've expanded their gestational limits in, say, Spokane where they could've better met the needs of rural women? Or maybe opened a clinic in a region of Washington State (or Idaho, or Montana, or Oregon) where there wasn't an abortion provider at all, instead of going to Yakima and directly competing? Hell, yes. That would've been the altruistic thing to do: the thing that would've truly been in rural women's best interests (women travel upwards of 10 hours because Yakima is the only provider going further than around 15-16 weeks west of Missoula and east of Seattle). There are large areas of Washington state without abortion providers, so it seems there was/is growth potential there. Why didn't Planned Parenthood take the high road instead of directly compete? On the other hand, we could all ask Cedar River Clinics why they didn't expand to an unserved area to improve access, too.

My point is: Cedar River in Yakima must've missed some opportunities for growth that Planned Parenthood captured. So if small, independent clinics are doing anything wrong at all, it may be that they don't/can't meet the demands of the clients and what their needs are when (gulp) Planned Parenthood did/does (like Amazon sometimes meets my needs better than my local bookstore). And this does make me cringe. But we're talking about consumer behavior here.

Planned Parenthood has nothing on a legacy of a feminist clinic. It can't stand up and say it's been there for its community like a small clinic can say; but if the competition wins, it's not just because they're terribly corporate. Look, little independent clinics need to LEARN from Planned Parenthood. What do they do that's right? Branding. Clients trust them. They're everywhere. Like McDonalds. Independent clinics need to be firmly rooted in their communities. They need to promote themselves. They need to advertise. They need to be involved. They need to prove to their communities they know them better than Planned Parenthood does. They can't ostracize themselves just because they do abortions. They have to have their finger on the pulse of their clientele. Offer different days. Different hours. Have nice buildings. Decorate them well. Have them in good locations (see my dream clinic blog). Ask clients what they want. Make appointments shorter. Small, independent - even feminist - clinics will become obsolete unless they figure this out, significantly invest in strategy, and learn from Planned Parenthood. My sincere hope is that they will....

...who will pick up this gauntlet?

Wordplay

In a recent chat with fellow Abortioneers, the question arose of whether it is possible to work in Abortion Land without being a feminist. About a Girl recently expressed her discontent at the diminishing sense of feminism in our clinics, superseded by a for-profit model that shifts the focus from the woman to the service-payment exchange. I can't really begrudge that; you provide a service that people want, one that will never diminish in demand, and you've got a pretty steady stream of income. It's good business sense, not personal. Then again, it's not a dental office. It's an abortion clinic. Women go there to make some of the most important decisions of their lives. Shouldn't the clinics give a damn?

I suppose, by default, if you are providing a service that advances women, you hold some feminist ideals. Even if you are just a health care tycoon by day, the fact that you enter into the line of abortion fire confirms your feminist leanings. I would agree with that. But if I were to ask the manager of a large clinic chain if he were a feminist, what would he respond? Might he identify as a not-feminist, yet still commit to his position and intend to provide quality services? I would agree with that also.

I think there are two separate ideas at play: feminism and Feminism. You can be feminist, and believe in "the radical notion that women are people", or you can be a Feminist and officially align yourself with a cause that holds certain and specific ideals. And while this distinction may seem slight or nitpicky, I consider it important in distinguishing the who from the what, the estar from the ser.

Example: I have Depression. I am a Depressed person. This is a label that I wear, because having a clinically-diagnosed, chronic mental illness that necessitates treatment with drugs and/or therapy is a part of my being. It is a part of who I am, and not just a condition or a state. I rally 100% behind the Depression cause, because it is a struggle I will likely battle throughout my lifetime. On the other hand, some people are depressed. They feel sad from time to time, but not for unusually long periods of time. They may seek drug or psychotherapy, but those avenues are not essential to alleviating the condition. Depression is not an part of their being, but it is something about which they have some feelings, however strong, and experiences that do affect how they react and respond to life circumstances.

Wax philosophical, much?

The point is, I think that people are generally able to relate to feminist causes. People can stand behind women obtaining education, women receiving equal pay, and women having the same opportunities as men without too much debate. I believe in all of the above, and then some, but I can't say I stand 100% behind all Feminist ideals. Frankly, I feel there are too many different schools of thought, too many "waves" to keep track of, in order to arrive at a cohesive and concise definition of a Feminist movement. And so, I appreciate that folks can support and even enable a woman's right to choose without having to declare a commitment to Feminism per se. Maybe it's because they don't like labels. Maybe because they consider capital-F-Feminism to be a movement in a more stringent sense that they don't feel comfortable aligning with. Or maybe because, sometimes, you don't really need to give a special name to what it is that you do. Because you must. And no matter what you call it, you are in it for the women.


(That said, I absolutely adore About a Girl and love her post!)

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?

Feeling OK About Ourselves: Feminism, Abortion, "Cosmetic" Genital Surgery and Roots.

Flashback: it's the 70s/80s. Imagine a group of strong, like-minded, bell-bottom wearing women gathering around kitchen tables, sharing jobs they hate, talking about sex and politics, wanting things to change. Imagine a group of women, fired-up about feminism, deciding they're going to do something to make a difference in women's lives, such as fight for equality economically, socially, and physically. Imagine these small groups of women, scattered across different parts of the United States, creating self help groups (see here) which helped women have control over their bodies.

Thankfully, this did happen and from these platform shoe wearing sisters, our feminist abortion providers took root. Many of these self-help groups eventually provided Menstrual Extraction, something very similar to what is now called Manual Vacuum Aspiration (MVA). It wasn't much of a leap to then establish women run and operated abortion clinics, based in feminist ideals that all women will be trusted and treated with the same dignity, respect, compassion, and non-judgmental way; regardless of race, ethnicity, sexual orientation, size, physical ability, socio-economic background, religion, etc. This may sound fluffy, nice, and sweet; but these ideals were real and held onto tightly.

There aren't many feminist abortion clinics in the country, but there is a coalition called the Feminist Abortion Network. The network seems to collaborate and support one another to continue the mission of specializing in abortion care, but from a feminist perspective. Feminist abortion providers trust women to know what's best for themselves. They do not think they already know what the "best decision" is for a client; they simply provide accurate and complete information, and allow her to make her own choices. Without judgment.

Why am I talking about all this? Because I think it's time we go back to our feminist roots. It seems to me that we've taken two steps forwards, ten steps back in many areas. Young women seem not to understand how much their reproductive rights and freedoms are at risk, even though one in three women will have an abortion by the time they're 45. And if you follow anything on sexual health, you'll know that there's a scary trend occurring: women seem to have a lack of knowledge about their bodies, and as a result, there is an increase in female cosmetic genital surgeries, like labiaplasty (where the outter and inner labias are "trimmed"). Rebecca Chalker, author of "The Clitoral Truth" (must read!), recently wrote a brilliant, yet disturbing, article called "The 'Perfect' Porn Vulva: More Women Demanding Cosmetic Genital Surgery."

Women increasingly seem to be worried that their vulvas, especially labias, are deformed, or not quite right, or ugly, or nasty, or whatever; websites like Scarleteen are inundated with questions from young women about their vulvas, expressing disgust with their own bodies.


I am grateful to Rebecca Chalker for highlighting that all the labiaplasty, hymen restorations (sometimes done a "Valentines Day" presents to partners to look like a so-called-virgin), vaginoplasty (tighten the vaginal muscles) fit squarely within the UN's joint definition of Female Genital Mutilation (FGM). In 2008, 10 UN agencies released a 48 page joint declaration to end FGM, so obviously, there are concerns about it all from a global perspective. In the "developed" world, where women are requesting these procedures, the reasons stem from aesthetics and this belief that women's bodies are somehow disgusting and dirty and ugly.

This infuriates me and makes me so sad, too! Women, especially young women, are inundated with negative images of women and their bodies and what they should/shouldn't look like. This doesn't just relate to what shape they should be or what color their hair or eyes should be. They now think their vulvas should look a certain way - like how they look in porn, or how their friends' vulvas look. Recently, I overheard one of our doctors explain to a young woman that everyone's vulva is completely different, after the client - who was being seen for an abortion - asked the doctor why her "parts" didn't look like her friends' "parts." It's always about the "should." And the should = not good enough. As women, we carry this on our shoulders and it's enough already. Seriously.

I say we need to go back to our feminist roots, dig in deeper, and start sharing more info about vulvas. Betty Dodson has drawn some fabulous illustrations to give just a sample of how different and magnificent our bodies really are. And if we can't accept that we're all unique, all special, all amazing (and that every single vulva is completely different from another!), then I don't think we'll ever get rid of these "shoulds" that society/men/ourselves/ourselves/whoever throws upon us...

What does this have to do with abortion? Everything. It has everything to do with feminism and its true tenets: that we're beautiful women. That we're full of potential. That we're able and capable to do anything we set our minds to. That we are perfectly fine just.the.way.we.are. Seriously. That's what feminism is all about. And it's what feminist abortion clinics are all about: You are wonderful. You are powerful. You are capable. You can make any choice, given accurate and complete information. You have opportunities. You are strong.

We're not going to change any of this, though, unless we share more information and feel comfortable demystifying our bodies. Knowledge = power. So, I think we all need to tell our friends/daughters/sisters/cousins/mothers/lovers/whoever about all the information that really IS out there and start turning back the tide. We need to go back to our roots. Give everyone a copy of A New View of a Woman's Body (purchase here), make it required reading, along with Eve Ensler's Vagina Monologues and Heather Corinna's S.E.X, plus a lot of others. What would you add?

A huge thanks to all you feminist abortion providers and feminist sex ed providers out there who continually try to remind us that: We Are Ok...just.the.way.we.are!