On Parenthoods Unplanned: Cecile Richards’s Latest Battle in the War on Women

On September 29, President of the Planned Parenthood Federation of America Cecile Richards testified before a House Oversight Committee regarding a series of videos released at the end of the summer that purported to show the trade of fetal organs for money. Many have pointed out that The Center for Medical Progress, an anti-abortion group that staged and released the videos, is traditionally a pro-life lobbying organization. Now scrutinized thoroughly by a number of activist groups and news organizations, the videos’ contents actually show a legal and common activity: tissue donation. Specifically, the videos show tissue donations to medical research labs and reimbursement for shipping and handling costs by these labs. While abortion has always been hotly contested in the US, especially with the strong presence of the religious right in political discourse, this year’s events have catapulted the issue’s importance. Now, many in Congress are on a mission to defund Planned Parenthood in its entirety because of these videos and, in many cases, because it performs abortions.

To be clear, abortion is legal in this country at a federal level. States cannot make abortion illegal in clear terms because they would be in violation of the Constitution and of the Supreme Court ruling in the case of Roe v. Wade. Regardless, state legislatures enjoy incredible power in expanding upon or restricting rulings from the federal level. Many states have restricted the availability of pregnancy termination services to a great extent by creating strict regulations on health care providers. Many abortion clinics in rural areas in the South have been closed down by stringent regulations. Legislatures have also implemented demand-side policies in their attempt to restrict abortion rights; the women who visit whichever clinics remain open are often required to go through waiting periods and mandatory counseling before terminating their pregnancies. To be fair to states, even the federal government has instituted its own barriers to abortion rights. In the 1970s, forms of the Hyde Amendment banned the use of certain federal funds (namely, those disbursed by the Department of Health and Human Services through Medicaid) to pay for pregnancy terminations. The Hyde Amendment contains exemptions for cases where a woman seeking an abortion has gone through rape, incest, or is in a situation where her life is in danger.

Enter Cecile Richards — a seasoned Democrat, Brown University alumna, and the daughter of Texas’s last Democratic governor, Ann Richards. As the president of Planned Parenthood, Richards is pushing back against restrictions on women’s health and autonomy. But perhaps even more challenging, she’s affirming the fact that her organization needs the federal funding it receives because of how important Planned Parenthood is to low-income Americans. The funding comes mostly through Medicaid reimbursements for procedures other than pregnancy termination. The fact that the contested funds are in Medicaid coffers adds a unique dimension to the debate about defunding Planned Parenthood; the entire enterprise of cutting Medicaid reimbursements to the organization of clinics looks more and more like an assault on the poor.

Prior to her tenure at Planned Parenthood, Richards helped found America Votes, an organization with Democratic Party affiliations, which was intended to support progressive candidates prior to the 2004 election and ran ads critical of President George W. Bush. Richards also worked on the staff of Democratic congresswoman Nancy Pelosi. In addition to doing pro-choice advocacy work with Planned Parenthood during the 1990s, Richards also worked with the Turner Foundation to help push the choice movement nationally. In the 1980s, before working in national politics, Richards excelled as a labor organizer. She has served as president of Planned Parenthood since 2006, and has pushed forward the organization’s political activist arm: Planned Parenthood Action. Her upbringing in a heavily political family — her mother, the governor of Texas, and her father, a labor attorney with a long distinguished career — helps to elucidate her passion for progressive issues. Nevertheless her manner in defending Planned Parenthood and women’s reproductive rights against attacks from the right is calm, measured, and markedly fact-based.

Planned Parenthood has a variety of revenue sources for its operations, and Richards handles extensive administrative duties as the head of this large nonprofit organization. However, she is also extremely active in fundraising and in political activism on issues that affect women. This means that in addition to federal funds and reimbursements from insurers, Planned Parenthood depends on donors, to a large extent. Indeed, having a strong pool of donors makes it possible for clinics across the country to offer many services to do walk-ins at no cost. Even people who do not qualify for Medicaid can obtain free or low-cost services at Planned Parenthood, such as STI testing, breast exams, and cancer screenings. And, when needed, women can also use Planned Parenthood to obtain high-quality and safe pregnancy terminations in a well-staffed and equipped setting.

Regardless, any attempt to reduce the number of providers available to the poor fundamentally restricts their right to choose from an array of clinical settings in which to receive care.

Regardless of how the Planned Parenthood Federation of America obtains non-governmental revenue, nearly half of their annual budget comes from the Centers for Medicare and Medicaid Services in the form of reimbursements for services to the poor. While many Republicans in Congress ensure that their efforts to cut funding to Planned Parenthood will be matched with efforts to divert these funds to other community health centers, they fail to acknowledge the fact that other community health centers may either not exist or may not provide the quality care that Planned Parenthood provides. Regardless, any attempt to reduce the number of providers available to the poor fundamentally restricts their right to choose from an array of clinical settings in which to receive care. Many of the contraceptive services that Planned Parenthood provides are helping people in states that chose not to expand Medicaid under the Patient Protection and Affordable Care Act of 2010. Restricting access to nationally recognized clinics with extensive resources for great care tips the scales further, underscoring the war against the poor that Republicans have waged alongside their war  against women.

Ultimately, Richards embodies many of the qualities of the people that Planned Parenthood seeks to help. Granted, she is a white leader of a nonprofit organization earning a high income in an organization that serves many poor people of color. But she has been candid with the public about a pregnancy termination she once obtained, shedding light on the stigma that many women face for making reproductive choices. She has also been an advocate for sex education in schools and for increasing access to contraceptives, the latter falling squarely in line with the larger goals of Planned Parenthood nationally. Poor women in this country are five times more likely to become pregnant unexpectedly than their wealthier counterparts. These outcomes are the result of a variety of factors, like education and access to contraceptives. To add insult to injury, about 80 percent of Planned Parenthood’s 2.7 million patients in 2013 visited a clinic for contraceptives. What many politicians fail to acknowledge is that their quest to restrict abortion is part of a larger and more nebulous agenda to reduce access to basic health services in lower income women. It’s a uniquely revanchist and neoconservative movement that simultaneously cuts along class and gender lines to marginalize an already disenfranchised group. Some religious groups that oppose abortion aid Republicans in their efforts and offer them the supposed legitimacy of God’s will. They are also, however, supported by a history of ideologically driven economic policies that seek to cut government programs for the poor. For the Republican base, this seemingly paradoxical collusion makes complete sense.

Cecile Richards is in many ways a threatened woman. Her testimony before the House Oversight Committee was eerily symbolic — a woman answering to a predominantly male body, forced to defend the rights of fellow women to access contraceptives and affordable medical care. She is an easy target because of her political ties in a policy climate where the most partisan voices demand impartiality from others. But make no mistake: This is a political fight from the start. General consensus in the medical community, better equipped than Congress to act in the interests of women’s health, is that contraceptive services provided by Planned Parenthood prevent many unwanted pregnancies and, by extension, many abortions every year. At the heart of this debate are the right to time pregnancies, the right to have or not have children, and the right to have options other than abstinence or adoption. While the language of choice carries weighty presumptions of ‘killing babies’ for many conservatives, choice is just that: choice. Richards understands that Planned Parenthood isn’t just the name of the organization she spearheads, it is a mantra that has helped women flourish in arenas other than motherhood for many decades. But more deeply, this mantra has reassured poor women whose lives are often marked by precarious finances and shoddy employment prospects – that at least their reproductive choices and decisions to enter parenthood can be affirmed, affordable, and, yes, planned.

Photo