01 February 2012

What does planned parenthood actually do?

One thing which has long pissed me off about the christianist faction in US politics, with regard to their never-ending quest to impose their definition of "life" onto everybody else in the country, is the way they put their ideology and their theology above the actual health and lives of real, actual, living and breathing women. Their belief in a magical spirit force in a clump of nonsentient cells is important enough they they are willing to lay waste to the rights, privacy, and also the health of the women who sinfully misuse their ladyparts.

For years, the symbol that women's health activists have used to communicate this was the coathanger -- the implication that if abortion is driven underground then women will die from back-alley botched septic abortions. I always thought that was a bit over-the-top, though: too hypothetical and unlikely to carry much punch nowadays. It may have had more relevance in the '70s, when the era of illegal abortion was fresher in people's minds.

But now, if you are looking for real, actual evidence of how the radical christian right is willing to put women's lives at risk to save the spirit babies, look no further than the war on Planned Parenthood. Over the last two years, it has come under constant assault from conservative politicians, seeking to cut off its funding and force it to wither on the vine. The tactic is simple, and possibly effective: if you can kill or cripple an institution which is a major abortion provider, there will be fewer abortions. If all you care about are abortions, the math works out fine.

It is important to remember, though, that Planed Parenthood does way more than just abortions. They are a comprehensive provider of women's health services, primarily to low-income women who cannot afford to see a primary doctor or a gynecologist. Abortions are, in fact, a tiny minority of what Planned Parenthood does!

Planned Parenthood is caricatured in right-wing circles as no more than an abortion mill. As you can see, however, of all the patient contacts Planned Parenthood has, only 3% are for abortions. 35% are for STD screening and treatment, 35% are contraceptive, 16% are cancer prevention and screening. They perform nearly a million breast cancer screening exams annually, and a similar number of screening tests for cervical cancer. (source: PDF)

In fact, Planned Parenthood estimates that they prevent over 250,000 abortions annually, as a result of their contraceptive services preventing nearly 600,000 unintended pregnancies. Never mind the number of cases of tubo-ovarian abscesses and ectopic pregnancy they prevent by treating STDs and the number of lives they save through their cancer screening services -- particularly cervical cancer screenings.

Now, if you kill Planned Parenthood by pulling its federal funding, as Congressional Republicans tried, or by restricting its access to medicaid clients, as Indiana Republicans tried, or by burdening it with onerous and prohibitive pointless regulations, as Kansas tried, then you could possibly prevent 300,000 abortions a year. The consequence to that, however, would be that millions of women who have no other alternative would lose access to these other services, and some of them would die as a result of that.

That's not being hysterical, just simply pointing out the fact that policy decisions have consequences and some of those are what are drily euphemized in the medical literature as "increased morbidity and mortality," which is to say -- increased sickness and death. And to the true believers, the holy warriors (I won't say jihadists) of the anti-abortion movement, they are OK with those collateral human costs.

Planned Parenthood is an important provider of health care for women, particularly vulnerable women. And it's important for those of us in the health care community to stand up in its defense against the religious extremists who want to shut it down.


  1. One of the main problems Planned Parenthood has is their name, it is pretty much the opposite of what they do. If you plan to be a parent they no longer want to talk to you. (At least this was true in LA in the 80s when a couple friends had unwanted pregnancies and went to them).

    Another real problem is their early connection with Eugenics. The millions of abortions they have performed on mostly lower income, less educated women can easily be seen as a tool of Eugenics, is is exactly what their founder advocated.

    I think reorganizing as a women's health organization with a different name and publicly distancing themselves from the beliefs of their founder would do them a world of good. The wouldn't even have to change anything they do.

    Sure, some wackos would still go after them, but most of the half of the US population that is against abortions would be much less upset at them.

  2. Thanks. Well said.

    Seems to me that the only thing simple in heath care are the simplistic views of talking heads that don't care about health.

  3. I wrote something very similar about PP when Indiana was trying to nix the program. (IU dental student over here)


  4. They want to create a utopia where everyone lives according to their moral beliefs, so they will feel comfortable and happy about the way "their" country operates. The nicest way I can speak of that is to call it overbearing. If I said what I really think, I'd be mistaken for someone in the throes of a bout with Tourette's Syndrome.

  5. nonsentient cells? Seriously? I've seen some early ultrasounds - no way I could use that description. Wake up.

  6. Up here (vancouver, canada) they have changed their name to Options for Sexual Health. Perhaps a more apt description?

  7. I'd suggest, perhaps, a bit more of a tempered approach. Your viciously judgemental discussion of those "religious extremists" automatically turned me off to your argument before I'd even heard much of it. What would you do if you truly believed that each abortion was an actual murder?

    To you it's just a euthanization of "nonsentient cells," but they honestly believe that a person's life is being wiped out by each abortion. How can you expect them to take the same position as you if they honestly believe that? I could understand your strong approach if you thought they didn't believe it and were just making it all up and sacrificing women's health to get votes or settle some sort of score (do you?), but I have a hard time condemning people who believe abortion to be murder for siding against organizations that promote it...

    To extrapolate their point of view to something with which you can relate, what song would you be singing if Planned Parenthood helped women in all of those great ways, then euthanized enough three-year-olds to equal 3% of those that they helped? As far as I understand it, to them it's the same thing. I say this not to justify their actions or to equate the two, but just to maybe understand their actions. When their mindset is viewed in that light, it is a little more understandable that they oppose Planned Parenthood.

  8. Excellent job pointing out that Planned Parenthood provides a range of much needed and valued health services. Assuming that National health care is not going to be provided women deserve as a basic right to have access to health services.

  9. VinceRN: Please stop misrepresenting what Planned Parenthood does. They provide health services to women and men, regardless of whether they wish to become parents or not. These services include contraceptives and abortions, true. But they also include STD screening, cancer screening, and other health services unrelated to pregnancies. In fact, they are one of the largest providers of low cost pre-natal vitamins. Of course, that only protects the health of the woman, so maybe it's irrelevant in your world.

    The Eugenics argument is old hat, and has little relevance to today's Planned Parenthood.

    Recognizing that 3% of what you do doesn't define everything shouldn't be difficult.

  10. Justin, you said: "I have a hard time condemning people who believe abortion to be murder for siding against organizations that promote it... "

    I don't. The reason is that whether abortion is or isn't murder isn't actually the issue. The main, primary, end-of-line issue is whether this ball-of-cells, potential baby, new life, whatever you want to call it -- if that fetus has rights which outweigh the mother's rights to control her own body.

    Many people DO believe that an abortion ends a life, and that is a horrible, awful thing that should happen as rarely as possible. But in the end, that life still should not have the ability to force a woman to carry it, birth it, and support it if she believes she can't, and there is currently NO WAY for that to not happen without abortion.

    The choice about abortion is not whether the fetus is a life, but whether the choice to have one should be solely up to an individual woman and her doctor, or if that choice should be made by the state, generically for all women.

    People who side against organizations that provide abortion claim they are only protecting the fetus's rights, but in doing so, they are completely denying the woman HER rights.

  11. Planned Parenthood isn't only used by women. Men also use PP for reproductive healthcare services and would also be denied access to STD treatment and cancer screenings. I took the fact that men use PP for granted when I used them as my main provider, but apparently this comes as a real shock to some people. A sad testament on how both sides of the abortion debate have swept every other consideration to the sidelines.

  12. Barbara, when I read you saying, "But in the end, that life still should not have the ability to force a woman to carry it, birth it, and support it", I had to go back and read it again. I'm freakin' amazed that someone has the gall to say something like that. Putting cases of rape and incest aside (as I have mixed feelings on that in the abortion debate), you're telling me that even if the embryo is a life, that life has no rights compared to the right of a women to extinguish it? The same woman that made a decision to have sex knowing she could get pregnant, and also knowing there are other choices after delivery like adoption? My God, it chills me to even write out that line of thinking. If we are to agree, for the reason of debate, that the embryo does classify as a life, then that women gave up her right to make any life altering decision for that embryo once she was complicit in the cause of that life. Your logic is akin to me deciding to shoot my child in the head because she developed life-threatening cancer, and I as her father didn't want to go through the expense or hassle of treatment. Unbelievable that someone could even think that.

  13. Jim Smoak +1

    I agree - if we are assuming the unborn child is a life, then that life DEFINITELY has a right to life which supersedes the right of the mother to a pursuit of happiness. In no universe is it right to destroy another life simply because it inconveniences you, regardless of the scale of the inconvenience.

  14. It would be interesting to see if Komen is just shifting their funding from Planned Parenthood to other organizations. As long as Komen continues to fund mammograms, does it really matter what organization they do it through, Planned Parenthood or otherwise? I would say no.

  15. Thalia: Don't think I misrepresented anything. Planned Parenthood does not provide prenatal care, they are, in fact, about planning not to be a parent. When you plan to be a parent they send you elsewhere.

    As for the Eugenics thing, I did not say they are a Eugenics organization. I said their founder was very into Eugenics and that that is something that bothers a lot of people, and that is true and easily verifiable. I suggested that they would do well to distance themselves from that, and I think they would.

    As for the prenatal vitamins thing, those are available everywhere for very low cost. My wife took them consistently for four years between pregnancies and breastfeeding, I doubt we spent a hundred bucks on them in all that time. Likely Walmart and Costco are much larger suppliers of low cost prenatal vitamins than planned parenthood. I'm pretty sure you made that up.

    Again, a name change, something like what a poster above says they did in Canada, and distancing themselves from their founder's ridiculous views would do them a lot of good. The majority of those against them would cease to be a problem.

    You probably also missed that I said they wouldn't have to change anything they do.

    I'll add, just to annoy you, that that 3% of their business provides 15% of their funds. They get something like 300 times as much from performing abortions than the small amount they were getting from Komen that started this topic. Those abortions pay for a large portion of the other services they offer.

    I saved this for last because I figure it won;t be read - I'm not against planned parenthood. They provide very important services to the community. I don;t want to outlaw abortion, though I would say that abortion of a viable baby, say 24 weeks, should only be done to save the life of the mother.

  16. Perhaps they need to consider doing the 3% of services under another charitable umbrella. They could continue to do all of the other services with public funding and funds provided by Komen and even Girl Scouts but separate the two. People who WANT to support abortion (though I have no comprehension of why you would do that) can donate to that part of their services and people who walk for breast cancer would not be somehow supporting abortion at the same time. I like to make a choice to support what I agree with and I don't support charities who fund PP simply because they offer both. I choose to support women in ways that don't offer services to destroy life. Simple biology tells me that a baby is life from the moment of conception.

  17. First, let me say that this is an extraordinarily civil discussion of a topic which often degenerates.

    If an embryo, from the moment of conception, is a human life with all of the attendant rights, what's to be done with all of the IVF embryos created but not implanted? Logically, they would have to have the right to be carried to term and born as well, right? Should the couple that "ordered" them be required to have them all implanted? Should women be sought as surrogate mothers? Drafted? One answer would be to outlaw IVF, but that doesn't solve the problem of all the embryos currently in storage. Complete logical consistency on this issue is difficult.

  18. I think that "STD screening and treatment" and "contraceptive" are points that don't jive well with Christians – these points would be another "reason" (if this is the right word) for the religious (with their public display of their pre- and extra-marital sex phobia) to rally against planned parenthood.

  19. Thoughtful thread, though an old and tired topic.

    I am not sure where I stand on abortion via Planned Parenthood. Considering, abortion is considered a violation to many American's religious beliefs, the Government should treat it as we are suppose to treat School and government. Stay out of it. Leave it as as non private/private provider. Planned Parenthood benefits from much support. I would much rather our tax dollars be put toward education, or caring for the living then paying for abortion- we do not have the resources as a Country to continue wasting our time right now on Public dollars to Planned parenthood- I promise you, as long as there are women who are sexually active, there will be a need for all sorts of family planning. Most women really don't need the government holding their hand.

    I for one believe abortion is a personal choice- on one hand, who would bring yet another child that is unwanted into this world? Do your realize that the US has the highest rate of child abuse then any of other 1st world Nations? Our children are dropping daily in educational obtainment. Our seniors are neglected, our homeless numbers are through the roof, people are dying of treatable diseases, 1 in 10 Americans has spent time in jail,unemployment,addiction,no care or facilities for those with serious mental health needs- who needs or wants more people in our country born into such a system and existence?
    On the other hand, any Mother who has carried a child, who has loved a child, would find it quite difficult to give up that love to either abortion or adoption.
    Perhaps Abortion would become a no issue at all, if we made an effort to care for the breathing and living vs fixating on those who may or may not be born.

  20. On the "right to life" question, any man can currently refuse to donate an organ, bone marrow, or even blood that is needed to save someone else's life. The fact that the other person will die without it has no relevance under current law. No man can be legally forced to help keep another person alive if it requires donation or use of any part of his body.

    Why does that idea suddenly change when it's a woman, and the potential life in question is an embryo rather than a child or adult who is already born?

    A parent cannot be compelled to donate blood to save their child. Why should a woman be compelled to donate so much more to an embryo?

    And yet I don't see the "right to life" people working to change those laws at all. Or institute mandatory organ donation.


  21. PP is the wrong partner for Komen. and Komen is the wrong partner for PP.

    1 - PP has disingenuous accounting practices when 3% of its business accounts for 40% of its revenue - assuming abortions average $450. This makes grant makers concerned because while true it is distorting. If they were to divorce the abortion revenue from the revenue from other services, they would go broke.

    2 - PP lacks good staff training and for an organization of its age, this suggests a lack of executive oversight and vision. Several stings in 2011 involving child prostitution make even pro-choice people flinch. Stuff like this, makes grant makers nervous. PP neither denies the videos nor has sued the creator of them.

    3 - The fact that they do some breast exams co-incident with std, contraceptive and abortion services does not make them a partner in the fight against breast cancer. They do not do mammograms. They do not assist with the myriad of issues related to poor women with cancer. Quite frankly, the PP money would be better spent for taxi and babysittig grants for women to get rides to a hospital for mammos. In a hospital (as opposed to a sexual health clinic) they are integrated into a healthcare system with continuity. PP never developed any paradigm for breast cancer detection, care or research despite a gigantic female database. The mission of PP is not a good fit for Komen. Nor is the mission of Komen a good fit for PP.

    3 - PP undoubtedly does some physical breast exams as this is the standard of care for women of childbearing age seeking reproductive health services. However, with the preponderance of women seeking PP services under 30, and the breast cancer rate in that demographic being 1 in 2500, the money is better spent elsewhere.

    4 - While PP will cry foul and Komen will hide behind their policies, neither organization's objectives are in tandem and it is smart for them to part ways. Komen is the leading breast cancer non-profit. PP is the leading abortion - STD - contraception non-profit. They have nothing in common and no common mission.

    Both organization's efforts are better served by parting.

  22. Well, even given the lies that pour out of that place, I'll take their word for it regarding the reason for visit given percentages of patient encounters.

    But check out another number, and go do it yourself--I expect you to presume I'm too biased to report honestly. Check out what percentage of their INCOME comes from abortion, and ask yourself what's important to them. According to some basic math using numbers on Wikipedia, that's around $400 x 329,445 abortions, or $130M annually; compared to their clinic income of $374.4M, that's around a third.

    As for those "pointless regulations" -- would that be something like, "subject them to the same informed consent regulations, health and safety regulations, and record-keeping regulations as other ambulatory surgery centers"? Why is it bad for their patients to have fully informed consent?

    Contraceptives all fail, except for gonadectomy. Promoting contraceptive use is promotion of unplanned pregnancy. At least when people aren't using contraceptives, they are more likely to remember that the truth that sex makes babies actually DOES apply to them.

    Also, beware of terms like "cancer screenings," which for PP DOES NOT mean mammograms, but rather manual palpation breast exams, no different and hardly any better than the self-exams you are right to promote.

    Defunding PP will not cause them to "wither on the vnie" when their annual budget is more than $1 billion, and federal contributions are less than 36% of that.

    Shadowfax, you're a doctor. You are no doubt urging people to control their urges to eat too much, to eat unhealthy food, to smoke, to drink, to visit tanning beds -- you're counseling them to abstain from risks. If you can urge them to abstain from risks that make them hypertensive, arteriosclerotic, insulin-resistant, diabetic, cirrhotic, chemically dependent, or get melanomas, what's wrong with urging them to abstain from risks that can make them parents?

    @Justin -- thanks for seeing the other side. I believe that every member organism of the species Homo Sapiens is a human being with human rights. To all you choice advocates: If these are not human beings, why not? If they are, and they don't have human rights, why not?

    A woman has COMPLETE CONTROL over whether she gets pregnant, through her own behavior. If she doesn't want to get pregnant, she should abstain from sex. If a man doesn't want to sire offspring, he should abstain from sex. It's not like we are animals, unable to control urges.

    @Elena Perez,
    do you really see no difference between an obligation to provide body parts to other people who may die without them, and an obligation not to slay a child who depends upon you?

  23. Barbara and Elena, you both are spot on.


  24. "On the "right to life" question, any man can currently refuse..."

    1 - Refusal to donate an organ, blood, etc. means that the person dies as a result of some pathology that has a fatal endpoint. Refusal is an "inaction".

    2 - In an abortion, a person dies as a result of some pathology but the intentional act of a 3rd party whose sole intent is its destruction.

    3 - While one may hold the position that the embryo-fetus is some sort of unjust trespasser in a woman's body, it does not follow that the woman has a right to hire a 3rd party to dismember, poison or burn said trespasser to death. It too has a right to bodily integrity.

    You can I suppose, remove the embryonic-fetal person alive and allow it to die as a result of immaturity, or give it to another to gestate if someday it is possible, or someday maybe place it in an artificial womb, but it is unjust to dismember, or otherwise mutilate a person's body simply because they are innocently present, in the vast majority of cases, by the expected end of a consensual act.

  25. It's looking like Komen dropping them turns out to be boon for Planned Parenthood. Donations are increasing, they will likely be replacing that paltry few hundred thousand with millions, that won;t have strings attached. They can use it for the same things, different things, or to buy a yacht for their executives.

  26. Komen's lost my donations, forever.

    PP now gets a direct donation.

    And Jim Smoak, the degree of slut-shaming in your post is deeply shameful. It's also evidentiary of the truth of John Kenneth Galbraith's aphorism:

    "The modern conservative is engaged in one of man's oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness.
    John Kenneth Galbraith

    If you doubt that, let's review your statement below:

    You claim:

    "...you're telling me that even if the embryo is a life, that life has no rights compared to the right of a women to extinguish it? "

    OK, fine - she helped make it, now she has to deal with it IN THE WAY YOU PRESCRIBE.

    Are you going to help pay for the birth and raising the child - both public healthcare and public school, and other publicly funded programs to aid in healthy childrearing?

    Not willingly, you won't. Instead, you'll be the typical conservative who rails about promiscuity and premarital sex and unplanned pregnancy, blaming the women, while there are well-established means to deal with it - termination of a pregnancy, or publicly funded support for families.

    You're a short-term-minded idiot, sir. And your short-term thinking derived from idiotic adherence to a neolithic belief system will destroy this country, sure as can be.

  27. Justin: It is NEVER a human right to FORCE another person to harm themselves physically, mentally, or financially, even to save your life. And I suggest you look into the reasons WHY women have abortions before you dismiss it as a mere "inconvenience."

    Jim: As far as women being entirely complicit in their own pregnancy, do you also believe that women are responsible for their own rape?

  28. @VinceRN - I'd like to beg to differ about Planned Parenthood not offering prenatal care. I'm sure it varies from location to location, but in my area, they partner with the Certified Nurse-Midwife program at a local hospital to offer prenatal care to women with low-risk pregnancies and referrals for those at higher risk. They took very good care of me...

  29. @Barbara: I have no end of compassion for rape victims, who deserve our compassion and support.

    Part of that means that we bear in mind that when a woman becomes pregnant through rape, we have not one victim, but two. Her child is every bit as much the rapist's victim as she is. Such children are denied fathers, which they deserve to have.

    Really, since when is it justice to punish the victim for a crime?

  30. These shoes aren't walking The 3 Day.

    As always I find it ridiculous that men think they can make decisions in the stead of the individual, woman. Your consult was never asked for.


  31. @Cathy W - That's interesting. Did they actually provide the service, like you went to their facility for the visits, ultrasounds and such It would be very cool if they were doing that.

  32. Simple question - why does the government need to get involved with/fund Planned Parenthood anyway? There are many who are offended by what they do and do not want to see their tax dollars supporting them. Why can't PP just rely on donations and *gasp* payments from their clientele? I for one can see the need for SOME abortions (rape, incest), but I certainly do NOT want my taxpayer money going to pay for some irresponsible girl who gets knocked up after a one night stand. Again this all goes back to personal responsibility and the lack of it fostered by our communist government.

    Komen has every right to do what they wish with their money. Whether they choose to fund organizations like PP or not is their prerogative and I cannot complain about it. I have donated to them in the past and now I will refuse to do so. Shadowfax complains that they gave into the religious right, but now I'm going to complain that they gave into the communist left after US representatives and senators pressured them to resume funding PP. If that is not state control of commerce and means of production right out of the communist manifesto, I don't know what is. Shame on you, Komen, for not standing up for what you believe. Now that I know my potential donations will be going to fund PP, you can forget any future support from me. Shadowfax is right, there are many other worthy causes out there.

  33. Anonymous: I recommend you look into some statistics about who gets abortions, and where. Your "some irresponsible girl who gets knocked up after a one night stand" almost certainly has insurance and the money to pay for her own private abortion with her PCP. The ones who NEED the service are more likely to be the ones who literally can't afford another mouth, whose boyfriend just left them and they have nowhere to live, who are underage and jobless and pressured by their boyfriends, and many other unfortunate circumstances.

    It's funny, really. If the government decides a woman is unfit physically, mentally, or financially to take care of a child, they will forcibly take it away from her. If the woman decides she is unfit physically, mentally, or financially to take care of a baby, "pro-life" people would force her to do it anyways.

  34. Barbara - all of your bleeding heart scenarios can be fixed with one simple solution - don't get pregnant. If you can't take care of the child then TAKE SOME PERSONAL RESPONSIBILITY and don't get pregnant in the first place. Personally,I am pro-choice, but don't feel the need to pay for anyone else's abortion. Seriously, the communist left in this country is fostering personal irresponsibility by creating dependence on the state instead of empowering the individual. Without this dependence, the left would whither away on the vine.

  35. Well we all know there is an easy fix - anon 6:59, and that lies with men taking some of the responsibility for their own actions. Oops, that's unrealistic now isn't it.


  36. Daniel F. Kane: pointing out that much of their revenue comes from abortions is being extremely disingenuous, given that we have established how many other of their services are free or subsidized for people with low incomes.

    If they charged full price for a doctor's visit, that revenue chart would look very different. Likewise if they gave abortions for free.

    So, who's gonna step up and subsidize the free abortions? Komen just established that they're too chickenshit to pay for BREAST EXAMS in this political climate. It stands to reason that they get revenue from abortions that they don't get for all their, y'know, free services. A million times zero is still zero.

    And you just insulted medical science, on a physician's blog, by suggesting a self-exam is as good as an expert's. It's not, for various reasons. It's useful because it can be performed more frequently, but an expert can spot things a layperson cannot.

    ...Somebody please do lead testing on this man's water supply.


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