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Facing uncertain future, Planned Parenthood workers turn to unions for support

A large blue sign for Planned Parenthood.
Steve Helber

The recent upheaval in abortion access seems to have tested the patience of unionized employees at Planned Parenthood of Western Pennsylvania, who are 14 months into negotiating their first contract with management.

The union says low wages and understaffing undermines the ability of workers to provide abortion care at the provider’s Downtown clinic, which has been pushed to its limits serving out-of-state patients since the Supreme Court overturned Roe v. Wade. The city’s geographic proximity to Ohio, West Virginia and Kentucky makes it a so-called “abortion haven” for much of Appalachia.

Elizabeth Villanueva, a health care assistant for Planned Parenthood of Western Pennsylvania, rallies with her union in downtown Pittsburgh. 07/26/2022
Sarah Boden
90.5 WESA
Elizabeth Villanueva, a health care assistant for Planned Parenthood of Western Pennsylvania, rallies with their union in downtown Pittsburgh on Tuesday, July 26, 2022.

“We are living in a regional and national health care crisis. We, the workers, and our patients, need much more than the bare minimum,” said health care assistant Crystal Grabowski at a Tuesday evening rally in downtown Pittsburgh.

Western Pennsylvania’s Planned Parenthood affiliate is one of five to have unionized since 2020. Others include Planned Parenthood North Central States and Planned Parenthood League of Massachusetts: Staff in both those locations announced plans to organize within weeks of learning the high court would overturn the constitutional right to abortion.

In Massachusetts, patient care navigator Cara Callahan said the fall of Roe helped convince people at her affiliate to vote in favor of unionization. “We know the work is going to get harder, and we already are feeling a lot of constraints,” she said.

The Massachusetts and Western Pennsylvania affiliates did not respond to requests for comment, nor did the national Planned Parenthood office.

A season of discontent

Organized labor is having a moment. In 2022, unions have been formed by Amazon workers in New York City, exotic dancers in Los Angeles and knights (among other performers) at a Medieval Times in New Jersey.

Across the board, workers have said they’re overworked, undervalued and underpaid. And in many ways, collective action among reproductive health workers has been spawned by the ongoing legal crisis that adds to the impact COVID-19 has had on the broader workforce.

Bob Bruno, a University of Illinois professor of labor and employment relations, believes that’s mobilized workers across reproductive health care. He notes that this month employees voted overwhelmingly to unionize Guttmacher Institue, one of the country’s leading research and policy organizations for abortion rights. The pro-abortion rights National Women's Law Center unionized in 2020.

“Nonprofits like Planned Parenthood are driven by their mission,” said Bruno. “That mission status can be used to persuade workers that they should sacrifice more than your average production worker.”

Demoralizing blows to abortion access in recent years have likely resulted in less willingness to defer to upper management and greater levels of job dissatisfaction, said Bruno.

“Times are really hard for reproductive health care workers,” said Ashley Schmidt, a training and development specialist for Planned Parenthood North Central States in Nebraska. “We want a voice at the table.”

Uncertainty and Opportunity

People who work in reproductive health faced a precarious future even before Roe was overturned.

According to Guttmacher, in 1982, there were more than 2,900 abortion providers in the U.S. The most recent data from 2017 shows there are now fewer than 1,600. Many closures followed onerous regulations and funding cuts.

“[Employees] in those clinics don’t have jobs anymore. That’s, I think, also a really necessary component of understanding this context in which unionization really makes sense,” said University of Cincinnati medical sociologist Danielle Bessett. She cautioned this instability may sow divisiveness within the reproductive justice movement.

(Bessett serves on the external research advisory group for Planned Parenthood Federation of America. But she does not provide input to Planned Parenthood on labor or management policy and practices.)

The fact that unionized Planned Parenthood workers in Pittsburgh are making their grievances public after more than a year of contract negotiations indicates the process may not be going well, said Bruno.

More than 100 people attended a rally in downtown Pittsburgh in support of unionized workers at Planned Parenthood of Western Pennsylvania. Employees says management are dragging their feet after 14 months of contract negotiations. 07/26/2022
Sarah Boden
90.5 WESA
More than 100 people attended a rally in downtown Pittsburgh in support of unionized workers at Planned Parenthood of Western Pennsylvania. Employees says management are dragging their feet after 14 months of contract negotiations on Tuesday, July 26, 2022.

At the Tuesday rally in Pittsburgh, workers say that management has been dragging their feet in negotiations, which ultimately hinders the staff’s ability to care for patients.

“We have like a skeleton [crew] for a vast region of the United States…That health care doesn’t happen without us,” said Grabowski

Bruno thinks an organized workforce will ultimately benefit Planned Parenthood patients. Research shows that hospitals with nurses’ unions produce better patient outcomes. And a study published in September 2020 found that unionized nursing homes saw lower COVID-19 mortality rates among residents.

Bessett also sees the value of a union. Given the stresses that abortion care workers are under right now,” she said, “I think anything that provides them with greater security and greater job satisfaction will just help them do their jobs better.”

That might be the case for workers at Planned Parenthood North Central States. When asked for a comment, the affiliate referred WESA to a joint statement its CEO penned with the head of SEIU Healthcare Minnesota and Iowa, the union representing its workers.

“At a time when reproductive rights and the freedom of bodily autonomy are under intense attack,” the statement said, “we are ready to work together to make sure we are supporting the dedicated employees across the affiliate.”

Contagion Effect

“Within the next year or so, I would not be shocked if almost all affiliates were unionized,” said Cara Callahan in Massachusetts, who likened the trend to a domino effect.

Part of that trend will likely be influenced by demographics. UI’s Bob Bruno says Planned Parenthood’s younger, progressive workforce means its employees are more likely to be open to collective action when compared to workers in other industries

Ashley Schmidt in Nebraska agrees that more reproductive health unions are likely to emerge. She’s even gotten a couple of messages over social media from people in her field wondering how to organize their own worksites.

In sociology, when beliefs and attitudes spread through a group, it’s known as “contagion.” Cincinnati’s Danielle Bessett says you can see the effect at work with reproductive health workers: “As one clinic or facility unionize and is successful in doing that, it becomes a reality for others.”

Crystal Grabowski in Pittsburgh, said workers here often speak with staffers at other reproductive health organizations, including those who are trying to unionize their own workplaces.

“We learn from one another,” she said. “We support one another. We’re all going through the same thing.”

Sarah Boden covers health and science for 90.5 WESA. Before coming to Pittsburgh in November 2017, she was a reporter for Iowa Public Radio. As a contributor to the NPR-Kaiser Health News Member Station Reporting Project on Health Care in the States, Sarah's print and audio reporting frequently appears on NPR and KFF Health News.