Attacks on Planned Parenthood are Ideologically Driven and Dangerous

Anne Davis & Pratima Gupta

We are board-certified obstetrician/gynecologists, and our daily work includes providing comprehensive reproductive health care, such as abortion. We know that defunding Planned Parenthood is a bad idea. All our clinical experience and current research indicate doing so would cause great harm.

Planned Parenthood and comprehensive sexual and reproductive health care perennially come under attack in the United States. Recently, scientists, doctors and patients have been the targeted for participating in fetal tissue research, despite the fact that medical breakthroughs from such research benefit each and every one of us. This most recent siege on abortion expanded into a broad campaign to defund Planned Parenthood—a months-long media circus punctuated by fruitless Congressional investigations and political posturing.

In our country’s incomplete and complicated patchwork of health care, access depends on a number of factors, especially geographical location and income. For many, Planned Parenthood is the only safety net. Recent analysis by the Guttmacher Institute shows unequivocally that Planned Parenthood plays a major role in delivering publicly supported contraceptive services nationwide.¹ The numbers are striking; in 2013, of the nearly 2.7 million people who received care from Planned Parenthood, at least 60% qualified for public health coverage programs. The vast majority of these Americans lived at or below 150% of the federal poverty level.² Barring Planned Parenthood and other entities that provide family planning services from Title X or Medicaid funding unfairly burdens people with low incomes.

Planned Parenthood strives to care for our most vulnerable populations: young people, the poor and marginalized, and the uninsured or underinsured. In many locations, there is simply no other provider who fills this need. As research from the Congressional Budget Office illustrates, blocking Medicaid patients from seeking care at Planned Parenthood health centers would result in as many as 390,000 people losing access to preventive health care in the first year.³ Adding insult to injury, taxpayers would bear the financial brunt: Over the next decade, they would pay $130 million due to the inevitable increase in unintended pregnancies.⁴

In a poll conducted by USA Today, over two-thirds of Americans support continued funding for Planned Parenthood⁵—they recognize the integral role the organization plays, and the quality care it provides for families around the country. Those who seek to defund Planned Parenthood claim that other health care providers can fill the void, but this is simply not true. Already, overextended community health centers lack the capacity to step in as reproductive health care providers.⁶ Currently, Medicaid-managed care struggles with extreme provider shortages, with only 42% of in-network obstetrician/gynecologists able to offer appointments.⁷ It is unconscionable that members of Congress would vote to curtail vital preventive care: cervical and breast cancer screening, contraception, prenatal care, sexually transmitted infection screening – all vital parts of maintaining a healthy community.

Planned Parenthood and other Medicaid service providers are being targeted because they provide abortion services. Defunding could force the closure of hundreds of locations where women receive preventive care, if the organization also provides abortion with their non-federal funding stream.

And more to the point: Regardless of one’s personal feelings about it, abortion remains critical to women’s health and well-being. One in three U.S. women has an abortion by 45 years of age.⁸ These are our sisters, our friends, our coworkers. These women are us. Ninety-seven percent of obstetrician-gynecologists report having seen a patient who was in need of abortion care.⁹ However, due to a variety of complicated issues, only 14% are able to offer abortion services.¹⁰ Without Planned Parenthood and its doctors, more women will be forced to postpone abortions until later in pregnancy, carry complicated, risky pregnancies to term, or—most worrisome—seek illegal, and dangerous, means of ending their pregnancy. This is already happening in Texas, a state that has shuttered 28 of its abortion clinics. Women bear the burden as needless delays pile up and self-induced abortion is on the rise.¹¹ As physicians trained after Roe v. Wade, we hope we never see our patients suffer or die from the complications of illegal abortion.

The attacks on abortion, abortion providers, and women who have abortions do nothing to advance women’s health. It is shameful that ideologues discount the dedication and compassion of clinicians who devote their lives to helping women. Stopping Planned Parenthood from providing care for low-income women would have devastating and long-term consequences for public health, and as physicians who care for, and about, women, we won’t stand by and let this happen.

About the Authors

Dr. Anne Davis is an associate professor of clinical obstetrics and gynecology at Columbia University Medical Center in New York City. Her research interests include new hormonal contraceptives, how women use contraceptives, and contraception in women with medical problems. She is the Consulting Medical Director of Physicians for Reproductive Health.

Pratima Gupta, MD, MPH, joined Physicians for Reproductive Health in August 2015 as the third Reproductive Health Advocacy Fellow. Dr. Gupta has worked at Kaiser Permanente since September 2007. She completed a Fellowship in Family Planning at the University of California, San Francisco in 2005. During this fellowship, she also received a Masters in Public Health from University of California, Berkeley, in Global Health. She is a former PRH board member and a graduate of the Leadership Training Academy class of 2010.

References

1. Frost J and Hasstedt K, Quantifying Planned Parenthood’s Critical Role in Meeting the Need for Publicly Supported Contraceptive Care, Health Affairs Blog, http://healthaffairs.org/blog/2015/09/08/quantifying-planned-parenthoods-critical-role-in-meeting-the-need-for-publicly-supported-contraceptive-care/ (accessed 1 November 2015).
2. Topulos GP, Greene, MF, Drazen JM, Planned Parenthood at Risk, New England Journal of Medicine 373;10, September 3, 2015.
3. Congressional Budget Office (CBO). “Cost Estimate: H.R. 3134 Defund Planned Parenthood Act of 2015.” Washington, DC: CBO, https://www.cbo.gov/sites/default/files/114th-congress-2015-2016/costestimate/hr3134.pdf (accessed 1 November 2015).
4. Letter from Keith Hall, Director of CBO, to Representative Kevin McCarthy, Majority Leader, U.S. House of Representatives. https://www.cbo.gov/sites/default/files/114th-congress-2015-2016/costestimate/ltrpermanentdefundplannedparenthood.pdf, (accessed 1 November 2015).
5. Firozi P and Page S, Poll: By 2-1, funding for Planned Parenthood supported, USA Today, Sept. 29, 2015. http://www.usatoday.com/story/news/politics/2015/09/29/poll-2-1-funding-planned-parenthood-supported/73016440/
6. Rosenbaum S, Planned Parenthood, Community Health Centers, and Women’s Health: Getting the Facts Right, Health Affairs Blog. http://healthaffairs.org/blog/2015/09/02/planned-parenthood-community-health-centers-and-womens-health-getting-the-facts-right/, (accessed 1 November 2015).
7. United States Department of Health and Human Services Office of Inspector General (OIG). (December 2014). “Access to Care: Provider Availability in Medicaid Managed Care,” Washington, DC: OIG, http://oig.hhs.gov/oei/reports/oei-02-13-00670.pdf (accessed 1 November 2015).
8. Jones RK and Kavanaugh ML, Changes in abortion rates between 2000 and 2008 and lifetime incidence of abortion, Obstetrics & Gynecology, 2011, 117(6):1358-1366.
9. Stulberg, DB, Dude, AM, Dahlquist, I, and Curlin, FA. Abortion provision among practicing obstetrician-gynecologists, Obstetrics & Gynecology, 2011, 118(3), 609-614.
10. Id.
11. Grossman, Daniel et al., The public health threat of anti-abortion legislation, Contraception, Volume 89, Issue 2, 73 – 74.