Planned Parenthood
Planned Parenthood Federation of America, Inc., or Planned Parenthood, is a nonprofit organization that provides reproductive health care in the United States and globally. It is a tax-exempt corporation under Internal Revenue Code section 501 and a member association of the International Planned Parenthood Federation. PPFA has its roots in Brooklyn, New York, where Margaret Sanger opened the first birth control clinic in the U.S. in 1916. Sanger founded the American Birth Control League in 1921, which changed its name to Planned Parenthood in 1942.
Planned Parenthood consists of 159 medical and non-medical affiliates, which operate over 600 health clinics in the U.S. It partners with organizations in 12 countries globally. The organization directly provides a variety of reproductive health services and sexual education, contributes to research in reproductive technology and advocates for the protection and expansion of reproductive rights. Research shows that closures of Planned Parenthood clinics lead to increases in maternal mortality rates.
PPFA is the largest single provider of reproductive health services, including abortion, in the U.S. In their 2014 Annual Report, PPFA reported seeing over 2.5million patients in over 4million clinical visits and performing a total of nearly 9.5million discrete services including 324,000 abortions. Its combined annual revenue is, including approximately in government funding such as Medicaid reimbursements. Throughout its history, PPFA and its member clinics have experienced support, controversy, protests, and violent attacks.
History
Origins
The origins of Planned Parenthood date to October 16, 1916, when Margaret Sanger, her sister Ethel Byrne, and Fania Mindell opened the first birth control clinic in the U.S. in the Brownsville section of the New York borough of Brooklyn. They distributed birth control, birth control advice, and birth control information. All three women were arrested and jailed for violating provisions of the Comstock Act, accused of distributing obscene materials at the clinic. The so-called Brownsville trials brought national attention and support to their cause. Sanger and her co-defendants were convicted on misdemeanor charges, which they appealed through two subsequent appeals courts. While the convictions were not overturned, the judge who issued the final ruling also modified the law to permit physician-prescribed birth control. The women's campaign led to major changes in the laws governing birth control and sex education in the United States.In 1921, the clinic was organized into the American Birth Control League, the core of the only national birth-control organization in the U.S. until the 1960s. By 1941, it was operating 222 centers and had served 49,000 clients. However, some found its title offensive and "against families", so the League began discussions for a new name. In 1938, a group of private citizens organized the Citizens Committee for Planned Parenthood to aid the American Birth Control League in spreading scientific knowledge about birth control to the general public. In 1942, the League officially changed its name to the Planned Parenthood Federation of America.
Largely relying on a volunteer workforce, by 1960 the Federation had provided family planning counseling in hundreds of communities across the country. Planned Parenthood was one of the founding members of the International Planned Parenthood Federation when it was launched at a conference in Bombay, India, in 1952.
Both Planned Parenthood and Margaret Sanger are strongly associated with the abortion issue today. For much of the organization's history, however, and throughout Sanger's life, abortion was illegal in the U.S., and discussions of the issue were often censored. During this period, Sanger – like other American advocates of birth control – publicly condemned abortion, arguing that it would not be needed if every woman had access to birth control.
After Sanger
Following Margaret Sanger, Alan Frank Guttmacher became president of Planned Parenthood, serving from 1962 until 1974. During his tenure, the Food and Drug Administration approved the sale of the original birth control pill, giving rise to new attitudes towards women's reproductive freedom. Also during his presidency, Planned Parenthood lobbied the federal government to support reproductive health, culminating with President Richard Nixon's signing of Title X to provide governmental subsidies for low-income women to access family planning services. The Center for Family Planning Program Development was also founded as a semi-autonomous division during this time. The center became an independent organization and was renamed the Guttmacher Institute in 1977.Planned Parenthood began to advocate abortion law reform beginning in 1955, when the organization's medical director, Mary Calderone, convened a national conference of medical professionals on the issue. The conference was the first instance of physicians and other professionals advocating reform of the laws which criminalized abortion, and it played a key role in creating a movement for the reform of abortion laws in the U.S. Focusing, at first, on legalizing therapeutic abortion, Planned Parenthood became an increasingly vocal proponent of liberalized abortion laws during the 1960s, culminating in its call for the repeal of all anti-abortion laws in 1969. In the years that followed, the organization played a key role in landmark abortion rights cases such as Roe v Wade and Planned Parenthood v Casey. Once abortion was legalized during the early 1970s, Planned Parenthood also began acting as an abortion provider.
Faye Wattleton became the first African American president of the Planned Parenthood Federation of America in 1978. Wattleton, who was also the youngest president in Planned Parenthood's history, served in this role until 1992. During her term, Planned Parenthood grew to become the seventh largest charity in the country, providing services to four million clients each year through its 170 affiliates, whose activities were spread across 50 states.
From 1996 to 2006, Planned Parenthood was led by Gloria Feldt. Feldt activated the Planned Parenthood Action Fund, the organization's political action committee, launching what was the most far reaching electoral advocacy effort in its history. The PPAF serves as the nonpartisan political advocacy arm of PPFA. It engages in educational and electoral activity, including legislative advocacy, voter education, and grassroots organizing to promote the PPFA mission. Feldt also launched the Responsible Choices Action Agenda, a nationwide campaign to increase services to prevent unwanted pregnancies, improve quality of reproductive care, and ensure access to safe and legal abortions. Another initiative was the commencement of a "Global Partnership Program", with the aim of building a vibrant activist constituency in support of family planning.
On February 15, 2006, Cecile Richards, the daughter of former Texas governor Ann Richards, and formerly the deputy chief of staff to the U.S. Rep. Nancy Pelosi, became president of the organization. In 2012, Richards was voted one of Time magazine's 100 Most Influential People in the World.
Richards' tenure as president of the organization ended on April 30, 2018. Current Planned Parenthood board member Joe Solmonese was appointed as transition chair to temporarily oversee day-to-day operations of Planned Parenthood after Richards’ departure.
On September 12, 2018, the organization announced that Leana Wen would take over as president, effective November 2018. Wen was removed as president of Planned Parenthood by the organization's board of directors on July 16, 2019. Alexis McGill Johnson, a board member and former chairwoman, became the organization's acting president.
Margaret Sanger Awards
In 1966, PPFA began awarding the Margaret Sanger Award annually to honor, in their words, "individuals of distinction in recognition of excellence and leadership in furthering reproductive health and reproductive rights." In the first year, it was awarded to four men: Carl G. Hartman, William H. Draper, Lyndon Baines Johnson, and Martin Luther King, Jr. Later recipients have included John D. Rockefeller III, Katharine Hepburn, Jane Fonda, Hillary Clinton, and Ted Turner.Services
The services provided by PPFA affiliates vary by location, with just over half of all Planned Parenthood affiliates in the U.S. performing abortions. Services provided by PPFA include birth control and long-acting reversible contraception; emergency contraception; clinical breast examinations; cervical cancer screening; pregnancy testing and pregnancy options counseling; prenatal care; testing and treatment for sexually transmitted infections; sex education; vasectomies; LGBT services; and abortion. Contrary to the assumption of some, Planned Parenthood conducts cancer screenings but does not provide mammograms.In 2013, PPFA reported seeing 2.7million patients in 4.6million clinical visits. Roughly 16% of its clients are teenagers. According to PPFA, in 2014 the organization provided 3.6million contraceptive services, 4.5million sexually transmitted infection services, about 1million cancer related services, over 1million pregnancy tests and prenatal services, over 324,000 abortion services, and over 100,000 other services, for a total of 9.5million discrete services. PPFA is well known for providing services to minorities and the poor; according to PPFA, approximately four out of five of their clients have incomes at or below 150percent of the federal poverty level. Services for men's health include STD testing and treatment, vasectomy procedures, and erectile dysfunction services. Education is available regarding male birth control and lowering the risk of sexually transmitted diseases.
Planned Parenthood won the 2020 Webby Award for Machine Learning and Bots for their Sex Education chatbot.
Facilities
PPFA has two national offices in the U.S.: one in Washington, D.C., and one in New York City. It has three international offices, including a hub office in London, England. It has 68 medical and related affiliates and 101 other affiliates including 34 political action committees. These affiliates together operate more than 700 health centers in all 50 states and the District of Columbia. PPFA owns about in property, including real estate. In addition, PPFA spends a little over per year for rented space. The largest facility, a, structure, was completed in Houston, Texas, in May 2010.Worldwide availability
PPFA's international outreach and other activities are performed by Planned Parenthood Global, a division of PPFA, and by the International Planned Parenthood Federation which now consists of more than 149 Member Associations working in more than 189 countries. The IPPF is further associated with International Planned Parenthood Federation affiliates in the Caribbean and the Americas, and IPPF European Network, as well as other organizations like Family Planning Queensland, Pro Familia and mouvement français pour le planning familial . Offices are located in New York, NY; Washington, D.C.; Miami, FL; Guatemala City, Guatemala; Abuja, Nigeria; and Nairobi, Kenya. The organization's focus countries are Guatemala, Nicaragua, Costa Rica, Ecuador, Peru, Senegal, Burkina Faso, Nigeria, Sudan, South Sudan, Uganda, Ethiopia, and Kenya. The Bloomberg Philanthropies donated for Planned Parenthood Global's reproductive health and family planning efforts in Tanzania, Nicaragua, Burkina Faso, Senegal and Uganda. Among specific countries and territories serviced by Planned Parenthood Global's reproductive planning outreach are Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Peru, Suriname, Venezuela, Puerto Rico, U.S. Virgin Islands, Dominican Republic, Barbados, Bolivia, Ecuador, Guadeloupe, Saint Martin, Guyana, Cape Verde and Samoa.Funding
Planned Parenthood has received federal funding since 1970, when President Richard Nixon signed into law the Family Planning Services and Population Research Act, amending the Public Health Service Act. Title X of that law provides funding for family planning services, including contraception and family planning information. The law had support from both Republicans and Democrats. Nixon described Title X funding as based on the premise that "no American woman should be denied access to family planning assistance because of her economic condition."Donors to Planned Parenthood have included the Bill & Melinda Gates Foundation, the Buffett Foundation, the Ford Foundation, the Turner Foundation, the Cullmans, and others. The Bill & Melinda Gates Foundation's contributions to the organization have been specifically marked to avoid funding abortions. Some donors, such as the Buffett Foundation, have supported reproductive health that can include abortion services. Pro-life groups have advocated the boycott of donors to Planned Parenthood. Corporate donors include CREDO Mobile.
In the fiscal year ending June 30, 2014, total revenue was : non-government health services revenue was, government revenue was, private contributions totaled, and came from other operating revenue. According to Planned Parenthood, 59% of the group's revenue is put towards the provision of health services, while non-medical services such as sex education and public policy work make up another 15%; management expenses, fundraising, and international family planning programs account for about 16%, and 10% of the revenue in 2013–2014 was not spent.
Planned Parenthood receives over a third of its money in government grants and contracts. By law, federal funding cannot be allocated for abortions, but some opponents of abortion have argued that allocating money to Planned Parenthood for the provision of other medical services allows other funds to be reallocated for abortions.
A coalition of national and local anti-abortion groups have lobbied federal and state governments to stop funding Planned Parenthood. As a result, federal and state legislators have proposed legislation to reduce funding levels. Eight statesAlabama, Arkansas, Indiana, Kansas, Louisiana, New Hampshire, Ohio, and Utahhave enacted such proposals. In some cases, the courts have overturned such actions, citing conflict with federal or state laws; in others the federal executive branch has provided funding in lieu of the states. In some states, Planned Parenthood was completely or partially defunded.
In August 2015, Louisiana Governor Bobby Jindal attempted to end Louisiana's contract with Planned Parenthood to treat Medicaid patients at a time when there was an epidemic of sexually transmitted diseases in Louisiana. Planned Parenthood and three patients sued the state of Louisiana, with the United States Department of Justice siding with Planned Parenthood.
On February 2, 2016, the U.S. House failed to override President Obama's veto of which would have prohibited Planned Parenthood from receiving any federal Medicaid funds for one year.
Late in 2016, the Obama administration issued a rule effective in January 2017 banning U.S. states from withholding federal family-planning funds from health clinics that give abortions, including Planned Parenthood affiliates; this rule mandates that local and state governments give federal funds for services related to sexually transmitted infections, pregnancy care, fertility, contraception, and breast and cervical cancer screening to qualified health providers whether or not they give abortions. However, this rule was blocked by a federal judge the day before it would have taken effect. In 2017, it was overturned by new legislation.
The proposed American Health Care Act, announced by Congressional Republicans in March 2017, would have made Planned Parenthood "ineligible for Medicaid reimbursements or federal family planning grants."
On August 19, 2019, Planned Parenthood voluntarily withdrew from Title X funding due to a regulatory gag order stating that medical institutions that receive Title X funding cannot refer patients for abortions.
Political advocacy
Planned Parenthood is an advocate for the legal and political protection of reproductive rights. This advocacy includes helping to sponsor abortion rights and women's rights events. The Federation opposes restrictions on women's reproductive health services, including parental consent laws for minors. To justify this position, Planned Parenthood has cited the case of Becky Bell, who died following an illegal abortion rather than seek parental consent for a legal one. Planned Parenthood also takes the position that laws requiring parental notification before an abortion can be performed on a minor are unconstitutional on privacy grounds.The organization opposes laws requiring ultrasounds before abortions, stating that their only purpose is to make abortions more difficult to obtain. Planned Parenthood has also opposed initiatives that require waiting periods before abortions, and bans on late-term abortions including intact dilation and extraction, which has been illegal in the U.S. since 2003. Planned Parenthood supports the wide availability of emergency contraception such as the PlanB pill. It opposes conscience clauses, which allow pharmacists to refuse to dispense drugs against their beliefs. Planned Parenthood has been critical of hospitals that do not provide access to emergency contraception for rape victims. Citing the need for medically accurate information in sex education, Planned Parenthood opposes abstinence-only education in public schools. Instead, Planned Parenthood is a provider of, and endorses, comprehensive sex education, which includes discussion of both abstinence and birth control.
Planned Parenthood's advocacy activities are executed by the Planned Parenthood Action Fund, which is registered as a 501 charity, and files financial information jointly with PPFA. The committee was founded in 1996, by then-president Gloria Feldt, for the purpose of maintaining reproductive health rights and supporting political candidates of the same mindset. In the 2012 election cycle, the committee gained prominence based on its effectiveness of spending on candidates. Although the Planned Parenthood Action Fund shares some leadership with the Planned Parenthood Federation of America, the president of PPAF, Cecile Richards, testified before Congress in September 2015 that she did not manage the organization. The Planned Parenthood Action Fund has 58 active, separately incorporated chapters in 41 states and maintains national headquarters in New York and Washington, D.C. Planned Parenthood has received grants from the Obama administration to help promote the Patient Protection and Affordable Care Act, or ObamaCare.
Political spending
Planned Parenthood spends money on politics and elections through the Planned Parenthood Action Fund, through its Super PAC, and through a variety of related 501 entities. Planned Parenthood endorsed Obama in the 2008 and 2012 presidential elections. In the 2014 election cycle, Planned Parenthood spent on contributions to candidates and political parties and on independent expenditures.Before the U.S. Supreme Court
Planned Parenthood regional chapters have been active in the American courts. A number of cases in which Planned Parenthood has been a party have reached the U.S. Supreme Court. Notable among these cases is the 1992 case Planned Parenthood v. Casey, the case that sets forth the current constitutional abortion standard. In this case, "Planned Parenthood" was the Southeast Pennsylvania Chapter, and "Casey" was Robert Casey, the governor of Pennsylvania. The ultimate ruling was split, and Roe v. Wade was narrowed but upheld in an opinion written by Sandra Day O'Connor, Anthony Kennedy, and David Souter. Harry Blackmun and John Paul Stevens concurred with the main decision in separately written opinions. The Supreme Court struck down spousal consent requirements for married women to obtain abortions, but found no "undue burden"—an alternative to strict scrutiny, which tests the allowable limitations on rights protected under the Constitution—from the other statutory requirements. Dissenting were William Rehnquist, Antonin Scalia, Clarence Thomas, and Byron White. Blackmun, Rehnquist, and White were the only justices who voted on the original Roe v. Wade decision in 1973 who were still on the Supreme Court to rule on this case, and their votes on this case were consistent with their votes on the original decision that legalized abortion. Only Blackmun voted to maintain Roe v. Wade in its entirety.Other related cases include:
- Planned Parenthood of Central Missouri v. Danforth. Planned Parenthood challenged the constitutionality of a Missouri law encompassing parental consent, spousal consent, clinic bookkeeping and allowed abortion methods. Portions of the challenged law were held to be constitutional, others not.
- Planned Parenthood Association of Kansas City v. Ashcroft. Planned Parenthood challenged the constitutionality of a Missouri law encompassing parental consent, clinic record keeping, and hospitalization requirements. Most of the challenged law was held to be constitutional.
- Planned Parenthood v. ACLA. The American Coalition of Life Activists released a flier and "Wanted" posters with complete personal information about doctors who performed abortions. A civil jury and the Ninth Circuit Court of Appeals both found that the materials were indeed "true threats" and not protected speech.
- Gonzales v. Planned Parenthood. Planned Parenthood sued U.S. Attorney General Alberto Gonzales for an injunction against the enforcement of the Partial-Birth Abortion Ban Act of 2003. Planned Parenthood argued the act was unconstitutional because it violated the Fifth Amendment, namely in that it was overly vague, violated women's constitutional right to have access to abortion, and did not include language for exceptions for the health of the mother. Both the district court and the Ninth Circuit Court of Appeals agreed, but that decision was overturned in a 54 ruling by the Supreme Court.
- Ayotte v. Planned Parenthood of Northern New England. Planned Parenthood et al. challenged the constitutionality of a New Hampshire parental notification law related to access to abortion. In Sandra Day O'Connor's final decision before retirement, the Supreme Court sent the case back to lower courts with instructions to seek a remedy short of wholesale invalidation of the statute. New Hampshire ended up repealing the statute via the legislative process.
Other court cases
In 2006, Kansas Attorney General Phill Kline, a Republican, released some sealed patient records obtained from Planned Parenthood to the public. His actions were described as "troubling" by the state Supreme Court, but Planned Parenthood was compelled to turn over the medical records, albeit with more stringent court-mandated privacy safeguards for the patients involved. In 2007 Kline's successor, Paul J. Morrison, a Democrat, notified the clinic that no criminal charges would be filed after a three-year investigation, as "an objective, unbiased and thorough examination" showed no wrongdoing. Morrison stated that he believed Kline had politicized the Attorney General's office. In 2012, a Kansas district attorney found that the practices of the Kansas City-area Planned Parenthood clinic were "within accepted practices in the medical community" and dropped all of the remaining criminal charges. In all, the Planned Parenthood clinic had faced 107 criminal charges from Kline and other Kansas prosecutors, all of which were ultimately dismissed.
In 2006, the Indiana Court of Appeals ruled that Planned Parenthood was not required to turn over its medical records in an investigation of possible child abuse. In 2005, Planned Parenthood Minnesota, North Dakota, and South Dakota was fined for violating a Minnesota state parental consent law.
In 2012, a Texas state court judge, Gary Harger, denied Planned Parenthood request for a temporary restraining order against the State of Texas, concluding that the State may exclude otherwise qualified doctors and clinics from receiving state funding if the doctors or clinics advocate for abortion rights.
Impact
A 2020 study found that closures of Planned Parenthood clinics resulted in increases in the maternal mortality rate: "Planned Parenthood clinic closures negatively impacted all women, increasing mortality by 6%–15% across racial/ethnic groups."A 2016 study found that the exclusion of Planned Parenthood-affiliated clinics from Texas's Medicaid fee-for-service family-planning program was linked to reductions in the provision of contraception and an increase in child-bearing for women who used injectable contraceptives and who were covered by Medicaid.
Debate and opposition
Margaret Sanger and eugenics
In the 1920s, various theories of eugenics were popular among intellectuals in the U.S. In her campaign to promote birth control, Sanger teamed with eugenics organizations such as the American Eugenics Society, although she argued against many of their positions. Scholars describe Sanger as believing that birth control and sterilization should be voluntary, and not based on race. Sanger advocated for "voluntary motherhood"—the right to choose when to be pregnant—for all women, as an important element of women's rights. As part of her efforts to promote birth control, however, Sanger found common cause with proponents of eugenics, believing that she and they both sought to "assist the race toward the elimination of the unfit".Critics of Planned Parenthood often refer to Sanger's connection with supporters of eugenics to discredit the organization by associating it, and birth control, with the more negative modern view of eugenics. Planned Parenthood has responded to this effort directly in a leaflet acknowledging that Sanger agreed with some of her contemporaries who advocated the voluntary hospitalization or sterilization of people with untreatable, disabling, or hereditary conditions, and limits on the immigration of the diseased. The leaflet also states that Planned Parenthood "finds these views objectionable and outmoded" but says that it was compelled to discuss the topic because "anti-family planning activists continue to attack Sanger because she is an easier target" than Planned Parenthood.
Abortion
Planned Parenthood has occupied a central position in the abortion debate in the U.S., and has been among the most prominent targets of the U.S. pro-life movement for decades. Some members of Congress, overwhelmingly Republican, have attempted since the 1980s to end federal funding of the organization, nearly leading to a government shutdown over the issue in 2011. Planned Parenthood has consistently maintained that federal money received by Planned Parenthood is not used to fund abortion services, but pro-life activists have argued that the federal funding frees up other resources that are, in turn, used to provide abortions.Planned Parenthood is the largest single provider of abortions in the U.S., but pro-choice advocates have argued that the organization's family planning services reduce the need for abortions; in the words of Megan Crepeau of the Chicago Tribune, Planned Parenthood could be "characterized as America's largest abortion preventer". Pro-life activists dispute the evidence that greater access to contraceptives reduces abortion frequency.