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Dr Shelly Tien, who traveled across state lines to provide abortions pre-Dobbs, is seen performing an abortion at Planned Parenthood in Birmingham, Alabama.
When people living in the Upper Midwest lose their right to have an abortion, where will they go?
They’ll go to Minnesota, of course, where abortion is legal and will likely remain so for the foreseeable future, thanks to a 1995 ruling that codified access to abortion in the state’s constitution.
Abortions were nearly impossible to access in North Dakota and South Dakota before the U.S. Supreme Court’s recent decision to overturn Roe v. Wade. But now, they are entirely banned in both states, thanks to trigger laws that were on the books in anticipation of this decision.
Planned Parenthood simply cannot afford to lose any more staffers to “burn out and exhaustion,” given the expected influx of patients seeking abortions in Minnesota.
The reproductive health care landscape isn’t much better in Wisconsin, where abortions have also halted in the aftermath of the recent Dobbs v. Jackson Women’s Health Organization ruling, as an anti-abortion law from the nineteenth century was reinstated and is casting doubt on the future of abortion access in the state.
Abortions remain legal in Iowa for now, but that could change quickly. As Lina-Maria Murillo, assistant professor of gender, women’s, and sexuality studies at the University of Iowa, noted in a recent public radio interview, there is a twenty-four-hour waiting period for abortions in Iowa right now that will “likely turn into an all-out ban.”
As a result, many more patients in need of an abortion will likely be headed to Minnesota. It’s good that Minnesota will continue to be a refuge in this way, but this situation also raises some important questions. For instance, when these patients arrive, who will take care of their medical needs?
Currently, a key source of reproductive health care in the Upper Midwest comes from Planned Parenthood North Central States (PPNCS), an affiliate of the national Planned Parenthood organization.
Each year, approximately 100,000 people seek comprehensive health care services—including abortion—from this group, which operates twenty-eight clinics in Minnesota, Iowa, North Dakota, South Dakota, and Nebraska.
More than 400 front-line health care staffers work for PPNCS. Before Roe was overturned, these essential health care workers were struggling to keep up with their workload and lacked adequate resources. Now, their situation has become even more dire.
PPNCS workers began a unionization drive in 2021—months before U.S. Supreme Court Justice Samuel Alito’s draft opinion on Dobbs was leaked to the press as a precursor to the June 24 decision that eliminated the federal right to abortion.
On May 26, PPNCS rank-and-file members held a virtual press conference to describe not only their successful push for unionization, with more than 60 percent of workers voting in favor of joining SEIU Healthcare of Minnesota and Iowa, but also the challenging working conditions that compelled them to organize. (The National Labor Relations Board will do a final vote count on July 21.)
Journalist Mike Kuhlenbeck covered this for The Progressive in a piece published on June 18, just six days before Roe was overturned. Kuhlenbeck reported that the union drive among PPNCS staffers was a slow and steady one, built on grassroots tactics such as door knocking and word of mouth.
Nurses and other front-line PPNCS employees began sharing stories of being so understaffed that they couldn’t take lunch breaks or adequately meet patients’ needs. At clinics that operate with bare bones staffing numbers, many patients have been forced to delay or reschedule their health care appointments, as Kuhlenbeck points out.
Sadie Brewer is a nurse at a Planned Parenthood clinic in St. Paul. At a May 26 PPNCS press conference covered by the Union Advocate, an AFL-CIO newspaper based in St. Paul, Brewer voiced concerns about the pending Dobbs decision.
Many of her coworkers were already feeling “overworked, underpaid, and undervalued” before SCOTUS voted to overturn Roe, Brewer stated. Planned Parenthood simply cannot afford to lose any more staffers to “burn out and exhaustion,” she said, given the expected influx of patients seeking abortions in Minnesota.
Additionally, there are not very many reproductive health care facilities in Minnesota. In fact, there are only eight of them, and most are clustered in the Twin Cities metropolitan area.
Local abortion rights activists have described the challenges this posed even before Dobbs, when Minnesota residents often needed to head out of state themselves rather than wait weeks for an abortion appointment to become available.
There is also a host of abortion restrictions on the books that have been implemented in Minnesota over the past fifty years, including a mandated twenty-four-hour waiting period (similar to Iowa’s) that can further delay patients who are in need of an abortion.
Whether or not they’re aware of it, Minnesota taxpayers support a Positive Alternatives program that sends more than $3 million in state funds to so-called crisis pregnancy centers, which work to dissuade patients from seeking abortions.
These issues point to the lack of actual unrestricted access to abortion that exists even in emerging sanctuary states like Minnesota. Hopefully, PPNCS clinic staffers’ push to unionize will be one step toward protecting not only abortion rights but also the rights of those tasked with carrying out this essential health care service.