Working at a Planned Parenthood health center is difficult in the best of times. Grace, whose last name is omitted to protect her identity, is a float nurse in Minnesota, meaning she fills in as needed across several clinics, providing a variety of services, ranging from family planning to abortion care. “Across the board, no matter which clinic we’re at, it’s always busy,” she says.
The workers have put up with the hustle and understaffing, not to mention harassment by anti-abortion activists, because they care about the patients. Grace finished nursing school during the pandemic, when nurses were in high demand. Planned Parenthood was where she wanted to be. “Being able to have my first nursing job in a place that fights for reproductive justice is like a soul match,” she says.
But passion for the job doesn’t mean the workers overlook the fact that things could be improved. That’s why Grace and her colleagues publicly announced their union drive with SEIU Healthcare Minnesota & Iowa on May 26.
With the long-threatened repeal of Roe v. Wade becoming a reality, the weight that reproductive health and justice workers like Grace carry is only increasing. Already, abortion clinics—and the network of organizations that support them and those who use them—were under terrific amounts of stress, performing delicate procedures, and shepherding patients through an array of emotions under conditions deliberately made more difficult by legislators and anti-abortion protesters. Now they face a future in which the only thing certain is that their jobs will get even harder.
“We’ve always needed a voice in a union, but especially now,” Grace says. “We are planning to ramp up our services, especially in Minnesota. Oftentimes, there are decisions made by a small group of people at the top, and they don’t really know how those decisions look in action. We would like to be heard about the decisions that affect us, and ultimately our patients.”
But Planned Parenthood North Central States (PPNCS), the affiliate for which Grace and her colleagues work, didn’t voluntarily recognize the union, meaning that while preparing for Roe to fall, they were also gearing up for a National Labor Relations Board election. While Grace is certain they’ll win, the situation is nevertheless frustrating: “At the end of the day, we’re on the same side as the executive team, it’s just that they’re an executive team.” [Editor's Note: PPNCS workers voted to form a union in July.]
“Abortion services are already spread thin,” she adds. “We’re already cutting hours and days that we’re offering it, because we don’t have the staff. The staff are being burned out at unprecedented rates, and the things that are happening in the clinics aren’t sustainable.”
The North Central workers are not the first to push for a union. In 2020, before COVID-19 hit, I spoke with Ashley Brink, a former clinic staffer at Planned Parenthood of the Rocky Mountains (PPRM), about her union drive, and included her story in my book, Work Won’t Love You Back: How Devotion to Our Jobs Keeps Us Exploited, Exhausted, and Alone. The decision to close several clinics run by an affiliate in Wyoming made her and her co-workers get serious about organizing. Health center workers hadn’t been consulted, she told me, yet they were the ones counseling patients in tears over the loss of their provider.
In response, PPRM hired an anti-union law firm and employed the same union-busting tactics recently made famous by Amazon—captive audience meetings and the like—as well as a technique particularly effective for nonprofit and care workers: They claimed, Brink said at the time, that if the workers unionized, patient care would suffer. The pitting of staff against their patients is a common anti-union tactic, though perhaps not as well-documented as captive audience meetings. But for a new generation of reproductive rights workers who grew up with labor struggles, this tactic is no longer effective. “Economic justice is not a separate issue from reproductive justice. Labor rights are just as much in line with reproductive justice and feminist values,” Brink said.
“Economic justice is not a separate issue from reproductive justice. Labor rights are just as much in line with reproductive justice and feminist values.”
In an editorial in the labor publication Strikewave, employees at the Guttmacher Institute, a reproductive rights policy advocacy organization, laid out the case for their union: “Despite numerous attempts to foster necessary change through the usual channels, longstanding workplace issues remained: hostile, toxic behaviors; murky promotion criteria; inequitable compensation. Worse was being shamed, ignored, and punished by senior leadership for trying to address these issues.”
On July 12, Guttmacher employees voted overwhelmingly in favor of unionizing.
It shouldn’t be surprising that at this critical moment for abortion access, staffers at these organizations would want union protections. The challenge now for abortion providers and supporters is: How do we work sustainably through the crisis?
A recent story in The Intercept, by Ryan Grim, laid out the conflict at Guttmacher without noting, until the last sentences of the article, that workers were in the middle of unionizing. The article’s framing was unsurprising—most of Grim’s interviewees were managers at Washington, D.C., nonprofits, and many of them explicitly pitted the staff at those organizations against the recipients of their services or other beneficiaries. The reason these organizations are losing battles, even with a Democrat in the White House, the article implied, is that their staff members are simply too woke for their own good.
But, to borrow and turn a phrase from the Chicago Teachers Union, workers like Grace and Brink know that their working conditions are their patients’ health care conditions. Underpaid, overworked staff working fourteen-hour days do not give the kind of care that Planned Parenthood’s patients deserve.
Turnover is the main issue at many of these organizations, and it can be significantly ameliorated with some basic protections for staffing and work time. Yet there’s a passion-project culture at these organizations that encourages workers like Grace to put themselves last. In Minnesota, which is neighbored by states with either pre-Roe bans still on the books or so-called trigger laws that banned abortion upon Roe’s reversal, the clinics are preparing to ramp up services. But they cannot do that while understaffed and desperately trying to train new people to replace those that they are losing.
Ellen Bravo, a longtime labor organizer and campaigner for paid family and sick leave, told me not long ago, “I hate when people talk about ‘tireless’ activists. No, we get tired and we rest. If we’re doing it right, that’s what we do because there are enough of us. One of my mottos was, ‘We’re all special and none of us are indispensable.’ That’s the only way you can really build a lasting movement.”
During the early years of 9to5, an organization of women office workers, Bravo noted, “it was really important to be living our values,” which meant giving fully paid family leave at a time—the 1980s—when that was nearly unheard of. More than just creating a sustainable culture for paid staff, she said, this attitude also ensured that the movement was welcoming to women activists who didn’t have a lot of time or money to give, but wanted to help in whatever way they could.
As Brink said, abortion is not separate from so-called bread-and-butter issues, and the movement for workers’ and reproductive rights should be far closer than they are. Our tendency for silo organizing also leads to a habit of seeing intersections as threats. But as Asha Banerjee, an analyst at the Economic Policy Institute writes, “Women’s economic lives, livelihoods, and mobility are at the heart of the reasoning to overrule Roe.” Research, Banerjee notes, shows the deep interconnection of our economic and reproductive lives: “Some of the economic consequences of being denied an abortion include a higher chance of being in poverty even four years after; a lower likelihood of being employed full time; and an increase in unpaid debts and financial distress lasting years.”
The conservative movement has spent decades building to the point of overturning Roe. In that time, progressive groups and abortion providers have been building, too. Of course, they have had more to build: The right, which only wants, in this instance, to tear down, to block, and to ban, can focus entirely on that mission, while those of us who support reproductive rights must divide our attention between the legislative struggle and direct provision, care, and funding. Workers like Grace and Brink have been at the center of that battle, walking through shouting protesters simply to go to work every day, schooling their faces into smiles or straight lines, depending on what is called for at that moment, and putting their bodies on the line for all of us.
It is not too much to ask for them to be paid decently, and to have a say in the conditions of their labor. It is not too much to ask for us to trust them to know how to do their jobs. After all, we already trust them with so much. ◆