Introduction
One can't be as close to women's lives as Planned Parenthood is without being keenly aware of the profound gap between the freedom and options women ought to have and the realities women face every day.
When it's all said and done, Planned Parenthood is about narrowing and eventually eliminating that gap. And we're about confronting anti-choice, anti-family planning forces that are determined to widen the gap by erecting one barrier after another.
So, the question we have to ask ourselves every day is, "What do we have to do differently to achieve our goals more quickly and more effectively?"
With that question in mind, our Strategy for Moving Forward presents five key steps critical to our success in the weeks ahead. They're based on my first nine months as the leader of Planned Parenthood and on my years of experience fighting for progressive values in America's heartland. But, most important of all, they are based on the wisdom and experience our organization gains as our network of Planned Parenthood affiliate health centers delivers health care to thousands of people every day.
For nine decades running, Planned Parenthood has played two critical roles in the lives of America's women. We are the leading, most trusted provider of women's health services in the country. And we are a passionate advocate, insisting that women must have all the options they need to protect their health and to make deeply personal decisions about whether and when to have a child.
With millions of supporters behind us, we do more than any other organization in the country to prevent unintended pregnancies and to provide vital reproductive health care and education services. Our affiliate network of more than 860 health centers across the country reaches nearly five million women, men and teens every year with sexual and reproductive health care, education, and information. We conduct more than 900,000 breast exams and nearly 1.2 million cervical cancer screenings annually. We also provide prenatal care, midlife services, birth control, and other services for more than 2.9 million people each year.
The two roles we play — trusted service provider and passionate advocate — go hand in hand.
When we speak in the arena of public policy, we do so with the authority and hard-earned wisdom borne of our on-the-ground experience. And when Planned Parenthood affiliates deliver concrete services to thousands of clients every day, it is done with passion and knowledge of the barriers thrown in the paths of women by those who would limit our options and constrain our freedom.
But what has kept Planned Parenthood so vital isn't just the reach of our organization; it's also our forward-looking vision. We not only know what women's lives are like today, we have a keen understanding of what they will be like tomorrow.
This month, Planned Parenthood is celebrating our 90th year of standing up for America's women. Throughout those nine decades, we have been constant in our principles and constantly alert to changing circumstances and new opportunities.
As Planned Parenthood supporters, we have important work to do in defending choice and expanding the critical services that Planned Parenthood affiliates provide to people every day.We can't shy away from any fight or stand down from any principle. And, especially at pivotal moments like this, we have a responsibility not only to work hard, but to work smart.
I urge you to read A Strategy for Moving Forward with the care and compassion of one of Planned Parenthood's most committed supporters. As you do, I hope you will understand even more fully than you do now the importance of your personal leadership. You give our organization the resources and political strength to act on the ideas laid out in this document.
There has never been a more important time for you to express your leadership by making a generous personal grant to Planned Parenthood Federation of America. Now, let's turn to those five essential steps that I believe can dramatically strengthen our ability to make progress in the weeks and months ahead.
#1: We have to make it clear what we are for, not just what we are against.
There are powerful, broadly supported ideas at the heart of the Planned Parenthood agenda. Protecting women's health. Educating teens. Reducing the number of unintended pregnancies. Groups that stand in opposition to those objectives are the ones that are out of touch with mainstream values.
But years of fighting an aggressive anti-choice movement with powerful allies in every branch of government, including the White House, have resulted in us spending a lot more time telling the American people what we're against than what we're for.
That has to change. Of course we have to stop our opponents' dangerous ideas from going forward and we have to challenge the countless barriers they throw in the path of women seeking to control the most personal decisions of their lives. But we can't let our opposition to the agenda of anti-choice extremists define us — or define people's understanding of our vision.
Too often, we've let the debate over abortion, birth control, and choice be told as the story of what anti-choice extremists are trying to achieve and how we're trying to fend them off. But the real story is what we're working to achieve and how they're trying to stop us.
Planned Parenthood and its affiliates spend our time, energy, and resources providing and protecting a vast array of health care services for women eager to protect their health and take charge of their lives. Our opponents spend every waking hour trying to make it harder for women to exercise their freedom and protect their health.
The great contradiction at the heart of the anti-choice movement is the fact that the same forces who oppose abortion also vigorously oppose expanding access to the services and tools that prevent unintended pregnancy and reduce the need for abortion.
Each year, approximately six million American women become pregnant, and about half of those pregnancies are unintended. Helping women and families prevent unintended pregnancies is a cornerstone of Planned Parenthood's mission. More than 80 percent of Planned Parenthood's clients come to us for contraceptive services. Planned Parenthood provided women with emergency contraception more than a million times last year. All told, it's estimated that contraceptive services provided by Planned Parenthood affiliate health centers prevent 617,000 unintended pregnancies each year.
And there's so much more that could be done if common sense about contraception prevailed in the making of public policy. That's why Planned Parenthood is actively supporting the Prevention First Act, landmark legislation that would reduce the rate of unintended pregnancies in the United States.
This bill would expand access to family planning services: ending insurance discrimination against women; promoting emergency contraception, especially for sexual assault survivors; reducing the rate of teen pregnancy; and ensuring that information about the use of contraception provided as part of any federally funded program is medically accurate.
These are all crucial elements in a strong, affirmative, prevention-based agenda. And common sense would tell you that those who oppose abortion would be working hard to advance dramatic steps like these that could prevent unintended pregnancies.
But the truth is, most anti-choice groups have done nothing but throw one roadblock after another in the way of efforts to prevent unintended pregnancies. For example, between 1990 and 2000, seventy-five percent of the decline in teenage pregnancy was due to improved contraceptive use. But, since 1996, more than one billion dollars of taxpayer money has gone into abstinence-only education, which denies young people access to information about contraception.
Fewer than half of the public schools in the United States now offer information on how to obtain birth control despite the fact that 75 percent of parents support comprehensive, medically accurate sexuality education. Anti-choice groups fought tooth and nail to prevent the Food and Drug Administration (FDA) from granting over-the-counter status to Plan B emergency contraception — even though experts estimate that increased access to and use of EC could prevent up to 1.7 million unintended pregnancies and 800,000 abortions a year.
These facts represent powerful evidence of the ways in which rigid anti-choice, anti-family planning extremists are directly affecting women's lives. But sometimes a persuasive individual story can convey as much as a mound of statistics. Here's an example.
In Lebanon, Pennsylvania, recently, an emergency room doctor refused to give a rape survivor emergency contraception because he said it was against his religion. Turned away by the emergency room doctor, the woman called her gynecologist, who wrote the prescription. Her local pharmacy told her it was out of the drug and referred her to a store in Reading some 25 miles and 45 minutes away.
The former medical director of the hospital said he saw nothing wrong with sending a rape survivor, running a race against time to prevent a possible pregnancy, on a frantic search for the drugs the hospital could have provided. After all, he intoned, "People drive to Reading to buy jeans."
No one hearing that story can come away without understanding the enormous barriers and frustration that women encounter when denied access to reproductive health services. Neither can they come away without a deeper appreciation of the callous disregard for women exhibited by people who construct those barriers.
If anti-choice groups get their way, more women will be refused their prescriptions all across America. Four states already have laws that specifically allow pharmacists to refuse to fill prescriptions — and at least 18 others have considered such laws.
With your help, we'll make sure people understand how much good can be achieved if America acted both to protect access to abortion and to adopt efforts to dramatically reduce our country's rate of unintended pregnancies, which is currently higher than that of any other industrialized nation.
And we'll make it clear that anti-choice extremists and their political sponsors are doing everything in their power to stand in the way of such progress.
#2: We have to play offense, not defense.
The political strategy of right-wing groups is to define the terms of debate and keep us constantly on the defensive. They like to act as if they have the American people on their side and we're the ones swimming against the tide of public opinion. But the truth is, if we take control of the conversation and expose how far they intend to go in restricting access to abortion and undermining common-sense family planning measures, these groups will lose popular support left and right.
Ninety-eight percent of American women use birth control at some point in their lives. Eighty-nine percent of Americans favor more access to information about birth control, and 81 percent think access to birth control is a good way to prevent the need for abortions. But extreme anti-choice groups are determined to paint birth control as evil, just as they've tried to do with abortion. They have attacked the pill and emergency contraception — they've even campaigned against condoms!
A New York Times Magazine cover story earlier this year documented the "Contra-Contraception — War on Contraception" being waged by the same anti-choice forces bent on criminalizing abortion. Judie Brown, president of the anti-choice group American Life League, was quoted in the magazine saying, "The mind-set that invites a couple to use contraception is an antichild mind-set. . . We oppose all forms of contraception."
And just last month, 250 anti-abortion activists from around the nation converged on Rosemont, Illinois, for a conference called "Contraception Is Not the Answer." The Chicago Tribune reported that "experts at the gathering assailed contraception on the grounds that it devalues children, harms relationships between men and women, promotes sexual promiscuity and leads to falling birth rates, among social ills."
Joseph Scheidler, whose Pro-Life Action League sponsored the conference, told the Tribune that "contraception is more the root cause of abortion than anything else."
The growing stridency of the anti-contraception movement has put anti-choice politicians in a bind.
The bottom line is many politicians don't want to say out loud to mainstream Americans what they say to their most intensely anti-choice allies. And we have to expose that contradiction.
We need to go on the offensive, demanding that anti-choice groups and their political sponsors try to explain their most indefensible anti-family planning positions.
Most people in our country don't want to live in a world in which ideology trumps science ... a world where mandated ignorance puts young people's lives at risk ... a world where freedom means the freedom of anti-choice extremists to throw one barrier after another in the path of women seeking to make the most personal decisions of their lives?
The plainer we make it that this is where anti-choice groups want to take us, the sooner we can start to drain away their political support.
#3: We have to speak common sense to
folks in the heartland of our country.
Every day, Planned Parenthood affiliates deliver health care to women all across America's heartland. Our affiliates' network of more than 860 health centers stretches from California to Florida, from Wisconsin to Texas. We're there in the bluest of blue states and the reddest of red ones. And daily experience tells us that women in all of those states have common experiences and shared values.
But when it comes to generating political support, the pro-choice movement has too often dismissed America's heartland as difficult terrain. And there's been a tendency to make broad, unfounded assumptions about the people who live there, where they stand on our issues, and how open they are to our arguments.
We have to recognize and act on two realities. Planned Parenthood and the ideas it represents have broad support all across America. And there is no such thing as a successful pro-choice strategy that writes off whole regions of our nation.
To put it in political terms, Planned Parenthood and the movement we lead need a 50-state strategy. We already work across America's heartland and we need to communicate and organize there, as well. Why? Because that's where anti-choice policies first take root; where they do the deepest and most painful damage; and where, by being successful, we can tear at the very foundation of our opponents' political strength.
We can do that by emphasizing Planned Parenthood's prevention agenda — the far-reaching and effective steps we take to prevent unintended pregnancies. And we can do it by calling people's attention to the fact that anti-choice groups are standing in the way of many of those common-sense steps with devastating consequences.
The price our country pays for not adopting sensible policies to prevent unintended pregnancies is severe. For example, take one shift in the policies surrounding Medicaid coverage for contraception. Imagine if the Government were able to expand the Medicaid coverage for contraception to the levels of pregnancy related care. New research from the Guttmacher Institute suggests that such a shift would result in the prevention of nearly 500,000 unintended pregnancies and 200,000 abortions annually amongst lower income women. That expansion in coverage would not only prevent an estimated 225,000 unwanted births, it would also save $1.5 billion annually in federal and state expenditures.
Preventing unintended pregnancies should be something that draws support from all sides of the political spectrum. When that doesn't happen, the true nature of the anti-choice agenda becomes clear. From the president of the United States on down, anti-choice politicians are fearful of endorsing birth control measures that have wide public support because the dark truth is their extreme anti-choice allies don't support birth control — even though it is used by 98 percent of American women in the course of their lives.
#4: We need a new, better deal between the
pro-choice movement and legislators and policymakers.
There will be times when we will have to call on government officials for extraordinary acts of courage in supporting our work. But there also have to be times when we've done such a good job communicating our message, building a strong foundation of public support for a pro-choice issue, and parrying our opponents' arguments, that there can be no question that standing with us is the right thing to do.
No recent event has better demonstrated the power of a strong partnership between the pro-choice movement and leaders who stand up for our values than our victory in pressuring the Food and Drug Administration to approve over-the-counter access to emergency contraception.
It took 40 months to win — and we still have work to do extending that victory to women under the age of 18. But we achieved success on this critically important issue for only two reasons.
We had leaders in Congress who were willing to go to the wall for us time after time until we prevailed. And, at every turn, those elected officials had Planned Parenthood and the entire pro-choice community making sure that access to emergency contraception was at the forefront of public debate.
Those members of Congress never flinched, never tired of working with us, and never yielded until we achieved our goal. Their dedication and our powerful support proved to be an unbeatable combination. That's the approach we need to take over and over again if we want to advance our agenda.
#5: We have to use the courts not only to protect
our rights, but also to get our ideas across.
Throughout our 90-year history, litigation has always been one of Planned Parenthood's most powerful tools for defending women's rights and overcoming efforts to constrain our freedom. It's still true today.
On November 8, Eve Gartner, a skilled Planned Parenthood litigator, will stand before the U.S. Supreme Court and argue against the federal abortion ban. In the case of Gonzales v. Planned Parenthood, she will urge the court to sustain the essential principle that no abortion restriction can disregard a woman's health or risk a woman's life.
That this case is before the court at all demonstrates the relentless persistence of our adversaries.
It was 11 years ago when anti-choice forces passed the first nationwide abortion ban through Congress. That 1995 measure was vetoed by President Clinton in 1996. The House overrode the veto, but the Senate sustained the president's action, preventing the measure from becoming law.
Twice more during the Clinton administration, Congress passed abortion ban legislation. In 1997, President Clinton again vetoed the ban and, while the House overrode his veto, the Senate once again stopped its enactment. In 2000, an abortion ban passed by Congress died with the end of the congressional session. That same year, the Supreme Court, in a 5-4 decision, struck down a Nebraska abortion ban, which had been modeled on the federal ban.
Still not relenting, in 2003, Congress passed and President Bush signed the first federal law banning abortions, including some as early as 12 to 15 weeks in pregnancy. Suits to block implementation of the federal abortion ban were immediately filed by Planned Parenthood Federation of America, the ACLU, and the Center for Reproductive Rights. In all three cases, the courts have struck down the federal abortion ban because,, among other things, it does not protect women's health.
But still anti-choice extremists persist. Indeed, the last 18 months have seen a significant escalation in their efforts. On the federal level, they threw their support behind Bush Supreme Court nominees John Roberts and Samuel Alito, hoping to add two anti-choice votes to the highest court in the land.
Meanwhile, the abortion ban proponents have dramatically stepped up their activity at the state level. In March, South Dakota Gov. Mike Rounds (R) signed a law criminalizing abortion in that state — a move that led to a spirited campaign to overturn the law, putting the unconstitutional ban on the ballot and allowing South Dakota voters to decide on November 7.
In June, Louisiana Gov. Kathleen Blanco (D) signed into law an abortion ban that would go into effect if the Supreme Court were to overturn Roe v. Wade. In total, 12 other states have considered 19 measures to ban abortion in one way or another in the 2006 legislative session.
As history has taught us, high-profile legal cases are not just opportunities to win courtroom victories. They also offer a broader chance to reach out to the public and deepen support for our cause. Now more than ever, it is absolutely essential that we carry the day not only in the court of law, but also in the court of public opinion. With your help, Planned Parenthood will be following up the November 8 oral arguments in Gonzales v. Planned Parenthood with an extensive effort to educate the public about the principles involved and the critical importance of the Supreme Court in defending reproductive freedom.
The Essential Role We Need You to Play
As always, Planned Parenthood's success in upholding a woman's right to choose, promoting prevention, and ending government interference in our most personal decisions depends on your personal commitment and that of other Planned Parenthood members.
It may not happen overnight. But, with your support, we can fundamentally alter the political landscape when it comes to women's health and reproductive freedom.
With your support, we can move from a world where anti-choice demagogues have the upper hand to one in which pro-choice ideas and principles dominate the American mainstream.
With your support, we can transform America's heartland into a place where a deep commitment to preventing unintended pregnancies thrives — and where efforts to advance anti-choice extremism flounder.
Most important of all, with your support, we can create a world in which barriers standing between women and their freedom are swept away — a world where women, at long last, have access to all the options they need to protect their health and take care of their lives.
It won't be easy to get there, but such a world is within our reach if we have the imagination and tenacity to seize it.
