Shefali Luthra: Planned Parenthood tries to revise its image

— Photo by S. MiRK

From Kaiser Health News

PROVIDENCE

The Trump administration is pushing ahead with its reproductive health agenda. It has rolled out changes to the Title X program, which funds family planning services for low-income people, that are designed to have a chilling effect on organizations that provide abortions or include this option in counseling. It also has nominated federal judges widely believed to support state-level abortion restrictions. (See visit to Providence clinic below.)

Against that backdrop, Planned Parenthood, known as a staunch defender of abortion rights, is working to recast its public image. Under its president, Dr. Leana Wen, who took office in November, the nation’s largest reproductive health provider is highlighting the breadth of care it provides — treating depression, screening for cancer and diabetes, and taking on complex health problems like soaring maternal mortality rates.

This strategy, analysts say, could buttress Planned Parenthood against the efforts by the White House and other abortion opponents. But it’s complicated. Even as the organization leans into its community health work, Wen isn’t abandoning the abortion-related services that have helped form the organization’s identity — and its opposition.

“We cannot separate out one of our services. That’s not how medicine works,” Wen told Kaiser Health News.

This effort to thread the needle could, if successful, change the public’s perception of Planned Parenthood. But if it backfires, it could make the organization even more vulnerable. Some people are skeptical of the payoff, given how polarizing abortion politics are.

“The minute you start talking about abortion, it’s a risky strategy,” said Karen O’Connor, a political scientist at American University who studies the politics of reproductive health care. It’s likely to attract strong reactions from people who see abortion providers not as reproductive health professionals but as “baby killers,” she said.

“If I was doing it — and this is as somebody who studies social movements and women’s organizations — I would take abortion out of the equation and talk about ‘reproductive health is health care.’”

Already, the new strategy is drawing fire from abortion opponents, who dismiss Planned Parenthood’s positioning as a frontline community health provider.

“This framing is simply a PR exercise,” said Mallory Quigley, vice president of communications at the Susan B. Anthony List, a Washington-based anti-abortion group. “I don’t think this campaign will be successful, and I don’t think it will last long.”

Reproductive health experts have a different view, saying Planned Parenthood’s effort to promote its array of health care offerings — including abortion — is consistent with reality and in line with top medical standards. To bolster this message, Wen, a former Baltimore health commissioner and the first physician to take the group’s helm, has embarked on a national listening tour.

“It’s who we are. We are a health care organization,” Wen said. “That’s what all of our affiliates do around the country, is meeting people where they are with the health services they need.”

So far, Wen and other Planned Parenthood officials have visited 17 affiliates in locations around the country. They plan to visit several more, Wen’s staff confirmed.

The idea is not to standardize what Planned Parenthood sites offer, Wen said, arguing that each clinic should take the lead in devising its own public health programs, based on its patients. Even so, the organization’s national leadership is working to identify the health programs that could be expanded and encouraging clinics around the country to consider implementing those best practices.

Recently, Wen and her team visited the organization’s Rhode Island clinic to investigate how it is planning to expand its primary-care offerings.

The clinic, a 10-minute walk from downtown Providence, serves patients of all genders and ages, its staff noted. It has upped its focus on things like wellness visits, along with its programs to make sure patients who want to have children are healthy before they get pregnant.

Wen also focused on the clinic’s efforts to reduce the area’s maternal mortality rates, a problem that afflicts low-income and black women at far greater rates. In 2018, 18.3 Rhode Island women per 100,000 births died from causes related to the pregnancy; for black women, the figure was 47.2 per 100,000, and for white women, 18.1. Planned Parenthood leadership touted proposed state legislation that would extend Medicaid coverage to doulas, non-medical birth coaches often seen as a valuable resource in reducing maternal deaths.

Wen tours a lab in the basement of a San Jose, Calif., clinic that processes tests for gonorrhea and chlamydia. “When I was in college, we did all the pipetting manually,” she told the staff.(ANNA MARIA BARRY-JESTER)

At a Planned Parenthood Mar Monte clinic in San Jose, Calif., staff members highlighted the facility’s mental health services — keeping behavioral health professionals in the building to help patients transition seamlessly into care — and its in-house testing center for sexually transmitted infections.

At both clinics, staffers talked about helping patients who face a threat of domestic violence find safe housing resources, and steering them toward available resources for things like healthy food.

Even while promoting that work — often overlooked by the public — Wen, a 36-year-old emergency doctor by training, emphasizes abortion services at each stop, trying to weave the message into the public health narrative.

In Providence, the Planned Parenthood team stopped by a news conference to talk about a local bill that, if the Supreme Court scales back Roe v. Wade, would explicitly legalize abortion protections in Rhode Island.

“Abortion is part of the spectrum of full reproductive health care, and we know reproductive health care is health care,” Wen said to applause. “And health care is a human right.”

But it’s unclear how the listening tour and messaging efforts will pan out politically. While a majority of Americans have positive opinions of Planned Parenthood, they are, polling suggests, evenly split on abortion.

“Planned Parenthood to some extent is taking a risky strategy by trying to thread these two. I see these as very different messages,” said O’Connor, the political scientist. “If you take out the ‘abortion is’ and go to reproductive health, you have a winning message that is very simple.”

In other ways, though, this branding effort perhaps comes at the right time, suggested Lucinda Finley, a law professor at the University at Buffalo. She ties the organization to what polling suggests is voters’ No. 1 concern, especially going into the 2020 election: health care.

Framing it as “‘Abortion is health care, health care is a human right’ links it to the larger debate about health care, and how we should provide health care to people in this country,” Finley said.

When asked if this messaging could politically insulate Planned Parenthood from conservative attacks — or win the organization new supporters — Wen suggested the community health emphasis is simply a response to medical needs.

“I don’t want people to think we are doing this because it’s politically the right thing to do,” she said. “It’s the right thing to do because that’s what our patients are requesting.”

Shefali Luthra: ShefaliL@kff.org, @Shefalil

Don Pesci: Connecticut's confused moralists

Lincoln quoting Jefferson: “I tremble for my country when I remember that God is just!'’

During his political career, which spans four decades, Connecticut U.S. Sen. Dick Blumenthal has been storming moral mounts and shaking his fists at the gods. At some point, the gods of Western morality may respond.

Blumenthal’s reaction to American Nazis in Charlottesville was commendable and necessary; in any denunciation of Nazism, there must be no ambiguity – no moral confusion. There are indeed degrees of evil in the world. The bank robber who murders a teller commits a greater evil than the bank robber who simply robs a bank.

However, using the greater evil to excuse the lesser cannot be defended on moral grounds. The Antifa movement, like the American Nazi movement and the KKK, uses violence as a means of moral suasion. The Nazis and the members of the KKK who hijacked a protest over an attempt to remove a statute of Robert E. Lee from a park in Charlottesville should have been unreservedly condemned for who they are by all people whose moral sense is not impaired by political considerations.

These two groups have been with us a long time; we know them, and we should not pretend to forget or forgive the unrepented sins of their dark past. Both groups have bathed in blood up to their knees. The anti-black, anti-Semite, anti-Catholic KKK used to hang or terrorize its victims; these days, they are content to defame and rouse public opinion against them. German Nazis persecuted and murdered Jews; these days, American Nazis accuse Jews, who they falsely believe are animated by anti-patriotic globalist pretensions, of capitalist greed.  The shadow of Buchenwald falls over all of this, and although David Duke is not Himmler – because there are differences in moral degrees of evil -- the seeds of the greater evil are sown in the ground of the lesser evil.

The Antifa movement – so called anti-fascists who have adopted the Stormtrooper tactics of Fascists -- should be roundly denounced for who they are by those who regularly storm moral mounts and shake their fists at the gods whenever television cameras are rolling. The Antifa movement has long been infiltrated by anarchists; in the anarchist dystopia, such senators as Blumenthal would be unnecessary excrescences.

Even for those who agree there is a moral order of greater and lesser evils, Blumenthal’s too ardent support of the more indefensible practices of Planned Parenthood is difficult to justify on moral grounds. Blumenthal's position on late term abortions, Orthodox Jews would say, is morally indefensible. Even a Reform Jew like Blumenthal may be uncomfortable with the killing of nearly born babies and the selling of their body parts to doctors, a process, some may think, that comes uncomfortably close to morally noxious Nazi practices?

The moral position on abortion – most especially partial birth abortion -- of 3rd District Congresswoman Rosa DeLauro also is confusing, which is why, she laments in her recent book, “The Least Among Us: Waging the Battle for the Vulnerable,”  her bishop removed her as a trustee of her Catholic High School.  Scandal in the Catholic Church is synonymous with sowing moral discord in the minds of Catholics. And Catholics who are public figures, so long as they remain in the faith, have a moral duty to maintain Catholic religious convictions in a morally confused universe. If they break with their Church on important matters of doctrine, a devil word in the modern period, they cannot maintain communion with the believing church, lay or clerical.

Of course, DeLauro has little use for bishops and little understanding of the historic opposition of her Church to the grave sin of abortion. She believes as a professing Catholic -- “My faith has always been important to me…” – that abortion has, within her Church, completely taken over “the conversation on faith in politics.” And she is inching toward a wholly indefensible moral position that important moral issues should be decided by the state, not bishops or rabbis.

DeLauro seems unaware that Catholic opposition to abortion and infanticide during Imperial Rome was the lever that freed women from a crushing paternalism in which the paterfamilias of a Roman family exercised complete dominion over the life and death of his unborn and born children. Abortion, infanticide and euthanasia, not uncommon in the Roman Empire, are becoming more common in the Western world as Christian perceptions are replaced by a morally neutral secularism, both in Europe and America.

The modern notion of human equality, unknown in the Roman Republic, descends from Biblical doctrine: “There is neither Jew nor Gentile, neither slave nor free, nor is there male and female, for you are all one in Christ Jesus (Galatians 3:28).” And the highly romantic notion of the love of children also has its roots in Christian faith, “But Jesus said, suffer little children, and forbid them not, to come unto me: for of such is the kingdom of heaven (Matthew 19:14).”

In Heaven, one hopes, abortion is frowned upon, as it is among bishops in DeLauro’s church. There, one hopes, Nazism, Klu-Kluxery, Antifa fascism and anarchism will not gain a foothold. Here below, the usual strife continues. Flawed moralists continue to belch fire from their secular pulpits. Medical practitioners, unbound by the Hippocratic oath – noxamvero et maleficium propulsabo: “I will utterly reject harm and mischief”— perform partial birth abortions, after which dismembered baby parts are auctioned off, while politicians, wrapping themselves in moral mantels, wink behind the curtain.

Not a church going man, Abraham Lincoln, quoted from Thomas Jefferson, not a church going man, in his Columbus, Ohio, debate with Steven Douglas: “… there was once in this country a man by the name of Thomas Jefferson, supposed to be a Democrat -- a man whose principles and policy are not very prevalent amongst Democrats today, it is true; but that man did not take exactly this view of the insignificance of the element of slavery which our friend Judge Douglas does. In contemplation of this thing, we all know he was led to exclaim, 'I tremble for my country when I remember that God is just!' …  He supposed there was a question of God's eternal justice wrapped up in the enslaving of any race of men, or any man, and that those who did so braved the arm of Jehovah -- that when a nation thus dared the Almighty every friend of that nation had cause to dread His wrath. Choose ye between Jefferson and Douglas as to what is the true view of this element among us.”

Lincoln’s audience applauded this sentiment of a frail man leaning for support upon the crutch of an eternal truth. How often, we should ask, do the political heirs of Lincoln and Jefferson tremble when they consider that God is just?

Don Pesci is a Vernon, Conn.-based essayist.