Politics

Why Did Planned Parenthood Halt Abortions in Oklahoma Before the Ban Went Into Effect?

It’s complicated.

Facade of Planned Parenthood of Central Oklahoma building
The organization’s motto is “Care. No matter what.” AP Photo/Sue Ogrocki

Last week, Oklahoma became the first state since 1973, when Roe v. Wade was decided, to ban all abortions from the moment an egg is fertilized, except in life-threatening medical emergencies and cases of rape or incest that have been reported to law enforcement.

But neither of Oklahoma’s two Planned Parenthood locations—which make up half of the abortion clinics in the state—have provided abortion care since April.

There was no legal reason for this decision. Oklahoma’s other two clinics continued providing abortion medication and in-clinic procedures, even after a previous ban from May made abortions illegal after about six weeks. (The state passed both bans within the same month.) According to Planned Parenthood, the organization stopped providing abortions at its Oklahoma locations because of logistical challenges and decision-making at the local level. But the nonprofit did not dispute that it had ended abortion services before the law required it to do so.

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Planned Parenthood, as a national organization, walks a delicate line.

It is both the largest provider of reproductive health care in the country, with clinics scattered throughout the U.S., and the most prominent face of the abortion rights movement. Its motto is “Care. No matter what.” (“Make your tax-deductible gift today so we can continue to protect and provide care, no matter what,” its website says.) And as one of the biggest charitable organizations in the U.S., Planned Parenthood brings in hundreds of millions of dollars each year from private donors, in addition to revenue from its medical services.

But the health care nonprofit has been criticized by abortion rights advocates for its relatively conservative response to this moment of crisis in reproductive rights.

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Though Planned Parenthood has been institutionally involved in legal challenges to the abortion bans being passed in states around the country, including in Texas and Oklahoma, several of its health centers in Texas and Oklahoma have voluntarily ceased abortion services—even when abortion remained legal.

The affiliate that runs two such health centers, Planned Parenthood South Texas, resumed abortion care several weeks after stopping it last September. Jeffrey Hons, the head of the affiliate, defended his initial decision, calling Planned Parenthood “a risk-averse organization” that couldn’t take the chance of being sued by anti-abortion activists. (The current Texas and Oklahoma bans are enforced through the threat of lawsuits from private citizens, who can sue anyone suspected of performing or “abetting” an abortion for at least $10,000, plus attorneys’ fees.)

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Since his clinics serve tens of thousands of patients who need non-abortion health care, Hons said, he needed to be cautious to ensure the locations could remain open.

[Read more about abortion restriction in Texas—and how it is messing up pharmacies.]

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The Oklahoma clinics’ reasoning was a bit different. The locations that stopped providing legal abortions in Oklahoma are operated by Planned Parenthood Great Plains, an affiliate that also runs clinics in Arkansas, Kansas, and Missouri. Its president and CEO, Emily Wales, said in a press call in May that the clinics had paused abortion care to allow managers “to meet together and talk to our teams” about what a six-week ban would mean for them—and “what it means to be sued by any person who wants to pursue a case against you for providing care.”

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Yes, any individual employee can be sued. It’s not just the parent organization taking the risk.

The locations did eventually get buy-in from staff members to continue providing abortions up to six weeks, Wales said. But by the time they made the decision and prepared to start again, the Oklahoma legislature had passed the total ban. So they never resumed abortion care. [Update, June 2, 2022, at 5:51 p.m.: They did continue to refer patients to other clinics where they could be served, in addition to providing gas cards and connecting them to other sources of financial support.]

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To be clear, the Oklahoma Planned Parenthood locations are dealing with immense logistical challenges. The one in Oklahoma City employed part-time physicians who flew in from out of state; it was hard to say exactly when or if abortion care would become illegal, since the legislature was working on multiple bans at once; and the clinic didn’t want to put patients on the schedule two weeks in advance, only to have to cancel and force those patients to scramble to find care elsewhere in the country if the law suddenly went into effect. (Oklahoma also imposes a 72-hour waiting period between an abortion patient’s first consult and her appointment for pills or a procedure, which poses additional scheduling challenges when a ban may begin at any moment.)

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But, to take Wales at her word, timing and logistics were not the main concerns. It was the specter of baseless lawsuits that kept Oklahoma patients from getting abortions at Planned Parenthood in the last weeks before the era of legal abortion ended in the state.

What the Indie Clinics Did Instead

The approach Planned Parenthood took in Oklahoma seems excessively cautious. The Texas ban has already been in effect for several months, and the frivolous, expensive lawsuits from overzealous civilians that abortion rights advocates dreaded have never materialized.

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Even if they had, Planned Parenthood almost certainly would have beaten them in court if they’d stuck to offering legal abortions (in this case, for patients whose ultrasounds showed no fetal cardiac activity). Whatever legal expenses employees incurred could have easily been covered by the billion-dollar organization (though, of course, hypothetical lawsuits would still demand time, energy, and emotional strain from sued employees, whether or not they received financial support).

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Certainly, Oklahoma’s two remaining abortion providers, which are independently run, were no better equipped to defend themselves against ill-founded lawsuits. But the Tulsa Women’s Clinic continued to provide abortions in the first six weeks of pregnancy, until the legislature passed the full ban. And Trust Women, the other abortion clinic in Oklahoma City, kept providing abortions except for a few weeks in April, at a time when administrators feared that a hastily passed ban could take effect in the middle of a patient’s procedure.

Zack Gingrich-Gaylord, the communications director at Trust Women, said he did not take issue with Planned Parenthood’s strategy. “It’s very difficult for me to question their decision-making in that, because I know how much goes into even getting to the point of providing care in this area, and all the things that derail it at any moment,” he said. “Even a frivolous lawsuit—I know, for us, that would be a very big drain on our resources.”

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When I pointed out that Planned Parenthood may be the one network of abortion providers in the country that actually has the resources to fight such suits and remain solvent, Gingrich-Gaylord laughed. “I mean, that’s—yeah, they definitely have more resources than we do.”

It’s hard to say how many abortions Planned Parenthood’s two Oklahoma locations could have provided in the final weeks before the total ban began. In Texas, providers have been stunned by how many patients are catching their pregnancies early and making it into clinics before the six-week mark. When I visited a Houston abortion clinic in April, a nurse told me that Texans “are peeing on sticks every day” to see if they’re pregnant, terrified of being too late to get an abortion in their home state.

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According to Gingrich-Gaylord, the landscape looked different in Oklahoma. People traveling from Texas had made up more than half of the Oklahoma patient load in the months after the Texas ban took effect; they stopped coming once Oklahoma passed its own six-week ban. That new ban took effect the day after Justice Sam Alito’s leaked draft opinion overruling Roe v. Wade was published, creating “a perception that it was all over in Oklahoma,” Gingrich-Gaylord said. Patients were unsure if abortion was still legal, so barely any called the Trust Women clinic seeking care.

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Tulsa Women’s Clinic, the other independent provider in Oklahoma, tells a different story. Executive administrator Andrea Gallegos said the clinic didn’t see a decrease in calls after the Oklahoma six-week ban began, and some patients who called weren’t even aware of the new law. The clinic continued to treat patients who made it in before the six-week mark.

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Gallegos expressed appreciation for Planned Parenthood’s breadth of services and advocacy for abortion access, but said it can be frustrating to watch the organization dominate fundraising for reproductive health care even as it quietly backs away at a critical moment. “Sometimes as an indie clinic, it does feel like, OK, but we’re still providing these services, and you guys aren’t,” Gallegos said. “We definitely need Planned Parenthood. But private clinics, smaller clinics, are kind of overlooked in what we do and what we continue to do throughout these restrictions.”

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Indeed, it makes Planned Parenthood’s motto of “care, no matter what” seem like it has a giant asterisk tacked on the end—the fierce, resolute rhetoric ringing somewhat hollow. “While we are dismayed by today’s news, we will not stop fighting back,” said Alexis McGill Johnson, Planned Parenthood’s president and CEO, when Oklahoma’s six-week ban took effect. “To the patients who turn to Oklahoma’s abortion providers: we will not stop fighting for you. Planned Parenthood will do everything in our power to ensure that all people can access care, no matter what it takes.”

What Happens Next

After Roe v. Wade is overturned, a lot of people will be forced to consider what their values are, how essential they consider reproductive health care to be, and what they’re willing to do to help mitigate the damage of this assault on women’s lives. Not everyone will land in the same place; it’s easy to imagine, for instance, that a Planned Parenthood CEO and a clinic ultrasound technician might be comfortable with different levels of risk.

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But care providers should be having these conversations now. Wales said her Oklahoma clinics paused abortion care to allow time to “regroup as a team” and launch “a collaborative effort where our team feels safe and ready to provide.” This came after advocates had spent weeks watching the six-week ban trickle through the state legislature, and after months of observing how an identical ban played out in Texas. Why wasn’t a plan already in place?

[Read: There’s Already a Revolution in Abortions Happening—and the Supreme Court Can’t Touch It]

Between clinics, the disparities in risk tolerance and ability to pivot are even more pronounced. In Texas, there was a brief two-day period in October when a judge had blocked enforcement of the six-week ban. In those two days, a handful of Texas clinics resumed care for patients who were more than six weeks pregnant, then stopped again when the block was lifted.

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How many patients might they have served who otherwise wouldn’t have been able to get an abortion?

The decision to provide or cease services in a moment of crisis is a statement of values, a measure of an organization’s commitment to a stated mission. And the abortion ban is just the beginning of what’s almost certainly to come in Oklahoma: The ban explicitly excludes morning-after pills and birth control, but a law that dubs a fertilized egg an “unborn child” could easily pave the way for an end to contraception. What would Planned Parenthood health centers do in the weeks before a birth control ban took effect? If Oklahoma begins considering limits on adults’ access to trans health care, as Republican-led legislatures have begun to do, will Planned Parenthood continue to offer still-legal care to the trans people who rely on its clinics for hormone treatment?

When I spoke to Gingrich-Gaylord of the Trust Women clinic, he told me he’d just had a conversation with a colleague about living through this turning point in abortion rights. “We were just kind of being amazed that, like, oh, wait, we are the grown-ups in this historical moment,” he said. It is terrible and wrong that already-beleaguered abortion providers in already-hostile states should have to take on additional risks and logistical strain as they watch the infrastructure of reproductive health care crumble. But patients are counting on them, now more than ever, to refrain from accelerating its demise.

For an in depth look at the fight for abortion rights, listen to the new season of Slow Burn: Roe v. Wade.

Read more of Slate’s coverage on abortion rights here.

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