It's All About Abortion! Douthat's Misguided Attempts to Attack Planned Parenthood

Is there anything, at this point, that can explain Ross Douthat's hubris in attacking a health care provider that offers care to millions of low-income Americans, as health care becomes more a privilege than a right for all Americans?

His latest column reveals he enjoys making baseless claims to support his belief system. Douthat, like many anti-choice movement members, wants to strip women (and men) of a certain income level of this country of reproductive and sexual health care because he doesn't like that some providers offer comprehensive, legal medical procedures with which he doesn’t agree. Douthat is opposed to legal abortion, so he painstakingly plays off of a Family Research Council fabricated controversy over Planned Parenthood - the provider nationwide that happens to represent one of the few options remaining for women (and men!) of a certain income level who need (no, not want) critical health care like contraception, family planning, sexually transmitted infection testing and treatment, HIV testing, annual exams, Pap smears, and more. 

Even William Saletan acknowledged what Douthat's "campaign" is really about -  abortion. Saletan goes so far as to call Planned Parenthood the most "effective pro-life organization in the history of the world."

But the Family Research Council (FRC) isn't buying it. They claim, via an email today, that Planned Parenthood is "awash" in funds and that if Planned Parenthood truly wanted to decrease the number of abortions, rather than providing birth control, contraception and family planning (you know, those things proven to actually prevent pregnancy and STIs), they should just "stop providing them."  Because, you know, if Planned Parenthood stopped providing abortions, unintended pregnancy would magically disappear.

Douthat's post is truly as painful to read (in its lack of common sense and evidence-based reasoning) as the FRC email. As we engage in a nationwide discussion on the absolutely horrifying state of our health care system - one in which millions of Americans are forced to go without care, including reproductive and sexual health care, in part because health care providers can no longer afford to treat those who require Medicaid subsidies or to provide care on a sliding scale basis, Douthat and the FRC want to refocus Americans' attention on dismantling an organization that does provide such care. Planned Parenthood steps in, with the aid of tax dollars (and where else would Douthat like to see “his” tax dollars go in order to ensure health care for the millions of Americans who need STI prevention services, HIV testing, contraception, family planning, annual exams, Pap smears and more?) in order to provide these services. Yes, they also provide abortions. And, yes, Douthat and others do not like abortion. But, here’s the thing:

• Planned Parenthood must (by federal law) keep their abortion services separate from their other services. The funding they receive to ensure that millions of Americans are given access to critical reproductive and sexual health care services must be funneled to those services. Federal law dictates that taxpayer money cannot pay for abortions. If Douthat has evidence that the organization is behaving in a fraudulent manner in this regard, then there’s a story here. If not, Douthat is simply registering his frustration with the fact that a legal medical procedure for women can be provided by an organization that also receives federal funds to provide other health care. I’m afraid Douthat has a big battle in front of him. What about those folks who believe contraception is murder? Should we bar health care providers who offer contraception to patients from receiving federal or state money too? What about independent physicians in private practice who perform abortions and also accept Medicaid subsidy for low income clients for other services (though, as I mentioned above, they are fewer and farther between these days)?

• While Douthat tries to turn that 3% of Planned Parenthood costs spent on abortion care into a 250,000 number-of-abortions outrage he’s still left with the original (true) fact – 3% of Planned Parenthood’s services are abortion services. Which means that 97% of services Planned Parenthood provides are reproductive and sexual health care services which are not abortion. Douthat comes awfully close to admitting that the anti-choice movement is anti-contraception as well. He complains that 250,000 abortions/year are too many, but what is his answer? Defund Planned Parenthood, the organization that ensures that millions of young women and men are given the preventive tools, care and information to avoid unintended pregnancy.

As a former women's health center employee and part of the reproductive health movement that prioritizes prevention, education and trust, this next part of Douthat’s “argument” makes my head spin. Douthat tries to “prove” that Planned Parenthood is somehow fudging the numbers by using an article Charlotte Allen wrote:

Just three percent, hmm? Why, that makes it sound like Planned Parenthood almost never performs abortions. Of course, the reality is rather different, as Charlotte Allen noted last year:

The 3 percent pie slice in the 2005-06 financial report, representing 264,943 abortion customers served, can only be described as deliberately misleading.

So, here we go again. First of all, as any current or former nonprofit employee of a service organization understands, in an annual report, you categorize services in terms of percentages. If Planned Parenthood’s abortion services make up 3% of their services, then categorizing this fact isn’t “sneaky” – it’s true. But more than that, the way Douthat uses Allen’s reasoning to “prove” how Planned Parenthood tweaks this number is stunning in its ability to demonstrate how little anti-choicers understand about women’s health care provision and how badly they want to politicize women’s health care at any cost.

One way Planned Parenthood massages the numbers to make its abortion business look trivial is to unbundle its services for purposes of counting. Those 10.1 million different medical procedures in the last fiscal year, for instance, were administered to only 3 million clients. An abortion is invariably preceded by a pregnancy test--a separate service in Planned Parenthood's reckoning--and is almost always followed at the organization's clinics by a "going home" packet of contraceptives, which counts as another separate service. Throw in a pelvic exam and a lab test for STDs--you get the picture. In terms of absolute numbers of clients, one in three visited Planned Parenthood for a pregnancy test, and of those, a little under one in three had a Planned Parenthood abortion.

Okay, so, for the sake of anti-choice advocates who want to see abortion criminalized, I’ll address Allen’s points but I am hopeful that RH Reality Check will present an actual health care provider’s perspective to crush this nonsense.

Planned Parenthood isn’t “massaging” numbers by separating out numbers of reproductive and sexual health care services provided to women either before or after an abortion. When a woman comes to a health care provider with an unintended pregnancy and wishes to discuss her (legal!) options, she is first asked to take a pregnancy test. This is, of course, a separate service from an abortion procedure. The medical provider needs to know for sure that this woman is pregnant first. Then they can discuss options: continuing the pregnancy and parenting the child, continuing the pregnancy and working with adoption services, or having an abortion, thus terminating the pregnancy. That’s what health providers do - should they instead, in Allen and Douthat’s world – ask women to come in with a used pregnancy test? Secondly, Planned Parenthood does not provide prenatal or childbirth services. Women who visit Planned Parenthood for a pregnancy test are more than likely already thinking about abortion as an option.

Secondly, Allen’s condescending description of a "going home" packet of contraceptives’ post-abortion reveals her true feelings about contraception. While I can only suppose that the medical offices of Allen and Douthat would send women away post-abortion without the tools to actually prevent unintended pregnancy again, most health care providers in this country (and all mainstream medical associations) understand that ensuring women’s access to contraception and family planning is critical to a healthy life. It is unquestionable at this point that access to contraception, globally, improves women’s health and lives, elevates their status in society and is only beneficial for the health of a nation. As Guttmacher puts it (PDF),

In addition to improved health, sexual and reproductive health services contribute to economic growth, societal and gender equity, and democratic governance.

But Douthat uses Allen’s quote as a “gotcha” for Planned Parenthood. Again, providing women with the means, post abortion, to prevent unintended pregnancy does not catch Planned Parenthood in some elaborate scheme – it catches them at doing exactly what they should be doing, and what we should all be grateful they are doing: providing women and families with the means to prevent unintended pregnancy and STIs.

Ultimately Douthat’s entire article will resonate only with the fiercest of anti-choice advocates. As has been made clear this election season, and through more polling than one can count, Americans support ensuring access to health care for women - even (!) reproductive and sexual health care. In addition, they oppose piling on even more legal restrictions based on narrow, fundamentalist religious perspectives. Instead, Americans are desperate to invest more time, energy and resources into those programs – both advocacy and service –that focus on prevention and education. It’s that darn common ground concept that Douthat doesn’t like. Unfortunately for women, though it's most certainly the fuel for our fight, finding “common ground” in the reproductive health movement is about much more than “gotchas” and hot-button ideological accusations. It’s about our health and lives.