GOP presidential hopeful Donald Trump distinguished himself from the rest of the Republican field on Tuesday when he defended Planned Parenthood’s reproductive health services, saying that “they do good things” and abortion is “actually a fairly small part of what they do.” His statements stand in sharp contrast to the current political atmosphere as other Republican candidates have taken strong stances against the group.
The way Trump articulates his position on the national women’s health organization plays into a very old narrative that many of Planned Parenthood’s supporters have recently adopted: Downplaying the group’s role as an abortion provider to make the case that it’s worthy of support.
Pivoting to Planned Parenthood’s essential family planning services seems like a welcome shift, particularly amid ongoing controversy over whether the organization is profiting from fetal tissue donations. But this framework comes with some issues of its own.
At the heart of Trump’s statement is the assumption that it’s possible to separate abortion services from the rest of women’s reproductive health care. This conservative approach to abortion, which sets the standard for current U.S. policy in the field of reproductive health, has been harming patients for decades.
U.S. lawmakers have worked to keep abortion segregated from the rest of the health care industry for years. Under the decades-old Hyde Amendment, taxpayer funding isn’t allowed to be allocated toward abortion services, which presents an inherent divide. On top of that, the political nature of the issue has dissuaded many public hospitals from performing abortions, so the procedure has been relegated to stand-alone clinics that are left more vulnerable to anti-abortion harassment. More recently, political fights over the Affordable Care Act have given abortion opponents an opportunity to restrict insurance coverage for the procedure even further, continuing to prevent abortion from being streamlined into the rest of medical care.
As a result, getting an abortion in the United States can be a confusing and complicated process. Pregnant patients are often surprised to learn that their regular OB-GYN — the doctor whom they’ve grown comfortable with — can’t perform the procedure for them. It can be hard to find the closest stand-alone clinic. And then their insurance provider may not cover the cost.
It’s an inefficient system that doesn’t reflect the true nature of reproductive services. In reality, when it comes to women’s health care, abortion doesn’t stand alone.
The need for abortion services doesn’t exist in a vacuum. If a woman is facing an unwanted pregnancy, that obviously means she’s sexually active. She may need to be tested or treated for a sexually transmitted infection. She could be due for her regular gynecological exam. She might need to be screened for signs of intimate partner violence or domestic abuse. She’s probably interested in the birth control options available to help her prevent future pregnancies. Plus, since the majority of U.S. patients who have abortions are already parenting at least one child, she may also be thinking about health services related to her children — maybe she needs help breastfeeding, or maybe she has questions about her child’s recommended vaccinations.
And that doesn’t even take into account the blurry line between the health services related to miscarriage and abortion. No matter how a pregnancy loss is officially defined, women typically need the same type of medical care. But if they’re in a hospital that doesn’t perform abortions, they may not get that care — and their health could seriously suffer as a result.
Aside from the practical and logistical questions about the delivery of health care, proponents of abortion rights say there’s another problem with separating out abortion care: It reinforces the stigma against abortion. Ultimately, in a society that already treats abortion as something that’s shameful and immoral, it communicates to the estimated one in three U.S. women who will have an abortion in their lifetimes that this procedure is not routine.
“There are a million ways in which our laws create institutional stigma and tell women that they’re doing the wrong thing,” Louise Melling, the deputy legal director for the American Civil Liberties Union and an expert who often speaks on abortion stigma, explained in a previous interview with ThinkProgress.
Downplaying Planned Parenthood’s abortion services in favor of highlighting the “good” things that the organization does reinforces this separation and this stigma. It creates an implicit hierarchy for the types of services that “good” patients visit their local Planned Parenthood clinic to receive. Nonetheless, this is a framework that the pro-choice community itself sometimes falls into. Planned Parenthood officials often assure the public that abortion represents just 3 percent of the organization’s overall health services. The message comes across as: Don’t worry, you can trust us, we’re mainly focused on the right things.
From a political perspective, Planned Parenthood’s supporters may assume it’s simply easier to defend the organization without wading into contentious abortion politics. For instance, when President Obama became the first sitting president to address the national organization during an appearance at its 2013 annual conference, he didn’t use the word “abortion” once in his speech to a room full of women’s health proponents.
But, as a strategy to combat the current controversy swirling around Planned Parenthood — which has come under attack from anti-abortion activists who have a long history of working to discredit the organization’s work — the defense is a bit mismatched.
After all, Planned Parenthood isn’t being attacked by abortion opponents because it offers STD tests and Pap smears. It’s been a longstanding target since Roe v. Wade specifically because it provides abortions. A more logical response to that, though it’s one that Donald Trump certainly isn’t likely to make, would be a defense of abortion itself as an essential health service for millions of women who say it was the right choice for them.