Last week, when Planned Parenthood Federation of American abruptly pushed out President Leana Wen after less than a year in her position, it brought a long-simmering debate at the organization into the open. In an op-ed in The New York Times, Wen said she had been asked to leave over “philosophical differences”—specifically Wen’s attempt to cast Planned Parenthood as politically neutral, a health care provider that offered a range of services that merely included abortion. In insisting that abortion is “not a political issue but a health care one,” Wen hoped to remove Planned Parenthood from conservative crosshairs and expand its support.
But nothing could be more misguided. What Wen fails to understand is that abortion is unavoidably political, and that ceding the moral high ground to the right would only hurt the pro-choice cause. Indeed, with anti-abortion extremism on the rise across the country, there has never been a worse time for the pro-choice movement to retreat in this manner.
Planned Parenthood is the largest single provider of abortion services in the United States (although independent clinics provide over half of all abortions and the vast majority of procedures occurring after the first trimester). Its name is essentially synonymous with abortion to people on both sides of the issue, and this perceived ubiquity has positioned the organization as both the default beneficiary from pro-choice donors and the largest and most visible target of the anti-choice movement. Planned Parenthood has leveraged its position well, amassing a formidable share of political and grassroots support that has translated into unrivaled power to set the tone of the pro-choice movement. The organization is a communications powerhouse that has absorbed much of the responsibility for branding abortion itself, the right to which is supported by 73 percent of Americans, with varying degrees of enthusiasm and clarity.
Only 3 percent of the services provided by Planned Parenthood are abortion, although you may not have heard this statistic trotted out recently. Abortion supporters have become bolder in recent years, less inclined to minimize or apologize for abortion’s existence. Clinton-era slogans like “safe, legal, and rare,” have fallen out of favor, while grassroots movements like Shout Your Abortion (which I co-founded) and #YouKnowMe have brought personal stories out of the shadows and into public discourse. Some of Planned Parenthood’s contemporaries in the movement, such as Sister Song and the National Network of Abortion Funds, define themselves explicitly as reproductive justice organizations, situating abortion within a much more holistic human rights framework. But Planned Parenthood is a health care provider, a tricky vantage point from which to talk about abortion with total ideological clarity. Abortion is indisputably a medical procedure, but it is also one many people see as morally complex, which makes developing a unified message around the issue particularly challenging.
Even among those who support abortion rights, there is a vast range of attitudes about whether or not abortion is actually a good thing; whether or not the circumstances surrounding the pregnancy are relevant; how many abortions one person should have; and how far along pregnancy can be before it is too far. Among people who have abortions, there is an equally vast range of emotional experiences, although 95 percent say they do not regret their decision. The pro-choice movement—or pro-abortion movement, as some prefer to say—has nothing approaching consensus in terms of how to talk about abortion, let alone how to fight for it.
The stakes have never been higher: In the last five years, state-level abortion restrictions have decimated access to abortion, leaving six states with one remaining clinic and upward of 90 percent of counties in those states with none. Thanks to an empowered conservative majority on the Supreme Court, Roe v. Wade is on the chopping block. And even if Roe remains intact, access to safe and legal abortion is rapidly becoming a class privilege.
Against this backdrop, Wen’s departure came as a shock. In a statement released on Twitter after her ousting, Wen, a physician whose background is in public health, expressed a desire to remove Planned Parenthood from the crossfire of the culture wars, saying that depoliticizing the issue would “expand support for reproductive rights by finding common ground with the large majority of Americans who understand reproductive health care as the fundamental health care that it is.”
Abortion is health care, of course. But attempting to depoliticize abortion or insist that the procedure is categorically identical to other health care procedures downplays the implications of abortion in a way that removes it from any honest analysis of its political salience. Because the anti-abortion movement has long dominated the conversation with the assertion that abortion is murder, the impulse to remove abortion from a murky moral debate and frame it as a simple matter of health is understandable. But it is not simply a medical choice with no repercussions beyond the realm of the personal; abortion affects everyone. One in four women will have at least one abortion in their lives. Our communities have been shaped in a million invisible ways by people having abortions—abortions that allowed them to build their lives and careers and families with intention. Abortion has shaped families who live comfortably at the top, and lack of access to abortion has denied many poor families the ability to shape their own futures.
Deciding whether or not to terminate a pregnancy is a personal choice. But suggesting that abortion is a private matter between doctor and patient mistakenly characterizes it as an individual issue, as opposed to a fundamental human rights issue and a matter of justice. Abortion bans are one of many strategies the right is employing in a much larger project to disenfranchise poor people and people of color. This is also about controlling women and their bodies, of course, though ultimately wealthy women will always be able to buy their freedom.
The question of when life begins is deeply personal, and there will never be anything approaching consensus on the matter. But the abortion debate isn’t about when life begins: It’s about how much money a pregnant person needs in order to purchase their own self-determination, and about who our society deems worthy of freedom. The people fighting to ban abortion aren’t trying to eliminate abortion—if they were, they’d be advocating for medically accurate sex education, insurance plans that cover birth control, and widely accessible emergency contraception. If abortion opponents truly believed that abortions become increasingly evil as pregnancy progresses, they wouldn’t be trying to ban abortions at six weeks and implement waiting periods designed to make it impossible for those without means to terminate their pregnancies as soon as possible.
The most compelling argument that abortion is health care is the fact that the lack of abortion access is a rapidly escalating public health crisis, one that will only continue to deepen existing contours of inequality. Maternal mortality rates in the U.S. are the highest in the developed world, and in some places that rate is four times higher for black women. Abortion is health care, but we do not live in a country that frames health care as an inalienable human right. The fight for abortion rights is a structural power struggle, with clear winners and losers.
Leana Wen stepped into leadership at Planned Parenthood at a moment when the organization’s ability to continue providing a range of health care services had become jeopardized by its insistence that reproductive health care includes abortion. But Wen’s impulse to frame abortion as a simple medical procedure, divorced from larger moral or political realities, did not resonate with supporters—and it certainly didn’t placate Planned Parenthood’s adversaries. This moment demands leaders who recognize that this is a fight, and that in order to win, we must embrace the complex whole of the truth. Downplaying abortion in an attempt to reach people on the fence is a losing strategy. And because the right to choose is supported by the majority of Americans, we don’t actually need to convert those with anti-abortion views. We need to galvanize passive supporters of abortion rights by communicating that the fight for reproductive freedom is a fight for justice, and that the moral imperative is ours.