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It’s been six months since the United States Supreme Court overturned the constitutional right to abortion. Planned Parenthood was the nation’s largest abortion provider and still is a lightning rod for conservative lawmakers that would prefer to see the health care provider permanently shutter.
Planned Parenthood of Tennessee and North Mississippi CEO Ashley Coffield sat down with The Commercial Appeal to discuss what the healthcare provider’s next steps are, and what the days look like now in the wake of the decision in Dobbs v. Jackson Women’s Health Organization decision, which overturned Roe v Wade.
The Commercial Appeal: I wondered if you could tell readers a bit about where the fight for abortion access goes from here? To that end, is there a central strategy to TAPP’s (Tennessee Advocates for Planned Parenthood) work right now? How might you describe the areas of focus in the next 6, 12, 24 months?
Ashley Coffield: We’re looking at more of a relational organizing model, where we are having deep and meaningful conversations about shared values with people we’ve never talked to before. And we’re encouraging our supporters to do the same. And, we ultimately have a goal of having what we call action councils in all 95 counties in Tennessee, and those are grassroots-driven, organizing bodies that take a part of the movement that they’re interested in.
Francie Hunt, our executive director of Tennessee Advocates for Planned Parenthood is walking across the entire state of Tennessee, kicking off this radical relational organizing model by having these conversations with people in rural areas, metropolitan areas and suburban areas about our shared values.
And what she’s finding is that we have more in common than what than differences. That people agree that abortion should be legal, they agree that we should treat each other with kindness and with respect and have equal opportunity. And, that includes LGBTQ people and people of different races. That we should all have access to good health care, we should all have access to good education, we should all be able to vote … we share all of these values. The politicians in Tennessee are using fear to tear us apart, they’re preying on people’s fears. And the result is that we’re not having real conversations with each other about things that matter most to us, and our politics are broken. There is a brokenness in Tennessee and a complete disconnect between what elected officials are doing in office and what people want them to be doing.
The CA: I’m glad you brought up talking to each other, and I was thinking about it as you were speaking. There’s been this rise of this sentiment that the idea of talking with each other of really trying to reach for a common ground is somehow not conductive, not effective. It’s almost as if there’s this sense that you’re sleeping with the enemy and you’re coddling extremists. So my question is what would you ask people to consider before they completely write off having conversations with people they may or may not agree with, even on dire issues.
Ashley Coffield: Just because you have fears and and politicians have taken advantage of those fears doesn’t mean that at the end of the day, you’re an extremist. We all have fears of change, and we have fears that things are going to be different. It’s about changing the way we talk about the things that we’re afraid of, without ever minimizing the dangers of extremism. However, always acknowledge it (extremism), always call it out — but don’t make the assumption that because people are susceptible to the fear-mongering, they can’t be like you or that we can’t have a conversation about shared values.
The CA: I think for a lot of people, and certainly including Planned Parenthood staffers, the end of abortion access in Tennessee felt inevitable. Even so, knowing that it was a likely reality wasn’t something you could really prepare for. I wondered if you could sort of walk me through like what that last day of abortion access was like it Planned Parenthood?
Ashley Coffield: We knew abortion would be banned before the (Dobbs decision) leak, the leak just confirmed it, and it gave us a few weeks to get ready. The day that the Dobbs decision came down was a Friday. And we had previously made a decision that we would not provide abortions under the state’s six-week ban. We opened clinics that Saturday that weren’t normally open, because at the time we were open on some Saturdays, but not all.
So, we didn’t even have an abortion provider lined up that Saturday. But all of our providers raised their hands and said they would come in. So, we scheduled as many people as we could that Saturday, people who had appointments the next week. The last abortion we did was Monday morning, and then the six-week ban went into effect Monday afternoon.
It’s very scary, to be operating on a day-to-day basis and not to know if [the complete ban takes effect while] you’re in the middle of a procedure, or if you’ve medicated patients, and then suddenly complete ban is going to take effect and you’re going to have to turn people away. It was traumatizing to the patients, and it was traumatizing to our staff.
The CA: When we talk about our most disenfranchised citizens across the South and the Mid-South, access to information, and even the ability to really take in news and political goings-on going on is not always easy, or straightforward. Are there still a number of patients coming in who did not realize that abortion is no longer available to them?
Ashley Coffield: Yeah, we’re absolutely still getting pregnant people who think that we can help them and provide an abortion. We still have healthcare providers who are making referrals to us for abortion services. I had a call this morning with our our medical leadership team, and they confirmed that we’re still getting calls, that people don’t really understand what’s going on. This is a radical change. It is a fundamental change to people’s to the healthcare system. And, I just think doctors cannot believe that the services that they have counted on for decades are no longer here, and that they have to have these conversations with patients.
And for the people that do know abortion is no longer legal in Tennessee — we’re trying to educate them and say, we’re still here. And we can help people access abortions. Even though we can’t do it here at home, we can help them access abortion outside the state. And we’re providing patient navigation services that can help people with financial resources. We can help remove the logistical barriers that they have. So on the one hand, there are people who don’t know and then on the other hand, the people who do know but aren’t asking for help.
The CA: Moving on a bit, Black maternal mortality remains an issue in Memphis. To my knowledge, it never has not been an issue. Can you talk a little bit about the concerns we’re looking at for low-income pregnant people of color currently? And looking ahead, what are the direst issues that they could be facing unless something substantial changes?
Ashley Coffield: We’re most concerned about black women who are pregnant and have complications, and the hesitancy and fear that providers have in treating those complications because of the trigger ban. And, they may be the least equipped to advocate for themselves within our healthcare system. So we’re really worried that, you know, at the end of the day when we have some data about the impact of the trigger law, that there will be extreme disparities according to race, in terms of those who is able to get the emergency care that they need when they face pregnancy complications. Because black women are much more likely to suffer from a pregnancy complication than other races.
The CA: Memphis once was at the top of the nation for Black infants who died before their first birthday, and this was due to the severe lack of prenatal healthcare for those parents. I know Planned Parenthood did not provide, at any point, prenatal healthcare. But among your peers — professionals immersed in reproductive healthcare, is there a concern that Black infant mortality rates could start to rise again?
There’s absolutely concern. There’s a definite connection between maternal health and infant mortality. And, the ability for women to space their births has a big impact on infant mortality. And abortion is the key to being able to space births appropriately and to get pregnant when you’re ready to get pregnant. So, without abortion as that critical family planning piece of the puzzle, I do think not only will maternal mortality rise but so will infant mortality. They go hand in hand.
The CA: Outside of abortion, Planned Parenthood is also one of the area’s critical providers of needed public health services, like STI testing, gender-affirming care, and access to birth control. Now that abortion is illegal in Tennessee, how are those other services holding up? And are there any plans to expand those services?
Yeah, absolutely. We’ve definitely seen an increase in patients seeking family planning services, especially birth control, and seeking information about everything they can do to prevent pregnancy — including purchasing lots of emergency contraception. We’ve had a lot of men calling us and asking us for vasectomy services. These are largely younger men who don’t have insurance and also trans women have called and asked us for vasectomy services. So we plan to launch that early in 2023.
We’re also looking at expanding the primary care services. A number of our patients come to us with comorbidities that need to be treated, and we have to refer them out for those services. A lot of people treat their family planning provider as their only provider. We’re the only provider that many, many of our patients have. So, we have never had the bandwidth to go beyond traditional family planning and abortion. But we are going to, now that we have more bandwidth, and we think that that’s going to have a huge impact on the health of our population. It will be great to help them treat things like hypertension and diabetes.
The CA: Even though Planned Parenthood no longer provides abortions, I still see protestors outside of the facility almost daily. What are they protesting?
Ashley Coffield: There’s several things they’re protesting. They’re protesting our trans care. They’re protesting our values around bodily autonomy. And that connects to STI testing and treatment and birth control. And then thirdly, they want to close this down. They were hoping that abortion would be the death knell, and now that it’s not, they want to turn as many patients away as possible. So it’s those three reasons.
Micaela Watts covers the access and equity beat for The Commercial Appeal. She can be reached at micaela.watts@commercialappeal.com.
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