Abortion care workers are essential: How unionizing can protect and support clinic staff

Planned Parenthood of Northern New England staff across Maine, New Hampshire and Vermont organized our union and bargained our first contract to work toward ensuring all of our staff are able to do the important work of providing reproductive health care to our communities, while also living dignified lives ourselves. Our union, PPNNE United, is made up of clinicians, assistant site managers, health care associates, health center support folks, and philanthropy and public affairs organizers. Our Maine staff are represented by MSEIU and in Vermont and New Hampshire we are members of the AFT union.

We are the people who keep the doors open and make sure our communities have access to high quality, compassionate, and inclusive care. When we feel valued by our employer and the system we work within, we can commit to that work and provide better care and programming to those we serve. Because making the choice to dedicate our lives to reproductive health care forces so many of us to choose between necessities, it is also difficult to recruit and retain quality staff to carry out the mission of our organization. When folks can take jobs paying the same or more doing less emotionally stressful work, they often do. This directly limits patient access. This is why we organized to form a union.

Organizing for worker’s rights is rarely easy, but working for an organization with many locations spread out over three states in the middle of a pandemic provided an added challenge. We started by trying to reach workers by phone or through social media and inviting them to come to zoom meetings to get more information and build our movement to unionize. With many people working remotely or just spread out across Northern New England, it was hard to reach everyone and make sure that folks felt included and informed at all steps of the process. One-to-one contact is always integral to organizing, but with the need to rely so heavily on virtual meetings, those conversations become even more important to keep people engaged and informed.

We believe all abortion and reproductive healthcare workers and support staff deserve to have a say in their workplaces, and that unionizing is one way to ensure that. Below, we answer some of the most common questions about unionizing clinic staff.

What's the up side of a union for abortion clinic staff? What are some of the unique issues we should expect?

Unions are important for any workplace, ensuring all workers are a part of a democratic process to set the standards for our wages, benefits and working conditions and to have a say in decisions that impact our jobs. Now that we have unionized, our bosses can no longer make unilateral decisions about our work, and as workers we can support each other to make sure we are all being treated fairly. Our work as abortion/reproductive health care providers is inextricably tied to social justice, and so much of the unionizing conversation is rooted in terms of consent, self-advocacy, and being informed and empowered--the very things we strive to provide our patients. Those of us on the floor of abortion clinics know what we need to best serve our patients and take care of ourselves so that we can continue to keep our doors open. The process of organizing staff and engaging with our workplaces in this way is a very real extension of our most basic mission and values. 

PPNNE’s mission is “to provide, promote, and protect access to reproductive health care and sexuality education so that all people can make voluntary choices about their reproductive and sexual health.” As workers, we see unionizing as an essential part of this mission. Many of us are also patients at Planned Parenthood who struggle to pay for the care we provide. We also felt challenged at times because organizing for change often means creating disruption. One thing we wrestled with was a hesitation to take any action that may negatively impact patient access--even if unionizing might improve access in the long term.

As abortion providers, there is the concern about how anti-abortion people might try and take advantage of our union campaigns, or that public demonstrations might jeopardize the safety of our workers. Taking public action at abortion clinics comes with different risk factors for all of us based on our identities and roles within and outside of Planned Parenthood. Ultimately many of us felt that backing down from showing our support for our workers because we work in abortion care would be letting our opposition win.

How to get workers fired up when leadership is doing just enough to seem progressive?

“Being progressive” is not a static state--it’s dynamic. It requires us to be engaged and ensure that we are really living our values and not inadvertently perpetuating the things we claim to be working against. There’s always something to work on.  Where are the places your coworkers don’t feel heard?  Where do they feel undervalued or underappreciated?  Where do they feel stagnated? What voices are not being heard and why?  What community members are you not seeing and what can you do to bring them in?

The great benefit to unionizing is improved communication between staff across departments, tenure, and experiences. When it seems like leadership is doing just enough to seem progressive, staff can have increased dialogue and break down appearances versus actual experiences. For example, some of the disconnect between what leadership was saying and doing around union issues mirrored the experiences of some BIPOC staff experiences during organizational DEI work.

Working at a nonprofit like Planned Parenthood may already feel like a radical improvement to other jobs we have held, such as in food service or in the corporate world. Many of the people in leadership in our organization started in entry level positions in the organization and clearly came to this work because of the mission of our organization. But we felt compelled to organize because the same level of care that our management expects us to bring to our patients and our communities was not extended to the workers of our organization. We heard countless stories from workers who come to their jobs at Planned Parenthood because they care deeply for our communities, but struggle to pay for their very own basic needs like health care and housing. It was important for us to make spaces for these stories to be heard. We always start our organizing meetings asking people to share one thing they would like to see improved about their work, and we heard over and over again that we need pay equity, livable wages, better health care, and better systems for time off and rest breaks. There was a clear need for progress and that motivated us to keep organizing.

How can we build/sustain momentum around unionizing when everyone is burnt out?

Celebrate your wins, even if they seem small in comparison to what you asked for.  Celebrate your solidarity and the connections that come from that. We did a lot of group writing of emails and statements after meetings and that was a great way to stay engaged and shift the internal narrative a bit.  Let people do the things that excite them. And allow some time for silliness. 

Also, create a space where it’s ok to drop out for a bit if you need to recharge. One of our members used the analogy of a choir where singers stagger their breathing to create one sustained note while allowing others to breathe. We always encouraged each other to take time, knowing that the rest of us would carry things forward and that we’d return the favor.

There is a huge history connecting art and activism for this reason. Things like making posters together, listening to old organizing songs, and wearing creative illustrations of slogans like "rise, shine and unionize" for a button wearing campaign can boost morale and relationship building among unionized staff.

How can people negotiate for more when worried the clinic doesn't have the $$/could close?

We know how tight funding is for our organization, facing seemingly endless political attacks. But we also hear over and over again that our doors must and will stay open. The catch? They can’t without workers. For the last year, our clinics have been facing closures and staffing shortages due to high rates of staff turnover. It takes many months to train for our specialized roles and access (revenue) is limited when anyone is training. Therefore, we must invest in these highly skilled workers so that we will stay with the organization long term. All the workers in our union are essential to the running of this organization. Livable wages and benefits are necessary for retaining staff as well and treating all staff in the organization with dignity. We unionized because we want to make sure our organization is sustainable and that can’t be at the expense of the workers.

Also, unionizing is a conversation! As organizers, it’s our job to point out inequities and problems in the workplace and provide our best case scenario for what we’d like to change.  It is management’s job to hear that and do the financial analysis to make an offer they feel comfortable with. It’s unlikely that those two visions will match up immediately, hence, bargaining. But management will never agree to a contract that is going to financially harm the organization. We had big dreams for our first contract, and we know there is still a lot of work to be done. This contract is a huge win for PPNNE workers, and it is a building block to the next and a foundation to build on over the next few years.