By Randall K. O’Bannon, Ph.D. NRL Director of Education & Research
There have been a great many stories in NRL News, the pro-life media in general, and elsewhere about the clinic closings at Planned Parenthood, the mergers, the scandalous videos that reveal that the organs of children are harvested from late abortions. On a Monday through Saturday basis, NRL News Today has run many, many stories about these and other developments at the “largest abortion provider” in the United States.
But sometimes, in focusing on a clinic closing here, a merger there, a new megaclinic taking the place of dilapidated old building in one community, one can lose track of the big picture of some of the larger systemic changes that Planned Parenthood is undergoing across the country.
They are not random, and they are not inconsequential. They are the product of a business model which maximizes revenues by closing smaller clinics (often ones that do not perform abortions); adding chemical abortions; and by constructing megaclinics which allow PPFA to perform massive numbers of abortion at a central site.
Little versus Big Picture
Long-term, we know that there are perhaps a couple of hundred fewer clinics than there were at Planned Parenthood’s peak-and that the number of Planned Parenthood’s affiliates are perhaps a third what they were in the early 1980s.
With record revenues and a consistently high number of abortions performed, however, this is anything but a corporation teetering on the edge of collapse. So what is going on?
Let’s look at Planned Parenthood’s website. By examining the clinics and services that each affiliate was offering in the U.S. in 2016 and then comparing them with similar data from just six years earlier, we see that in that even in just that short window of time there have been significant, even profound changes.
Comparing 2010 and 2016 Data
In 2010, there were just about a hundred affiliates listed. Today, just six years later, there are only around 60. [1]
Merger mania, which has gripped Planned Parenthood for a few decades, has hardly abated in recent years. Larger, more powerful, more aggressive affiliates have gobbled up smaller ones that were often unprofitable and poorly managed. Often the new team closes down the non-abortion performing centers and invests in those larger, more professionally staffed clinics that can handle higher abortion volumes.
The overall number of clinics went from 872 in 2010 to 649 in 2016, a drop of 223 in just six years’ time. But during that same time period the number of abortion-performing clinics went up, from 302 to 362. This means that nearly 35% of Planned Parenthood’s clinics advertised abortion in 2010, but nearly 56% (well over half) did so in 2016.
Though we do not have “service” numbers for last year yet, this large increase in the number of PPFA clinics performing abortions does explain how the number of abortions at Planned Parenthood held relatively steady (around 320,000 to 330,000) for 2010 to 2014, even while national abortion figures have been in a tailspin, dropping around 250,000 since 2000 and some150,000 from just 2008 to 2011.
For Planned Parenthood, a lot of the stability in their numbers comes from adding chemical abortions to clinics which previously did not offer them. In 2010, 292 of its clinics advertised chemical abortions. Today, the number is 361. Some of these locations offer both surgical and chemical abortions, but many do not.
There are slightly fewer clinics performing surgical abortions now than there were six years ago – 166 against 175. But more Planned Parenthood clinics are offering later abortions, with 93 now advertising surgical or “in clinic” abortions of babies greater than 14 weeks. In 2010, there were just 80.
There also appears to have been more than 50% increase in the number of clinics advertising abortions at 18 weeks and beyond. Thirty two clinics now advertise that they will perform abortions at these very advanced stages of pregnancy. In 2010, there were only twenty advertising at that gestational age.
Even after undercover videos that showed Planned Parenthood employees haggling over compensation for the body parts of babies well into their second trimester, fifteen clinics were still advertising that they would perform abortions at 20 weeks or more. (The number would be higher if we included those seven who indicate they will go all the way up to 19 weeks and 6 days. )
Only eleven clinics said they would do abortions at 20 weeks or more in 2010, and none were saying that they would tiptoe up to that line by performing abortions at 19 weeks and 6 days.
Similar Patterns at the State Level
There are a handful of states which currently have no Planned Parenthood abortion clinic, [2] but many of the other states mirror the national group in their evolution.
Colorado, run by the Planned Parenthood of the Rocky Mountains affiliate, lost five clinics from 2010 to 2016 (26 down to 21). At the same time they experienced an increase of 50% in the number offering abortion (from 8 to 12).
Each of those four new clinics not only added chemical abortions, they did also add a week to their surgical abortion offerings- from 17 weeks, 6 days to 18 weeks, 6 days.
Florida had one fewer clinic in 2016, 22 versus 23, but more than doubled those offering abortion, from seven to 15. And while none of the five clinics performing surgical abortions performed abortions at more than 14 weeks in 2010, five of the ten surgical centers did in 2016; two performing abortions at up to 22 weeks, 6 days, and three at 15 weeks, 6 days.
Only two of Florida’s clinics offered chemical abortions in 2010, but 15 did by 2016.
New Jersey had three fewer clinics in 2016 than 2010, but the number offering abortions jumped from two to 23. That increase was totally in new clinics offering chemical abortions.
Interesting things happened in Michigan. In 2010, there were four different affiliates in the state, but only one clinic among them all offering abortions. Since then, the four affiliates have merged into one statewide affiliate, Planned Parenthood of Michigan, and the number of abortion clinics has risen to six. Two offer surgical abortions at 18 weeks or later.
Final Impact of Funding Cuts Unclear
Several states tried to reprioritize or cut funding for Planned Parenthood after the release of the Center for Medical Progress videos in 2015, but it is a little early to pick up patterns in the data just yet.
Many of the larger states attempting these cuts only passed legislation to that effect earlier this year (e.g., Arizona, Florida, Ohio, Missouri) and some of these are currently tied up in the courts. And states that passed cuts last year did not necessarily have many Planned Parenthood clinics in the beginning (e.g., Alabama, Arkansas, Kansas).
Despite dire predictions from Planned Parenthood, the few clinics that operate in those states have generally remained open, just without funding from the state’s taxpayers.
Texas, much in the news of late with the Supreme Court’s recent Hellerstedt case, took action a few years before the video scandal, and has seen a significant drop in both Planned Parenthood’s abortion clinics and clinics overall since the state initiated a series of legislative moves in 2011 to redirect family planning funding to entities that did not perform abortion.
Planned Parenthood’s 93 clinics in 2010 shrunk to 34 in 2016. The number of abortion clinics in Texas decreased from 15 to 5.
Clinics in Texas shut down for a number of reasons, as we have pointed out elsewhere (here and here, p. 8). Funding probably played a significant role, as did other clinic and abortion regulations later passed by state. But as we have explained in detail, clinics also close because they get old, the abortionists retire, there is financial mismanagement, or just because there is a reduced demand.
One thing that has happened in Texas, like many other places, is that smaller, older clinics in smaller towns are closing and sending their abortion business to giant new metropolitan mega-clinics set up to handle higher volume and perform later surgical abortions.
In 2010, there was just one clinic, in Austin, performing abortions after 20 weeks. In 2016, there were two, the one in Austin, at 21 weeks, 6 days, and now one in Houston that offers surgical abortions up to 23 weeks, 6 days.
A big new clinic in Dallas performs abortions up to 17 weeks and one in Fort Worth offers second-trimester surgical abortions up to 15 weeks, 6 days.
Abortion numbers in Texas did indeed fall with the reduction in the number of clinics. The clinics that remain seem more than capable of handling the state’s current caseload. With the court handing abortion advocates a victory in Hellerstedt in June, however, there is talk that some clinics could reopen. Thus neither the analysis or the story is complete.
The Killings, not the Closings, are the Issue
Clinics have been closing at a significant rate at Planned Parenthood, closing by more than 25% over the past six years. But the number of Planned Parenthood clinics offering abortion is actually up. As noted above, this explains how abortion numbers and overall revenues at Planned Parenthood have managed to remain stable in time when abortion in the U.S. have been falling.
Planned Parenthood has adapted its strategy to fit the times. It has broadened its reach by adding chemical abortions to many of its smaller centers, building larger surgical centers so that they can handle more referrals from smaller clinics, and beefing up their ability to offer second-trimester abortions.
What is clear from the numbers is that while it is pruning operations, Planned Parenthood is maneuvering nevertheless to strengthen its core abortion business.
And that is why, though we might note the latest clinic closing, we are saving our celebration for the day the killing stops.
Footnotes
[1] Though we will provide the numbers that we have, the reader should understand that these are constantly fluctuating and often fuzzy. Some affiliates appear to have set up separate organizations, sometimes with identical addresses, to handle their abortion business. It is unclear whether Planned Parenthood or the law treats these as different affiliates or not.
Also, clinics disappear all the time, sometimes staying listed as “temporarily closed” with no clear indication of future relocation or reopening, while others we know are being built are not yet listed. Our own count for both years, therefore, is at best merely a snapshot of what the Planned Parenthood website was publishing at a couple of given moments in time.
[2] These include Kentucky, Louisiana, Mississippi, North Dakota, Oklahoma, West Virginia, and Wyoming, though it should be noted that unborn babies are not as safe from Planned Parenthood as it might seem. The Planned Parenthood clinic in Louisville, for example, got authorization from Kentucky’s previous governor to begin performing abortions there last year (since stopped by the present pro-life governor), and a giant new megaclinics has recently opened in New Orleans and is expected to attempt to get a license to perform abortions.
Editor’s note. This appeared in the September digital edition of NRL News. Please share as many stories as you can, using your social media contacts.