By Randall K. O’Bannon, Ph.D., NRL Director of Education & Research
Planned Parenthood boasted nearly nine hundred clinics as recently as 2010. Today, they have just a little over six hundred. Yet, somehow, abortion, the “service” for which they are most widely known, hasn’t faltered. In fact, in their most recent annual report, they reported performing more abortions than ever – 345,672 for 2018. This, while basking in record revenues topping $1.6 billion a year.
Many fewer clinics, yet PPFA is performing more abortions. How is this possible?
From data we have gathered, it appears that Planned Parenthood has closed many clinics which did not offer abortion and added it to many that previously had not. Several states appear to have built one or more larger regional abortion hubs. These hubs often offer a full range of abortion services, including aborting much older babies, with feeder satellite centers sending their abortion clients to the megaclinic.
And, very important, nearly two thirds of all Planned Parenthood clinics now offer at least chemical abortion (“medication abortion,” in their parlance).
Meanwhile, on the organizational front, a lot of the smaller affiliates have been gobbled up by rich, powerful, more aggressive regional ones.
It all leads to an organization which is leaner, meaner, and considerably richer. And obviously, more dangerous than ever to unborn children and their mothers.
Getting a Count
Every few years, National Right to Life goes through the clinic data published on Planned Parenthood’s website. We see the number of clinics which are in each state and what services they offer. We compare that data to data published on their website in previous years. We note the appearance of new clinics, old ones that disappear, and those that change the services they offer.
This does not tell us how many abortions each center performs, how many clients they see, the level of staffing they have, or the relative size of their facilities. Independent research sometimes gives us an idea of how or when a clinic closed or when Planned Parenthood builds or relocates to a larger, newer megacenter.
Even so, nailing down a precise number of operating facilities is difficult. Planned Parenthood is opening or closing clinics on a regular basis. How does one count a clinic like the one in Fayetteville, Arkansas, which is “temporarily closed” while they spend nine months looking for a new place to relocate?
Sometimes there are what appear to be two clinics occupying the same address–one that performs abortions, the other that offers other services. Other times they occupy different floors or different suites but otherwise the same address. Phone numbers may be one digit different.
They may, for legal reasons, want to be recognized as different entities. They may be even incorporated under different affiliates, so that the abortion clinic can meet certain health and safety codes or the non-abortion side can still qualify for state or federal family planning money.
But if they share the same staff, the same premises, have the same management, as they appear to in at least 18 cases, it is difficult to determine whether it is best to count these at 18 different clinics or 36.
The raw numbers
Taking into consideration the caveats mentioned above, Planned Parenthood currently lists 614 clinics, including those that are double booked at an identical or only slightly modified address. Of those 614, 387 (close to two thirds–63%), currently advertise “abortion services.”
Ten years ago, Planned Parenthood listed 872 clinics, with just 302 (about 35%) offering abortion.
That represents the closure of more than 250 clinics from 2010 to 2020, but an overall increase of 85 clinics performing abortion. Most of the new abortion clinics are those which were not previously performing abortions but have since added chemical abortions using mifepristone.
There were 175 Planned Parenthood clinics offering surgical abortions (or, in Planned Parenthood’s lingo, “in clinic” abortions) in 2010, but just 163 such surgical clinics at Planned Parenthood in 2020.
Later late abortions
Though the number of Planned Parenthood clinics offering surgical abortions declined in the past ten years, more and more of those surgical clinics that remain are offering later abortions. In 2010 just under half, 80, advertised that they performed abortions at 14 weeks gestations, but in 2020, 110, more than two thirds, said they do so.
Perhaps just as disturbing, in just the last four years, at least 32 of the clinics offering surgical abortions increased their upper gestational limit by at least one week. Most increased by at least two weeks (say, from 13 weeks, 6 days, to 15 weeks, 6 days), but some increased by four, six, eight, or even ten weeks!
The upward trend is undeniable. Only a handful (we counted four) decreased their gestational limit from 2016 to 2020.
There were just three Planned Parenthood clinics advertising that they performed abortions at 24 weeks gestation in both 2010 and in 2016, and a couple more saying that they did abortions at 23 weeks or 23 weeks and six days.
In 2020, there were fifteen Planned Parenthood clinics offering abortions at 24 weeks. This is in addition to the two which said they would perform abortions on women 23 weeks pregnant or 23 weeks and six days.
Eleven of the clinics newly offering surgical abortions through near the end of the second trimester were in California. These were all from just two Planned Parenthood affiliates – Planned Parenthood Mar Monte (eight), and Planned Parenthood Los Angeles (three).
In case either of those affiliate names sound familiar, chances are you remember them from the undercover videos provided by the Center for Medical Progress.
This is the same Planned Parenthood Los Angeles affiliate with late term abortionist Deborah Nucatola saying she would “crush below… crush above” to see if she could get the fetal organs “intact.” The one where fellow abortionist Mary Gatter said she would use “a less crunchy technique” on these late term babies to get “more whole specimens.”
Mar Monte, one of the biggest Planned Parenthood affiliates in the country, was one of those revealed to be involved in contracts with fetal tissue procurer and processor StemExpress.
If so, it appears that rather than be intimidated by the negative publicity associated with their role as fetal tissue suppliers, Planned Parenthood affiliates in California seem to have been emboldened to perform and promote even later abortions!
Affiliates Shrink to Grow
While by our count, there appears to be six fewer Planned Parenthood affiliates now than there were four years ago, or are now, calculating precisely is a tricky matter.
As mentioned earlier, affiliates in some states incorporate their surgical or abortion facilities under a different affiliate name, although their degree of separation from the regional affiliate may be more a matter of legal technicality than any physical distinction.
For example, Planned Parenthood of Greater Texas (PPGT) has no abortion clinics under its own name, but has six abortion clinics under the name of “Planned Parenthood of Greater Texas Surgical Health Services.” Several of these appear to be large regional megacenters in Austin, Dallas, El Paso, Ft Worth, and Waco. Those clinics share addresses (except for maybe a different suite or floor number) with other non-abortion performing clinics run by PPGT.
There are similar arrangements between Planned Parenthood of the Gulf Coast and the Planned Parenthood Center for Choice in both Houston and in Stafford, Texas. Planned Parenthood’s large Midwest affiliate, Planned Parenthood of the Great Plains is connected to Comprehensive Health of Planned Parenthood Great Plains, which operates clinics in Wichita and Overland Park, Kansas, and Oklahoma City, Oklahoma.
Another large midwestern affiliate formed when Planned Parenthood’s Minnesota and North and South Dakota affiliate gobbled up the Planned Parenthood of the Heartland affiliate centered in Iowa. It actually lists itself two ways: as “Planned Parenthood North Central States – PPH” and “Planned Parenthood North Central States – MNS,” though it bills itself as a single unified regional affiliate (PPNCS).
Considering the two varieties of PPNCS as one affiliate but counting the specialized abortion affiliates in Texas as separate, there were 61 affiliates in 2016, and 55 in 2020.
Merging to Make More Money
What appears to be perhaps just a matter of counting actually tells us some important things about Planned Parenthood. Consolidation continues at Planned Parenthood, as smaller less profitable clinics close and larger, richer, more powerful affiliates take over smaller weaker ones and purge expensive management.
For example, the recent merger of five New York affiliates into one, Planned Parenthood of Greater New York, now involves 28, or close to half the state’s 57 clinics. It is supposed to cover 65% of the state’s population. An officer for the new affiliate told the Schenectady Daily Gazette (5/14/19) that one of the ways the merger was supposed to help them “better serve our patients” would be through reductions in the administrative workforce.
If Planned Parenthood can perform as many services, or maybe even more of their most profitable services, like abortion, with fewer employees, they can increase revenues while decreasing expenses.
And this is precisely what the data appears to show.
For reference, in 2010, with 104 affiliates and 872 clinics, Planned Parenthood performed 329,445 abortions and saw overall revenues of $1 billion, 48.2 million. In 2020, with 55 affiliates and 614 clinics, Planned Parenthood performed 345,672 abortions (2018) and revenues (for fiscal 2019) reached a whopping $1 billion, 638.6 million.
While Planned Parenthood annual reports from those years show us abortions and revenues were up during that time frame, overall services from 2010 to 2018 (the latest year available) were down 10.7%. Their highly publicized “cancer screenings” dropped nearly two thirds, or 64.%. Even birth control, Planned Parenthood’s supposed signature product, fell by 50.4%, in those reports.
Saturation versus Strategic Location
It is no secret that Planned Parenthood is stronger in some states than in others. And depending on their strength and the size of the state, they employ different models to try and extend their lucrative abortion empire.
In some smaller, older states like those on the north eastern seaboard, as well as larger states like California and New York with high population, Planned Parenthood appears to have tried a saturation strategy.
California boasts 111 clinics, a hundred of which perform abortion. New York has the next most in both categories, with 57 clinics, 52 performing abortion. By population, that keeps them in the top ten when it comes to abortion clinics per person, with about one abortion clinic for just under every 400,000 people. A few other larger states with sizeable population like Oregon, Washington state, and Colorado are also fairly saturated with at least one abortion clinic for every half million people.
If one abortion clinic per hundreds and hundreds of thousands of people doesn’t sound like that many clinics, consider this. According to estimates from the U.S. Census bureau, less than 20% of the population were women of “reproductive age” (15-44 years) in 2018. But the overall population figure not only includes large numbers of women outside this age range but men as well.
More lightly populated states with an inordinate number of abortion clinics like Alaska and Montana also tend to have more clinics per person.
Planned Parenthood abortion clinics are also concentrated in smaller east coast states such as Vermont, Connecticut, and New Jersey. These states also show up on a top ten list counting the number of clinics according the state’s square mileage, along with Delaware, Rhode Island, and Maryland, but the District of Columbia takes the top spot. Its single clinic serves an area of just 68 square miles.
The Metro MegaClinic Model
Our study of Planned Parenthood’s clinics also shows another model being employed. In this arrangement, Planned Parenthood sprinkles the state with several non-abortion clinics that feed one or more central large abortion mega-clinics that handle both chemical and later surgical abortions. This is how several larger, more populated states in the Midwest tend to operate.
For instance, Minnesota has 18 Planned Parenthood clinics but just two that offer abortion. The facility in Rochester does only chemical abortions. The megaclinic in St. Paul, in addition to chemical abortions, performs surgical ones all the way up to 23 weeks and 5 days.
In both Ohio and Wisconsin, only three of each state’s 24 Planned Parenthood clinics perform abortions, and all of those perform chemical abortions. In Ohio, each of those three also offer late second trimester surgical abortions: Columbus up to 17 weeks, 6 days, Bedford Heights (just outside of Cleveland), 19 weeks, 6 days, and Cincinnati at 21 weeks 6 days.
In Wisconsin, two of the three offer surgical abortions, both Madison and Milwaukee advertising abortions up to 19 weeks, 6 days.
Clearly, operating with fewer abortion clinics does not impose a significant limitation on Planned Parenthood’s abortion business. Though figures on the total number of abortions Planned Parenthood performs in Ohio and Minnesota are not available, the relative dearth of abortion clinics did not stop Planned Parenthood Wisconsin from performing 4,128 abortions in 2017, nearly two thirds (64.9%) of abortions performed in the state that year.
Texas, which has 42 Planned Parenthood clinics but just 10 which perform abortions, may be a special case. You may recall that several years ago, when the Supreme Court was considering the Hellerstedt v Whole Woman’s Health case on Texas abortion clinic regulations, the media was all agog over the number of abortion clinics which had closed since the disputed law had been adopted (e.g., “Here Are the Texas Abortion Clinics That Have Closed Since 2013.” Texas Tribune, 6/2816).
Misleading data on when and why those clinics closed even made its way into the court’s discussions and later decision (see NRL News Today analysis, March 8-17, 23, June 30, 2016).
Many clinics did close, but in many cases, that was because they were unable to sustain business. Texas continued to see demand for abortion dropping, and they faced the prospect of expensive repairs and remodeling to bring aging clinics up to code. But an earlier Texas law from 2011 redirecting state family planning funds to clinics which did not perform abortions probably helps account for the unusual arrangement seen in Texas.
Of the ten Planned Parenthood clinics offering abortion in Texas, only one is officially operated by a standard Planned Parenthood affiliate – a San Antonio clinic run by Planned Parenthood South Texas which performs chemical abortions up to ten weeks and surgical abortion up to 15 weeks and six days. The other nine abortion clinics in the state are officially part of three specialized abortion affiliates – the Planned Parenthood South Texas Surgical Center, Planned Parenthood of Greater Texas Surgical Health Services, and the PP Center for Choice, which is officially a separate corporation, but appears to be connected in some way to Planned Parenthood of the Gulf Coast.
Again, several of these share the same street address (maybe a different floor or suite number) as other non-abortion performing clinics. Two of these special surgical affiliates are directly linked to the websites of Planned Parenthood’s regular Texas affiliates.
The reason for this arrangement is not spelled out, but it may be to enable the non-abortion clinics to qualify for state family planning money, or to ensure that only certain of their facilities have to qualify to meet state health department requirements for ambulatory surgical centers.
In any case, Planned Parenthood seems to have adapted to the situation in Texas by expanding facilities or setting up large abortion megaclinics in major metropolitan areas such as Houston, Dallas, and San Antonio which can handle large volumes of referrals from regular Planned Parenthood clinics in the surrounding area.
A similar situation appears to exist in Missouri. Faced with state regulations on clinics being litigated in the courts they believe threatened operation of the state’s lone abortion clinic in St. Louis, Planned Parenthood of the St. Louis Region and Southwest Missouri recently set up a new megaclinic just across the river in Fairview Heights, Illinois (NRL News Today, 10/14/19 or https://www.nationalrighttolifenews.org/2019/10/why-is-the-industry-is-building-big-abortion-clinics-just-across-state-borders/).
Explaining what it means
Whether it is by packing the state with clinics, adding chemical or surgical abortion services to existing clinics, or simply building large regional abortion megacenters, the point is that Planned Parenthood has maintained or expanded its lucrative abortion business, even while their overall number of its clinics has been in steep decline.
It explains a lot.
It explains how you can have at least 250 fewer Planned Parenthood clinics than ten years ago, but still add to the number of Planned Parenthood clinics performing abortion.
It explains how Planned Parenthood got to be the nation’s largest abortion provider, now performing four out of every ten abortions in the United States.
It explains why when people think of “Planned Parenthood,” they think “abortion.”