What you may not know: Independent Abortion Clinics Responsible for Majority of American Abortions

By Randall K. O’Bannon, Ph.D., NRL Director of Education & Research

As the nation’s largest abortion chain and the entity directly responsible for some 40% of the abortions performed in the United States, Planned Parenthood clearly earns and deserves all the negative attention it gets. But what about the other 60%?  Who performs the rest of America’s  abortions? And how are they faring in the new post-Dobbs era?

A new report from the Abortion Care Network, something of a trade federation of independent abortion providers, has just issued its 2023 report, “Communities New Clinics: The Abortion Care Ecosystem Depends on Independent Clinics.” Amid calls for greater appreciation, more donations, and fewer regulations, the report does contain some news of interest to pro-lifers: 139 of its abortion clinics have closed since 2018, 42 in 2022, the year Dobbs came down, and another 23 so far this year.

Who are these independent operators?

While that may be the most salient information for members of our community, the report does tell us a lot about the industry and particularly those “other” clinics that do most of the country’s abortions.

Though officially made up of “independent providers,” many of these clinics are part of their own smaller national or regional chains. “Whole Woman’s Health” has clinics in Indiana, Maryland, Minnesota, New Mexico, and Virginia (and is apparently connected to a “virtual abortion provider” that sells abortion pills online). “A Woman’s Choice” operates five clinics in the southeastern coastal states, one in Florida, three in North Carolina, one in Virginia.

The “high end” abortion “provider” Carafem has brick and mortar clinics in 4 states – Georgia, Illinois, Maryland, Tennessee – and has a virtual presence that reaches ten states and DC (Connecticut, D.C., Georgia, Illinois, Maryland, Massachusetts, Nevada, New Jersey, Rhode Island, Vermont, Virginia).

This is also, of course, the association connected to some of the nation’s most infamous abortionists such as Warren Hearn, Curtis Boyd, Willie Parker, and the late LeRoy Carhart as well as some of the larger, notorious clinics like Women’s Health Services of Brookline, MA, ParkMed  NYC, Cherry Hill, NJ, Dupont Clinic in Washington, DC, Hope Clinic in Granite City, IL, and Cedar River Clinics in Washington state, all specializing in late abortions

The report makes these abortionists out to be heroes and champions, “bold advocates” who “fiercely defend each person’s right to access abortion.”

Continuing on this hero theme, they tell how “Indie providers listen to their patients, have built trusted community partnerships, and hold deep expertise in patient-centered care. These clinics often serve as the only source of health care for many individuals, including people who are uninsured or underinsured.”

They even try to make much of how, in light of new legal circumstances, some clinics have adapted and begun offering prenatal and birthing care, but this is one place for which the report offers no data. Some may be doing this to stay in business, but it clearly isn’t because of any change of heart.

Affected disproportionately?

The report asserts that “indies [independent abortion clinics] were disproportionately impacted by the U.S. Supreme Court’s decision to overturn Roe v. Wade and the flood of abortion bans that followed. With over half the states in the U.S. banning or severely restricting abortion and fourteen states lacking a single abortion clinic, access to abortion care in many parts of the United States has been decimated.”

The brick and mortar, standard surgical abortion clinics were some of those most affected, the report says.  There were 510 of these brick and mortar clinics in 2012 when the Abortion Care Network did its first study. Even with a few new openings and the addition of virtual clinics, there were just 346 brick and mortar clinics overall in this most recent report, a drop of 32% in just a dozen years time.

While the closing of clinics obviously meant lost business for some of its members, the report claims that this meant increased demand and heavier workloads for independent clinics in other states.

Performing late abortions

The report proudly trumpets the fact that their members are responsible for 61% of those abortions performed in the second trimester, 86% of those after 22 weeks, and 100% of those performed after 26 weeks. (They fail to note, however, that these last abortions are clearly after the point that the baby is typically developed enough to survive outside the womb.)

Oddly enough, the authors seem anxious to pin responsibility for these later abortions on pro-life policies. They attribute second and third trimester abortion to elements such as “abortion restrictions, a lack of resources, increased clinic wait times, and factors related to health, safety, and viability.”  How ‘viability,” or one supposes, the child’s impending ability to survive outside the womb, factors in here goes unexplained.

Defending surgical abortion

The authors seem especially anxious to defend surgical abortion and the skills these abortionists have.

While nearly three quarters (73%) of the Abortion Care Network’s members offer surgical and chemical abortions (contrasted to Planned Parenthood, where only 42% offer both), they make it a point to emphasize that chemical abortions aren’t ideal for abortions after 10 to 12 weeks.

The U.S. Food & Drug Administration’s protocol suggests a 10 week limit. After that point, women seeking generally have to go the surgical route, the report asserts, taking time off from work, factoring in additional time to travel and extra out of pocket costs. 

Hinting at some of the known problems with chemical abortions that other abortion groups or “providers” have proven reluctant to mention, they say that certain women need or prefer the original surgical. “This is especially true for patients for whom it’s not safe to end a pregnancy outside the clinic,” they assert. This includes, they say, “those experiencing intimate partner violence, minors without support at home, people experiencing homelessness, and patients who cannot take time off from work or from caretaking.”

While a handful of members are in fact online abortion pill providers, the report features these more traditional abortion practices. Having a brick and mortar presence gives abortionists legal standing to sue, the authors note, so that they can challenge state legislation that would put limits on abortion.

“Clinic closures also mean,” the report claims, “the loss of trusted medical expertise, community-based jobs, comprehensive reproductive and sexual health services, and neighbors who have cared for each other with compassion, respect, and shared cultural knowledge.”

As might be expected, the report asserts “closures and bans disproportionately affect people who are already systemically marginalized, criminalized, and surveilled, including Black and Indigenous people and other people of color, immigrants, people with disabilities, LGBTQIA+ people, rural communities, young people, and people with low or no incomes.”

Abortion as Environmentalism?

Torturing and twisting the English language to a near breaking point, the report tries to present this as some sort of environmental cause. The front page subtitle baldly declares that “The Abortion Care Ecosystem Depends on Independent Clinics.” Employing environmental graphics like flowers, birds, butterflies throughout, the report asserts in the language of gardening that “All of these providers are necessary to cultivate and create a sustainable, accessible, and meaningful landscape of reproductive health care, including abortion.” 

The irony of using metaphors associated with new life, growth, and beauty with killing, death, and bloody ugliness seems lost on the report’s authors.

Later they explain that independent clinicians “are part of an ecosystem that includes other providers, abortion funds, practical support organizations, advocates and activists, researchers, policy experts, artists, and individual community members—all working to ensure that people can get the abortions they need.”

Of course, says the report, “There is a place for everyone in this ecosystem.” By that, they clearly don’t mean the unborn child, but suggest that the reader “take action” by “raising awareness,” donating, supporting private abortion funds, volunteering, and working with “reproductive health, rights, and justice groups” (like theirs, presumably). 

They beg readers not to criminalize but to support aborting women, assuming, despite evidence to the contrary, that abortion is what a desperate young mother needs and ignoring the long standing position of National Right to Life and other pro-life organizations of never prosecuting aborting women.

Unappreciated?

After going on about their performing the abortions no one else will, authors of the report relay again in this report something they’ve noted before: a complaint that they are not sufficiently appreciated or supported by their peers or the public at large.

The report says “independent abortion clinics remain under-resourced and are rarely centered in the public discourse on abortion care in the United States. Indies lack the institutional support, visibility, name recognition, and fundraising capacity of national health centers and hospitals, making it especially difficult for them to secure the resources needed to keep their doors open.”

It never seems to occur to members of the Abortion Care Network that maybe it is their product that is the problem.  One can’t just wave a verbal magic wand and suddenly make the killing of an innocent unborn child an environmentally enhancing endeavor.

Abortion doesn’t make the patient nor the planet better.  All the birds and flowers, all the bees and butterflies in the world won’t change that reality.