Access to abortion is being attacked across the country after the fall of Roe v. Wade. Each new curtailment of reproductive rights means that states where abortion is still legal are expanding their services to meet the needs of out of state patients. This amounts to increasingly difficult conditions for reproductive health care workers. At the same time, these workers are facing a hostile working environment as their newly formed unions are being punished by employers. Patients aren’t the only ones who need care, and the reproductive justice movement is only as strong as the people on the front lines providing direct services to patients amid escalating attacks on women’s bodily autonomy.
“Abortion rights are workers’ rights, we cannot have one without the other,” said Grace Larson, a recently fired licensed practical nurse at Planned Parenthood North Central States (PPNCS), at a press conference on April 3 calling for her reinstatement.
Larson, a member of the bargaining team for the Service Employees International Union (SEIU) local recently formed to represent workers at PPNCS, had her contract terminated on Tuesday, March 28, in what appears to be a blatant act of union busting. All twelve members of the bargaining committee have been given a final written warning from PPNCS leadership. The warning stated that any future violation of the employee handbook or code of ethics would be cause for immediate termination and would stay in their personnel files indefinitely, potentially affecting opportunities for promotions, raises, and transfers. Larson and one other bargaining team member have been fired, and two of the disciplined members of the bargaining committee have put in their resignation letters, citing management’s hostile actions.
A Unionized Planned Parenthood
More than four hundred employees of PPNCS voted in July 2022 to unionize with SEIU Healthcare Minnesota and Iowa, an affiliate of SEIU. The wall-to-wall bargaining unit, which includes everyone in the Planned Parenthood affiliate who is not a supervisor, represents staff who do around a hundred different jobs at twenty-eight locations in five states: Minnesota, Iowa, Nebraska, North Dakota, and South Dakota.
Workers at PPNCS discussed the need for a union well before the Dobbs decision overturned Roe v. Wade last year, but that enormous setback made the situation feel even more urgent. “We want to take care of ourselves so we can take care of our patients,” explains Larson, citing persistent understaffing and burnout, as well as the need for more concrete diversity, equity, and inclusion initiatives as the main staff motivations for unionizing.
PPNCS chose not to voluntarily recognize the union but staff won their vote in July with over 90 percent support. Larson found the decision not to voluntarily recognize the union confusing. “If we are allocating autonomy to our patients, we should do the same for our staff,” she says. The statement in support of the union that PPNCS leadership put out soon after the overwhelmingly positive vote left her feeling hopeful, however, and ready to start bargaining their first contract.
About two weeks after the thirteen-person bargaining team was elected in August, one of them was inadvertently cc’d on an email which stated management’s desire to terminate her contract without doing an investigation, following a complaint from a coworker. After the union requested that an investigation be made, the complaint was shown to be incorrect and management apologized for their mistake. It was “terrifying that it looked like a bargaining team member was potentially being targeted so soon after the union vote,” says Larson, but again, they were hopeful about the bargaining process.
The next round of disappointments began soon after bargaining got under way in October. Diversity, equity, and inclusion (DEI) was very important when surveying union members. Out of a staff of over four hundred, only two and half people work on DEI initiatives. “We pay a lot of lip service to racial equity and trans rights, but there isn’t a commitment,” says Larson. “The staff deserve more of a concrete commitment and so do our patients.” After PPNCS initially nixed the union’s robust proposal to enshrine a strong shared commitment to racial justice in the contract and offered a watered-down DEI statement instead, the union recently reached a tentative agreement on DEI language.
Things went from frustrating to hostile in January 2023, when the bargaining team asked a member to step down after an alleged assault of another team member, and days later, PPNCS management appeared to acquire the private Signal chat of the bargaining committee. One member of the bargaining team was terminated, and then the rest of the team was put under investigation. That investigation was led by a person on management’s bargaining team. Despite multiple people pointing out the conflict of interest, nothing was done to appoint someone unconnected with the contract negotiations.
PPNCS claimed that the twelve remaining bargaining team members had knowledge of wrongdoing and failed to report it. It’s unclear exactly what wrongdoing the team members were meant to report, though it could be related to a meeting that the recently terminated employee attended without permission about management’s plans to enforce a previously unenforced dress code as a way to prevent staff from wearing their union T-shirts.
“None of the things we’ve been accused of involve patient data or patient safety. And it all seems to be based on things we said to each other in a private encrypted chat among bargaining team members,” explains Larson. Everyone on the bargaining team got a final written warning stating that any future violation of policy in the staff handbook would result in immediate termination, to be kept in their personnel files indefinitely.
In mid-March, Larson sent an email, from her personal email address and outside of work hours, to an outside organization about the person who allegedly assaulted her coworker to alert them of the incident, as the alleged perpetrator also worked for this organization. Two days later, Larson was put under another investigation, this time for “retaliation” against a coworker. Despite alerting her manager to the alleged assault, filing a compliance report, and mentioning the assault in her first investigation, Larson’s contract was terminated two weeks later, and she was given no satisfying answer about how her actions could be viewed as retaliatory or caused harm to PPNCS.
Now SEIU Healthcare Minnesota and Iowa is demanding that Larson be immediately reinstated and that PPNCS management show up at the bargaining table ready to concretely support the work of the frontline staff caring for patients. The union is fighting for fair and equitable wages, dedicated meal times and breaks, adequate staffing levels, and a seat at the table in decision-making that affects their daily work. “We truly love Planned Parenthood and its mission and the patients we serve,” says Larson. “We are fighting for a good contract because we want the organization to be the best that it can be.”
Extending the Fight
Abortion rights are workers’ rights, a powerful statement that Larson and others in the reproductive health care industry have been emphasizing in recent years. Reproductive health workers have unionized or are in the process of unionizing at at least five Planned Parenthood affiliates, including in Western Pennsylvania and Massachusetts, and since 2016, workers at roughly two dozen reproductive health–related organizations have formed unions, including Guttmacher Institute, the Center for Reproductive Rights, American Civil Liberties Union chapters, and Emily’s List.
The unionization efforts have not always gone smoothly, as workers at Planned Parenthood of Greater Texas can attest to. Planned Parenthood workers across the country cite many of the same issues that motivated them to unionize: low pay, understaffing, and a lack of decision-making. Many come into the organization passionate about the mission and eager to provide the best care to their patients, but burnout happens quickly. The turnover at PPNCS, and many other affiliates, is high. Larson says that after about six months she was training new staff and has seen many workers leave after a year at the organization.
“We cannot continue providing this crucial health care without taking care of the people who provide it,” says Larson. An organized reproductive health care workforce will not only benefit frontline clinic staff but patients, too. Research shows that hospitals with nurses’ unions produce better patient outcomes. In our post-Roe world, with shrinking access to abortion care and added stress on the remaining providers, the well-being of workers is intimately tied to the well-being of patients. The reproductive justice and labor movements are deeply connected; as reproductive health care workers face a precarious future in a hostile political landscape, activists need to stand in solidarity with these unionizing workers to support both movements.
The bargaining team is now working on filling the vacated seats. “People feel scared for their jobs, they feel worried to bring other people into the bargaining process and put them at risk. But people are ready to keep fighting for the contract because this all reinforces the issues that brought us to the table in the first place. We will keep going,” says Larson.