The Supreme Court may have struck down Roe v. Wade with its decision in Dobbs v. Jackson Women’s Health Organization, but reproductive healthcare and nonprofit workers in the Midwest are rising up—and unionizing—to demand better working conditions. 

“We’re constantly in the crosshairs, and every moment, we’re operating to some degree in crisis mode,” said Kameron Brodie, who was a Leadership Annual Giving Officer with Planned Parenthood North Central States (PPNCS) and is now a Senior Manager in Donor Engagement. “We’ve been creating our own little support system with the union.”

Around 435 PPNCS workers in Minnesota, Iowa, Nebraska, North Dakota, and South Dakota voted to join SEIU Healthcare Minnesota and Iowa and create PPNCS United. They announced their union drive in May and won their election on July 21 with over 90% of the vote after a three-week voting period. The union is necessary because, according to workers, decisions are often made by executives who have little experience and knowledge of what it’s actually like for the frontline workers in the clinics. 

These workers are weathering the changes brought on by the Supreme Court’s decision in Dobbs that overturned Roe in June and criminalized and restricted abortion in 22 states. In Minnesota, abortion is a right enshrined in the state constitution, and in July, Ramsey County judge Thomas Gilligan ruled that abortion restrictions are unconstitutional in Doe v. Minnesota.  However, the states surrounding Minnesota that haven’t ruled abortion to be a constitutional right have been enforcing bans against the procedure, making the state of Minnesota an island of abortion access for patients who can afford to travel. Before the Dobbs decision, clinics struggled to meet demand for abortion as nearby states increased restrictions. After the Dobbs decision, staff at Planned Parenthood and Whole Woman’s Health experienced a surge of patients traveling from out of state.

In this challenging environment, the PPNCS workers were buoyed by a gesture of support from the Minnesota labor movement. In September, the Minnesota AFL-CIO convention unanimously passed a pro-choice resolution in support of workers at PPNCS, calling for Roe v. Wade to be codified and for protection for abortion seekers and clinic staff.

The resolution acknowledges that working people and people of color are more vulnerable under abortion bans because of a lack of financial resources. According to the resolution, “the MN AFL-CIO will publicly advocate for reproductive freedom, including access to safe, reliable, and legal abortion services, by participating in rallies, legislative advocacy, and other campaigns to protect those rights where they remain in place and, where they have been taken away, to establish them again.”

“A long battle”

Sage Shemroske is a health center associate in Minneapolis. “On the mirror in our employee locker room, there’s a printout of a pink piece of paper that says ‘grateful for you!’ with the Planned Parenthood font and the Planned Parenthood logo,” they said in a press conference celebrating the union victory. “I taped up informational flyers all over the locker room and underneath that piece of paper. And when I saw the contrast, I thought, ‘grateful for our labor, but not grateful enough to pay us fairly for it.’’”

Restricting reproductive freedom means that those who seek care have to take matters into their own hands. This mural across the street from Planned Parenthood’s St. Paul location shows monarch butterflies floating around a hand encased in barbed wire grasping a flower.

April Clark, Senior Training and Development Specialist R.N., in Iowa, said that there were many hugs and tears in the clinic after the election results. “The vibe of the working environment has changed,” she said. “We had to move how we saw patients very quickly with the 24-hour informed consent process that the Iowa Supreme Court put back in place. It’s been really overwhelming. We’re basically seeing each patient twice, so it’s limiting our capacity. With the fall of Roe, we’re getting more patients from out of state, and we’re the lowest state for people coming from the South.”

Clark said the recent changes in access to abortion care made the fight for unionization stronger.

“This has been a long battle and we have done a lot to get here. We are all very tired,” said Mimi Arabalo, Bilingual Health Educator in Nebraska. “While we’re fighting for ourselves, we’re also fighting for our patients to have access to reproductive justice.”

Internal changes to work environment

Pro-choice organizations devoted to the mission of reproductive rights and freedom can still suffer from toxic workplaces. The Planned Parenthood Federation of America, which is the national office PPNCS is affiliated with, unionized with SEIU last year. PPNCS refused to voluntarily recognize the union, forcing an election. The CEO of Planned Parenthood League of Massachusetts circulated a letter discouraging employees from voting in favor of a union before workers won an election in July.

Compounding the political climate, PPNCS workers say they have faced internal changes. PPNCS announced the resignation of its president and CEO Sarah Stoesz last December after 20 years of leadership. 

On September 7, PPNCS announced its new president and CEO, Minnesota state representative Ruth Richardson, who just won her reelection. PPNCS says that, while acting as state representative, Rep. Richardson won’t be involved in political work or lobbying for PPNCS. Since Minnesota has a part-time legislature, it’s not unheard of that representatives have jobs related to their government work. When Workday Magazine reached out to PPNCS for comment on unionization, Molly Gage, Vice President of Human Resources, sent a statement:

“Planned Parenthood North Central States is committed to working together with Service Employees International Union Healthcare Minnesota & Iowa (SEIU) to advance the mission of Planned Parenthood across our five-state region. At a time when reproductive rights and the freedom of bodily autonomy are under intense attack, we are dedicated to improving access to all sexual and reproductive health care, including abortion, and comprehensive sex education. We are working together to make sure we are supporting the dedicated PPNCS staff across the affiliate as we preserve abortion access for the community and provide essential education and health services. Every person deserves the right to control their bodies and their futures, and our partnership will continue advancing our values and collective impact. After our second day of bargaining, we remain optimistic we will reach a collective bargaining agreement through the organizing process that reflects these values.” 

What workers are asking for

Kameron Brodie, who started at PPNCS in December 2019, interned with Planned Parenthood Federation of America in the past. She was going to school to be a teacher, and taught second grade and Pre-K in New Jersey for a while. She had been to Minnesota before, and when she saw an opening at PPNCS, she decided to make it her new home.

Brodie said that the priorities workers will be fighting for in their first contract include fair wages and equal pay, improved benefits and healthcare, improved staffing and scheduling, and contract language that supports diversity efforts.

Read PPNCS United’s list of demands.

“I’m so excited to continue building on this work, as this network of colleagues has grown into a great source of support personally, and I hope that everyone who is a part of PPNCS United will get to experience that camaraderie, without silos and geographic boundaries,” said Brodie in an email. “And I am so excited to get to work on our first contract–our first opportunity to demand the working conditions we deserve, now coming from a place of power.”

Regional organizing

Brodie works remotely and at an administrative office in St. Paul, Minn. She said her experience as a union member when she was a teacher motivated her to fight for a union at PPNCS, where “mission-driven work” is exalted.

“With nonprofits, everyone is really passionate about the work they do,” she said. “That can often be utilized to excuse poor conditions or poor behavior by leadership. We all know that the pay isn’t great, but we’re doing it because we love it. To some degree, that’s true. But also, when someone is struggling to get by, the mission and love for the mission can’t pay rent.“

PPNCS is the result of two separate affiliates that merged in 2018. One affiliate in Minnesota, North Dakota, and South Dakota, merged with another in Iowa and Nebraska. Since the PPNCS headquarters are located in the Twin Cities, a lot of attention tends to focus on that area. Admin staff who are based there would hear about working conditions of the frontline staff through the grapevine. The admin staff and the frontline staff began to organize separately from each other.

“When we contacted SEIU Healthcare Minnesota & Iowa, they actually let us know that a group of clinic staff at Vandalia had been talking to them,” Brodie said. “As a group of admin workers in the Twin Cities, we intentionally wanted to make sure we were reaching out to folks in Iowa, and Nebraska, in North and South Dakota, in the clinics, across every department, every location. We didn’t want to replicate the organizational structure that we saw was over-privileging us.”

In South Dakota, abortion is illegal, and the PPNCS center in Sioux Falls is no longer providing abortion. It still remains open for family planning and sexually transmitted infection testing and treatments. But Brodie’s colleagues in the state are navigating the uncertainty of not knowing which services will continue to be provided, and what effect that will have on staffing and work location.

One thing that’s important to Brodie is fighting for improved benefits, including better health coverage. PPNCS has programs that help patients who can’t afford care, but the staff has healthcare needs, too. “We have a waiting period, which is not uncommon, but personally I find it reprehensible,” she said. “In our clinic, if someone comes in for an appointment, they can meet with a financial counselor who will help them apply for some sort of insurance coverage if they don’t have it. Yet, we’ve got staff who are starting, and for the first two months, can’t get health coverage through their work.”

Another thing on Brodie’s mind is transparency. “Knowing that our CEO is making a salary that is 10 times more than what some other folks are making, that can be really hard,” she said. “Why are things the way they are? The fact that there isn’t that transparency makes it really hard for folks to understand and reconcile what is going on. And I think whether it is justified or not, if folks don’t know, they can’t feel good about it.”

The role of the labor movement in abortion access

The arguments in Roe and Doe v. Gomez, the 1995 case that gave Minnesotans the legal right to abortion enshrined in the state constitution, are based on a theory of privacy between the government and individuals. But that privacy can’t, in itself, ensure people get the care they need.

“Privacy is about being left alone, it’s not about having access,” said University of Minnesota Law School professor Jill Hasday. “Being left alone works if you have all the resources to make it happen and you just need the state to stay away, but a lot of people don’t need to be left alone. They need to be helped.”

Some reproductive justice advocates believe that defense of abortion rights, coupled with advocacy for proactive and robust provision of care, is a natural fit for a labor movement that is also struggling to secure unions for reproductive healthcare workers. As the Economic Policy Institute notes, losing the right to abortion can be catastrophic to one’s economic situation. 

There appears to be some political momentum behind defending the right to abortion. In the recent midterm elections, Michigan, California, and Vermont voted to amend their constitutions to include reproductive rights. As the political landscape for abortion access evolves locally and nationally, the frameworks being used by advocates must evolve, too, advocates say. 

“Reproductive justice says we have the right to have children, not have children, and parent the children we have, in safe and healthy environments. I don’t know if that is something that the United States constitution would ever consider supporting, to be really frank,” said Shayla Walker at a panel on abortion access. Walker is the executive director of Our Justice, an abortion fund providing logistical support for people seeking abortion care in Minnesota. 

Our Justice was a plaintiff in Doe v. Minnesota and is a member of the coalition UnRestrict Minnesota. According to Walker, organizers prepared for an influx of out-of-state patients needing assistance, but that hasn’t been reflected in the funding. A lack of access to funds means that poor and historically marginalized people are less likely to be able to travel.

“There are so many barriers that prevent people from traveling,” said Walker. “It’s not just about getting somebody to pay for your hotel or your bus ticket or your plane ticket. It’s about finding somebody to take care of your kids. It’s about making sure your boss is not going to fire you for missing so many days of work. It’s about lost wages.”

Although the future of abortion rights and access is uncertain, PPNCS workers beginning to bargain for their first contract are finding solidarity with each other.

“Organizing in this moment has really been, for a lot of people that I’ve talked to and certainly for me, a really great anchoring point for the work and a reminder of why we’re doing this,” said Brodie. “How can you not let your workers have a say, if you’re preaching for people to have control over their destinies?”

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