Steph’s post here at Abortion Gang back in November, prompted by the closing of the 30-year-old Cedar River Clinic in Yakima, asserted that “we need to value independent clinics.” That got me thinking – how exactly and actually do we as repro justice activists go about “valuing” independent women’s clinics? And is valuing indie women’s clinics in some tangible way enough to keep the rest of our indie women’s clinics from going the way of the dodo?
Let me start with some analogizing. It’s a terrible analogy for a dozen reasons, but I think it’s a good analogy for a few particular reasons, so bear with me: Planned Parenthood is to Starbucks as any given independent women’s clinic is to your independent corner coffee joint.
Now it’s not inherently bad for there to be a Starbucks of reproductive healthcare providers. The fact that nearly everyone short of my mom (and maybe even she does) thinks of Planned Parenthood as the go-to for reproductive services means that at least there IS an obvious choice – which seems good for choice and thus inherently good for women. As the 800-pound gorilla in the room of reproductive healthcare, Planned Parenthood is positioned organizationally, resource-wise, and politically as a force with which to be reckoned, rather than a single ignorable voice in the wilderness.
Indie women’s clinics, on the other hand, get to be the mavericks (can we please have that word back now?) of reproductive healthcare. Because they operate independently rather than under the auspices and directives of a larger parent entity, indie clinics can highlight, focus on, or be particularly stellar on individual facets of patient care and operations in ways that Planned Parenthood often can’t or won’t.
Where the women’s clinic to coffee shop analogy falls off of course is that all repro healthcare clinics, unlike their coffee-shop counterparts, have to grapple with factors borne out of an atmosphere of increasing hostility towards reproductive healthcare issues and politics. This drastically impacts their ability to establish and increase their respective visibility within the community, and to cross-promote their particular character and range of products and services.
For example – any coffee shop is pretty obviously a coffee shop; they tend to be in visible, highly trafficked areas, often capitalizing on the presence of adjacent shops and businesses, and wouldn’t likely set up shop in a completely deserted, hard-to-access or other area that left them functionally invisible. However many women’s clinics either by dictum of building owners and/or trying to keep a low profile to avoid unwanted attention end up understating their presence such that even folks who set out to get there have trouble finding it.
Also contrasting with coffee shops, women’s clinics often have a hell of a time leasing space. It’s probably not surprising to learn that building and business owners frequently just flat out refuse to lease to an organization that provides abortions services. So rather than being able to cherry pick an ideally visible and accessible location, women’s clinics are often relegated to whatever non-ideal location they’re able to procure – including locations that are some combination of unsecured, not accessible via public transit, or difficult to find, drive to, or park near.
Other factors to consider include the ability to court customers for an entire range of offered products, and to bring back repeat customers. A coffee shop would never survive if their clientele were only comprised of folks who dropped in once or a few times then never again, nor would they thrive if most customers only ever bought a cup of black coffee. Women’s clinics face the challenge of promoting themselves to the masses as not only a place for quality abortion care, but the range of other repro health services they offer as well. Couple that with the tendency for most possessed-of-healthcare adult women to seek out their primary health care providers for run-of-the-mill birth control, STI testing, gynecological exams, or other repro/sexual health needs, and women’s clinics have a sizeable hole where there should be a lucrative demographic.
Then there’s the factor of word-of mouth. If there’s a great coffee shop you happen to find – what’s the first thing you do? You mention it to your friends. So what about word of mouth for abortion services, STI testing, birth-control and gynecological exams? Probably not something most women will tweet about or check into on Foursquare, or likely to mention in casual conversation even to good friends.
Which brings us back to indie women’s clinics versus Planned Parenthood. An indie coffee shop survives not only because they have a product that’s competitive with (and likely exceeds) that of the Starbucks, but because they’re effectively able to capitalize on factors like location, visibility and word of mouth in conjunction with their charm and quality products to generate loyalty and repeat business. Where independent women’s clinics should be able to continue to survive, if not thrive, capitalizing on those same elements of the indie business model, they instead continue to experience more and more barriers to their existence and operations that indie businesses simply don’t have to struggle against.
It’s those factors which I assert are inching independent women’s clinics closer to extinction in a way that Planned Parenthood will likely be able to largely withstand. Individual Planned Parenthood clinics may likewise suffer from some of the above factors – but Planned Parenthood as an entity, like Starbucks, will survive if for no other reason than merit of its brand recognition, reach and strength-in-numbers. As one who feels that choice within the realm of reproductive healthcare is nearly as important as the right to reproductive choice itself, I worry that we may already be past the point where no amount of “valuing” done by us well-meaning repro justice activists will matter to the survival of indie women’s clinics.