How a Divided Left Is Losing the Battle on Abortion

Ilyse Hogue, president of the abortion rights organization NARAL Pro-Choice America, said that independent clinics “absolutely” needed to be better funded, but that ultimately protecting the clinics depended on bigger changes.

“I don’t think they will be able to continue to operate at all if you don’t shift the culture and politics,” she said. “The trajectory we are on will outlaw service.”

Still, some worry that Planned Parenthood and other national groups have overly prioritized politics and power instead of patients and providers. Though Planned Parenthood is perhaps best known as the nation’s largest abortion provider, it provides a range of health services across more than 600 centers across the country, including contraception; testing for sexually transmitted infections; and hormone therapy for transgender patients.

The tension between Planned Parenthood’s political goals and its mission as a health provider was one of the main reasons Dr. Wen, with a background as a physician, had such a stormy tenure as president.

Pamela Merritt, who co-founded a reproductive rights group called Reproaction in 2015, compared Planned Parenthood’s legal priorities to a lobbyist for a commercial enterprise like McDonald’s, focused on protecting its own business needs. Activists refer to the organization and its outsize influence, she said, as “the big pink elephant in the room.”

“The movement needs independent providers that provide most abortions to be loud and out front,” said Ms. Merritt, who described herself as an “unapologetic lefty.”

For many of those independent providers, the problem extends well beyond politics.

In Alabama, Ms. Gray’s biggest challenges are practical. Drug prices for medical abortions are high, she can’t find a physician to replace her aging medical director, and an electrician recently refused services because he opposed abortion, she said.

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