Almost one year after the fall of Roe v. Wade in June, employees at six Planned Parenthood clinics in Orange County are seeking union representation to demand better working conditions.
“I'm not gonna lie. It's exhausting,” says Alex Marin, an administrative medical assistant.
She and her front desk co-workers announced their intent to form a union in May with UFCW local 324. Part of the problem, workers say, is chronic understaffing, fueled by workers leaving for higher pay elsewhere. Marin’s base pay is $22 an hour. She and her coworkers want a pay increase and changes to the number of patients the clinics see.
Some of the pressure is driven by a rise in patients coming to California from states where abortion restricted or illegal, says Marin. In her experience, out-of-state patients require more attention to help them feel comfortable after what can be a traumatizing journey.
“We already have such a high volume of patients, and then we have these other patients from out-of-state coming here for something that only we can help them with,” says Marin. “It's more of a mental load now.”
Alex Marin attended the Anaheim event, where she and her co-workers announced their intent to join the UFCW 324. She’s been an employee for over seven years. Photo courtesy of UFCW 324.
Representatives of Planned Parenthood Orange and San Bernardino Counties (PPOSBC) acknowledge an increase in patients from out of state, but say patient volume is manageable.
According to their records, it was rare to have an out-of-state patient before 2021. Then shortly after a six-week abortion ban went into effect in Texas in September, the clinics saw three out-of-state patients. Last summer, after the Supreme Court issued its decision on Dobbs v. Jackson Women’s Health Organization, ending abortion access in many states, the clinics saw around 80 out-of-state patients. After a second surge of around 50 patients in October, the volume leveled off at about 35 out-of-state patients a month.
Such numbers can be squishy, cautions Sue Dunlap of Planned Parenthood Los Angeles. Over the past year, fewer patients reveal where they are from, as some states explore how to punish residents that cross state lines for care, and abortion advocates recommend patients withhold their addresses.
Management assesses these numbers differently than employees. The number of out-of-state patients seeking care in Orange County was something the organization was prepared for, says Nichole Ramirez, senior vice president of communication and donor relations for PPOSBC.
“While we are incredibly proud to be able to provide this critical care for people who are unable to obtain it in their own state, it's a very, very small increase,” says Ramirez. She says patients from outside California represent just 2.6% of abortions performed over the last year.
The Orange County clinics have a goal to see three patients per hour, Ramirez says, and clinics are averaging less, at 2.6 patients per hour.
And Ramirez says while they struggled with staffing at the end of the pandemic, they’ve increased their team size by 16% since August. Pay is market rate and they have given inflation bonuses.
“We really try to put staff first at PPOSBC and go above and beyond, and to do everything we possibly can to create a great work environment,” says Ramirez.
As is typical in the unionizing process, PPOSBC is not voluntarily recognizing the bargaining unit. They also told the National Labor Relations Board that the unit should be expanded to include the back office medical assistants. This could delay the union vote for months while the board investigates.
A national trend
Frustrations around staffing, schedules, and pay were already building in Planned Parenthood clinics across the country when the Supreme Court overturned Roe v. Wade on June 24, 2022. Since then, Planned Parenthood workers have unionized in seven states where abortion is still legal, like Massachusetts, Minnesota, and Iowa.
California’s location near other states with abortion access means abortion providers here aren’t seeing nearly as many out-of-state patients as those states surrounded by more restrictions. In Kansas, for instance, an abortion provider in Wichita called Trust Women received 16,000 calls for appointments on one day in December, says Dr. Jennifer Kerns, a San Francisco-based provider who performs abortions at the Wichita clinic.
“It's been really hard for the workforce,” says Kerns of all abortion providers. There’s a feeling that access to abortion care will continue to shrink, and workers where it is legal will have to be ready to adjust, against a backdrop of burnout in the medical field. It’s an opportunity, she says, for leadership and staff to have conversations about values and sustainability. “The rising burnout is an indication that it's not always happening.”