It has been six months since the United States Supreme Court overturned the constitutional right to abortion. Planned Parenthood was the nation’s largest abortion provider and is still a lightning rod for conservative lawmakers who would prefer the healthcare provider to be permanently closed.
Ashley Coffield, CEO of Planned Parenthood of Tennessee and North Mississippi, sat down with The Commercial Appeal to discuss what the healthcare provider’s next steps are and how the days after the Dobbs v. Jackson Women’s Health Organization decision overturned Roe v Calf.
The Commercial Appeal: I was wondering if you could tell the readers a little bit about how the fight for abortion access continues from here? To this end, is there currently a central strategy for the work of TAPP (Tennessee Advocates for Planned Parenthood)? How would you describe the priorities in the next 6, 12, 24 months?
Ashley Coffield: We’re looking at more of a relational organizational model, where we have deep and meaningful conversations about shared values with people we’ve never spoken to before. And we encourage our supporters to do the same. And ultimately, our goal is to have in all 95 counties of Tennessee what we call Councils of Action, and they’re grassroots, organizing bodies that take on a portion of the movement that interests them.
Francie Hunt, our executive director of Tennessee Advocates for Planned Parenthood, is walking across the state of Tennessee launching this radical relationship organizing model by having these conversations with people in rural, metropolitan, and suburban areas about our shared values.
And what she finds out is that we have more in common than just differences. That people agree that abortion should be legal, they agree that we should treat each other kindly and respectfully and have equal opportunities. And that includes LGBTQ people and people of different races. That we should all have access to good health care, that we should all have access to a good education, that we should all have choices…we all share those values. Tennessee politicians are using fear to tear us apart, preying on people’s fears. And the result is that we don’t really have conversations with each other about things that matter most to us, and our politics are broken. In Tennessee there is fragmentation and a total disconnect between what elected officials do in office and what people expect of them.
CA: I’m glad you grew up talking to each other and I thought about it while you talked. There was this feeling that the idea of talking to each other, really trying to reach common ground, is kind of non-conductive, non-effective. It’s almost like sleeping with the enemy and coddling extremists. So my question is, what should you ask people to consider before completely copying conversations with people they may or may not agree with, even on darker topics.
Ashley Coffield: Just because you have fears and politicians have exploited those fears doesn’t mean you’re an extremist at the end of the day. We are all afraid of change and we are afraid that things will change. It’s about changing the way we talk about the things we fear without ever downplaying the dangers of extremism. However, always acknowledge it (extremism), always call it — but don’t assume that because people are prone to fear mongering, they can’t be like you, or that we can’t talk about sharing values.
The CA: I think for many people, and certainly for Planned Parenthood staff, the end of abortion access in Tennessee felt inevitable. Even so, knowing that it was a probable reality couldn’t really prepare for it. I was wondering if you could explain to me how the final day of abortion access was like Planned Parenthood?
Ashley Coffield: We knew abortion was going to be banned before the leak (Dobbs’ decision), the leak just confirmed it, and it gave us a couple of weeks to prepare. The day the Dobbs decision was made was a Friday. And we had previously made a decision that we would not perform abortions under the state’s six-week ban. We opened clinics that Saturday that weren’t normally open, because back then we were open on some Saturdays, but not all.
So we didn’t even have an abortion provider in line that Saturday. But all of our service providers raised their hands and said they would come in. So we scheduled as many people as possible for this Saturday, people who have appointments for the next week. The last abortion we performed was Monday morning, and then the six-week ban went into effect Monday afternoon.
It’s very scary working everyday and not knowing if [the complete ban takes effect while] You’re in the middle of a procedure or you’ve been treating patients with drugs, and then all of a sudden a total ban comes into effect and you have to turn people away. It was traumatizing for the patients and it was traumatizing for our staff.
The CA: When we talk about our most disenfranchised citizens of the South and Mid-South, access to information and even the ability to truly absorb news and politics isn’t always easy or straightforward. Do patients still come who don’t know that abortion is no longer possible for them?
Ashley Coffield: Yes, we absolutely still get pregnant women who think we can help and offer an abortion. We still have healthcare providers who refer us for abortion services. I had a call with our medical leadership team this morning and they confirmed we are still getting calls that people don’t really understand what’s going on. This is a radical change. It’s a sea change for people in the healthcare system. And I just think doctors can’t believe that the services they’ve relied on for decades aren’t there anymore and that they need to have these conversations with patients.
And for the people who know that abortion is no longer legal in Tennessee, we try to educate them and say we’re still here. And we can help people access abortion. Even though we can’t do it here at home, we can help them achieve out-of-state abortion. And we offer patient navigation services that can help those with financial resources. We can help them remove the logistical barriers they have. So on the one hand there are people who don’t know and on the other hand there are people who know but don’t ask for help.
The CA: Move a little further, black mother mortality remains a problem in Memphis. to my knowledge it was never a problem. Can you talk a little about the concerns we are currently looking at for low-income pregnant people of color? And looking ahead, if nothing major changes, what are the worst problems they might face?
Ashley Coffield: We are most concerned about Black women who are pregnant and have complications, and the hesitancy and anxiety that providers have in treating these complications because of trigger prohibition. And they may be the least able to advocate for themselves in our healthcare system. So we’re really concerned, you know, that at the end of the day when we have some data on the effects of the Trigger Act, there’s going to be extreme disparity by race in terms of those who are capable of doing that get emergency care they need when faced with pregnancy complications. Because black women are much more likely to suffer from a pregnancy complication than other races.
The CA:Memphis was once at the forefront of the nation for black infants who died before their first birthday and this was due to the severe lack of prenatal health care for these parents. I know that Planned Parenthood has never offered prenatal health care. But are there any concerns among your peers – professionals who work in reproductive health care – that the infant mortality rate among blacks could be on the rise again?
There is absolute concern. There is a clear link between maternal health and infant mortality. And women’s ability to plan their births has a major impact on infant mortality. And abortion is key to properly planning childbirth and conceiving when you are ready to conceive. In my opinion, without abortion as this crucial piece of the family planning puzzle, not only will maternal mortality increase, but also infant mortality. They go hand in hand.
The CA: Outside of abortion, Planned Parenthood is also one of the top providers of essential public health services in the area, such as STI testing, gender-affirming care, and access to birth control. Now that abortion is illegal in Tennessee, how are these other services holding up? And are there any plans to expand these services?
Yes absolutely. We’ve definitely seen an increase in patients using family planning services, particularly birth control, and seeking information on everything they can do to prevent pregnancy — including purchasing many emergency contraceptives. We’ve had many men call us asking for vasectomy services. These are mostly younger men who don’t have insurance, and trans women have also called us asking about vasectomy services. So we plan to launch that early in 2023.
We are also examining the expansion of family doctor care. Some of our patients come to us with comorbidities that require treatment and we need to refer them to these services. Many people treat their family planning provider as their only provider. We’re the only provider that many, many of our patients have. So we never had the bandwidth to go beyond traditional family planning and abortion. But now that we have more bandwidth, we will, and we believe it will have a huge impact on the health of our population. It will be great to help them treat things like high blood pressure and diabetes.
The CA: Even though Planned Parenthood no longer provides abortions, I still see protesters outside the facility almost every day. What are you protesting against?
Ashley Coffield: There are several things that you object to. They’re protesting our trans care. They protest against our values around bodily autonomy. And that ties into STI testing and treatment and birth control. And third, they want to close this. They had hoped that abortion would be the death knell, and now that it isn’t, they want to turn away as many patients as possible. So it’s these three reasons.
Micaela Watts covers the access and equity beat for The Commercial Appeal. She can be reached at [email protected]