Next year, CHOICES Memphis Center for Reproductive Health will open the first non-profit clinic in the U.S. providing both birth and abortion services under the same roof.
The road to a truly comprehensive reproductive health practice has been long, winding and full of potholes. I could not be more proud that in April, we’ll finally get there.
I joined CHOICES as Executive Director in 2009 after a 15-year career in arts administration. Although I was an experienced non-profit executive, I was clearly entering a different world. Where was the mailing list? What was the marketing plan?
Although the clinic was providing safe medical care by a compassionate team, it had a precarious business model and was isolated from the rest of the healthcare community. That isolation combined with the political climate in the south kept the organization stuck in what felt like a vulnerable and dangerous place.
As I began to ask about the clinic’s history and operations and to attend conferences with other abortion providers, I understood that this isolation was primarily the result of anti-choice strategy. The care was so stigmatized that many physicians refused to perform the procedure out of fear of repercussions, both professional and physical. As a result, most abortion providers tended to work in stand-alone, abortion-only clinics with little to no interaction between them and other healthcare providers, hospitals or community groups.
At the same time, I was so impressed by the patient-centered and respectful care CHOICES provided to our patients. I remember thinking that everyone deserved this type of care. We soon started asking ourselves what else we could provide, and who else we could serve.
The private fertility practices in Memphis at this time would not take patients who were not married, leaving single people and same sex couples with no options for fertility help—sour nurse midwife began offering basic fertility assistance services. We added family planning for persons living with HIV, another population whose reproductive needs and preferences had been ignored or dismissed. We saw a need for hormone replacement services and wellness checkups for persons of transgender experience, so we added those services too. With these additions, we began expanding the scope and definition of reproductive health care beyond abortion and contraception.
As CHOICES grew, we consciously increased our involvement in the larger Memphis healthcare community. I started attending any local meeting that had “health” in its title—conferences on diabetes, hypertension and discussions of payment changes in the insurance industry. I introduced myself in these groups and spoke with pride about CHOICES’ work.
One day, when I was searching for stock photos for our website, and was mostly seeing many pictures of happy mothers and babies, I had another thought: Wait a minute. Why do “they” get all the happy pictures? Birth is part of feminist health care. We should take that back.
A few months later, the CHOICES Board of Directors approved adding prenatal care and birth services to the organization’s strategic plan.
We understood that the people who have abortions and the people who give birth are the same people, because the majority of our abortion patients were mothers. And as we began to learn more about the maternity system in the U.S., we found that, unlike many other developed countries, U.S. caesarean rates were skyrocketing. Other medical interventions were also on the rise but the outcomes for moms and babies were getting worse—especially for people of color. We learned that black women were three to four times more likely to die in childbirth than white women. It was clear that birthing women of color were either not being seen or heard, or else their stated intentions and desires were being discounted.
We learned that midwifery provided another model—one that was more personal and more relationship-based, much like the abortion care that we were already providing. While Memphis had some outstanding home-birth midwives, it did not have a birthing center, and soon, bringing this choice to birthing people, especially to people of color, became a critical part of our mission. Off we went, on a $5 million dollar capital campaign.
Our inclusion of birth services also diversifies our revenue stream. With the current make-up of the United States Supreme Court, the ability of practices like CHOICES to provide abortion care hangs on a thread. We watched powerless just a few years ago while dozens of abortion-providing clinics closed in Texas while awaiting an ultimately positive judgement from the Supreme Court. We understood then that you have to be able to stay open in order to fight bad laws. By diversifying our services, we plan to be able to stay and fight, should providing abortion become illegal or impossible.
CHOICES’ mission is to provide patient-centered medical care and champion sexual and reproductive rights. Our vision is a world where sexual and reproductive healthcare is recognized as an essential human right.
Our new center hasn’t opened yet, but we have already changed perceptions in our community. Organizations that once would have hesitated to work with an abortion provider are building professional partnerships with our midwifery program. Patients here for an abortion have asked to speak to a midwife and ultimately decided to continue their pregnancies. At least one midwifery patient, after having access to truly unbiased counseling, decided to terminate her pregnancy.
People are making their own CHOICES—and we are here to support them.