All About Abortion Clinics and Providers

An abortion, a common form of healthcare in America, can be performed safely at a healthcare facility or at home. Before medication abortion was made available through telehealth and the mail, however, the vast majority of abortions took place in a healthcare facility.

Unlike other forms of healthcare, abortions are predominantly performed at specialized abortion clinics, rather than hospitals or other types of healthcare facilities. Abortion clinics are staffed by what we often refer to as providers, which includes (but is not limited to) doctors, nurses, patient support staff, security, and administrative staff.

Why Separate Clinics for Abortion?

When Roe v. Wade legalized abortion nationwide in 1973, most states still had abortion bans in effect and therefore, no infrastructure or plan as to how to implement legal abortion care. The few states that had legal abortion, like New York, had separate clinics where abortion was performed, rather than at a hospital. This pattern continued in the wake of Roe—freestanding clinics, dedicated to abortion care, were less expensive than hospital care and ensured that the staff was supportive of abortion care so that the patient was treated with dignity and respect. Freestanding abortion clinics proliferated; by 1978, there were 129 abortion clinics across the United States. And it radically changed the landscape of reproductive health. By the end of the 1970s, abortion-related deaths had fallen by 98%.

But the separateness that made abortion clinics unique and able to provide customized care also led to unintended consequences. They made abortion patients and providers easier to target for abortion opponents, and publicly designated abortion care as a different kind of medical procedure, one that was largely left out of hospitals, public healthcare systems, and private practices. That difference may have contributed to the pervasive stigma against abortion and against the people who provide them. As recently as 2020, half of all medical schools don’t include any formal training or more than a single lecture on abortion care. Fewer than a thousand abortion facilities across the country also means that the number of places medical professionals can learn during residencies or while practicing is also inherently limited.

Types of Abortion Facilities

There are a handful of different types of clinics and medical facilities that offer abortion services:

Affiliated Clinics

The most broadly known type of clinics are Planned Parenthoods, which are also known as “affiliated” clinics. This means that, rather than having independent ownership and staff, they are part of the broader Planned Parenthood name and brand. Affiliated clinics operate under the auspices of Planned Parenthood, which provides name recognition, funding, and broader political connections. 45% of abortions are done at Planned Parenthoods and the vast majority of Planned Parenthood clinics only offer first trimester care, with abortion care just 3% of the healthcare they provide.

Independent Clinics

The majority of abortions in the United States are performed at independent abortion clinics, which are community-based reproductive health clinics. Unlike affiliated clinics, independent abortion clinics are locally owned and operated, and do not operate as part of the broad, national brand of Planned Parenthood.

While independent abortion clinics provide 55% of abortions in the U.S., lack the name recognition, political connections, and resources that Planned Parenthood has. Not only that, but the majority of abortions performed after the first trimester take place at independent clinics, which are also more likely to offer both medication and procedural abortion care. 86% of abortions at or after 22 weeks and 100% of abortions after 26 weeks are provided by independent clinics. This means that independent clinics often offer abortion seekers a more expansive array of services so that they can have the kind of abortion that they want.

Other

Abortion is also performed at some hospitals and private physician practices, but compared to independent and affiliated clinics, it is woefully inadequate. Private practices account for 3% of abortions in the U.S., and hospitals a mere 1%. This means that 96% of all abortions that are done in a healthcare facility are performed at clinics that specialize in abortion care.

Dwindling Access

Unfortunately, the number of abortion clinics in America has dramatically decreased in recent years. The Abortion Care Network, which represents independent abortion clinics, collects and shares data on independent abortion clinics across the U.S. in their annual “Communities Need Clinics” report. According to their most recent edition, nearly a third of all independent abortion clinics have been forced to close in the past decade. What’s more, closures aren’t just in states with abortion bans, either—supportive states like California, New York, and Illinois have had 35 independent abortion clinic closures since 2018 alone.

Violence Against Abortion Providers

While having separate, designated sites for abortion care made it easier for providers to offer customized care, it also made providers easier to target for abortion opponents. Ever since Roe v. Wade, abortion clinics have been sights of targeted aggression and violence from anti-abortion fanatics. Beginning in the late 1970s, groups of abortion opponents began “picketing” outside of abortion clinics, yelling at abortion seekers and trying to keep them from accessing care. In the 1980s, a radical group called Operation Rescue brought thousands of abortion fanatics to clinic sites; some would chain themselves to the clinic’s doors, glue the locks, physically block patients from entering the clinic—anything to keep abortion clinics from operating.

Since 1977, there have been more than 1.4 million reports of violence and disruption against abortion clinics in the United States. Anti-abortion terrorists have murdered 11 abortion staff, including physicians, clinic workers, volunteers and security guards, since 1994. According to the National Abortion Federation, which tracks violence and aggression against abortion providers, violent threats against abortion providers have increased dramatically in the past five years.

What are Crisis Pregnancy Centers (CPCs)?

Crisis pregnancy centers (CPCs) are fake, unlicensed facilities that are designed to look like abortion clinics but are instead run by abortion opponents to deceive, shame, and pressure people out of having an abortion. They often have deceptive names that mimic names of abortion clinics in an attempt to confuse abortion seekers. CPCs outnumber legitimate abortion clinics in the United States nearly 3 to 1, which will only increase as more states ban abortion. 

HBO’s John Oliver explored CPCs and the harm they perpetrate in a featured segment on his show: