by Marion Winik
“In some ways, I’ve been preparing for this my whole career,” says Karen Nelson, Executive Director of Planned Parenthood of Maryland, “this” being the Supreme Court’s recent decision in Dobbs v. Jackson, ending federal protection for American women’s access to abortion and leaving all control in the hands of the states.
Fortunately, when it comes to the state of Maryland, women are in good hands.
In early 2022, the Maryland General Assembly ratified the Abortion Care Access Act, sponsored by Senator Dolores Kelly and Delegate Ariana Kelly, currently the strongest protection to access codified into law in any of the fifty states. (An amendment to the state constitution would be even stronger.) With the act on the books, Planned Parenthood of Maryland — and Nelson, at its helm — is at the forefront of regional and national efforts to face, and hopefully shape, our frightening new world.
As an undergraduate at the University of Maryland, Nelson was involved in the campaign for Question Six, the 1992 referendum in which Marylanders affirmed that the state may not interfere with the decision of a woman to terminate a pregnancy. Her first job out of college took her to Buffalo, NY, where she worked for Planned Parenthood for two decades, becoming CEO in 2008. With the Question Six experience behind her, returning to Maryland in 2016 to become a leader in the work that led to the Access Act felt like the closing of a circle.
We spoke with her by Zoom about her role, and the role of Planned Parenthood, in the current situation and in what lies ahead. Our conversation has been edited for length and clarity.
Baltimore Fishbowl: How has Planned Parenthood of Maryland prepared for the post-Roe era? How has the Supreme Court decision changed your mission?
Karen Nelson: Though the fundamental mission of Planned Parenthood — to provide reproductive health care and education, and advocacy for access to health care and abortion care — is never going to change, it is starting to look a little different state by state. In Maryland, we were able to get the Access Act through the legislature, overriding the governor’s veto, in time to start working on logistical support for those who may need to travel to our state for care.
BFB: How did the Act improve access?
KN: One, it expanded the number of providers that could perform abortion care. Two, it created equity by ensuring that insurance providers and Medicaid would treat abortion care like any other health care, with no co-pay and no deductible. Three — and this is where you’ve heard controversy — state law now requires that each year, the Maryland General Assembly fund a $3.5 million program to train abortion care providers, but the governor has failed to release those funds.
BFB: He can do that?
KN: Only because when the Maryland General Assembly passed the budget for the upcoming year, this wasn’t yet a law, so it wasn’t in the budget. The funds would have had to be set aside and released from another area, and the governor has refused to let that happen. On July 1, 2023, there will be a new budget passed and at that point, the funding must be included.
BFB: So could the governor’s race have an impact on abortion access in Maryland?
KN: Yes, because the incoming governor could release the funding immediately after taking office. We need those funds as soon as we can get them to train additional providers. We struggle right now to serve Marylanders and as more states enact bans, we are expecting to see some of their patients here.
BFB: So you’re looking at an influx of people from other states?
KN: We are monitoring the situation very closely. Fourteen states have lost access and as many as 26 states are at risk. In those 26 states, there are more than 36 million people who can be pregnant. In other words, half the population of women of reproductive age in the United States will no longer have access without leaving home — taking off work, arranging childcare (CDC data shows that 60% of those seeking abortion are already mothers), paying the costs of travel and lodging, etc.
We are already seeing Texas patients since Texas was the first to enact a really severe ban last fall. Now we’re monitoring the situation in our bordering states. West Virginia, for example, is certainly going to lose care. And they only have one provider as it is.
In the reproductive health world, Maryland is seen as either the southernmost northern state or the northernmost southern state. So we watch the I-95 corridor very carefully. The first stop right now for women who need help is probably North Carolina. But they have only so many providers. Virginia is the next option, at least for now — you saw what happened there in the last election.
Maryland is relatively easy to get to, not just by road but by air and train, and our fundraising department is working very hard to raise funds to help us prepare to open additional hours and centers as needed. [see “How to Help,” below.]
BFB: I keep hearing people say that the American population is majority pro-choice, like if we all just could sit down and vote on this, we would all have access to abortion.
KN: I do believe that most people are pro-choice. I see it not just in the bubble of Planned Parenthood, I see it throughout my professional life, and I see it across this state. On the day the court overturned Roe v. Wade, we were receiving calls from all kinds of people.
People who I know supported Trump were saying I can’t believe this happened. But you can’t have an I told you so attitude. You have to use it as a teachable moment, a chance to talk about why elections matter.
On Decision Day, I was out on the Eastern Shore where of course it’s more conservative, and the rally we held that afternoon got such an amazing response, including from people driving down the street, people giving thumbs up, people saying I’m with you — we don’t typically get that reaction.
BFB: Speaking of which, your headquarters on Baltimore City is literally next door to a “crisis pregnancy center.” What is that like?
KN: This is something we are very used to because one of the strategies of the anti-choice movement is to set up as close as possible to Planned Parenthood, in order to create confusion and to intercept patients on their way in. I dealt with it in western New York, they’re right across the street in Annapolis, so when they showed up on Howard Street a couple of years ago, I was not surprised.
Every single day, our patients and our staff are greeted by protestors. And we have to balance our concern for free speech with the security issues it creates. It’s mainly very maddening because it doesn’t matter why they’re coming in the door, folks have to deal with this in order to get health care.
The fact is, 60% of the patients that we see will not go anywhere else for healthcare at all during the year. This is it for them. So 60% of over 25,000 patients can’t get in to see a doctor for whatever reason without being harassed and being judged.
For anyone coming in to see us — please look for the escorts who are there to help you get into the building.
BFB: Why is that? What makes Planned Parenthood the single place they will go?
KN: Well, a couple of reasons. If you are uninsured you know we’re an organization that will see you, no matter what. Many people don’t have primary care doctors, but they do need birth control or STD testing, and we’re the way they know to get it. For younger patients, we are often the first entry into the healthcare system on their own.
BFB: Is there any bright side to the current situation?
KN: I do think that this is causing lots of discussions. People are beginning to talk about their own abortions — something that was traditionally stigmatized and highly secret — more freely and easily. It’s still a very private matter for many, but you are seeing people talk more openly about abortion care. And the younger people are talking about it on social media.
How To Help
• SHARE https://Abortionfinder.org with anyone seeking care.
• LEARN MORE at https://BansOff.org or text ACCESS to 22422
• DONATION OPTIONS
1. Planned Parenthood of Maryland’s Abortion Access Campaign. All donations up to $100,000 are matched by the Hackerman Foundation. www.ppm.care/abortionaccess
2. PPM’s June Coleman abortion assistance fund directly helps patients without funds or insurance cover the cost of their abortion visit at PPM. www.ppm.care/junecoleman
3. Outside of PPM, local abortion funds provide traveling and lodging support for patients who face barriers to care. https://www.baltimoreabortionfund.org.
• VOLUNTEER
Planned Parenthood of Maryland: https://www.plannedparenthood.org/planned-parenthood-maryland/get-involved-locally/volunteer-internship-information
Baltimore Abortion Fund https://www.baltimoreabortionfund.org/volunteer
Thank you for printing this interview with PPM CEO Karen Nelson. As a former PPM Board member I’m very very proud of Karen and her staff – the health care services they provide are cricially important and PPM is about way more than abortion care. Many patients have no other source of health care and for those who have very limited incomes and no health insurance – PPM is a life saver. KUDOS to all who serve patients at PPM clinics in Maryland. I hope your readers will want to volunteer as well as contribute to PPM.