Abortion care workers look to unionize as Roe decision nears

Trust Women abortion clinic director Ashley Brink prepares a room at the clinic in Wichita, Kan.
(Molly Hennessy-Fiske / Los Angeles Times)

A wave of unionization is sweeping the U.S. abortion care industry as burned-out employees prepare for a major rollback of reproductive rights.

The group Planned Parenthood North Central States United is trying to unionize more than 400 Planned Parenthood workers in Iowa, Minnesota, Nebraska, North Dakota and South Dakota to address issues such as low pay. It’s seeking an election this summer to get the union officially recognized. The organization is joined by clinic workers in Massachusetts trying to unionize, while employees at a major reproductive healthcare researcher are also looking to organize.

“There’s a general disillusionment with the organization,” Sage Shemroske, who uses the pronoun they and works at a clinic in Minneapolis, said of Planned Parenthood.


Shemroske, who checks in patients and supports clinicians at the front desk, complains of low pay — $18 an hour, up from $16 when they started — and overscheduling. Other employees in the network said in statements late last month that they see a strong divide between front-line workers and leadership and said they’re facing burnout. Shemroske says they want to make conditions better to help retain workers amid the broader societal need for maintaining access to reproductive healthcare.

“I like my job — that’s why I’m unionizing,” Shemroske said. “I feel very passionate for reproductive health and reproductive justice, for being pro-abortion and pro-bodily autonomy. It’s almost a feeling of discomfort, of grief, when I come home and know this thing I care about so deeply is also the thing that’s causing me to go to bed late or not be able to go to sleep well, because I’ve seen tomorrow’s schedule and I know it’s going to be overwhelming.”

Molly Gage, vice president of human resources at Planned Parenthood North Central States, said the organization is “committed to creating an inclusive work environment that acknowledges the individual and collective challenges employees face.”

“We support employees’ decisions about whether to be represented by a union and want every union-eligible employees’ voice to be heard,” Gage said in an emailed statement in response to questions from Bloomberg News. “Elections are the essence of democracy. Our staff make our mission possible, and as we work together to empower our patients and achieve our mission, we will work to support the election process underway.”

Healthcare workers have been under extreme stress due to the pandemic, but those providing abortion services are facing heightened strain. Already, a slew of states have passed laws limiting abortion access, forcing some clinics to close and sending droves of patients to the facilities that have been able to stay open elsewhere.

If the U.S. Supreme Court overturns Roe vs. Wade, 26 states are certain or likely to ban or limit abortion, further jeopardizing access for 33 million women. That’s creating increased uncertainty in an industry facing a shortage of providers and putting additional pressure on those in states that still offer care and are dealing with an influx of patients.


In a 2020 survey of 300 reproductive healthcare providers, including at abortion clinics, two-thirds reported increased stress and one-third reported increase anxiety or depression related to providing care during the pandemic. That was before the latest wave of legislation restricting abortion in some areas. In September, Texas’ six-week abortion ban went into effect. That law, known as SB8, has forced 1,400 Texans out of state for abortion care monthly, according to a study by a group based at the University of Texas at Austin. It’s also inspired copycat legislation in other states.

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Some Texans are traveling as far as the East Coast to seek an abortion and are being seen by workers at places including the four centers represented by Planned Parenthood League of Massachusetts. Facing increasing demand and pressure, workers in the Massachusetts group are now looking to form a union.

“What we’re seeing, especially since SB8 passed in Texas, is that there is this unending need for care,” said Caroline Propersi-Grossman, organizer at 1199SEIU United Healthcare Workers East, which is working with the Massachusetts employees in their union effort. “What they want to make sure is that they have enough time to care for and address all patient concerns at every visit.”

Workers want to see better infrastructure and enough staff, and they want access to a union training fund for continuing education, Propersi-Grossman said.

Planned Parenthood League of Massachusetts United, the group looking to unionize about 150 workers, is in touch with the National Labor Relations Board to have ballots mailed out in the coming days. Votes will be counted July 6.

Planned Parenthood League of Massachusetts “respects its workers’ right to organize in favor of a union,” President Jennifer Childs-Roshak said in an emailed statement in response to questions from Bloomberg News. The organization is actively working with the NLRB “to facilitate an election later this month, giving every eligible employee the opportunity to fully understand the process and make their own choice. PPLM will honor the results of that election.”


One Massachusetts worker joined the union effort after clinic leadership made a decision earlier this year to cut visit times for patients to 10 minutes for certain visits, down from 20. That includes screening for sexually transmitted infections and pregnancy options counseling. The employee, who requested anonymity because they feared being targeted as an abortion provider, also said another complaint is that the organization offers minimal paid parental leave.

“To not only attract the most qualified people, but to increase equity in an organization, you have to have benefits and you have to have pay that makes people want to work there,” Propersi-Grossman said. “You can’t go to the grocery store and pay with a mission statement. You have to pay with money.”

It’s not just clinic workers who are looking to organize. Guttmacher Employees United, which is trying to unionize about 70 workers at reproductive healthcare researcher Guttmacher Institute, will also be seeking a union vote this month.

“Guttmacher management has and will continue to encourage staff to participate in this election and their right to vote,” the organization said in an emailed statement. “Following the outcome of the election, we will engage accordingly in contract negotiations.”

Madeleine Haas, who is part of the organizing committee and has worked at the institute for two years, said “there are structural cultural issues at Guttmacher that have been there for a while.”

“Some of the things we want to see change are bringing us closer to pay equity, giving us clearer pathways to promotion, establish more transparency in decision making, better working conditions and many, many other things,” Haas said.


Shemroske, the Minneapolis clinic worker, said those who don’t understand the need for a union should think about “why they feel comfortable without one.” “If we’re not being treated right, how can we give the care patients need in a time when things are so stigmatized?”

Bloomberg staff writer Josh Eidelson contributed to this report.