Planned Parenthood staff in New York complain about ‘devastating’ cuts to abortion services

In the coming weeks, Planned Parenthood’s Manhattan health center will stop providing basic reproductive health services, including abortions after 20 weeks and deep sedation for procedures such as abortions or IUD insertions.

The Manhattan clinic currently offers abortions up to 24 weeks and is the only Planned Parenthood location in the state to do so. The group has struggled financially and plans to close several New York clinics in the near future.

Planned Parenthood of Greater New York (PPGNY), which runs the Manhattan clinic, announced the changes — which the group said were temporary and would go into effect Sept. 3 — earlier this month, blaming financial problems. The organization said it would refer patients who needed the services to independent providers.

“Any reduction in access is really devastating,” said one staff member. “People who seek abortions later in their pregnancy are a very vulnerable and highly stigmatized group of people.”

Staff said the clinic had already quietly stopped providing some services more than three weeks before the Sept. 3 date.

In a press release, PPGNY reports quoted budget deficits partly due to state lawmakers’ failure to increase Medicaid reimbursement rates for medical abortion. More than half of the organization’s patients have Medicaid, a state-run health insurance program for low-income people. The affiliate says financial pressures make it impossible to afford an outside anesthesia provider, and that deep sedation is the standard of care for abortions after 20 weeks.

The New York office said it has implemented other cost-cutting measures, such as executive pay cuts and consolidated functions, but PPGNY also plans to near four health centers awaiting state approval – including the clinic only in Staten Island, where currently only medication abortion is offered.

More than 115 employees of the Manhattan clinic signed a petition on August 2 to the leadership of PPGNY, requesting an extension of the contract with the anesthesia nurse. Deep sedation – one level below general anesthesia – is an important option for minors, survivors of sexual abuse and people with PTSD and other mental health diagnoses, the staff wrote. They added that of the clinic’s abortion patients who don’t use pills, about 80 percent opt ​​for deep sedation.

According to clinic staff, the facility quietly scaled back its services several weeks before the planned change.

According to an employee, deep sedation is now available only to abortion patients who are more than 19 weeks and six days pregnant, to people who are allergic to the medications used for moderate sedation, and to people with a substance use disorder. (The medications are an opioid and a benzodiazepine.) There are no other exceptions, they said.

Some patients who booked deep sedation abortions for August had made the necessary and often expensive preparations, only to find upon arrival that their only options were moderate sedation and local anesthesia, a second worker said. Some chose not to have an abortion as a result, while others felt they had to go ahead because they had already taken time off work or had arranged for childcare. Both workers asked to remain anonymous for fear of professional retaliation.

The anesthesia staff will continue to work on site until August 31 for permitted cases, even though they will not be providing services to patients under 20 weeks.

“We had a minor who flew in from out of state who was devastated and inconsolable because she now had to be referred for deep sedation,” an anonymous staff member said in a proposition issued by 115 anonymous staff members protesting the change. “We had to tell a patient who wanted to have the procedure without deep sedation but couldn’t tolerate it that he needed to get dressed and that we couldn’t complete the procedure here, even though our anesthesiologist was 10 feet away,” another staff report said.

Wendy Stark, CEO of Planned Parenthood of Greater New York, acknowledged in a proposition that the clinic had “reserved deep sedation resources in the last month of our contract” for select patients. Stark said the operational changes were “heartbreaking” to implement and cited “unprecedented challenges” facing the subsidiary, including budget deficits of “well over $10 million.” She urged state officials to increase Medicaid reimbursement rates for abortions performed with pills.

“A lot of people do very well with moderate sedation,” the first worker said. “We just want people to still have that option.” The other added, “We have a lot of patients who would rather sleep, for whatever reason.”

Planned Parenthood leadership said at a June meeting that the new pregnancy limit would affect a small number of people, with “only” 282 patients having abortions after 20 weeks in 2023. “As health care professionals, we consider this to be unbearable collateral damage,” the staff wrote in the petition.

The workers are calling on PPGNY, New York State and donors to “find a way” to avoid the service cuts.