История Планированного родительства в США: от борьбы за контрацепцию до защиты репродуктивных прав.

US nonprofit reproductive health services organization

Its combined annual revenue is US$1.3billion, including approximately $530million in government funding such as Medicaid reimbursements. They distributed birth control, birth control advice, and birth control information. All three women were arrested and jailed for violating provisions of the Comstock Act, accused of distributing obscene materials at the clinic. The so called Brownsville trials brought national attention and support to their cause. Sanger and her co defendants were convicted on misdemeanor charges, which they appealed through two subsequent appeals courts. While the convictions were not overturned, the judge who issued the final ruling also modified the law to permit physician prescribed birth control. The women's campaign led to major changes in the laws governing birth control and sex education in the United States. In 1921, the clinic was organized into the American Birth Control League, the core of the only national birth control organization in the U. S. until the 1960s. By 1941, it was operating 222 centers and had served 49,000 clients. In 1923, Sanger opened the Birth Control Clinical Research Bureau (BCCRB) for dispensing contraceptives under the supervision of licensed physicians and studying their effectiveness. Some found the ABCL's title offensive and "against families", so the League began discussions for a new name. In 1938, a group of private citizens organized the Citizens Committee for Planned Parenthood to aid the American Birth Control League in spreading scientific knowledge about birth control to the general public. The BCCRB merged with the ABCL in 1939 to form the Birth Control Federation of America (BCFA). In 1942 the name of the BCFA was changed to the Planned Parenthood Federation of America. In 1961, the population crisis debate, along with funding shortages, convinced PPFA to merge with the World Population Emergency Campaign, a citizens' fund raising organization to become PPFA World Population. For much of the organization's history, however, and throughout Sanger's life, abortion was illegal in the U. S., and discussions of the issue were often censored. During his tenure, the Food and Drug Administration (FDA) approved the sale of the original birth control pill, giving rise to new attitudes towards women's reproductive freedom. The Center for Family Planning Program Development was also founded as a semi autonomous division during this time. The center became an independent organization and was renamed the Guttmacher Institute in 1977. Focusing, at first, on legalizing therapeutic abortion, Planned Parenthood became an increasingly vocal proponent of liberalized abortion laws during the 1960s, culminating in its call for the repeal of all anti abortion laws in 1969. In the years that followed, the organization played a key role in landmark abortion rights cases such as Roe v Wade (1973) and Planned Parenthood v Casey (1992). During her term, Planned Parenthood grew to become the seventh largest charity in the country, providing services to four million clients each year through its 170 affiliates, whose activities were spread across 50 states. From 1996 to 2006, Planned Parenthood was led by Gloria Feldt. Feldt activated the Planned Parenthood Action Fund (PPAF), the organization's political action committee, launching what was the most far reaching electoral advocacy effort in its history. The PPAF serves as the nonpartisan political advocacy arm of PPFA. It engages in educational and electoral activity, including legislative advocacy, voter education, and grassroots organizing to promote the PPFA mission. Feldt also launched the Responsible Choices Action Agenda, a nationwide campaign to increase services to prevent unwanted pregnancies, improve the quality of reproductive care, and ensure access to safe and legal abortions. In 2012, Richards was voted one of Time magazine's 100 Most Influential People in the World. Richards' tenure as president of the organization ended on April 30, 2018. Current Planned Parenthood board member Joe Solmonese was appointed as transition chair to temporarily oversee the day to day operations of Planned Parenthood after Richards' departure. On September 12, 2018, the organization announced that Leana Wen would take over as president, effective November 2018. Wen was removed as president of Planned Parenthood by the organization's board of directors on July 16, 2019. Alexis McGill Johnson, a board member and former chairwoman, became the organization's acting president.

In October 2021, a hacker gained access to the data network of the Los Angeles branch of Planned Parenthood and obtained the personal information of approximately 400,000 patients. On December 1, 2021, The Washington Post reported that the breach was a ransomware attack. The organization did not say if they paid the ransom or if the perpetrators made any demands. There was no indication as to who was responsible for the hack. The Metropolitan Washington branch of Planned Parenthood was also hacked in 2020 with donor and patient information compromised, including dates of birth, social security numbers, financial information, and medical data.

In 1966, PPFA began awarding the Margaret Sanger Award annually to honor, in their words, "individuals of distinction in recognition of excellence and leadership in furthering reproductive health and reproductive rights." In the first year, it was awarded to four men: Carl G. Hartman, William Henry Draper Jr., Lyndon B. Johnson, and Martin Luther King Jr. Later recipients have included John D. Rockefeller III, Katharine Hepburn, Jane Fonda, Hillary Clinton, and Ted Turner.

The services provided by PPFA affiliates vary by location, with just over half of all Planned Parenthood affiliates in the U. S. performing abortions. Services provided by PPFA include birth control and long acting reversible contraception; emergency contraception; clinical breast examinations; cervical cancer screening; pregnancy testing and pregnancy options counseling; prenatal care; testing and treatment for sexually transmitted infections; sex education; vasectomies; LGBT services; and abortion. Contrary to the assumption of some, Planned Parenthood conducts cancer screenings but does not provide mammograms, although Planned Parenthood physicians do refer their patients to other outside clinics where they can get mammograms. In 2013, PPFA reported seeing 2.7million patients in 4.6million clinical visits. According to PPFA, in 2014 the organization provided 3.6million contraceptive services, 4.5million sexually transmitted infection services, about onemillion cancer related services, over onemillion pregnancy tests and prenatal services, over 324,000 abortion services, and over 100,000 other services, for a total of 9.5million discrete services. Education is available regarding male birth control and lowering the risk of sexually transmitted infections. Planned Parenthood won the 2020 Webby Award for Machine Learning and Bots for their Sex Education chatbot.

PPFA has two national offices in the United States: one in Washington, D. C., and one in New York City. It has three international offices, including a hub office in London, England. It has 68 medical and related affiliates and 101 other affiliates including 34 political action committees. These affiliates together operate more than 700 health centers in all 50 states in the U. S. plus the District of Columbia. PPFA owns about $54million in property, including real estate. In addition, PPFA spends a little over $1million per year for rented space.

PPFA's international outreach and other activities are performed by Planned Parenthood Global, a division of PPFA, and by the International Planned Parenthood Federation (IPPF) which now consists of more than 149 Member Associations working in more than 189 countries. The IPPF is further associated with International Planned Parenthood Federation affiliates in the Caribbean and the Americas, and IPPF European Network, as well as other organizations like Family Planning Queensland, Pro Familia (Germany) (de) and mouvement français pour le planning familial (French Movement for Family Planning) (fr). Offices are located in New York, NY; Washington, D. C.; Miami, FL; Guatemala City, Guatemala; Abuja, Nigeria; and Nairobi, Kenya. The organization's focus countries are Guatemala, Nicaragua, Costa Rica, Ecuador, Peru, Senegal, Burkina Faso, Nigeria, Sudan, South Sudan, Uganda, Ethiopia, and Kenya. The Bloomberg Philanthropies donated $50million for Planned Parenthood Global's reproductive health and family planning efforts in Tanzania, Nicaragua, Burkina Faso, Senegal and Uganda. Among specific countries and territories serviced by Planned Parenthood Global's reproductive planning outreach are Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Peru, Suriname, Venezuela, Puerto Rico, U. S. Virgin Islands, Dominican Republic, Barbados, Bolivia, Ecuador, Guadeloupe, Saint Martin, Guyana, Cape Verde and Samoa. Nixon described Title X funding as based on the premise that "no American woman should be denied access to family planning assistance because of her economic condition." Donors to Planned Parenthood have included the Bill & Melinda Gates Foundation, the Buffett Foundation, the Ford Foundation, the Turner Foundation, the Cullmans, and others. The Bill & Melinda Gates Foundation's contributions to the organization have been specifically marked to avoid funding abortions. Corporate donors include CREDO Mobile. In the fiscal year ending June 30, 2014, total revenue was $1.3billion: non government health services revenue was $305million, government revenue (such as Medicaid reimbursements) was $528million, private contributions totaled $392million, and $78million came from other operating revenue. According to Planned Parenthood, 59 percent of the group's revenue is put towards the provision of health services, while non medical services such as sex education and public policy work make up another 15 percent; management expenses, fundraising, and international family planning programs account for about 16 percent, and 10 percent of the revenue in 2013–2014 was not spent. Eight statesAlabama, Arkansas, Indiana, Kansas, Louisiana, New Hampshire, Ohio, and Utahhave enacted such proposals. In some cases, the courts have overturned such actions, citing conflict with federal or state laws; in others the federal executive branch has provided funding in lieu of the states. In some states, Planned Parenthood was completely or partially defunded. In August 2015, Louisiana Governor Bobby Jindal attempted to end Louisiana's contract with Planned Parenthood to treat Medicaid patients at a time when there was an epidemic of sexually transmitted infections in Louisiana. Planned Parenthood and three patients sued the state of Louisiana, with the United States Department of Justice siding with Planned Parenthood. On February 2, 2016, the U. S. House failed to override President Obama's veto of (Restoring Americans' Healthcare Freedom Reconciliation Act of 2015) which would have prohibited Planned Parenthood from receiving any federal Medicaid funds for one year. Late in 2016, the Obama administration issued a rule effective in January 2017 banning U. S. states from withholding federal family planning funds from health clinics that give abortions, including Planned Parenthood affiliates; this rule mandates that local and state governments give federal funds for services related to sexually transmitted infections, pregnancy care, fertility, contraception, and breast and cervical cancer screening to qualified health providers whether or not they give abortions. However, this rule was blocked by a federal judge the day before it would have taken effect. In 2017, it was overturned by new legislation. The proposed American Health Care Act , announced by Congressional Republicans in March 2017, would have made Planned Parenthood "ineligible for Medicaid reimbursements or federal family planning grants." On August 19, 2019, Planned Parenthood voluntarily withdrew from Title X funding due to a regulatory gag order stating that medical institutions that receive Title X funding cannot refer patients for abortions.

Planned Parenthood is an advocate for the legal and political protection of reproductive rights. This advocacy includes helping to sponsor abortion rights and women's rights events. The Federation opposes restrictions on women's reproductive health services, including parental consent laws for minors. To justify this position, Planned Parenthood has cited the case of Becky Bell, who died following an illegal abortion rather than seek parental consent for a legal one. Planned Parenthood also takes the position that laws requiring parental notification before an abortion can be performed on a minor are unconstitutional on privacy grounds. The organization opposes laws requiring ultrasounds before abortions, stating that their only purpose is to make abortions more difficult to obtain. Planned Parenthood has also opposed initiatives that require waiting periods before abortions, and bans on late term abortions including intact dilation and extraction, which has been illegal in the U. S. since 2003. Planned Parenthood supports the wide availability of emergency contraception such as the PlanB pill. It opposes conscience clauses, which allow pharmacists to refuse to dispense drugs against their beliefs. Planned Parenthood has been critical of hospitals that do not provide access to emergency contraception for rape victims. Citing the need for medically accurate information in sex education, Planned Parenthood opposes abstinence only education in public schools. Instead, Planned Parenthood is a provider of, and endorses, comprehensive sex education, which includes a discussion of both abstinence and birth control. Planned Parenthood's advocacy activities are executed by the Planned Parenthood Action Fund, which is registered as a 501(c)(4) charity, and files financial information jointly with PPFA. Although the Planned Parenthood Action Fund (PPAF) shares some leadership with the Planned Parenthood Federation of America, the president of PPAF, Cecile Richards, testified before Congress in September 2015 that she did not manage the organization. The Planned Parenthood Action Fund has 58 active, separately incorporated chapters in 41 states and maintains national headquarters in New York and Washington, D. C. Planned Parenthood has received grants from the Obama administration to help promote the Patient Protection and Affordable Care Act, or ObamaCare.

Planned Parenthood spends money on politics and elections through the Planned Parenthood Action Fund (its federal political action committee), through its Super PAC, and through a variety of related 501(c)(4) entities. Planned Parenthood endorsed Obama in the 2008 and 2012 presidential elections. In the 2014 election cycle, Planned Parenthood spent $6,587,100 on contributions to candidates and political parties (overwhelmingly to Democrats) and on independent expenditures.

A 2020 study found that closure of Planned Parenthood clinics resulted in increases in the maternal mortality rate: "Planned Parenthood clinic closures negatively impacted all women, increasing mortality by 6–15% across racial/ethnic groups." A 2016 study found that the exclusion of Planned Parenthood affiliated clinics from Texas's Medicaid fee for service family planning program was linked to reductions in the provision of contraception and an increase in child bearing for women who used injectable contraceptives and who were covered by Medicaid.

In the 1920s, various theories of eugenics were popular among intellectuals in the U. S. In her campaign to promote birth control, Sanger teamed with eugenics organizations such as the American Eugenics Society, although she argued against many of their positions. Scholars describe Sanger as believing that birth control and sterilization should be voluntary, and not based on race. Sanger advocated for "voluntary motherhood"—the right to choose when to be pregnant—for all women, as an important element of women's rights. As part of her efforts to promote birth control, however, Sanger found common cause with proponents of eugenics, believing that she and they both sought to "assist the race toward the elimination of the unfit". Critics of Planned Parenthood often refer to Sanger's connection with supporters of eugenics to discredit the organization by associating it, and birth control, with the more negative modern view of eugenics. Planned Parenthood has responded to this criticism directly in a leaflet acknowledging that Sanger agreed with some of her contemporaries who advocated the voluntary hospitalization or sterilization of people with untreatable, disabling, or hereditary conditions, and limits on the immigration of the diseased. The leaflet also states that Planned Parenthood "finds these views objectionable and outmoded" but says that it was compelled to discuss the topic because "anti family planning activists continue to attack Sanger[ ] because she is an easier target" than Planned Parenthood.

Planned Parenthood has occupied a central position in the abortion debate in the U. S. and has been among the most prominent targets of the U. S. anti abortion movement for decades. Some members of Congress, overwhelmingly Republican, have attempted since the 1980s to end federal funding of the organization, Planned Parenthood has consistently maintained that federal money received by Planned Parenthood is not used to fund abortion services, but anti abortion activists have argued that the federal funding frees up other resources that are, in turn, used to provide abortions. but pro choice advocates have argued that the organization's family planning services reduce the need for abortions; in the words of Megan Crepeau of the Chicago Tribune, Planned Parenthood could be "characterized as America's largest abortion preventer". Anti abortion activists dispute the evidence that greater access to contraceptives reduces abortion frequency.

Periodically, anti abortion advocates have tried to demonstrate that Planned Parenthood does not follow applicable state or federal laws. The groups called or visited Planned Parenthood health centers posing as victims of statutory rape, minors who by law need parental notification before an abortion, racist donors seeking to earmark donations to reduce the African American population, or pimps seeking abortions for underage prostitutes. As a result of some of these videos, several Planned Parenthood workers have been disciplined or fired. advising patients on how to procure sex selective abortions, while one who said they would immerse a child born alive after a botched abortion in a chemical solution to make it stop moving and breathing. No criminal convictions resulted, but some Planned Parenthood employees and volunteers were fired for not following procedure, and the organization committed to retraining its staff. Additionally, one center was placed on probation.

In the U. S., abortion providers have been threatened with death, and facilities that provide abortions have been attacked or vandalized. In 1994, John Salvi entered a Brookline, Massachusetts Planned Parenthood clinic and opened fire, murdering receptionist Shannon Elizabeth Lowney and wounding three others. He fled to another Planned Parenthood clinic where he murdered Leane Nichols and wounded two others. In 2012, a Grand Chute, Wisconsin, Planned Parenthood clinic was subject to a bombing perpetrated by an unknown individual. In 2015, a Planned Parenthood clinic in Pullman, Washington was heavily damaged by arson.

On November 27, 2015, a gunman shot and killed two civilians and a police officer during a five hour gun battle at the Colorado Springs, Colorado clinic. The 57 year old gunman, Robert Dear, surrendered to police and was taken into custody. During his arrest, he gave a "rambling" interview in which, at one point, he said "no more baby parts", echoing language used in the news media about the clinic following the Center for Medical Progress videos. Dear was declared incompetent to stand trial for the shooting, citing experts' finding that he has "delusional disorder, persecutory type" and is now confined indefinitely to a state mental hospital.