Planned Parenthood’s Sarah Stoesz says empathy is key to winning abortion rights fight

After 20 years as CEO of the Planned Parenthood serving Minnesota, Sarah Stoesz plans to step down this fall. The decision comes at a critical time for abortion rights in the country, with a supermajority of conservative Supreme Court justices poised to repeal significant portions of Roe v. Wade, or overturn it completely.

That would make Minnesota a haven for abortion rights for people across the upper Midwest. Minnesota’s state constitution protects people’s rights to an abortion, while neighboring states, including Wisconsin and the Dakotas, have so-called “trigger laws” that would automatically ban most abortions if Roe is overturned.

But even with a state constitutional protection, abortion rights advocates say access is threatened in Minnesota, too. A Texas-style abortion ban was introduced at the Legislature this session and while it’s unlikely to pass, lawmakers have already passed barriers to abortion such as a 24-hour waiting period, mandatory two-parent notifications and a requirement that doctors first give scripted lectures filled with questionable medical assertions to patients. Those laws are being fought in court.

Stoesz says Planned Parenthood North Central States, which serves Minnesota, Nebraska, Iowa and the Dakotas, is already making plans for how to continue serving people across the region in a post-Roe world.

The organization has a much larger footprint now than it did two decades ago when Stoesz took the helm. Planned Parenthood North Central States expanded from two states to five, built three new clinics, renovated four and expanded or relocated another 14.

The organization’s clout has also grown, with Planned Parenthood becoming a key player in state-level political campaigns and policymaking. Under Stoesz’s leadership, the organization helped twice defeat anti-abortion ballot initiatives in North and South Dakota. The most recent North Dakota ballot initiative, in 2014, sought to define an embryo as a person with constitutional rights. It failed by a two-to-one vote.

But even as Stoesz celebrates abortion becoming less stigmatized over the past two decades, she recognizes that the threat to abortion access has rarely been so great as it is today. Leaving at such a critical juncture is difficult for Stoesz, but she says there’s no good time to step down and she has faith in her team to carry the organization forward.

This interview has been edited for length and clarity.

I’m going to ask about the existential threats Planned Parenthood has faced over the years, but I want to first ask about your successes. Your organization has grown from serving two states to five. You’re serving many more patients. Can you talk about how Planned Parenthood North Central States has evolved over your tenure?

Over the last 20 years, we have grown our ability to reach people from fewer than 50,000 people to now well over 100,000 people. And we have served over a million patients during that period of time, many of whom did not have to pay anything unless they could afford it or they had insurance

So I am very, very proud of the number of lives that we have touched over the past 20 years. And as you know, although we are known for providing abortion services — and we are proud to do that and it’s core to our mission — it’s not the primary thing that we do. In Minnesota, we served about 75,000 patients last year, roughly 6,500 were abortion patients. So it’s a small part of what we do.

The primary thing that people come to us for is what I came to Planned Parenthood for when I was a young person. And that was basic family planning and sexual and reproductive health care. At the time, and I’m dating myself, talking about sexuality was much more stigmatized than it is today. And so as a teenager, to walk through the doors of a Planned Parenthood clinic in the ‘70s, changed my life.

I’m curious what led you to Planned Parenthood that first time. And this is a personal question, I know, so feel free to take a pass.

I went there because I was beginning to explore my sexuality, and one of my friends in high school told me to go. I’d never heard of Planned Parenthood. I didn’t know what the exam would be like. I’d never heard of a pelvic exam. And I learned about all of those things and the nurse practitioner also helped me get on birth control.

As a result of being able to get on birth control at that time, I was able to finish high school. I was able to go to college. And I would just point out that that has not been the story of all of the women in my family.

My grandmother, for example, who was very poor and lived in northeast Minneapolis, had five children in six years. She had no regular doctor or access to sexual reproductive health care. She was very fortunate in that a doctor offered to tie her tubes after her fifth child, and that’s how she stopped having so many children.

She loved her children, don’t get me wrong. But she would not have chosen to have five children in six years, and it very much changed her life.

So with each successive generation in my family, women have had more opportunities. We’ve been able to have more education. We’ve had more economic independence. We’ve had more autonomy and more choices.

My own daughter is now a young mother herself. And I remember her saying to me when she was in high school in Minneapolis that there was a clinic there and kids could get birth control right at the clinic, right in school. Things were so different for her than they were for me.

Many fear this is a perilous time for abortion rights in this country, given the makeup of the U.S. Supreme Court. But that threat has also catalyzed a groundswell of abortion rights activism. Do you think the state of abortion rights and reproductive care is better or worse than when you took the helm 20 years ago.

It’s better and worse. It’s better in the sense that 20 years ago, women who had abortions lived in a highly stigmatized subculture. They did not talk about their experiences openly. And there was a certain amount of shame that was attached to women who had abortions, which was a terrible thing because one in four women have abortions in the United States. That has changed. Women are much more likely to share their stories.

Technology has also changed. We have access now to abortion pills. We have the ability to mail abortion pills. Telemedicine abortion is widely available across the country, at least in most parts of the country. Not in South Dakota, for example, where it’s illegal.

All of those things are good. What is not good is that the makeup of the judiciary has changed so dramatically in the last 20 years that we have virtually no chance of winning any of our court cases at the federal level. We still have chances at the state level in various states around the country, but to think that we will prevail or have much in the way of victory at the federal level is quite shortsighted.

We are preparing for the reversal of Roe v. Wade, which could happen as early as March or as late as next July. Within our five-state region, we are engaged in some very intense planning, so that we are able to keep as much access available as we possibly can.

Given how public sentiment and public attitude around abortion has changed, how did abortion rights supporters lose this fight in the judiciary?

You’re asking the political question. Why is it that support among the public for abortion rights continues to rise and yet at the same time, rights continue to diminish?

Yes.

Progressives lost the Senate and in losing the Senate, we lost the judiciary.

If abortion were the only issue on the ballot, we would win. But it’s not going to be the only issue on the ballot. And people who have abortions and who care about abortion rights, it isn’t the sort of issue that defines their identity as much as other issues do. And it’s very hard to find voters who vote just on that basis.

If we could put abortion on the ballot by itself, we would win. And we always do. We won two ballot fights in South Dakota and two in North Dakota by very large margins. This last one was two-to-one.

Now I’m very proud of the political powerhouse that we have become in Minnesota. When I started, we didn’t endorse candidates. We didn’t really get involved in races.

Because nobody wanted your endorsement?

No, the organization just hadn’t matured yet, and so we set out to do that. I was very interested in having Planned Parenthood be a presence at the (DFL) conventions. At the time, about 30% of the delegates were pro-life. And that has changed a lot.

But the other thing that’s changed is that we also had a lot of strong Republican support. We’ve lost that. Over the years the parties have just become far more polarized. We used to have Republicans on our boards, for example. We still do have Republican supporters, but not to the extent that we used to.

I am curious if, in your advocacy, you have ever changed someone’s mind on abortion.

I think so. I look at the ballot fights that we had in both of the Dakotas. If you poll there, people will say they’re pro-life. And yet we convinced large numbers of them to overturn bans on abortion, even bans that contained exceptions for rape and incest.

And the way that we did that is we allowed people to maintain their moral ambivalence about abortion because a lot of people just do have sincerely held moral beliefs about abortion that are either ambivalent or they don’t support it.

When we allow them to maintain that ambivalence, but also approach them with empathy and ask them to have empathy toward a woman who might be in a particular situation, people are able to do that.

The problem is that the parties have these purity tests that they apply to candidates. We’ve had plenty of anti-choice politicians tell us that they don’t really mean it, but they just have to do it or they can’t get elected.

Are you prepared to name any names on your way out the door?

Maybe one day, I don’t know. But there have been plenty.

This is interesting because I just finished reading “The Cider House Rules.” The protagonist Homer Wells’ conflict is that he feels abortion is wrong but he believes everyone should have the right to it … And then at the end he becomes an abortion doctor.

Right. Our side, we do not do ourselves any favors when we take a strident position either, right? So we have some responsibility here as well.

Say more about that.

If we insist that people come all the way over to our point of view and give up whatever ambivalence they might have, they won’t do it. We really need to think more carefully about the way that we talk about abortion.

What does that look like?

For example, in South Dakota, we initially were going to have a campaign that was going to be called something like “South Dakotans For Choice” with “bans off our bodies” and coat hangers as symbols and so on.

In talking with people there, I quickly came to understand that that was going to be a failed campaign. So instead, we began to talk about healthy families. What does it take to build a healthy family? And one component might be the ability of someone in the family to make a decision about abortion for a whole variety of reasons.

And once we began to talk about what those reasons might be and people came forward and talked about their personal experiences, we were able to convince people to empathize with us and to vote with us.

What’s important is that women have the right to have an abortion. That’s what’s important. It’s not so important that everybody believe every single thing that I believe about abortion.

My final question is what do you feel like you’re leaving undone as you step down?

I mentioned before the work that we have done to eliminate stigma around abortion, I’m really proud of that. And further, we have convinced organizations such as the American College of OBGYNs and the American Medical Association and quite a number of other medical societies and organizations to come out in favor of abortion access.

What has not happened, and what I do regret, is that abortion is still somewhat stigmatized inside the main health care systems. They do not provide abortions, and they have allowed Planned Parenthood and other providers to battle forward in a fairly isolated way.

I regret that I was not able to convince these systems that they should all be providing abortion. They should not let abortion clinics exist as standalone clinics. They should be folded into the standard of care that they offer for all patients everywhere.

We shouldn’t be driving through picketers every day as I have for every single day of my working life for the last 20 years. The medical community should not have tolerated that. That is one thing that is undone and should change.