In summary

Planned Parenthood clinics in Southern California saw a sharp increase in abortions after the Supreme Court struck down Roe vs. Wade. Now, workers at clinics in San Diego and the Inland Empire are creating a union.

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Mia Neustein calls her work for Planned Parenthood in the Coachella Valley her “dream job.”  She believes in the organization’s mission, and wants to be a part of it for years to come.

But the pace of that work has increased substantially since last year, when the Supreme Court ended the nationwide right to abortion, leading some out-of-state patients to travel to Southern California for care. 

That trend, coupled with several local decisions that she said exacerbated stresses on her colleagues, led workers at her clinic last week to vote to create a union. They’re joining a labor movement taking root at a number of other Planned Parenthood clinics in states that have protected abortion rights since the Supreme Court struck down Roe vs. Wade.

 “The types of working conditions that we’ve been dealing with, especially in the last year or so, have really pushed people toward realizing how necessary a union is,” said Neustein, who started working for Planned Parenthood as a health center educator two years ago. 

Her clinic belongs to Planned Parenthood of the Pacific Southwest, a group of 26 sites in Imperial, Riverside and San Diego counties that regularly sees patients from states with abortion restrictions. The organization estimates that 10% of its patients since the 2022 Supreme Court decision have come from other states.

About 93% of the workers who voted supported joining SEIU-United Healthcare Workers West. After certification by the National Labor Relations Board, the union would represent 550 Planned Parenthood workers ranging from clinicians to registered nurses and licensed social workers.

Workers said they hope to get better pay, an improved time-off policy and safer working conditions through this union.

California voters cemented the right to abortion in the state constitution last year, and Gov. Gavin Newsom has signed more than two dozen other laws that are designed to expand access to reproductive care after the 2022 Supreme Court decision known as Dobbs. He and other Democratic leaders have championed California as a safe haven for women seeking abortions.

At the same time, 22 states have introduced or passed legislation to restrict or ban abortion, according to the news organization Axios. One of them, Arizona, shares a border with California. Arizona prohibits most abortions after 15 weeks

More abortions in California

In states where abortion remains legal, reproductive care workers have been complaining about being overworked due to increased demand for care from out-of-state patients. Planned Parenthood workers in at least seven states, including Massachusetts and Nebraska, have decided to unionize, according to news reports.

“We’ve definitely seen an increase in patients,” said Libby Kusiak, a certified physician associate at a Planned Parenthood in San Diego. “We see a lot of out-of-state patients since we’re kind of really perfectly nestled geographically to serve and accommodate patients from other states like Arizona, but we do see patients from Texas and other states as well.”

A new study by the Guttmacher Institute, a research organization that supports reproductive rights, shows that the number of abortions in California has increased by 16% since the end of Roe vs. Wade. 

It found 12,300 more abortions were performed from January to June 2023 compared to a similar time period in 2020. That marked the second-largest numerical increase in abortions among states.

Cathren Cohen, staff attorney at the UCLA Center on Reproductive Health, Law and Policy, said some patients seeking abortions may be traveling from states where bans have not yet been legalized or instituted. 

“When people hear the news about the introduction of bans in states like North Carolina, Florida or even Arizona, there is a significant chilling effect,” she said. “People don’t seek out care because they think it is illegal, even if it is six months before those laws go into effect.”

Planned Parenthood union vote

Reproductive care workers, especially those close to the border, are feeling burdened by the increase in patients. The Planned Parenthood employees who voted to join the union last week said they believe they are underpaid and overworked, contributing to turnover. 

“I am excited to be able to hopefully repair employee benefits in this organization in a way that truly benefits our employees,” Kusiak said. “Given how hard we work, when we show up to work every day, we really need to have that better balance in our lives.”

“Given how hard we work, when we show up to work every day, we really need to have that better balance in our lives.”

Libby Kusiak, certified physician associate at a Planned Parenthood in San Diego

Alex Scordato was one of the earliest employees of Planned Parenthood Pacific Southwest who advocated to form a union.

“It started about a year ago, with actually a conversation between a relatively small group of admin workers and clinical staff,” they said. “We only had about eight people, had an informal session where we’re comparing our pay, talking about various issues.”

The group soon realized that they were dealing with similar issues and decided that a union would be their best bet.

The Planned Parenthood-East Los Angeles Health Center in East Los Angeles on Aug. 8th, 2022. Photo by Raquel Natalicchio for CalMatters
The Planned Parenthood-East Los Angeles Health Center in East Los Angeles on Aug. 8th, 2022. Photo by Raquel Natalicchio for CalMatters

Darrah Johnson, president of Planned Parenthood of the Pacific Southwest, said in a statement to CalMatters, “As an organization that champions everyone’s right to pursue their own path to a healthy and meaningful life, our goal throughout this process was to ensure that every employee had the opportunity to participate in a fair election.” 

“We are proud of the number of staff who participated in the National Labor Relations Board election and made their voice heard today. We look forward to continuing to work together with our staff and now, SEIU-UHW, to ensure Planned Parenthood of the Pacific Southwest is a compassionate and affirming place to give and get care,” she added.

The union could be one of the largest representing Planned Parenthood workers in the country. 

“I think this sends a ripple to not only other Planned Parenthood affiliates across the country, but other nonprofit health care organizations, that this is possible, this is coming,” he said. “This is the rebirth of the labor movement. It’s not just a hot labor summer. This is here to last.”

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit to learn more.

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Shreya is a former health care reporting intern for CalMatters. Prior to joining CalMatters, she worked at Malheur Enterprise as a rural climate reporting fellow for the USC Annenberg Center for Climate...