It’s an interesting time to work in reproductive health care.
Amy Handler and Dr. Sara Kennedy, the new CEOs
of Oregon’s two Planned Parenthood affiliates, say they’re ready.
On Sept. 21, 2020, leaders from Planned Parenthood affiliates across the country started talking.
Ruth Bader Ginsburg had died days before, creating a vacancy on the Supreme Court that then-President Donald Trump filled with a more conservative justice. Reproductive justice advocates had long dreaded the chain of events that followed
“She passed away on Friday. Monday morning we’re on the phone, looking at a map and saying, ‘Who’s going to go dark? What do we need to do?’” says Amy Handler, who was at that time the chief of education and community partnerships for Planned Parenthood of Southwestern Oregon. “We looked at all of the possible delays to care and started thinking, ‘OK, we could potentially start seeing patients at later and later gestational ages. There are regional airports in Eugene and Medford. What are going to be all the access points?’ We basically looked at a map and said, ‘This is what we can each do right now.’”
In May Handler became the president and CEO of PPSO, a Planned Parenthood affiliate headquartered in Eugene. The other major Planned Parenthood affiliate, Planned Parenthood of the Columbia Willamette, also hired a new CEO this spring: Dr. Sara Kennedy, an obstetrician and gynecologist who had most recently served as chief medical officer and chief operating officer at Planned Parenthood Northern California, headquartered in the San Francisco Bay Area. Kennedy started at Columbia Willamette in March.
Together, the CEOs of Planned Parenthood’s two Oregon affiliates oversee 12 of clinics — which altogether employ 362 people — across the state, one of which just opened in early 2023. Though they both have long careers in reproductive health care and public health, Kennedy and Handler are stepping into their roles during a critical moment for reproductive health care: Laws are changing rapidly and access to abortion across the country is diminishing rapidly, placing a greater strain on access to abortion in states like Oregon, where it remains legal. And even before Dobbs v. Jackson Women’s Health Organization — the June 2022 decision that overturned Roe v. Wade — reproductive health advocates faced challenges, like spiraling rates of sexually transmitted infections in certain populations as well as internal movement tensions that haven’t gone away.
Almost immediately in the wake of Ginsburg’s death, state legislatures began drafting and passing “trigger laws” — abortion bans that would kick in as soon as Roe was overturned.
Idaho was one of 22 states that had passed trigger laws in anticipation of that moment. Its law, which took effect in August 2022 after the Dobbs decision was formally announced, says doctors who perform abortions in the state can be punished with up to two years in prison.
While the law as written includes some exceptions for cases where the person seeking an abortion can prove the pregnancy was the product of rape or incest — or that their life is in danger — the ban has driven doctors out of the state. The Idaho Coalition for Safe Healthcare, which has advocated for a rollback of the state’s abortion ban, says the number of gynecologists practicing in the state dropped by 22% in the 15 months after the ban kicked in. Two hospitals have stopped performing labor and delivery services altogether. Idaho is not alone in seeing an exodus of gynecologists; those who’ve left states with bans have told outlets like KFF Health News they worry about facing criminal charges if they provide care for common pregnancy complications. While the state’s Supreme Court has since ruled that the law does not apply in situations where a patient presents with an ectopic or molar pregnancy, doctors say they need to be able to act quickly in emergencies, like when a patient is miscarrying but the fetus still has a heartbeat. (As this issue went into production, the U.S. Supreme Court dismissed an appeal over Idaho’s law, permitting emergency abortions in the state while the case makes its way through the courts.)
Conservative legislatures acted quickly in anticipation of Roe’s repeal, and so did their counterparts — and health providers in states where abortion remained legal.
By the time Dobbs was officially announced, Planned Parenthood had already leased clinic space in Ontario, which is situated on the Oregon side of the Oregon-Idaho border and about an hour from Boise, where Planned Parenthood had a clinic until 2022. The town, which had 11,645 people at the time of the 2020 Census, already draws significant traffic from Idaho due to a lack of sales tax and, more recently, legal cannabis.
The Ontario clinic “soft opened” in March 2023 and opened fully later that spring.
“One of the things that inspired me to join PPCW is because this affiliate, upon Dobbs, within 12 months had identified a location, totally refurbished the spot, hired the staff and did everything that we need to do to open that clinic with a focus of taking care of Eastern Oregonians,” Kennedy says.
Kennedy notes that there is a “horrible dearth of health care options for folks in general” in Eastern Oregon. According to its website, the Ontario clinic provides abortion services, STD testing and treatment, and gender-affirming care — much like other Planned Parenthood clinics. But according to Kennedy, 80% of the visits to the clinic are abortion-related.
“The rest of Planned Parenthood centers in Oregon, most of what we do is family planning-related,” Kennedy says. “That includes cervical cancer screening, chest and breast cancer screening, STI care, contraception, well-person care, gender-affirming care. We offer this comprehensive sexual reproductive health care across the state of Oregon and Southwest Washington. And in Ontario, the demand for abortion is very significant because of this horrific ban in Idaho.”
Kennedy says the number of patients coming from Idaho to Oregon seeking abortions has increased between 1,200% and 1,300%. A Guttmacher Institute report released this spring says the number of people traveling for abortions doubled between 2022 and 2023; 400 patients traveled from Idaho to Oregon during the first year after Roe.
And while Idaho, as a border state, is sending a lot of patients to Oregon, Handler and Kennedy say Oregon clinics are seeing patients from all over the country to get abortions.
“We see patients from Florida and Texas and the majority of states around that have bans,” Kennedy says. “What usually happens is that maybe a patient in Florida is looking for somewhere to get care and they try to go to New York, but New York doesn’t have capacity. And then they call Colorado, and Colorado is already at capacity. So ultimately things start to spill over. We are seeing patients from everywhere.”
Kennedy adds that if a state on the East Coast “goes dark” in terms of abortion access, “It’s all impactful … it absolutely impacts Oregon.”
“With SB 8, which was the Texas law that passed in the fall of ’21, it only took 10 days for the first patient to show up from Texas in Medford,” Handler says. “They drove up with three kids in the back. I mean, they were like, ‘You were the next available and we just need to get here.’ It only took maybe six weeks after Dobbs for us to see patients in the state of Oregon from every single state with an abortion ban.”
Kennedy says she is hoping to increase capacity for services other than abortion in Ontario, in part because rates of sexually transmitted diseases — like syphilis — are spiraling upward in Oregon.
According to Planned Parenthood spokesperson Kristi Scdoris, rates of syphilis in Oregon doubled from 2020 to 2022. Twenty-six counties reported a syphilis case in a pregnant person, and 19 counties reported a case of congenital syphilis — that is, babies born with syphilis because they were born to an infected person. Those numbers make Oregon 10th in the nation for rates of early syphilis and 16th for congenital syphilis. Scdoris also notes that STI testing is the most frequently requested appointment at PPCW health centers, and that rural counties are seeing the largest increase in syphilis overall.
“Amy and I feel like this is a classic example of a public health problem that shouldn’t exist, that disproportionately affects low- income folks and people of color, that we could do something about,” Kennedy says. “We can own this space and actually really work with state public health departments to move the needle on STIs.”
According to the Oregon Health Authority, most Oregon counties east of the Cascades have just one clinic that provides reproductive health services. A couple of counties — Wheeler and Sherman — don’t have any. That means rural Oregonians seeking abortions face a long drive — but so do many patients seeking other reproductive health services.
“What we’re really focused on now is how do we not only expand our care beyond abortion care, which is really important — and of course, which we need to do and we will always do. How do we really, actually expand that to all the other public health that we do, that patients need, that our Eastern, rural communities need and that our neighbors need from Idaho?” Kennedy says.
One goal is to hire another clinician in Ontario, which is seeing between 600 and 800 patients per year and enable the clinic to roughly double the number of patients it can see per year and expand the services it provides. And then, Kennedy says, “we’ll reassess what the community needs.”
In addition to her medical degree, Kennedy holds a master’s degree in public health — and so does Handler.
“I don’t know this for sure, but I think Oregon might be the only state that has two Planned Parenthood CEOs with public health backgrounds,” Kennedy says.
“I really came to this work — I came to medicine initially, but then came to leading health care organizations with the very deep belief that when you have options and choice, and when you are creating healthy pregnancies, when you’re allowing people to choose when and if they become pregnant, or when and if they stay pregnant, that that really empowers the community to be healthier,” Kennedy says.
Before she went to graduate school, Handler worked in politics in Wisconsin — and worked with Planned Parenthood lobbyists on the Healthy Youth Act, a bill that required all public schools to teach comprehensive sex education. That bill was repealed in 2012 but reintroduced this legislative session. Handler notes that similar bills have been introduced in states across the country, including Oregon.
“I really got the spark for focusing on sexual reproductive health and seeing that it’s the key to everything. It’s the key to everyone’s health, that’s the key to really your life course and health,” Handler says.
Handler and Kennedy spoke with Oregon Business this spring in a tandem interview, amid a series of meetings with other media outlets and elected officials. After our conversation, Oregon Public Broadcasting reported on a letter Kennedy and Handler sent to Planned Parenthood Advocates of Oregon, the group’s advocacy arm, announcing the intention to dissolve PPAO and focus on “health care and advocating for the needs of the Planned Parenthood affiliates and their patients.”
A person familiar with the situation who spoke with OB on condition of anonymity said the group had no warning such a move might be coming, but also noted that there had been tensions between PPAO and the two affiliates prior to the move.
PPCW and PPSO are 501(c)(3) nonprofits; PPAO is a 501(c)(4). Legally, all three organizations are nonprofits, but 501(c)(3)s are considered charitable organizations. That means they’re tax-exempt, but there are also restrictions on the types of advocacy such organizations can engage in. Nonprofit charities can take positions on political issues, including ballot measures — which isn’t meaningless in a referendum-heavy state like Oregon — but they can’t endorse candidates. 501(c)(4) organizations can. And many Planned Parenthood affiliates around the country have both a 501(c)(3) and a 501(c)(4) arm — one to run the clinics and one to run campaigns.
In addition to endorsing candidates, PPAO has a history of lobbying for things like the Reproductive Health Equity Act, passed by the state legislature in 2017. That bill codified into state law the right to have an abortion and provided additional funding for reproductive health services.
The two affiliates together send more than $700,000 to the lobbying arm annually, according to Scdoris; PPCW brought in $36 million in annual revenue, with total expenses at about $31 million, in 2022-23. PPAO also receives donations from the public.
Once reported, the move was met with swift backlash; U.S. Rep. Val Hoyle (D-4th District) said she signed a letter along with 100 people urging Kennedy and Handler to reconsider. The move to dissolve comes on the heels of the dissolution of Pro-Choice Oregon in 2023, leaving PPAO the only pro-choice advocacy organization in the state.
And they did reconsider — at least for the next few months. A few days after the story of the intended dissolution of PPAO broke, the two leaders announced they would temporarily pause their move to dissolve the group.
“Advocacy remains a top priority for Planned Parenthood in Oregon — and there will be no changes to our advocacy efforts prior to the November election,” said a joint statement from Kennedy and Handler. “The board of Planned Parenthood Advocates of Oregon has hired a facilitator to lead us through a process that considers the structure and policy agenda of future advocacy efforts. The shared goal is to build and strengthen a Planned Parenthood advocacy organization that aligns with the evolving needs of our patients, the core health care mission of our organizations, and the need to preserve and to expand reproductive rights across the state of Oregon and Southwest Washington.”
A person familiar with the situation said the decision was “stunning” and “myopic” but that PPAO staff and board members are hopeful for a resolution moving forward.
“New leaders sometimes make bold moves, and sometimes it works and sometimes it doesn’t,” the person said.
While Handler has lived in Oregon since February 2020, at the time of our conversation, Kennedy was still living in California and getting ready to move to Oregon over the summer with her husband and three children.
“We love to do everything outdoors, which is why we’re looking forward to being [in Oregon] — biking, hiking, swimming, playing outside,” Kennedy says.
Handler says she and her husband are both cyclists as well. And she’s a newly minted gardener, “which I’ve learned is basically just weeding. Just weeding all the time. But it’s very meditative.”
Asked if either of them thought they would see a post-Roe world, both said that early in their careers, they didn’t predict this. But working in the field changed that.
“Early in my career, I would say no, I didn’t. I wasn’t preparing for this moment. But the undercurrent, I think, in our country has been here for a long time,” Handler says.
“When you think about who is left out of society, and who has the hardest time accessing care, who has the worst outcomes, it is the most marginalized in the U.S. and included in those folks are primarily women and people who can become pregnant and their children,” Kennedy says. “We’ve always had to fight for something to help people just to get quality health care. We’re seeing it at scale. But it’s not really new. It’s not a new fight, and we were prepared for it.”
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