- (female announcer) Production funding for Behind the Headlines is made possible in part by the WKNO Production Fund, the WKNO Endowment Fund, and by viewers like you, thank you.

- Planned Parenthood in a post-Dobbs world, tonight, on Behind the Headlines.

[intense orchestral music] I'm Eric Barnes with The Daily Memphian.

Thanks for joining us.

I'm joined tonight by Ashley Coffield.

She is CEO of Planned Parenthood of Tennessee and North Mississippi.

Thanks for being here.

- Thanks for having me.

- Along with Bill Dries, reporter with The Daily Memphian.

We'll talk today about Planned Parenthood in a post-Dobbs world, two-plus years since then.

It's obviously a big political season nationally, and in Tennessee.

We'll talk about women's health, we'll talk about birth control.

We will obviously get to abortion.

It's obviously a very controversial issue and hot issue.

We'll have other folks on the show as we often do with issues like this, where we'll talk with Ashley about this.

And we'll have other folks, legislators and so on, who have different perspectives on it.

And together, get to the various perspectives so on this issue.

Let me first of all, thank you for being here.

And you're here in a slightly different role, you need to mention.

- Well, I'm here today also as a leader with Tennessee Advocates for Planned Parenthood.

Which is our 501(c)(4) organization that does advocacy work, social welfare advocacy, but also is allowed to do some electoral work.

- And, including raising money for candidates, and so on, and so forth.

- That's right, and- - To support, or not.

- Endorsing candidates and running independent expenditure campaigns.

- Okay, but you have been President and CEO of Planned Parenthood, I think of first of Tennessee, and then Tennessee and Mississippi, and it's expanded somewhat the role over the years.

- I started in with West Tennessee, with our Memphis affiliate.

And then, we expanded and two Tennessee affiliates merged, and we became a statewide-plus organization.

North Mississippi has been in our affiliate region, because it's the Memphis suburbs.

- Yeah, yeah.

So we as are two-plus years from the Dobbs decision, this is a general question to start.

How has the work of Planned Parenthood changed?

- Well, we had to stop providing abortion services in June of 2022, shortly after Roe was overturned.

And we have focused now on our other core services.

On birth control, STI testing and treatment, gender-affirming care, well-person care, cancer screenings, things like that.

And those services are now more important than ever.

- And you do those in Tennessee?

Those are not under restriction?

- They're not under restriction yet.

I mean, there are restrictions on gender-affirming care now.

- Yeah.

I wanna circle back to some of those.

- Sure.

- But, talk about abortion.

Since the ruling, you do help people navigate, I think on the website it sort of says, "We will help you navigate to get abortion services out-of-state."

What does that mean?

- What we're doing is, when people call us and they need assistance, we talk them through what that looks like.

How do you get an abortion out-of-state?

What are some of the best places to go?

How do you make an appointment?

And once they've made an appointment, they get back in touch with us, and we help them with their travel logistics.

We can help them pay for, we can give them gas cards, we can help them with a train ticket, a plane ticket, a bus ticket.

We can help them with hotel and other expenses to make sure that they can get the healthcare they need.

- It, am I right?

I mean, I know in some states, there's been talk of restricting the ability to do that, is that?

- We've already restricted it here.

The legislator has passed a law restricting minors the ability to travel.

Meaning that, adults who want to help a minor with travel are restricted from doing so unless they have parental consent.

So most of the time, parents are involved with their minor's care.

We have found 9 times out 10 when a minor approaches us about getting an abortion, the parent is very much involved.

But occasionally, the parent cannot be involved, the minor has circumstances where it's not safe to involve their parent.

And so, that restriction has been put on us in Tennessee.

- Two quick questions, or at, so quick questions, then I'll get Bill here.

Funding for Planned Parenthood, which has been my whole life subject to debate and confusion for me.

The funding right now for Planned Parenthood and the services you do provide comes from where?

- It comes from insurance coverage, when patients have insurance.

Whether it's private insurance, or public insurance.

It also comes from them paying fees.

And then, a good bit of it comes from our donors.

You know, we reduce, or eliminate the cost for care.

So that, patients can come and get the services they need.

- And let me go through, so just are on the same baseline.

Again, it's such a big topic nationally, in the national election.

And statewide, in certain states, have done referendums around this, and so on.

But the state law right now around abortion that, as it was after the overturning of Roe v. Wade, is what exceptions are allowed?

Some states have exceptions, some don't.

- Right.

- What exceptions are allowed in Tennessee?

- Well, the stakes could not be higher right now around abortion politics, because of the composition of our ban.

We have a ban at every stage of pregnancy.

We have no exceptions for rape or incest.

And, there are very narrow and vague medical exceptions.

We've had 10,500 women travel out-of-state in the past year to get an abortion.

We have seven women who have filed lawsuits against the State of Tennessee for what the harm that ban has done to them.

And we have documented cases of women who have died from abortion bans.

We have OB-GYNs who have left the state.

We have had medical residency applications that are down.

And that is the pipeline for future physicians in our state.

Not just OB-GYNs, but in other medical residencies.

That doesn't bode well.

We are the, we have the third-highest maternal mortality rate in the nation.

Only Mississippi and Arkansas are higher.

And every person who has not been able to get an abortion under this ban, for whatever reason, has been a victim.

- We'll circle back to a lot of that.

But, I wanna get Bill in here.

- Do you foresee with the litigation that's involved in this, with the stories of the different scenarios on this, do you foresee that the legislature might go back into this law, and change it in any way?

To address those situations?

- Bill, unfortunately I don't think that they will.

There was an exception bill introduced this past year that would had allowed girls age 12 and younger, who had been raped, to get an abortion in Tennessee, that was the exception.

Every single Republican in the House voted against that exception, including John Gillespie, here in Memphis.

- Is, and we talked about this before... Other states have put referendums on the ballot that would amend and allow, or resume access to abortions.

That, as I understand it, can not happen in Tennessee?

Can you explain that?

- Yeah, that's right.

In Tennessee, our State Constitution does not allow for citizen-led ballot initiatives.

Only the legislator can put an initiative on the ballot.

We have also found that traditional advocacy doesn't work.

They are immune to the stories from their constituents.

We have had thousands and thousands of civil conversations with legislators.

And, we have told the stories of the abortion ban over the past two years.

And, they don't move on it.

And think about it.

That's, the super-majority is the definition of it.

Is that two-thirds of the legislature is controlled by one party.

That means the other party doesn't even have to show up, you know, in order for them to conduct their business.

So, they have become very extreme, there's no moderating influence.

And so our only option, given that we can't do a ballot measure, is that we have to flip these seats.

We have to throw them out.

And, that's what our plan is at Planned Parenthood.

Is to build power, flip seats, and get our rights back.

- So, that was gonna be my next point.

These lawmakers who have these views on this, who have passed these laws, they continue to get elected.

So, does that mean that there is a mandate for the direction they've taken the state on abortion laws?

- Bill, I do not think there is a mandate.

Let's look at the political landscape in Tennessee.

We're not a red state.

We are a purple, non-voting state.

We are 51st in the nation in turnout for voting.

And we lead the nation in disenfranchised voters.

When you look at the polls, Tennesseans are actually very moderate on issues.

A recent Vanderbilt poll showed that the majority of Tennesseans are pro-choice.

This includes more than 90% of Democrats, more than 50% of independents, and 30% of non-MAGA Republicans.

- How has the healthcare offered to women who are pregnant, how has it changed in hospitals and major healthcare organizations in this state?

- Like I mentioned, the medical exceptions are vague.

And, they're narrow.

And so, a woman has to be sick, potentially very sick, before she can be treated for a pregnancy complication for a fetal anomaly.

So for example, one of the women who is suing the state is Allie Phillips.

She's also running in House District 75.

She's one of our endorsed candidates.

She had multiple fetal anomalies.

Her physician that were meant that the pregnancy was not going to be successful.

It was eventually gonna be a non-viable pregnancy.

Her physician refused to give her an abortion.

And, also refused to give her a referral out-of-state for an abortion.

That's what a law like this does.

It creates a lot of fear.

It's a Class C felony to provide an abortion in Tennessee.

That's the same as raping a child.

She had to find her own care outside of the state.

Once she got to New York, the pregnancy had ended.

And it was over, and she was at great risk of infection and sepsis and could of died, and was rushed to the emergency room.

All of that could of been taken care of here at home in Tennessee, if it were not for this ban.

- Is this a case of the healthcare organizations misreading the law, or not wanting to take any chances with it?

Or, is this a problem within the text of the law?

Within what the law does?

- Right.

It's a problem with the law.

And our Attorney General has said during this lawsuit, that he turned it on the doctors.

He said it's the doctors who are misinterpreting the law istead of the politicians who wrote it.

The fact is, it's vague.

It says simply that it's a medical exception "For serious, or substantial risk to the body.

Or, if it's the death of the mother."

And, that's up for interpretation.

It is not clear at what point how sick you have to be in order to qualify for an abortion.

And abortion care is also preventative.

It's done before you get sick, when a sickness and death is inevitable.

And so, that's why these hospitals and doctors are really struggling.

And I can't believe the Attorney General would turn it against them and their lawyers, and turn it to them and say, "You're not smart enough to figure out what we meant."

- So, which is more likely to succeed at this point, from your vantage point?

A lawsuit, or trying to flip seats in the legislature?

- I think trying to flip seats in the legislature is much more likely to succeed.

And we have a plan, it's a data-driven plan that we share with other partners.

The suburbs in Tennessee are becoming more progressive.

We think a moderate pro-choice candidate can win in the suburbs of Tennessee.

That's what the data show.

So, we are, that's where we're focusing.

And, we're focusing on four seats.

We're focusing on HD-18, House District 18 in Knoxville, with Bryan Goldberg, House District 49 in Middle Tennessee, with Louise Matta, House District 75 with Allie Phillips, and right here at home, House District 97 with Jesse Huseth.

- So, Tennessee is expected to go for Trump- - Right.

- In the November 5th election.

What gives you confidence that voters are going to go a different way in these races?

In these state legislative races?

- It's about looking at the data and focusing on where we can be successful.

It's not trying to do too much all at once.

Our plan is a multi-year plan.

We have to start somewhere.

So this year, we're putting at Planned Parenthood, we're putting $1 million into these four seats.

We're doing, we have community organizers in every district.

And, they're working with canvassers to talk to voters.

We have the largest phone program in the state.

We've made 100,000 calls to voters in those districts since April.

We have paid digital ads, and direct mail.

You may have already seen those coming your way.

The multi-year plan is that we do four seats this year.

We do three in 2026.

And the critical year is 2028, when we do a few more.

We've broken the super majority, we've brought balance to the legislature.

We've moderated their extreme views on issues.

And we are ready for redistricting.

Because once we have fairer districts, then we'll have lawmakers who are responsive to constituents.

And it's not bad to have divided government.

You know, it's actually a good thing.

That's how we build coalitions, that's how we get bipartisanship.

And we could actually get some good things.

We could get nice things, you know, that we don't have now, that we have been deadlocked on for years.

If we have moderation, if we have bipartisanship, we could get Medicaid expansion.

We could get medical marijuana.

We could get common sense gun safety laws.

And at Planned Parenthood, we just have to keep going inch-by-inch until we get the majority that we need to get our rights back.

- And, one more point before we go back to Eric.

For people who don't work in these kind of political calculations every day, talk about the difference between a Republican super-majorities and a Republican majority.

Because from what you're talking about, it sounds like you feel like a Republican majority makes legislatures more open on various issues, not just this issue, but, but- - Right, yeah, the definition of a super-majority is that the other party doesn't even have to show up for them to get their work down.

So, the super-majority is able to turn off your mic.

You're not able to move bills through the legislature.

There is no bipartisan cooperation on reaching a middle ground on issues.

They don't have to pay attention to the other party at all.

And, it's the result of having some really bad gerrymandered districts throughout our state so that moderate voters really have lost their voices.

It's one reason why we're 51st in voter turnout, people think my vote doesn't matter, my legislator doesn't listen to me.

So what we have to do is work really hard on the districts that we can flip, to bring that moderating influence.

Even a few more Democrats in the legislature to a point where we break the super-majority.

And like you said, it's just a majority.

It's going to moderate the legislature.

It's going to bring us alliances for things that we want.

- We have about 10 minutes left in the show.

I remind everyone who maybe joined late.

We'll have folks with other perspectives on this through the course of the fall and into next year, as the legislative session starts.

But as we do with a lot of topics like this, obviously, Ashley Coffield has a point of view, and we'll bring people on who have a different point of view.

To that end, I am sure there are people listening who, you know, are saying, "Well, but millions of Tennesseans voted for President Trump", who put three of the Justices on that voted to overturn Roe v. Wade, to the Senators, the U.S.

Senators.

To even with gerrymandering, millions of Tennesseans voted for candidates who are very happy that Roe v. Wade has been overturned.

And millions of Tennesseans are happy with that.

And so to them, what do you say?

Again, separate from the pol.. And, I'm not dismissing that.

The politics and the dynamics of the legislature and the way districts are drawn, and so on.

But to those millions of people, what do you say?

- I'm not sure if there's millions and millions.

But you know, because we're such a low voter turnout state, so we have to keep that in mind.

And that polls show that people, the majority of people in Tennessee are pro-choice.

So I think if we had a ballot initiative today, we would win.

But what I say to the people who support the abortion ban, I don't think that they would support it in the framing that it's in, where it's in such totality.

I don't think they want 10-year-old girls who have been raped not to have access to abortion services.

I don't think that they want a family member to die because an abortion was denied because of a fetal anomaly, or other pregnancy complication.

I don't think people want this.

The ban is very extreme.

- Yeah.

One of the things over the years, of many years of following this at a national level, and some, what some 30 years living in Memphis.

And one thing it seems to me, it's just my perspective, in post-Dobbs, and maybe, especially in this election season, that the notion of abortion in relationship to complications like you're talking about has been given much more definition, much more light.

Atopic pregnancies, problematic pregnancies.

- Right, right.

- Versus, for so many decades, I feel like overwhelmingly the people who wanted to end Roe, framed abortion as, abortion was an act of convenience, or of literally, of choice of convenience.

Your response to that?

- The anti-abortion movement has been lying about abortion for decades.

They have always, part of their lie, part of the big lie around abortion was that it was about convenience.

It was just women cavalierly using abortion as birth control.

They glossed over how complicated and dangerous pregnancy is for so many people.

They glossed over all the complications of life, and why people want to have reproductive freedom, and have choice within their families.

And the big lie has been uncovered at this point.

That, pregnancy is complicated, that it is a big deal.

That women really do need to be able to control their own bodies and what happens to them.

- Do you have?

You may not, but well, prior to Dobbs, you talked about 10,500, almost 11,000 women leaving the state in the last two-plus years.

About every year in Tennessee, was there basically about 5,000 abor...

I mean, how many abortions were performed pre-Dobbs?

And, maybe those numbers are complicated, or just harder to get to with mifepristone and pharmaceutical abortion and the rise of that.

But what, what...how... How many people were getting abortions in Tennessee before Dobbs?

- Right, well, in Tennessee there is a law that requires physicians to report every abortion that's provided.

And that law continues even under the ban.

Which again, makes it a little scarier for doctors to provide, because they do have to report to the state.

So before the ban, there were between like 8,000 and 10,000 abortions a year in Tennessee that were reported to the state.

- Would that include the prescription of mifepristone?

- Yes, if it was provided by a physician in Tennessee that we, you know, that reported it.

I mean, someone could of traveled to another state.

- We have five minutes left now.

We're gonna start fast through things we could do whole shows on, so apologies in advance.

Because theseare very sensitive and very complicated issues.

Have any doctors since Dobbs been, you know, charged or prosecuted?

- Not to my knowledge.

- Not to your knowledge.

I'm gonna try to shift, Bill may go back.

But, shift over to contraception.

In the ruling on Dobbs, Justice Clarence Thomas in the jobs decision who, Dobbs decision, excuse me.

He talked about reconsidering cases such as Griswold, which was the 1965 ruling that guaranteed the right to contraception.

Are you worried that that also could be lost?

Because, that's a big part of what Planned Parenthood does, as you said, and has always done.

It hasn't just been an abortion provider.

All kinds of women's health, contraception, all those kind of things.

- Yeah, I mean, just like abortion, contraception is common.

It's used, it's even more common.

One in four women will get an abortion in their, during their reproductive years.

But 99% of women use birth control.

So, it is something that we're concerned about.

You know, the legislature banned gender-affirming care for minors.

That's hormone treatment for minors.

It's not a big leap to say that they would ban hormone care for minors for contraception.

And then, minors are always the canary in the coal mine.

- Which would mean the pill, or- - The coming...the pill, or an IUD- - Implants, or an IUD, right.

- Right.

It's not that big of a leap to say that they're coming for the rest of us.

- Bill?

- Have you seen a connection in access to healthcare in general, and complications in pregnancies?

- You know, absolutely, we have people who come to us, and they're, to get ultrasounds, to get pregnancy dating so that they can make a decision about whether they're gonna track, whether they're able, they're early enough in their pregnancy that they can make an appointment out-of-state, and travel out-of-state.

And, people are desperate.

They're desperate for us to provide.

And, we can't.

So, I can only imagine how comp... Once they leave our doors, and we've only gone as far as we can help them, I can only imagine what happens to them.

- What do you hear from doctors who might not be part of Planned Parenthood, but just within the medical community?

- Fear, a lot of fear about the law.

A lot of frustration with the law.

Concern about the future for Tennessee about being able to recruit.

A lot of concern about recruiting physicians to come to Tennessee.

Because, it's not just OB-GYNs.

Doctors and other specialties have to rely on abortion for the care that they provide.

If you're an oncologist, you rely on abortion because you have pregnant people who need an abortion so they can continue their care.

If you're a rheumatologist, you need an abortion because someone with an immune-compromised condition needs an abortion to continue their care.

So, other specialists don't wanna come here if we've got this kind of ban.

- Gender-affirming care, huge hot button issue.

We could do a whole show on it.

I didn't know that Planned Parenthood provided gender-affirming care.

But now that's above, for people, adults?

- Eighteen and older.

- Eighteen and older.

What sort of pressure do you feel there?

- We're so proud to provide.

Our transgender patients are so grateful, especially in East Tennessee, where there are very few providers, except for Planned Parenthood.

An arsonist burned our health center down in Knoxville on December 31st of 2021.

We have rebuilt it.

It opens on Monday.

And, we are so excited to see our transgender care patients again there starting next week.

- I hate to even ask this, but have you ever been threatened in the years you've been doing this?

- I have.

- Yeah.

How do you deal with it?

- I, you know, I just set it aside.

And, get on with the work.

Because, you know, I'm not a physician.

I think physicians who provide abortion care feel even more threatened than an administrative person, and a leader in my position.

And so, I always try to put it in perspective.

- So many more questions, and I hate doing this with just a minute left.

About again, what, are there any, I mean, Bill will ask this again with the legislature.

Is there any room in the current makeup of the legislature, room for adjustments to what's going on from your point of view?

- I'm afraid not.

When little girls who have been raped, can't get an abortion, and they turned away from that bill, that exception this year.

I had lost hope, and I think now others have, too.

We have to flip the seats to get our rights back.

- And last one, mifepristone is right now legal to get from out-of-state?

I mean, is that where we are with, as a state?

If you do like telehealth, or something like that?

- Physicians can't call it in to Tennessee and treat a patient in Tennessee, if they're in Tennessee at the time of the telehealth appointment.

They have to travel to the state that, you know, where it's legal for a telehealth appointment.

There are states that have shield laws.

You know, where, like Massachusetts has a shield law.

And they are willing to send mifepristone to Tennessee through the mail, but that is- - It is, that's a major, pre-Dobbs even, that was a majority of how abortions work, isn't it?

- Pre-Dobbs, especially during COVID, it became more than 50%.

But you know, it's controversial, and it's legally questionable that they're doing it, but I'm glad they are.

- Again, thank you very much for being here.

Thank you for sharing all of this.

Thank you, Bill.

Thank you for joining us.

Again as I said at the top of the show, in the middle, we'll have folks with other perspectives on these issues over the coming weeks and months, as we got into legislative session and talk to other folks.

That is all the time we have this week, though.

If you missed any of the show, you can get the full episode at WKNO.org, where you have the video online at YouTube, at The Daily Memphian site, again, WKNO.org.

You can also download the full podcast of the show wherever you get your podcasts.

Thanks very much, and we'll see you next week.

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