Parkmed NYC, an independent abortion clinic on the east side of Manhattan, is located in a nondescript office building that also houses the Ecuadorian consulate. Five days a week, the clinic is flooded with patients, many of whom have traveled long distances by bus, train or plane to evade abortion bans in their home states.
Ever since Parkmed opened in 1971, two years before Roe v Wade legalized abortion nationwide, it has faced the typical struggles of any abortion clinic: aggressive protesters, bomb threats, legislative challenges. In the wake of the supreme court’s Dobbs decision, which erased the constitutional right to abortion, the clinic has ramped up security by installing new cameras and upgrading the telephone system to record threats; the addition of a bulletproof wall in the reception area is currently in the works. But now, it is facing a new, unlikely adversary: Planned Parenthood of Greater New York, which operates another abortion clinic located just two miles away.
A civil lawsuit, filed by Parkmed in the New York supreme court in October 2022, alleges that Planned Parenthood poached one of its only abortion providers in violation of a non-compete clause – a stipulation in an employment agreement that restricts workers from taking jobs at rival companies for a certain period of time – leaving the clinic unable to meet patient needs and teetering on the brink of collapse.
The lawsuit, which has not been previously reported, is the latest example of tensions between independent abortion clinics and Planned Parenthood as the US faces a ballooning crisis in reproductive health.
Planned Parenthood, the country’s largest single abortion provider, has net assets over $2bn, according to its latest annual report. Collectively, Planned Parenthood affiliates perform about 37% of all abortions in the US. Independent abortion clinics, which tend to offer abortions later in pregnancy and operate in some of the most abortion-hostile areas of the country, perform about 55%.
Despite Planned Parenthood’s dominance in the reproductive health field, some activists charge that the organization is too timid in its advocacy and can sometimes treat independent clinics like competition, instead of partners who share the same goal of maintaining abortion access for all who need it. A recent New Yorker article included accounts from several independent clinic owners who said that Planned Parenthood opened new health center locations near them without regard to how it might impact their ability to keep their doors open.
The Parkmed lawsuit alleges similar behavior. “They essentially trampled us,” an office administrator at Parkmed, who wanted to remain anonymous as he was not authorized to discuss the lawsuit, said. “We’re in a very precarious situation.”
In the summer of 2021, Parkmed hired a doctor whose name is being withheld due to safety concerns. According to the lawsuit, Parkmed brought her on right out of her fellowship and “expended significant time, efforts and resources … training her in the subspecialty of pregnancy termination services”, including second-trimester abortions. The doctor’s one-year contract included a non-compete clause that specifically barred her from working at nearby abortion providers, including Planned Parenthood of Greater New York, for a 12-month period after leaving Parkmed.
Non-compete clauses, though controversial, are fairly standard in the medical field. Advocates say they are needed to retain physicians and protect costly investments in training, while opponents say they unfairly trap doctors in unhappy work environments.
In March of 2022, according to the lawsuit, the doctor extended her Parkmed contract for three years. But two months later she advised the clinic she would be resigning to work for Planned Parenthood, beginning that August. She is currently employed there. The lawsuit accuses Planned Parenthood of “inducing her to breach her non-compete agreement despite knowing the terms of her contract and the disastrous effect poaching her would have on Plaintiffs’ in-demand, high-volume medical practice, and Plaintiffs’ continued ability to provide women’s health care services to an exploding population of needy patients”.
A spokesperson for Planned Parenthood of Greater New York said they could not comment on the lawsuit except to deny all of the allegations. The group’s filings to the court also include a critique of the non-compete clause, which it argues is harmful and unreasonable. The doctor, who is also named as a defendant, was also unavailable for comment.
In addition to enforcing the non-compete clause, Parkmed seeks damages against the doctor for breach of contract, as well as damages against Planned Parenthood for interfering with the employment agreement.
Parkmed’s administrator said that it is one of a dwindling number of clinics across the US that provide abortions later in pregnancy and that since the Dobbs decision, it has experienced a spike in demand. While the vast majority of abortions take place during the first trimester of a pregnancy – 93% occur at or before 13 weeks, according to the CDC – there are many reasons why patients need abortion at a later gestational stage, including learning about the pregnancy late, wait times for appointments, the absence of funds to travel for care and fatal fetal anomalies, which are often not identified until 18 or 20 weeks.
Post-Dobbs, accessing timely care has only gotten more difficult as widespread clinic closures have forced patients to travel farther, incur more costs and face longer wait times at remaining clinics. As a result, the Parkmed administrator said, a growing number of patients are being delayed until the second trimester before they can be seen. Independent clinics, such as Parkmed, provide the majority of abortion care after the first trimester. According to a report by Abortion Care Network, by 19 weeks gestation, 71% of clinics providing care are independent.
According to the Parkmed administrator, when the doctor resigned to go work at Planned Parenthood less than two months after the Dobbs decision, she was the only physician at the clinic performing second-trimester abortions. In order to adapt, the administrator said, the clinic had to significantly restrict appointment availability, and the sole remaining physician, who had not performed abortion procedures for over 15 years, was assigned to abortion care in an attempt to fill the void. Parkmed has also had to reduce gynecological appointments due to a physician shortage.
In order to meet patient demand, an abortion provider based in Buffalo, Katharine Morrison, who spoke to the New Yorker about the impact of Planned Parenthood on independent clinics, has been flying into New York on a regular basis to perform abortions at Parkmed. Around the time the New Yorker article came out, she received a letter from a law firm representing Planned Parenthood of Central and Western New York, accusing her of making blatantly false and damaging statements on her clinic’s website about services available at nearby Planned Parenthood locations, and threatening legal action against her.
“Planned Parenthood has no compunction about trying to squash independent providers,” she said. “They’re a huge corporation swimming in money. I’m a doctor doing so poorly that I have to fly to New York every week to do abortions to make enough money to keep my practice going.”
The Parkmed administrator said he was hesitant to speak out publicly against Planned Parenthood for fear of dividing the reproductive rights movement at such a critical juncture and concern over possible retaliation. Already, he said, the clinic had noticed a decrease in patient referrals from Planned Parenthood. Prior to initiating the lawsuit, he added, representatives from Parkmed tried to talk to Planned Parenthood and come to a compromise that would offer Parkmed staffing support during a transitional phase, so that the clinic’s day-to-day care would not be affected.
“We don’t want to keep physicians that don’t want to be here,” he explained. But he said Planned Parenthood was not interested. “They did not want to engage in a process of responsible transfer, responsible transition,” he said. “They brought us to the point of implosion, with zero regard to possible consequences – to the public and to abortion access.”
