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Jen Castle: Abortion care is compassionate health care

Jen Castle spoke at FFRF’s national convention in Madison, Wis., on Oct. 13, 2023.
(Photo by Steve Solomon)
Erin Heisler Wagner, granddaughter of Henry Zumach, introduced convention speaker Jen Castle. (Photo by Chris Line)

This is the speech (lightly edited) given by Jen Castle at FFRF’s national convention in Madison, Wis., on Oct. 13. She was introduced by Erin Heisler Wagner, the granddaughter of Henry Zumach, who has endowed the Henry Zumach Freedom From Religious Fundamentalism Award. You can watch the video of the speech (and all other convention speeches) at ffrf.us/con23.

Erin Heisler Wagner: I lead the communications team at Planned Parenthood North Central States — a Planned Parenthood affiliate that provides expert health care, comprehensive sex education, innovative research and fierce advocacy in Iowa, Minnesota, Nebraska, North Dakota and South Dakota.

Since the fall of Roe, the fight against religious fundamentalism has become a daily act at Planned Parenthood as politicians and judges have forced their religious beliefs into our health care exam rooms.

That’s why I’m honored to be here today — to represent my grandpa and present Planned Parenthood Federation of America with a $35,000 donation from the Henry Zumach Freedom From Religious Fundamentalism Award. I grew up listening to my grandpa’s stories of fighting religious fundamentalism. Whether it was founding the La Crosse Area Freethought Society or suing the city of La Crosse for allowing a Ten Commandments monument on city property, he has been active in this work for decades.

This award is his legacy, and in this eighth year, it is only growing stronger. He will be investing another $100,000 to ensure the award can make an even stronger impact in the future.

I will always remember what I was doing when the Supreme Court leaked its decision in Dobbs v. Jackson Women’s Health Center. I got a call from my grandpa. He was full of ideas for how to build up attention around the cause — some of them included calling out the Catholic Church in very creative ways. He knew this horrendous decision would put so many Americans’ rights and lives in danger. It’s truly a gift to have grandparents so involved in the fight for sexual and reproductive rights. I’m sure that’s part of why I am where I am today.

Now, a year later, he’s supporting Planned Parenthood and the fight again. I’m so happy to be here today, less than a month after abortion services were reinstated in Wisconsin, to welcome Jen Castle to accept the award on behalf of Planned Parenthood this year.

Jen Castle helps these providers across the country. As the national director of abortion service delivery at Planned Parenthood Federation of America, she leads a team that supports the delivery of exceptional abortion care through training, mentoring and consultation. Jen has worked and provided training in all abortion care clinical roles, and has been doing her heart’s work as an abortion provider since 2005. She is also one of a very few nurse practitioners in the country trained to perform procedures later in pregnancy, allowing her to provide health care that is nuanced, empathetic and sometimes even lifesaving.

Welcome, Jen Castle.

By Jen Castle

H

i, everybody. Thank you, Erin, for that kind introduction, and an especially heartfelt thank you to the Freedom From Religion Foundation’s members for their continued support to Planned Parenthood, to reproductive freedom and to a better future.

I’m really honored to be here with you all today on behalf of Planned Parenthood Federation of America to accept the Henry Zumach Freedom From Religious Fundamentalism Award.

As I’m sure many of you know, the resurgent white supremacist movement and its co-conspirator religious extremism are among the greatest threat the country faces. These are truly frightening times.

As Erin mentioned, my title at Planned Parenthood is national director of abortion services. When I was a young person, I felt so strongly that I wanted to do work that made a difference and given the events of the past few years, there are some times where I am reminded to be careful what you wish for. Despite my lofty title, I am just a small part of a 19-million-strong national movement made up of Planned Parenthood health centers, providers, staff, organizers and supporters. And in our work to ensure as much abortion access as possible, we are joined by many more partners. In this moment in time, doing right by people truly does take a village and then some.

Our fight is fueled by this incredible community and friends. We have been fighting like hell for the last 16 months. I’d like to start by sharing a bit about Planned Parenthood’s broad scale work which has become even more imperative since the Dobbs decision was handed down on June 24, 2022.

I think you know that we’ve been fighting in state and federal courts challenging abortion bans, especially where state constitutions might offer better protection for abortion rights. Of the approximately 30 cases on our litigation docket, in almost two-thirds of them the challenge has been blocked, allowing people to access the care they need. But, we aren’t just playing whack-a-mole, we are eyeing system-wide changes, as well, because we know that we can’t rely on the courts to protect our rights.

Antiabortion politicians have stacked all levels of the federal judiciary with judges hostile to reproductive rights and tilted the playing field against us. To secure our right to abortion and to restore the credibility of the judicial system, there are structural changes that need to be made. Planned Parenthood is working hand in hand with civil rights, democracy reform and reproductive justice partners, those who have led this work for decades, on key reforms to all levels of judiciary, including expanding the numbers of justices and instituting term limits for the Supreme Court, strengthening judicial ethics rules, creating additional judgeships on our lower courts and preventing single-judge districts.

Three cases

This work becomes all the more important in light of three cases filed by our opponents to undermine pillars of our country’s sexual and reproductive health care infrastructure: Title X, medication abortion, and the care provided by Planned Parenthood health care centers.

These lawsuits are a result of decades-long planning by anti-abortion organizations, politicians and individuals, not only to eliminate the federal constitutional protections for abortion under Roe v. Wade, but to impose their own beliefs on all of us and prevent people from controlling our own bodies.

We are bringing the full power of our movement to this existential fight — because we have to. The majority of people in this country support abortion access. They support access to birth control. They support reproductive health care and they support Planned Parenthood.

I want to pivot for just a minute and talk about something that I know folks are excited about on our action funds front: ballot measures. Last year, through ballot measures in several states, including my home state of Vermont, one of the least religious states in the country, voters resoundingly showed that the ability to control their own bodies, lives and futures is non-negotiable.

Planned Parenthood national and local organizations are continuing that momentum by supporting ballot initiatives in key states in 2023 and 2024 election cycles, including in Arizona, Florida, Nebraska, New York, Ohio, Maryland, Colorado and Illinois. To be clear, they’re not a silver bullet to undo the damage the Supreme Court has caused, but they are a key part of defending or enshrining reproductive rights toward a constitutional amendment.

I want to give a huge shout-out to the state we’re meeting in right now — Wisconsin. Because of successful legislation against a law dating back to 1849, Planned Parenthood centers in Milwaukee and Madison are now once again able to provide abortion.

Planned Parenthood of Wisconsin’s organizations deserve all the credit in the world for their role in restoring patients’ access to abortion, their role in the recent state Supreme Court ideological shift and for their incredible partnership to ensure that Wisconsinites were able to get the health care they needed, even if it was across state lines. Beyond our legal and policy efforts, the work my colleagues at Planned Parenthood focus on is patient care, navigation, funding, workforce, strategy, clinic legal assistance and training.

New focus, new thinking

I hope you will indulge me in doing a little bit of bragging about some of our work in just the last year, which has required new focus and new thinking and new efforts as we do all we can to maintain access to health care that people need as bans have been enacted in almost half of our states.

We continue to focus on expanding the use of telehealth in abortion care to increase capacity to serve a surge of patients in our access states. In some places, that care can now be provided asynchronously, so a patient can request a medication abortion appointment online, they can complete their paperwork at a time that works best for their lives — maybe that’s lunchtime in the work parking lot, maybe it’s late at night after they’ve put kids to bed — and a provider can review their information at a later time and, if it’s appropriate, mail them their medication and instructions, which would include a way to contact us as needed.

In another avenue to assist our health centers with the challenges of staffing shortages that we’ve seen across health care since the pandemic, we’ve created and launched a standardized and centralized training curriculum which provided foundational training and abortion care content to over 300 new-hire individuals across over 30 of our affiliates in the last year, and beyond introductory content about abortion care, it provides sessions about anti-Black racism, about caring for LGBTQIA-plus patients and reproductive justice. Because we truly believe that in order to provide exceptional care, we need to understand our history, which is the same history that our patients collectively overcome and bring with them to our health centers. Through this work we endeavor to advance and sustain a reproductive health landscape by fostering a skilled workforce, enhancing patient care and combatting stigma.

Maybe most significantly, we have pretty quickly stood up a nationwide network of patient navigators who truly are heroes without capes. These are folks who collaborate across Planned Parenthood affiliates, abortion funds and truly across miles and states and sometimes a lot of the country to do all they can to ensure that patients, no matter where they live, can secure an appointment. This looks like someone in Texas reaching out and a patient navigator connecting them with a health center in Illinois, perhaps also arranging for gas money, a childcare subsidy and hotel.

Challenges increasing

As the number of places to access abortion care grows smaller and smaller, you can imagine the challenges that are compounding in terms of people accessing care, even for people who live in states where abortion continues to be legal. I might live in Kansas, where there are a number of providers, but those providers’ schedules are very likely full for the next three to four weeks, because that’s the closest place for people from Texas, Missouri, Louisiana to go to. So now the decisions of lawmakers in those states have carried over into mine.

An example of how important our navigators are: We had a patient navigator in an Eastern seaboard state have a patient call who was a Spanish-speaking 12-year-old needing care later in the second trimester. This is care that not everyone provides. It can be challenging to access. The patient’s mom was her support and would accompany her, but the providers in the closest city were booked out for more than three weeks and neither could travel by plane due to being undocumented, so our navigator reached out to the patient navigation community for help with other options and immediately colleagues across the Northeast gave options of places to access care in New York City and Boston and offered to cover travel and procedure cost. I truly cannot imagine how patients with so many compounding injustices and barriers would find care without our amazing navigators. They see cases like this every day and we are so fortunate to have their compassionate support during this time.

While we share our appreciation for the time, talent and expertise of our patient navigators and our patients and our staff, I also want to recognize and share with you that a lot has changed for them.

Abortion, the work of their hearts, has gone from being a nominally protected right to being ever-further out of reach for too many patients.

The clinical care to which they’ve dedicated their skills, their compassion, their sense of justice and their belief in bodily autonomy has been criminalized, vilified and in some places, eradicated. Their positions have been lost, relocated and overwhelmed. There are fewer places for more patients to access care. Waits for appointments are long, as are travel times and later care needs are expanding. The stakes are so high for so very many people and the obstacles that patients must now overcome to get to care also mean that their emotional needs are much higher, as well.

A lot has changed. But many things have not. My colleagues continue to believe people need and deserve their skills, compassion, sense of justice and belief in bodily autonomy.

They continue to walk through groups of sidewalk bullies just to enter their workplace, eat lunch in bites between seeing patients and sit quietly holding a hand because someone needs them in the moment, even though at least an hour’s worth of charting awaits. They continue to manage emergencies, take a big breath, and then walk in fresh to care for the next patient. They continue to propose and carry out vital research. They continue to learn, to train, to train others. They continue to testify, to write editorials, to stand up, to speak out. They continue to serve as mentors. They continue to show up to, for and with their teams, colleagues and patients.

Compassionate group

Simply put, there is not a more courageous, compassionate and committed group of health care providers in existence. Trust that when you support Planned Parenthood organizations, this is who you are supporting.

Yes, we are a mission, and yes, we provide compassionate care to millions of patients every year, but we are also thousands of passionate supporters who have dedicated our lives to this cause and, as I stand here thanking you for your support, I want you to know that I, too, am a lifelong supporter of Planned Parenthood. I’m proud to say that I’ve worked as an abortion provider at Planned Parenthood for the past 22 years.

About a month ago, while I was in clinic, I saw a patient — a transgender man, who, at the age of 27, had never had a pelvic exam or interacted with the gynecological world. We took some time, we took our time, lots of time, to show him the instruments and make sure that he knew he was in charge of taking breaks, of having more chitchat or less, or what kind of music we would listen to. As his procedure neared the finish, he said: “I really freaked out when I found out I was pregnant, but I knew that if I called Planned Parenthood, they would take care of me, and you did.”

And this is the power of Planned Parenthood. You could say I’m a fan. I have seen firsthand what our care can give people and often that is the keys to their lives back. And this is the impact that nourishes me.

Given the setting that we’re in, I’d like to share that across my time in this work, I have drawn on both my Catholic past and my current Buddhist practices and their shared belief in the imperative to offer oneself in service to ease the suffering of others. I don’t need to tell you all that this is an imperative that does not need theological dogma to be understood or effectual.

I know firsthand that people seeking abortion care deserve compassion. There is no requirement that abortion care must involve suffering, other than what years of stigmatization and shame by our country’s culture demands. That is not a world that Planned Parenthood imagines, nor is it a belief that we subscribe to.

So often our patients come to us expecting to be judged and shamed and I am often saddened at the extent to which they’re surprised to be cared for by a kind, compassionate, professional staff, who are ready to share a joke, a hug, a tissue, as each situation requires.

In the media, abortion is often portrayed as an option of last resort, of desperation, the work of cold or invisible providers, when, for many people, it’s simply the best decision for them. It is quite simply health care.

Right now, we have far too many politicians making false and inflammatory claims about abortion and abortion providers, purely for political gain. So much of the conversation about abortion in this country is predicated on misconceptions and lies.

‘Nothing short of a miracle’

The reality is that abortion, like most other medical interventions, is nothing short of a miracle in many ways. It saves lives and not just physically, but also emotionally and financially and spiritually.

It creates opportunities for education and career and relationships and future children. For growth. For learning. It protects the well-being and future opportunities of living, breathing children.

Abortion can and should be understood as the medical intervention that has the power to do great good. Is it the right choice for everyone? Of course not. Should everyone be able to determine for themselves what is or is not the right choice for where they are as unique individuals in their unique moment in time? Absolutely!

But the stigma persists, in large part led by religious fundamentalists who would deny the beauty, reality and complexity of our existence. They demand that we flagellate and punish ourselves simply because we boldly, unapologetically choose to live in harmony with our bodies and our sexuality, because we dare experience our bodies for the sake of pleasure and connection and not simply for procreation. The fee demanded for all that is a demonstration of shame. I know how my patients feel. I myself felt shame as a patient. I didn’t find a birth control method that worked for me until I was 31. I thought that to be pregnant when I didn’t want to be was a reflection of my failure as a person rather than a simple fact of biology.

When I was 26, I came across a newspaper photograph of a woman who was the same age as me. She was a single parent surrounded by four very young children and I remember thinking that she looked exhausted and overwhelmed. I was preparing for a big life change, moving away to attend a degree program that would allow me to have a career in health care, and this shift was possible only because of my life circumstances. The care of others meant that I had been able to have four abortions by this point in my life, rather than four children. I cut the photo out of the paper, filed it away, packed it up and brought it with me over the next several moves and 22 years of my life. Over that time, I became a mother to two children.

The notion that my life might have played out differently, that I might not have ended up parenting these two beautiful, brilliant and exasperating human beings is terrifying to me. They are my world. I would do anything for them.

Patients frequently express similar thoughts to me. They want children or want more children, but don’t feel ready for them yet. They are often struggling to take care of the children they already have, and want to be the best parents possible. Isn’t that what we all want for our children? To those patients I say: It sounds like you are an incredibly loving parent.

I provide abortions confidently and compassionately precisely because I know that they have the power and potential to ease the suffering of the person who is pregnant. The person who’s come to the decision that being the best parent possible at this point in time means having an abortion.

At a meeting a few years ago, we were asked to come prepared to show a meaningful representation of our work in abortion care and so I dug into my desk drawer to find the photograph of the woman and her children, but what I ended up finding was an old card from my son that said: “Not many other kids can say their mom helps the lives of young women on a regular basis. Since I was a baby, you’ve been a guide, a nurturer, a hero, but most importantly, my mom. So, on your birthday, I just wanted to remind you how much you mean to me, and how proud I am to be your son.”

I brought this card with me to the meeting instead, because nothing I possess better reflects my gratitude for being able to do this work.

And of what a profound gift it was that someone else did the same work for me.

At Planned Parenthood, we hold the blessing of our work close to our hearts, with gratitude and solidarity for everyone who’s a part of it and everyone who supports it.

We know that the road ahead is likely to be difficult in the short term, and community support, like this, is what enables us to continue, to have the strength to provide care for many days to come so I hope you know how much your support means and how much we and our patients are grateful. Thank you everyone once again for your support of Planned Parenthood.