Opinion: 40 Years of Fighting for Feminist Health Care

The First Home: 715 N. Dodge Street, Iowa City.

The year is 1973. The Vietnam War is ending. The Watergate hearings are beginning. The World Trade Center is completed, making it the world’s tallest building. A gallon of gas costs about 40 cents. The U.S Supreme Court rules on Roe v. Wade, making abortion a constitutionally protected right for all women, irrespective of their financial means. And here in Iowa City a historic moment in women’s access to healthcare and reproductive autonomy occurs when a group of 12 women open the Emma Goldman Clinic, a feminist healthcare collective, offering birth control counseling, psychotherapy, birthing classes, massages, legal self-help information, healthcare education and first-trimester abortions.

The passing of Roe v Wade itself was the impetus for the project. Since 1971, a group of local feminist activists had been offering an abortion counseling and referral service. According to the Guttmacher Institute’s Report on Public Policy (2003), in 1970, four states had repealed their anti-abortion statutes. Women with (often considerable) means could travel to Alaska, Hawaii, New York, Washington—or even as far as England—to garner a safe, legal first-trimester abortion on demand. With Alaska, Hawaii and Washington requiring 30 days of residency in order to provide the procedure, local feminist activists were referring women to New York and even Mexico. When Roe v Wade was upheld, feminist healthcare activists began ecstatically making calls to find out when such services would be offered here and how much they would cost. To their horror and surprise, local gynecologists all but hung up the phones in their faces. That’s when Emma’s founding mothers decided to do it on their own. They opened a women’s health clinic that prioritized training lay people to offer basic women’s health services and also focused on providing reproductive health education to demystify women’s bodies and to empower women as active agents of their own health and as knowledgeable consumers when seeking services from the medical system. The collective paid to train a local physician to perform first-trimester abortions and the Emma Goldman Clinic, a feminist, consensus-driven healthcare collective was born.

This locally-grown, independent small business has been a leader in providing feminist reproductive healthcare for 40 years. The organization has also been an important player on both the state wide and national levels by allocating funds to support the opening of clinics in Cedar Rapids, Cedar Falls and Ames; training fitters for the cervical cap; successfully suing the State of Iowa in the ‘70s to extend funding for non-therapeutic abortions; and training medical students in how to provide abortion services, making The University of Iowa’s medical school one of the few OB GYN residency programs in the country that offers such training.


Grassroots – 1973: Iowa City’s Emma Goldman Clinic was the first feminist health clinic in the midwest

Survival of the Fittest

Since 2005, in the midst of increased competition from big-box reproductive care, like Planned Parenthood, local, independent, feminist health clinics have gone the way of the Dodo bird—some dying out after as many as 30 years. Now, less than 15 remain.

The Emma Goldman Clinic has in part survived by reconfiguring its collective structure in the mid-’90s and adopting a more hierarchically organized business plan. Emma currently has two co-directors, Francine Thompson and Jennifer Price. Thompson recalls, “I started working at the clinic in July of 1987. At that time the clinic still operated as a collective. All 12 of us associate directors shared and rotated jobs, and we were all paid the same wage.”

When asked about the significance of Emma turning 40, Thompson responds immediately. “Well, we are a local, grassroots organization that was started by women in the community in which they lived. In an age of big box stores and outsourcing, we are still here, 40 years later. We continue to provide personalized, high quality healthcare to the women who live in our community and state. We are still here because we have been uncompromising about our feminist values and our client-centered care.”


Still Standing: Co-Director Francine Thompson (R) and the current staff of the Emma Goldman Clinic

Challenges . . .They’ve Faced a Few

Thompson’s confidence about Emma’s future is unmistakable—almost eerily optimistic. When questioned about the current climate, which suggests that the age of grassroots women’s healthcare may be over, Thompson smiles. “It is an ongoing struggle to balance the desire to keep abortion financially accessible with the rising costs of operating an independent healthcare clinic,” she admits. “Combine that with the current economic challenges that many of the families we see are experiencing. . . .” she stops, unable to complete her sentence or even to imagine a future without a thriving Emma Goldman Clinic in it.

With Mitt Romney’s “only-in-the-case-of” stance on abortion, the yearly onslaught of overarching legislation strategically proposed to chip away at the principles that undergird Roe v Wade—the most recent being the Arizona legislature’s pronouncement that life actually begins before conception—and the looming possibility of a Republican president being poised to nominate up to four Supreme Court justices, it is essential to ask what is at stake for women in the upcoming election. Thompson gasps, “Everything! There is an all out war being waged against women. Last year over 1,000 pieces of legislation were introduced.”

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Perhaps Thompson is unflappable not because of a naïve vision of the future but because she doesn’t view the past with rose-colored glasses. “It is a little known fact,” she states, “that within days of the Supreme Court ruling on Roe, anti-choice legislation was introduced. For as long as the clinic has been in existence, there has been a concerted effort to make abortion illegal and inaccessible. Many tactics have been tried: fear and intimidation of providers.” Her eyes are fierce, “But we are here for our clients, for the women seeking services.”

This November the stakes are as high as they have always been: Will our experiment work? Can a nation founded on the idea of individual freedom stand? Will we develop spiritual, political, economic and social institutions that foster self agency for everyone, or is the freedom proclaimed in our Constitution only the domain of a select few? Will a woman’s health be primarily determined by her socio-economic status? When will we all, in these United States of America, have the opportunity to be free?

Raquel Lisette Baker is pursuing a PhD in English Literary Studies at The University of Iowa, specializing in Postcolonial Studies. She has been a member of Emma Goldman Clinic’s Board of Directors for three years and currently serves as the vice chair.