Most abortion care in the U.S. is provided by independently owned clinics, not big health centers like Planned Parenthood. Amy Hagstrom Miller of Whole Woman’s Health is on a mission to make abortions safe and stigma-free. The journey has taken her to the Supreme Court.
Read related article: Meet the Abortion Clinic Owner Who Took on Texas
Amy Hagstrom Miller Podcast Transcript
SUE: (as music plays lightly in the background) You’re listening to Good on the Ground...
VARIOUS VOICES: ...Good on the Ground...
COLLEEN: ...You’re listening to Good on the Ground from The Story Exchange.
COLLEEN: I'm Colleen DeBaise.
SUE: And I'm Sue Williams.
COLLEEN: And we are here once again to share our uplifting, motivating...
SUE: ...some might say inspirational...
COLLEEN: ...stories of women entrepreneurs doing incredibly important stuff...
SUE: ...as they run mission-driven companies.
COLLEEN: Yes. So that brings us to today...
COLLEEN: We -- through the magical abilities of podcast technology -- will be heading to Fort Worth, Texas, to talk to an entrepreneur who might best be described as a force of nature.
SUE: She really is.
AMY: I’m Amy Hagstrom Miller and I’m the founder and CEO of Whole Woman’s Health.
COLLEEN: Amy is an abortion provider.
AMY: Almost 40% of American women will have an abortion at some point in their life. For most women abortion isn’t a struggle. For most women they’re relieved and they’re happy to, you know, step into the future of their life.
COLLEEN: As you might well imagine, running abortion clinics in the Lone Star State is not the easiest job.
SUE: Oh my gosh. When we visited her clinic in Fort Worth, there were a number of hecklers. A grizzled old guy lugging a huge cross around and two to three women just hanging at the fence throwing some slurs from time to time.
COLLEEN: But it's not just the protesters that make this a difficult industry -- it's the state legislature, which has repeatedly tried to shut her clinics down.
AMY: So there was no question that we needed to bring a lawsuit and try to make it right, but the odds were very much against us.
COLLEEN: In today's podcast...
SUE: ...we'll tell you how Amy took on the state of Texas, in a case the went all the way to the Supreme Court.
COLLEEN: It's a remarkable story about drive, passion...
SUE: ...and what it takes to dig in your heels and make a difference.
COLLEEN: Stick around.
SOT: Hi, Amy!
-Hi, how are you? Here I come.
AMY: I have a very strong commitment to creating kind of an oasis in my clinics where we take care of women with really high medical standards.
SOT: Super good to see you!
-Great to see you!
-It’s nice to be here in Fort Worth!
AMY: Women don’t experience unplanned pregnancy only as a medical experience. It involves a cultural component, and a spiritual component for people, and we want to create an environment where all of that is welcome, where they can bring their friends and their loved ones and where we can talk about, you know, their hopes and dreams for their future.
SOT: You have an appointment?
SUE: We're inside the Whole Woman’s Health clinic in Fort Worth.
COLLEEN: The exam rooms have names like Amelia Earhart, Georgia O'Keefe...
AMY SOT: So part of what we’ve done is really intentionally creating a physical space
that’s really comfortable and warm, and then I’ve named each of the rooms after different women throughout history. So it really sort of changes how you might feel.
COLLEEN: Amy has been working in women’s health and abortion care for almost 30 years.
SUE: Around the time she was graduating from Macalester College in St. Paul, Minnesota in 1989...
COLLEEN: There was a women's march and pro-choice rally in Washington, D.C.
AMY: To be in Washington, D.C. with hundreds of thousands of people from all over the country was a huge, formative activist experience.
COLLEEN: She came back with a purpose.
AMY: I graduated and basically just literally walked six blocks down the street and walked into Planned Parenthood and said, “I want to work here.”
SUE: That was her first job out of college.
AMY: Answering eight phone lines and running the front desk at a Planned Parenthood clinic.
COLLEEN: At that time...
AMY: Abortion was explosive in the country. Clinics were being bombed, people were locking themselves to each other inside of clinics.
COLLEEN: There was conflict, and she was drawn to it.
AMY: You know, the moral and ethical dilemma, the sort of religious component, but then also that this was a political moment in our time where you could really have meaningful work.
SUE: Amy began training as a counselor.
AMY: Sitting with a woman at a time when she looks at all of her values, and her hopes, and her dreams and tries to make a really big decision.
COLLEEN: She got hands-on experience at Planned Parenthood.
AMY: I learned how to assist in the operating room, and how to do ultrasounds, and how to sterilize all the instruments, and float the tissue, and, you know, kind of learned every single job in the clinic.
COLLEEN: In 1994, she moved to New York City.
AMY: I worked in two different abortion clinics in Queens as a counselor.
COLLEEN: A year later, she was asked to open up a clinic in in the heart of Manhattan for a group of doctors.
SUE: Amy was just 27 years old.
AMY: So I picked the wallpaper, ordered all the instruments, hired all the staff, you know, placed all the advertisements, really grew the practice from the ground up.
COLLEEN: She stayed for five years, long enough to realize...
AMY: The abortion experience in New York was completely different than in Minnesota. The procedure, of course, is exactly the same but people’s experience, the culture, the values show up really differently in different parts of the country.
SUE: In the Midwest, for example...
AMY: The vast majority of people are Christians or Catholics and so you have this sort of abortion guilt kind of stuff. And so I learned this counseling model in Minnesota and I would say to women, you know, “Tell me how, you know, how you felt when you first found out you were pregnant,” and they would tell me the story.
COLLEEN: But New York was different.
AMY: In New York, like, there’s a cacophony of different kinds of beliefs and different kinds of cultures so you don’t have as many protestors.
SUE: When Amy first started as an abortion counselor...
AMY SOT: I have a funny story to tell you about that. Do you want me to tell you?
SUE SOT: Sure.
AMY SOT: I’ll never forget one time I said to this woman who had come from the Bronx to the this clinic I was in in Queens. I said, “So tell me how you find yourself here today,” and she was like, “I took the A train,” you know. And I was like, “Oh, I’m in a different place,” because there isn’t an emotional hang up here. She looked at me like, “What are you getting at, lady? Like, I came for an abortion. Like why do you want to know what train I took?” And it was just, it was awesome, right. It was just awesome because I thought, “Well, well, shit. That’s like perfect, right. Of course you took the A train and let’s just have an abortion.”
SUE SOT: That’s pretty great.
AMY SOT: It’s a good story.
SUE SOT: That's a great story.
COLLEEN: Yeah. In Amy's eyes, New York is how access to abortion care should be.
SUE: Accessible, affordable and stigma-free.
COLLEEN: So after five years in Manhattan...
AMY: Famous last words. I kind of opened myself up to, “Where should I go next? Like where can these skills that I have be of use to the field?
COLLEEN: An opportunity to manage an abortion clinic in Austin, Texas, came up...
AMY: And so we moved from Brooklyn to Austin in 2000. And pretty much ever since I moved to Texas they’ve passed a new law every two years restricting women’s access to abortion. And so this is what I mean when I say, “Be careful what you wish for.”
COLLEEN: We've been sharing the story of Amy Hagstrom Miller, founder of Whole Woman's Health.
SUE: I want to circle back to this idea of stigma.
COLLEEN: Yeah, right, it's what drives her.
SUE: Yes. She wanted to create a place -- in a state like Texas --- where women could receive abortion services, without feeling judged.
AMY: For some women there’s a struggle that mainly comes from the outside, the shame and stigma that comes from sort of what people have told them they’re supposed to feel, or what people have told them the kind of woman that has an abortion.
SUE: We have a photo of her clinic, which we included in our video profile of Amy.
COLLEEN: Yeah, and you can watch that on our site, www.thestoryexchange.org.
SUE: In that photo there's a red sign hanging in the window of Amy's clinic, that says “Good Women Have Abortions.” She really wants to make her message clear.
AMY: The need for advocacy in education was huge -- having a really strong commitment to sort of mitigate that sort of stigma and shame. It’s really targeted by the people that want to keep us in our place when it shows up in the context of unplanned pregnancy and abortion and especially in a place like Texas.
COLLEEN: So, Amy moves to Austin in the year 2000 to manage a clinic --
SUE: -- which she does, successfully.
COLLEEN: And in the process she finds a doctor who wants to sell his clinic and retire.
AMY: The majority of clinics in this country were started in the early ’70s right after the Roe v. Wade decision in the Supreme Court that legalized abortion in this country. And many of these doctors and, you know, women business owners who started clinics in the ’70s are now hitting retirement age and they want to see the facility that they built stay open after they retire.
SUE: Most people think that it's the big health centers like Planned Parenthood providing abortion services.
COLLEEN: But it's really the small, independently-owned clinics -- they provide about 60% of abortions in the U.S., according to the Abortion Care Network, which is a nonprofit that supports abortion providers.
SOT: You can relax your arm.
SUE: Amy borrowed money from a wealthy college friend, and bought the Austin clinic in 2003. She re-opened it as Whole Woman's Health.
SOT: All right, so the next time we call you back, hon, is going to be for your procedure.
-Okay, thank you.
AMY: And so the first clinic I bought he put the money up for me, and I borrowed it at a pretty high interest rate.
COLLEEN: Within six months, she bought a second clinic and merged the two, with her friend acting as an angel investor.
AMY: And then most of the clinics I bought from that point forward, I was able to do seller financing.
COLLEEN: That's where the doctor or owner selling the clinic would lend her the money to buy it.
AMY: I’ve sort of done every kind of financing you can do.
COLLEEN: And much like successful entrepreneurs do, she went on a buying streak.
AMY: Since 2003 Whole Woman’s Health has done, let’s see if I can get it right, 12 acquisitions of the clinics that were started in the ’70s in different parts of the country.
COLLEEN: But while Amy is buying up all these clinics...
SUE: ...the laws are getting more and more restrictive.
AMY: I like to say the best thing about the Texas legislature is that they meet every two years.
COLLEEN: Yeah, it started with waiting periods.
AMY: And then, you know, regulations on anesthesia, regulations on funding, state-mandated information the doctor has to read to the patient that’s not even true. You know, they developed a booklet that we had to, you know, show women that had misinformation and, you know, scary photographs that weren’t based on medical evidence. I could go on and on.
COLLEEN: And then something called House Bill 2 or HB2 happened, in 2013.
AMY: It reached national attention when Wendy Davis led her filibuster and there were thousands of people that showed up in the capitol, such that they actually closed the capitol.
COLLEEN: More on the Texas law that nearly destroyed Whole Woman's Health, after a brief break.
SUE: The Story Exchange is a nonprofit media company dedicated to women who mean business. Check out our videos -- including a profile of the entrepreneur you're listening to right now -- at www.thestoryexchange.org.
SOT: You're looking live as State Senator Wendy Davis of Fort Worth filibusters a vote on the abortion bill.
WENDY DAVIS SOT: I’d say if you vote for this bill you're simply happy to ignore medical science.
COLLEEN: That's a clip from KXAN-TV in Austin.
SUE: Yeah, I think many of us remember this.
COLLEEN: Yeah. Wendy Davis, of course, was wearing pink sneakers...
SUE: ...as she attempted to stop passage of HB2.
COLLEEN: In spite of her efforts...
SUE: ...and huge protests...
COLLEEN: ...it still passed.
AMY: HB2 required doctors who provide abortion services to have admitting privileges in a hospital within 30 miles of the clinic. It required all abortion facilities to become ambulatory surgical centers, which is like a mini hospital; completely unnecessary for abortion services but here again, making that requirement basically trying to shut all the facilities down.
COLLEEN: And that's exactly what happened.
SUE: The law forced more than half of Texas’s abortion clinics to close -- including several Whole Woman's Health locations.
AMY: Our facilities got shut down and we still had rent and mortgages to pay, we had staff to layoff, we had equipment leases we were still paying.
COLLEEN: You know earlier, we talked about protests...
SUE: ...clinic blockages, clinic bombings.
COLLEEN: And while those still happen...
AMY: The anti-abortion movement can use the power of the state to try to shut the clinics down or to make it difficult for us to do our work. And I think from their perspective that’s actually much more effective than some other ways to really close clinics down.
SUE: So now what happens?
COLLEEN: Well, clearly Amy has no choice.
SUE: She decides to mess with Texas.
AMY: These laws needed to be challenged. The misinformation that they were based on and erroneous, you know, health and safety kind of claims that they made were completely unsubstantiated.
COLLEEN: Amy became the lead plaintiff in a lawsuit against the state of Texas that ultimately went all the way to the Supreme Court.
SUE: She was represented by lawyers at the Center for Reproductive Rights.
AMY: The lawyer costs were covered by them pro bono. The rest of the costs were pretty much absorbed by us.
COLLEEN: She estimates she spent about $1 million fighting the law.
AMY: I went into great debt actually. The lawsuit took at least three of our highest-trained staff to prepare all the documentation. We had, I’ll give you an example, 10,000 of my emails, every single mortgage, every single lease, every single doctor contract, all the financials for seven years for five clinics.
SUE: As we sat in her office in Fort Worth, we asked her why she wanted to do this. Keep in mind, it took three years to fight this law.
AMY: One of my goals was to sort of raise the humanity of the abortion provider in the American public’s mind.
SUE SOT: Did you ever think you might not make it through this time?
AMY SOT: Yes. Yes, multiple times. I take being a business owner and providing a healthy workplace for my people that work in my company very seriously. And it was the first time where I couldn’t, I couldn’t promise people stability and it wasn’t, there wasn’t anything I could do. The money losses were also of course really difficult especially when I personalize it and I realize like, “Oh, there went the college fund for my kids,” et cetera.
COLLEEN: And then...June 2016.
SOT: This is a very big win for advocates of abortion rights. The Supreme Court by a 5-3 vote has struck down what was arguably the toughest abortion law in the country.
COLLEEN: That's NBC News.
SUE: Here’s Amy outside the Supreme Court.
AMY SOT: Oh, man. I am beyond elated. Every day Whole Woman’s Health Clinics serve women with respect and passion and dignity and compassion that they deserve. And today the Supreme Court did the same.
SUE: It was the the most significant high-court ruling in two decades on abortion.
AMY: Our victory in the Supreme Court has changed the game like, fundamentally. It’s changed the whole field way beyond Texas’s borders.
COLLEEN: In the spring of 2017, Amy finally re-opened her flagship Austin location.
SOT: Hi, how are you?
-Good. My name is Angel, I’m going to take you down to the lab.
AMY: Facing an unplanned pregnancy and the ability to control our fertility is really integral, not only to our ability to exercise our full humanity as women but is integral in our ability to realize our dreams and to have a future that we can plan for.
COLLEEN: Since we last spoke to Amy, she's had another win.
SUE: That's right -- she was involved in fighting yet another Texas law -- this one regarding that embryos are buried, regardless of a woman's beliefs.
COLLEEN: That's been blocked by a federal judge.
SUE: But there've been some setbacks.
COLLEEN: Right. We should note that while Amy was able to re-open clinics following the Supreme Court win...
SUE: ...many providers couldn’t -- so there's only about 20 abortion clinics now in Texas. There had been 41 in 2013, before the HB2 law.
COLLEEN: Meanwhile, she's been trying to open an abortion clinic in Indiana, but the state department has denied her application. She is fighting that decision.
SUE: Of course she is.
AMY: I’ve learned a lot about medicine. I’ve learned a lot about business. I’ve learned a lot about law. But all of that is at a byproduct of that central commitment that I have to sitting with a woman at a time of need and really advocating and supporting her to choose a course for her life.
COLLEEN: We thank Amy Hagstrom Miller for sharing her story.
SUE: And we thank you for listening.
SUE: Join us next time to hear more stories about innovative and inspirational women doing the things you’d never dream of. Or...maybe you would. This has been The Story Exchange.
COLLEEN: If there’s a female social entrepreneur you'd like to see featured on “Good on the Ground,” send us an email to [email protected] If you liked this podcast, please share on social media or post a review on iTunes. It helps other people find the show. And visit our website at TheStoryExchange.org, where you’ll find news, videos and tips for women entrepreneurs. Interview recorded by Sam Shinn. Sound editing provided by Nusha Balyan. Production coordinator is Christina Kelly. Executive producers are Sue Williams and Victoria Wang. Our thanks to C-SPAN for the media clip.