story and photos by Tricia Dewey
With the opening of their new offices on the edge of the Medical District slightly farther west than their original building, Choices staff and patients are wrapped in the quilt-like outer coat that architect Peter Warren used for the exterior of the new building. Choices executive director Rebecca Terrell and architect Peter Warren coordinated on the idea of the green quilt-like pattern ‘as a Southern symbol of comfort, strength, and diversity that holds all these diverse pieces and makes up this beautiful and strong thing that is very much what Choices is.’
Choices opened in 1974 immediately after Roe v. Wade was decided; several Midtown women bought a building, hired a doctor, and organized the clinic as a nonprofit to provide reproductive rights services. For the initial 20 years, it was a first trimester abortion care and birth control provider. In the last 10 or 15 years their services began to expand, and in 2013 Choices sought to physically grow their practice. Katy Leopard, director of external affairs at Choices, says it was then that they saw birth and prenatal care as part of that reproductive life journey. “There was a real need in our community for some choices around birth.” The board agreed and a marketing study showed that the community also embraced this idea. In 2014 they started the process of raising $6 million. Six years later, the result is a brand new, full services reproductive rights facility that more than triples their capacity to see patients.
Making their case to funders, Choices felt they had a powerful story to tell about the purpose of their new project. First, it was about reducing the stigma around abortion. Providing abortion in the context of birth, prenatal care, and all of their other services defines it as a part of reproductive health care. Second, from a business standpoint, by diversifying services, Choices can continue to operate if abortion becomes impossible to provide. Leopard says, the third reason is the community need. “They need choices around birth. Bodily autonomy is really what we’re about,” she said citing abortion, birthing methods, trans healthcare, and life choices as decisions that should be left to individuals.
It’s an experience just walking from the private parking lot to the secure entrance in the back of the building. Leopard says, “It is inspiring. I’ve had so many people tell me this is the one bright spot in their 2020. And it certainly is for me. We’ve been open and running since September 8. And we’re the first in the country as a nonprofit to do full spectrum reproductive health including abortion and birth under the same roof.”
The secure, back entrance is a covered open air seating area that can eventually open to the interior spaces to host community events, documentary screenings, or panel discussions
for community education around midwifery and other aspects of Choices services. Stepping inside, the large and bright waiting area is welcoming and airy. The three birthing suites upstairs are the crown jewels of this new space, each outfitted with a double bed, birthing tub for two, space for a birthing sling, and an outdoor area.
The focus on the birthing center brings additional work on maternal health care. Choices is working to advocate for better TennCare reimbursement rates for births and for postnatal care and to improve the outcomes in this area for their uninsured, underinsured, and TennCare populations. Choices is now able to provide natural childbirth and home birth options to their patients on TennCare, which includes about 70% of their birth patients. According to Leopard,
after care with Choices, patients are faring much better than Shelby County statistics. “Our folks are all breastfeeding, they are carrying to term, they have healthy babies, families are good. We really think postpartum care is a really important part of that.”
Currently the four midwives on staff at Choices are working on home or hospital births. The birth center will be credentialed by the state in November 2020 and then be ready for use. Choices expects 200 deliveries there in the next year.
All of the new developments at Choices track with their philosophy of bodily autonomy. Leopard explains, “There’s so much in the health care world, where people are being told what they can and cannot do and some of it wasn’t based on medical facts. So back in 2009 we decide to start a fertility practice because we had heard that the fertility practices here in Memphis would not work with you if you were not married to someone of the opposite sex. And to us that was crazy.” Choices doesn’t treat infertility but it can order sperm, do inseminations, and track cycles. In their birth center, families of all types can now give birth and not feel any kind of stigma.
After opening their fertility practice, Choices started to see many patients who reported a real need for a safe space for sexual and reproductive health that is open, welcoming, and culturally competent to serve the LGBTQ+ community. They began a dialogue with the community to learn more. Leopard explains, “We heard good and bad things on our journey. When we started serving the trans population we had a real education process to go through with our staff and that was good and it’s ongoing, it doesn’t end….We have almost 200 patients who come to us from a 300-mile radius or more because we don’t require a letter from a counselor, we have a payment plan, and other things like that that make the hormone replacement or whatever the care is accessible.”
Joy Evans is Choices’ LGBTQ+ coordinator who responds to these and other LGBTQ+ patients who have questions about Choices services provided and costs. She is a friendly face to answer questions and provide information about Choices available health care services. Like Choices itself, Evans and other staff expect to revel in their beautiful new space and turn their focus to the quality of their expanded services.
Above left, the lobby of the new Choices building features tons of natural light and bright, cheerful colors. Above right, a meeting space in subdued, calm tones. At left, a state of the art birthing suite that includes a birthing tub for two, double bed, space for a birthing sling, and an outdoor space directly accessible from the birthing suite.