Abortion

Exclusive: National Abortion Federation’s New CEO Hopes to Be a ‘Stabilizing Force’

Brittany Fonteno is the first Black leader of the country's largest professional organization for abortion providers.

Image of National Abortion Federation sign that reads Abortion Safe, Legal & Accessible
Brittany Fonteno will be the seventh person to lead the National Abortion Federation since its founding in 1977, and the organization's first Black CEO. Rewire News Group

After a nearly two-year search, the National Abortion Federation has found a new leader. The organization announced today that Brittany Fonteno will become its president and CEO as of September 1.

Founded in 1977, NAF is the country’s leading professional organization for abortion providers and counts hundreds of providers, clinics, and other facilities as members. The nonprofit offers training, technical, and security support to members, and it creates clinical guidelines for abortion care that are widely considered to be a gold standard.

NAF also operates the National Abortion Hotline, which connects callers to care and financial assistance, helping to cover abortion costs by pledging funds for a patient’s care directly to the clinic or provider. The NAF Hotline Fund is one of the largest sources of abortion funding in the United States.

NAF’s previous CEO, Katherine Ragsdale, stepped down in late 2021. This left the organization without a permanent leader in the aftermath of the 2022 Supreme Court decision overturning Roe v. Wade. Fonteno, who began working in reproductive and sexual health as a peer educator at age 19, will be just the seventh person to lead NAF since its founding. She will be the organization’s first Black CEO, and takes the helm in the midst of unprecedented upheaval in the U.S. abortion access landscape.

As news of Fonteno’s appointment circulated among NAF members, Rewire News Group was contacted on Wednesday by sources who expressed concern about the fact that Planned Parenthood Arizona is not a member of NAF and was not during her tenure there. Fonteno declined to comment.

“It’s a really challenging time within the movement, but it’s also a time filled with opportunities,” Fonteno told Rewire News Group in an earlier exclusive interview prior to the public announcement. The conversation has been lightly edited for length and clarity.

Rewire News Group: So, Brittany, you’re coming to NAF most recently having been president and CEO of Planned Parenthood Arizona. Prior to that, you worked for Planned Parenthood in New England, but I also see that you have some experience more on the grassroots side of the reproductive health, rights, and justice movement, such as being a board member for the New York Abortion Access Fund. What drew you to work in the movement in the first place, and what draws you to this position with NAF now?

Headshot image of Brittany Fonteno

Brittany Fonteno: It’s really my lived experience as a queer, Black woman of faith, and more recently as a mother, that has drawn me to my work in reproductive health, rights, and justice. My family has been in this country for generations and has experienced a cycle of generational poverty, which a lot of Black and brown families have experienced. My parents, luckily enough, were able to break out of that cycle of poverty and give me a different life than what they had. They grew up in the segregated South and in Brooklyn, before it was gentrified. A very different Brooklyn. And they were able to give me access to health care, and education, and opportunities. And I saw health inequities play out in my own family; for example, my cousins who didn’t have the same opportunities that I had, who experienced unintended pregnancies at a young age, or were not able to continue with their education.

When I went to college in Washington, D.C., that’s where my political activism started. I became a peer educator on my college campus and a campus organizer focused on sexual and reproductive health, rights, and justice. I fell so deeply in love with this work, and I knew from a pretty early age that I wanted to pursue this as my career. I would tell my mom that I wanted to be a professional feminist. And she was like, “How are you going to pay off your student loans by being a professional feminist?” Thankfully, I was able to find a way. I started off working at smaller nonprofits that were led by and dedicated to women of color. I worked at the National Latina Institute for Reproductive Justice, and I served on the board of directors for the New York Abortion Access Fund, where I did case management and abortion funding for a couple of years.

In more recent years, after doing this work for over a decade, I’ve had my own experience with having an abortion in a very hostile environment. Becoming a mother for the first time and then having an abortion really just solidified the work that I had already been doing. It made me an even stronger advocate for abortion access and reproductive freedom.

As you mentioned, you have a lot of experience working within organizations that are led by people of color. NAF has historically been a white-led organization, which is something it has faced criticism for. What does it mean to you to step in as the first Black leader of NAF?

BF: It’s such an incredible honor to step into this role as the first Black woman to lead this organization. NAF plays such a critical and essential role in the wider movement by unifying abortion providers, and I feel that it’s a great privilege to be at the helm, representing abortion providers and trying to serve as a unifying force within the NAF federation. It’s a really challenging time within the movement, but it’s also a time filled with opportunities.

I have been doing this work since I was 19, and to see the change in leadership within this movement start to reflect more people who look like me, as well as people who are most impacted by abortion and abortion bans, has been so incredible. Obviously, the reproductive justice movement really sprung up in response to predominantly white spaces, and predominantly white repro spaces in particular. I try to do my work from a reproductive justice lens. I have always felt very strongly that there’s no decisions about us, without us, and that we are the ones who should lead our communities forward in this historic moment in time.

The last year has been extraordinarily difficult, to say the very least. This is a big question, but what are a few major priorities that you have for NAF moving forward over, let’s say, the next year?

BF: First and foremost, my top priority is to work to unify all abortion providers within this space, understanding that we are in this new landscape that is constantly evolving, that is really chaotic. There is no time like now to stand together and fight back by providing and expanding access to abortion care. I can’t think of a more revolutionary thing for us to do as an organization and as a movement. And so, in unifying abortion providers, I really want to make sure that we’re ensuring true abortion access for all people.

A second priority would be to increase funding for patients on the hotline. After the Dobbs leak and in the direct aftermath of the decision, there was a surge of funding in the form of rage donations. Many organizations have experienced that really decreasing. But the need is greater now than it was a year ago, because more and more states have been continuing to claw back access. And so, I really want to highlight the real stories of devastation that people are experiencing, and be able to increase funding so that people are able to get the care that they need.

I also want to strengthen the support that NAF provides to people on the front lines through our policy and security work so that they can provide expert and equitable abortion care. The last thing that I’m really interested in is trying to cut through all of the political rhetoric and really center the conversation on abortion, on patients and providers. When we take out all of the politics and we recenter on health care, and people’s bodies, and their lives, we’re able to connect with people in a different way, and really lift up and elevate the real lived experiences that people are having in this crisis moment.

Photo of abortion rights rally in front of the Supreme Court building
Rewire News Group

Speaking of lived experiences, you mentioned that you yourself had an abortion that took place in a hostile environment. Is there anything more that you’re willing to share about that experience?

BF: Sure. I had an abortion, and it was in Arizona, where I currently live. It was a very much wanted pregnancy. Unfortunately, I went to the doctor for a standard checkup in my second trimester, and there was no heartbeat. And I was completely devastated. I asked the doctor what my options were, and he said my only option was to either induce labor and deliver, or to travel to California to get some sort of vague health care that he would not define. I knew, obviously, from my work that those were not my only options. And so I kept pushing, and specifically asking about a D&E [dilation and evacuation], and he said that that just wasn’t an option in Arizona. I know that it is. After he denied me my right to health care, I was able to access an abortion locally through one of the amazing providers here.

This was in the direct aftermath of Roe being overturned, and my experience was filled with compassion and expert care, during what was the most heartbreaking time in my life. So I know both from a provider and a patient perspective how critical abortion care is to people who need it.

Thank you for sharing that. Changing gears slightly, I wonder what you think being a NAF member should mean. What would you want it to signify to patients and to other people in the field, that a clinic or a provider is a NAF member?

BF: Oh, that’s a really wonderful question. The very first thing that comes to my mind is that, when patients or people in the community see that a provider is a NAF member, they know without a doubt that they can go to that clinic and receive expert, compassionate, evidence-based care. That they’ll be taken care of, that their needs will be met in a way that is patient-centered, and that they won’t have doubts about their decision to go there. I would want for providers to look at NAF and say, “Yeah, they’re using the most recent evidence and information to make sure that this care is not only accessible, but equitable.” And I would want for people in the broader community to see NAF as a strong community of providers and advocates for abortion access. Those are my initial thoughts, but I’m sure that will continue to evolve as I step into the role.

As you mentioned, one of the really important things that NAF does is create and disseminate clinical guidelines for abortion providers. I know that this can be a sensitive subject, because the anti-abortion movement wants to portray abortion as dangerous, and we know that it is not. But I have reported on situations where there were concerns that certain providers or facilities were not following NAF guidelines.

I’m not going to ask you to comment on anything that happened before you were working for NAF, but I’ve heard from some clinical workers that they would like for there to be a more formalized process for people to report concerns like this to NAF. Is that something that you would be interested in implementing?

BF: Since I haven’t quite stepped into my role yet, I would really want to be able to fully understand all of the different perspectives about this concern. What I do know now is that, as you mentioned, NAF’s clinical guideline policies are really a hallmark of a benefit that NAF offers. It’s something that sets our providers apart, being able to provide that evidence-based care. So what I would focus on is making sure that we continue to provide top-of-the-line information to providers so that they are able to serve patients in a way that is expert and compassionate. I would need more time to truly understand all of the different components at play, but that would be my ultimate goal.

Another word that has come up when I’ve spoken with providers about their experiences working with NAF, especially in the last year, is “dysfunction.” A lot of providers are feeling that there’s been internal disorganization that has resulted in them not always getting the support they need, or not receiving funds that have been pledged to them in a timely fashion. Are there any specific things that you’d like to address or change in terms of how NAF communicates with or supports providers?

BF: Since I haven’t stepped into the role yet, I can’t speak directly to internal operations and workings of the organization. But what I can say is that this has been a really confusing and chaotic time for everyone who’s working across abortion rights and access. All organizations, including NAF, I know, are trying to just do our best to keep up with a—sometimes on a daily basis—rapidly evolving legal landscape that has a direct impact on our operations. I think my focus would be to make sure that I could be a stabilizing force, both internally within NAF as well as throughout the federation.

We have an opposition that is incredibly well-organized and very savvy. I hate to give them any sort of compliment, but it’s true. This environment of chaos [is one] that they have created, and that our organizations are reacting to. I think it’s important that we place the blame where it is, and it’s with anti-abortion extremists. So I hope to be a stabilizing force, because we know that this chaos and confusion is only going to continue.

I’ve heard from so many abortion funds that many of their callers now need thousands of dollars in order to get their abortions, rather than a few hundred. NAF plays a huge role in covering the cost of abortion care, but more money is needed now than in the past, and even more is likely to be needed as more states ban abortion. What does a sustainable funding model for an organization like NAF look like? What are your goals in terms of fundraising?

BF: That is very much top of mind for me. I think that one of the biggest things that we need to do at NAF, but also across the movement, is continue to share stories of patients and providers. I think that when the media moves on to the next big story, we need to not step back and be okay with that, because we are seeing the real life impact, the devastation, play out on a daily basis, and we should not be the only ones to witness people’s stories if they want to share them. So I think that creating a more strategic and cohesive ongoing fundraising plan will be very top of mind.

I also want to see if we can tap into more people outside of the movement. Thinking about businesses and corporations, especially after 2020, their employees have demanded that they take a stand in different ways. And taking a stand by saying some nice words is one thing, but taking a stand with your actions is something different. I would also love to get a better understanding from NAF staff and members of what their ideas would be about how we continue to evolve the fundraising model to make sure that there’s financial sustainability both for NAF and for the providers and patients.

Another thing that NAF does is monitor anti-abortion violence and consult with clinics on safety and security. I’ve reported on clinic violence a lot over the years, and something that I’ve heard from a lot of providers and escorts is that they’re really interested in trying to find ways to address anti-abortion violence that don’t necessarily involve policing, because seeing police outside of clinic doesn’t always make patients, especially people of color, feel safer. There are also a lot of documented instances of police being openly sympathetic to anti-abortion protesters. I know that at one point NAF was working with a committee of abortion providers of color to think about this. Is this something that is a priority for you?

BF: Absolutely. Safety has always been a top concern in abortion work, even before the overturn of Roe. There’s always been an element of risk and danger in this work. And of course, that has only increased since the Supreme Court’s decision, and even more so in states that have banned abortion. I think that it’s incredibly important to make sure that providers and patients feel safe when they’re providing and receiving health care.

As a community, NAF is well-positioned to be able to think through what different options could be for safety. I’m excited to be able to collaborate with member providers and staff, and think about what the best solutions could look like. I think it probably looks different for different providers in different communities. I think being responsive culturally, and to the community that providers are in, would be a top priority in thinking about safety concerns.

Recently, the National Eating Disorders Association shut down its helpline after 20 years of operation, and transitioned to using an AI chatbot called “Tessa” to respond to people who reached out for help. Pretty quickly, there were reports that the chatbot was giving harmful advice, and it was suspended. This story made a lot of people nervous that something similar could happen in the abortion access realm given that NAF and other organizations, like abortion funds, rely heavily on hotlines. Under your leadership, would NAF ever consider using AI to respond to callers?

BF: Oh, that’s an interesting question. I feel like I am definitely behind on truly understanding AI. Maybe I’m a bad millennial in that respect. But I think that nothing can truly replace the relationship and the connection of two humans trying to help each other access a human right. I know from my own experience with abortion funding that the connection that you have to the person on the other side of the line is not something that I think could be easily replicated by technology. I think technology can help us in a lot of ways, and I’m very interested in and curious to see how technology could help us become more efficient. But I don’t at this time foresee AI taking over the human connection.

Image of headset on top of keyboard
Envato

Speaking of humans, and in particular the workers who power the hotline, those workers formed a union a few years ago. Initially, NAF really fought the unionization effort before ultimately recognizing and bargaining with the union. I will also disclose that, as a Rewire News Group employee, I’m a member of that same union, the Washington-Baltimore News Guild. Are you committed to working with the union?

BF: Yes, absolutely. I respect workers’ rights to be able to organize and to form unions, and would of course collaborate in the appropriate ways to make sure that union staff and all staff feel good about their work at NAF, and feel that NAF is a great place to work.

Great. As states have banned abortion, and with more states likely to do so in the next year, there are a number of clinics in ban states that are trying to stay open even though they can no longer provide abortion care. One of the critical things these clinics are providing is follow-up care for people who have to leave the state for an abortion and then return home. Are there any ways that NAF might consider supporting these clinics to try and help them stay around, even though they are not directly providing abortion care anymore?

BF: Since I haven’t stepped the role yet, I don’t know that I can comment directly on that, but what I can say is that I think we are all going to have to be open to evolving what our practices are, and how we show up and support providers and patients in this new world that we’re living in. As you said, there’s essential care that’s being provided in ban states by experts who may not be legally able to provide abortion care. And so I would definitely want to understand what their perspective is, understand what staff’s perspective is, and then collaboratively come to a decision on that.

Another thing that NAF came under fire for, particularly after SB 8 went into effect in Texas, was that a lot of providers wanted to defy that law, but were told by NAF that they’d lose their funding if they did. Similarly, many providers and funders were frustrated by NAF’s decisions regarding funding in states where abortion bans were temporarily blocked, as well as other NAF policies they see as unnecessarily restrictive. Is this something you’re interested in looking into as the new CEO? Could NAF consider taking a more legally aggressive stance, so to speak?

BF: I think that this is an important question, and I don’t have all of the answers because I wasn’t at NAF when [those decisions were made]. What I do know is that NAF, like every other reproductive health organization, has been navigating a really chaotic and cruel patchwork of anti-abortion laws that have been designed to keep people from being able to get the care that they need, and to make providers fearful of providing this essential health care. NAF’s priority has always been to work closely with providers and clinics that are on the front lines to ensure that they can continue to provide essential care to as many patients as possible.

I think that, overall, we’re going to continue to see a lot of unprecedented events play out legally. And our responsibility is to do our best to navigate this environment that has been created by anti-abortion extremists, keeping at the center the providers that we serve and the patients that they care for.

I have to assume that, having worked in the movement for a long time, you already know a lot of abortion providers. But it’s a big country. What’s your plan for your first couple of months on the job in terms of talking to people and figuring out what the current needs are among NAF members?

BF: I think my top priorities are really to listen and learn, first and foremost. I do have a long history in this movement, but I’m coming into NAF new and fresh, in a way, and I want to be able to listen and learn from staff, and from the providers that are on the ground. As an abortion provider, I have one experience, but as I mentioned, with this patchwork of policies across the country, I’m sure every provider is having a different experience. I want to listen and learn from their experiences and expertise. I want to build authentic relationships with people, because that’s how I think that we can best come together, unify, and create this community that I would like to see for NAF.

I would love to visit the independent health centers and really get a sense of what their day-to-day experiences are like and the challenges that they’re facing. I could also see doing town halls, whether they’re in person or virtual, and, of course, one-on-one or small group meetings just to create opportunities for connection. From there, having hopefully built a strong foundation, my hope is that I will be well-positioned to lead NAF into the future.

I’m glad you mentioned independent providers, because as I’m sure you know, independent abortion clinics often have a lot less funding and support for the challenges that they encounter. Especially right now, when abortion bans are pushing many people later into pregnancy than they wanted to have their abortions, independent clinics are providing the majority of those later abortions. In terms of clinics that provide third trimester care, it’s only independent providers. Is supporting those independent providers a priority of yours?

BF: Absolutely. Independent providers play such a unique and critical role in abortion access and provision. I want to make sure that all NAF members feel supported. I think part of using an equitable approach to this work is looking at what those specific and individual needs are, and then being able to respond to them.

The last question I have for you is about sustainability. We talked about sustainability in terms of funding, but something that a lot of people are talking about right now is burnout. It’s incredibly difficult to have any kind of role in abortion care or abortion access right now, because the work is so hard. People are experiencing torturous things, and workers in the movement are absorbing those stories and those experiences from patients.

I’m curious about how you hope to care for yourself in this role, and if there are any ideas you have about things you’d like to implement within NAF to help employees, especially those who are answering calls on the hotline, to care for themselves and make sure that they’re not getting burned out and losing their ability to do this work?

BF: Oh my goodness, this is so real. The past several years doing this work have been so incredibly hard, on a level that I think many people didn’t anticipate. It has really, at times, been traumatizing, especially for those of us who have these personal connections or lived experiences with this work. A lot of people come to this work because they have some sort of intimate connection to it. So I think that it’s really important to try to make abortion work as sustainable as possible, because creating this environment of unsustainability, again, is a tactic of the opposition to drive people away from doing this work.

It’s very top of mind for me to make sure that NAF staff and members feel that the work is sustainable, that they do feel supported, so that they can do their work on a daily basis. Overall, burnout solutions are not one-size-fits-all. For myself, trying to take intentional time to reconnect with my loved ones and reconnect with the things that fill my cup, like dancing, traveling—things like that help. I would really want to understand what staff and providers feel are the biggest contributors to burnout and hear what meaningful solutions might look like, and then try to try to work in collaboration with people to create some solutions to burnout.