Nov 17, 2019 By Sarah Fister Gale
Planned Balance
The divisiveness that surrounds Planned Parenthood means the healthcare organization’s facilities must strike a perfect mix of safety and experience.
By Sarah Fister Gale Nov 17, 2019
Published in

Care. Compassion. Health. Empowerment. Respect.

These five words exemplify the pillars of Planned Parenthood’s mission. They shape everything the organization does, from how it provides care to how it talks about the design of its clinics and office spaces.

“We want all patients—regardless of ethnicity, gender identity, income, language, or immigration status—to feel welcomed and respected and to know that they are receiving the highest-quality healthcare without judgment,” says Meg Barnette, chief of staff and general counsel for Planned Parenthood of New York City (PPNYC). “Those five words animate our vision and shape a lot of the design decisions we make.”

But these decisions must take one additional critical factor into consideration: safety. Because Planned Parenthood offers abortion services, many of its facilities are potentially subject to protests or even violent acts. According to the National Abortion Federation, whose members include Planned Parenthood affiliates, in 2018, the number of individuals attempting to intimidate patients and disrupt patient services at abortion facilities continued to increase. This included more than 21,000 instances of online hate speech, 125 cases of vandalism, 14 instances of stalking, and 15 instances of assault and battery.

That ire can pose a significant challenge for Planned Parenthood, its staff, and the nearly 2.4 million patients who rely on the organization for services like cancer screenings, hormone treatments, HIV services, and routine checkups.

While the image of daily protesters at every Planned Parenthood isn’t an entirely accurate one, says Grace Chiang, AIA, ASID, the president and co-founder of Chiang O’Brien Architects in Ithaca, New York, there is “always the underlying possibility of protesters who might not be so peaceful.


Safety Starts With the Site

That potential threat influences everything—from site selection to build-out, says Chiang, who has worked with the organization on multiple occasions over a span of 36 years.

All Planned Parenthood spaces must make every effort to protect the staff and patients, including on-site parking and features such as direct access to the building so patients don’t have to walk through protest lines. “Since protesters cannot be on private property without permission, this helps ensure safety and security for all the building users,” she says. The space also has to meet state and federal rules for a healthcare facility while being big enough to accommodate examination rooms, the abortion clinic, and education space—ideally all on one floor for ease of patient flow. And finally, it needs to be close to public transportation so it’s easily accessible to everyone in the community.

On a nonprofit budget, these requirements can be a tall order, Chiang says. When she launched her firm in 2012, one of her first projects was to complete the design for a new Planned Parenthood healthcare facility in Ithaca, New York that opened in 2014. Chiang had spent roughly the previous 10 years, on and off, helping the Planned Parenthood team search for the right location, and they followed her to her new firm so she could design it.

Over that decade of searching, Chiang visited dozens of sites with the Planned Parenthood team, conducting quick viability studies to determine whether they were worth pursuing. Most were either too small, too out of the way, or couldn’t be adapted to meet healthcare facility codes. In one case, they found a site downtown that met many requirements, but the client worried that it was too centrally located, raising the risk that patients would fear running into people they knew. They ultimately chose a small urban site that was adjacent to a bar and other small commercial establishments, an apartment building, and single-family homes.

Finding a Balance

Like all Planned Parenthood facilities, the single entrance to the Ithaca site features a metal detector and check-in desk protected by bulletproof glass. “Even in Ithaca, which is a liberal college town, security is critical,” she says.

Once past the check-in area, Chiang’s team chose an L-shaped design and created a garden in the corner behind a wall of windows in the waiting room to give it a more natural feel. “Even though you are 40 feet (12 meters) from the parking lot, it feels like you are in a garden,” she says. In the summer the space is lush with vegetation, and in the winter it’s covered in snow and ice. “It’s even prettier then,” she says.

Adding gardens and greenery is a common theme in newer Planned Parenthood designs, says Sarah Stoesz, president and CEO of Planned Parenthood North Central States. A few years ago, several Planned Parenthood groups hosted patient and staff focus groups to identify the design elements they wanted in new facilities. For example, they said they wanted light, bright spaces with living things and flexible seating in waiting areas to accommodate different patient groups. That feedback was shared across the Planned Parenthood network. “Every facility does their own thing, but many affiliates use these design elements as a starting point,” Stoesz says.

The patients also want privacy, particularly when using abortion services. Chiang addressed this need by secluding abortion procedure rooms and recovery spaces at the back of the facility. These procedures are also conducted during different operating hours to create an additional sense of privacy. Soft lighting, screen prints of clouds on the ceiling over exam tables, and small windows that look out at the garden add a further sense of calm and seclusion.

Chiang’s team also considered the needs of staff in this space. “The Planned Parenthood staff have the unique challenge of needing to address and treat patients who are particularly vulnerable and in some cases may be seeking care under distressed conditions,” she says. Her team focused on creating large spaces using a muted palette of soothing colors and natural light. “The acoustical separation between spaces also provided a sense of security for the patients, knowing that they could have confidential conversations,” she says.

Taking staff needs into consideration is very important, says Stoesz. “The people who work here care deeply about our mission, but in this political era it can get exhausting,” she says. Creating shared break rooms, changing rooms with showers, and protected outdoor space is “central to the employee experience.”

A Fresh Approach

Like Chiang, Barnette tried to break the mold on Planned Parenthood’s design when developing a new facility in the New York borough of Queens. The 14,400-square-foot (1,338-square-meter) space—which opened in 2016—includes waiting areas, exam and counseling rooms, procedure and recovery rooms, a community health education suite, and offices. It was an essential project for PPNYC because it was the first new facility it had built in years, and it would fulfill its goal of having a presence in every borough of New York. “It was an opportunity for us to design a brand new center around the kind of patient experience we wanted to create—one that is nurturing, welcoming and safe and that reflects the rich diversity of Queens,” Barnette says.

Her team worked with Stephen Yablon Architecture, a New York–based firm, to transform its vision into a state-of-the-art healthcare facility. Stephen Yablon has ample experience in the healthcare industry, so he understood the compliance and regulatory requirements for the building, which helped drive the design decisions. But he was also very focused on figuring out precisely what the PPNYC team envisioned for this space.

Like Chiang, Yablon strove to balance the need for security with a welcoming environment that made patients feel valued and respected. He also wanted to be sure the facility reflected the Planned Parenthood brand while still being unique to the diverse urban environment of Queens. “It was a chance to take a fresh look at how they delivered care and created a brand image in a secure space,” Yablon says.

The Queens site was a new building, so the team had the freedom to design it to exact specifications. Yablon’s team spent weeks with the PPNYC team sharing mood boards with different design elements to help them visualize the look and feel of the site. The Planned Parenthood team was adamant that the design reflect a quality healthcare environment. “They didn’t want cozy, woody designs and materials,” Yablon says. Instead, they chose a sleek and minimalist look that communicated up-to-date, modern medical care with touches of color for added warmth, welcome, and comfort.

The resulting design reflects that vision in every detail. The exterior, which abuts the public sidewalk, features gray bricks and a modern asymmetrical design that contrasts with the mostly brownstone neighborhood without sticking out. The street side is defined by soaring impact-resistant windows that flood the interior with natural light. “We felt it was important that this facility had a strong street presence,” Yablon says. This is especially important in today’s political climate, where politicians are pushing to defund Planned Parenthood and drive it out of the communities it serves. “[The design] says, ‘We perform an important public service, and we are not going anywhere,’” he says.

The building’s single entrance leads from a metal detector to a check-in station featuring bulletproof glass, reflecting the constant concerns about violence against staff and patients. To counter that fear and make the entrance welcoming and friendly, vibrant blue and green accent walls define the space. Both colors were intentionally selected from Planned Parenthood’s brand book. The entrance also features a large oval sign with the word “welcome” written in the 12 languages that are most common to Queens. “The bright colors and the welcome sign make it feel cheery, not like a high-security facility,” Yablon says.

Balancing security and design is a constant goal, particularly in the entry areas of these facilities, says Stoesz. “You don’t want it to be scary or depressing; you want it to be uplifting,” she says. In the Minneapolis facility where Stoesz is based, a protective wall covered in hundreds of colorful donor plaques flanks the entrance. The plaques are emblazoned with phrases like, “in loving memory of my Aunt Rose who died from an illegal abortion in 1918,” or “in celebration of my mother who made me the woman I am today.”

“It’s a purposeful expression of gratitude and love that you would never guess is also a security measure,” she says.

Always Moving Forward

To design a better space, Yablon spent time in other Planned Parenthood facilities in New York to observe the flow and interactions between patients and staff, Barnette reports. “They showed a deep curiosity in the experience, like where people sat and how staff used technology,” she says.

That led Yablon and his team to make small but necessary decisions, like designing a layout where patients are always moving forward in the space, rather than back through the waiting room. They also put computer tablets on mobile carts so physicians never have their backs to patients, and created separate seating areas where patients can check out and make follow-up appointments. “That’s what a good designer does,” Yablon says. “They put themselves in the place of the user.”

The designers also color-coordinated the hallways, using wall colors, long bands of colored lights along the ceilings, and color-coded oval signs as an orienting system. Staff members provide directions to exam rooms by color, making it easy to find your way regardless of the language you speak, Barnette says.

The final design delivered precisely the message of empowerment and respect that Barnette’s team aspired to achieve. Shortly after it opened, she recalls speaking to a young, undocumented woman who came to an educational event at the new site and asked her whom the clinic was created for. When Barnette told her it was a healthcare facility for all the women in Queens—including her—she was shocked. “She said, ‘But it’s so pretty,’” Barnette recalls. “It’s one of my favorite stories about this space.”

Beauty on a Budget

Meeting all of these safety, comfort, quality, and branding goals in a single design is made even more challenging since Planned Parenthood is a nonprofit organization. “They don’t have a lot of money, and because they aren’t building a lot of facilities all the time, they are a little naive about the process,” says Chiang, who only works with nonprofits.

When she worked on the Ithaca project, she made a point of guiding the team through the entire process, educating them on what to expect at each milestone and helping them make choices that made the most sense for their design aesthetic and budget. That included taking charge of managing the site and helping them choose materials and fixtures that were extremely durable so they wouldn’t have to be replaced. “We want these projects to go well, so we do whatever we can to help them make the best decisions.”

Chiang’s team also identified opportunities to create custom details that added quality and ease to the space without spending a lot of money. Chiang recalls designing a maple brochure rack with custom slots to accommodate each of the roughly 100 pamphlets that Planned Parenthood hands out. “They had been using a metal display that they had cobbled together,” she says. But when her team recognized that these educational materials were core to the facility’s offering, they took the time to make something better. “The rack is pleasing to the eye, easy to access, and it makes the provision of service flow efficiently.”

Along with managing material costs, these designers also help avoid scope creep by nudging the client teams to make decisions and pointing out where delays could occur, which Barnette appreciated. “It helped us manage our expectations and reflected their shared commitment to our mission,” she says.

When working with any nonprofit, it’s helpful if you believe in the mission of the organization, says Joan Blumenfeld, FAIA, FIIDA, design principal and global interior design director emeritus at Perkins+Will in New York. “Planned Parenthood wants to work with vendors who get what they are about and care about their work,” she says.

For many of these designers, working on these projects has been among the highlights of their careers. Blumenfeld’s first experience working for Planned Parenthood was in college when she held a part-time job compiling data about birth control access for underprivileged women. Years later, she had the opportunity to bid on a project to design the new Planned Parenthood headquarters in New York, which opened in 2003, and she shared that experience in her pitch. “I believe in their mission, and I told them that,” she says. “Planned Parenthood is an organization for women, led by women, and they all have a shared sense of purpose. They are in a class by themselves.”

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