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Wednesday, May 11, 2022

Planned Parenthood

From Wikipedia, the free encyclopedia
 
Planned Parenthood
Planned Parenthood.svg
AbbreviationPPFA
PredecessorAmerican Birth Control League
FormationOctober 16, 1916; 105 years ago
FounderMargaret Sanger
PurposeReproductive health
Headquarters
Region served
United States, and worldwide through Planned Parenthood Global and IPPF
Membership
600+ clinic locations58 medical or related affiliates
  • 101 non-medical affiliates
Key people
Alexis McGill Johnson
(President and CEO)
WebsiteOfficial website 

Planned Parenthood Federation of America, Inc. (PPFA), or Planned Parenthood, is a nonprofit organization that provides reproductive health care in the United States and globally. It is a tax-exempt corporation under Internal Revenue Code section 501(c)(3) and a member association of the International Planned Parenthood Federation (IPPF). PPFA has its roots in Brooklyn, New York, where Margaret Sanger opened the first birth control clinic in the U.S. in 1916. Sanger founded the American Birth Control League in 1921, which changed its name to Planned Parenthood in 1942.

Planned Parenthood consists of 159 medical and non-medical affiliates, which operate over 600 health clinics in the U.S. It partners with organizations in 12 countries globally. The organization directly provides a variety of reproductive health services and sexual education, contributes to research in reproductive technology and advocates for the protection and expansion of reproductive rights. Research shows that closures of Planned Parenthood clinics lead to increases in maternal mortality rates.

PPFA is the largest single provider of reproductive health services, including abortion, in the U.S. In their 2014 Annual Report, PPFA reported seeing over 2.5 million patients in over 4 million clinical visits and performing a total of nearly 9.5 million discrete services including 324,000 abortions. Its combined annual revenue is US$1.3 billion, including approximately $530 million in government funding such as Medicaid reimbursements. Throughout its history, PPFA and its member clinics have experienced support, controversy, protests, and violent attacks.

History

Origins

Margaret Sanger (1922), the first president and founder of Planned Parenthood

The origins of Planned Parenthood date to October 16, 1916, when Margaret Sanger, her sister Ethel Byrne, and Fania Mindell opened the first birth control clinic in the U.S. in the Brownsville section of the New York borough of Brooklyn. They distributed birth control, birth control advice, and birth control information. All three women were arrested and jailed for violating provisions of the Comstock Act, accused of distributing obscene materials at the clinic. The so-called Brownsville trials brought national attention and support to their cause. Sanger and her co-defendants were convicted on misdemeanor charges, which they appealed through two subsequent appeals courts. While the convictions were not overturned, the judge who issued the final ruling also modified the law to permit physician-prescribed birth control. The women's campaign led to major changes in the laws governing birth control and sex education in the United States.

In 1921, the clinic was organized into the American Birth Control League, the core of the only national birth-control organization in the U.S. until the 1960s. By 1941, it was operating 222 centers and had served 49,000 clients. In 1923, Sanger opened the Birth Control Clinical Research Bureau (BCCRB) for the purposes of dispensing contraceptives under the supervision of licensed physicians and studying their effectiveness.

Some found the ABCL's title offensive and "against families", so the League began discussions for a new name. In 1938, a group of private citizens organized the Citizens Committee for Planned Parenthood to aid the American Birth Control League in spreading scientific knowledge about birth control to the general public. The BCCRB merged with the ABCL in 1939 to form the Birth Control Federation of America (BCFA). In 1942 the name of the BCFA was changed to the Planned Parenthood Federation of America.

1940s – 1960s

Under the leadership of National Director D. Kenneth Rose, the PPFA expanded its programs and services through the 1940s, adding affiliate organizations throughout the country. By the end of World War II, the Federation was no longer solely a center for birth control services or a clearing house for contraceptive information but had emerged as a major national health organization. PPFA's programs included a full range of family planning services including marriage education and counseling, and infertility services. The leadership of the PPFA, largely consisting of businessmen and male physicians, endeavored to incorporate its contraceptive services unofficially into regional and national public health programs by emphasizing less politicized aspects such as child spacing.

During the 1950s, the Federation further adjusted its programs and message to appeal to a family-centered, more conservative post war populace, while continuing to function, through its affiliated clinics, as the more reliable source of contraceptives in the country.

From 1942 to 1962, PPFA concentrated its efforts on strengthening its ties to affiliates, expanding public education programs, and improving its medical and research work. By 1960, visitors to PPFA centers across the nation numbered over 300,000 per year.

Largely relying on a volunteer workforce, by 1960 the Federation had provided family planning counseling in hundreds of communities across the country. Planned Parenthood was one of the founding members of the International Planned Parenthood Federation when it was launched at a conference in Bombay (now Mumbai), India, in 1952.

In 1961, the population crisis debate, along with funding shortages, convinced PPFA to merge with the World Population Emergency Campaign, a citizens fund-raising organization to become PPFA-World Population.

Both Planned Parenthood and Margaret Sanger are strongly associated with the abortion issue today. For much of the organization's history, however, and throughout Sanger's life, abortion was illegal in the U.S., and discussions of the issue were often censored. During this period, Sanger – like other American advocates of birth control – publicly condemned abortion, arguing that it would not be needed if every woman had access to birth control.

1960s – present

A Planned Parenthood supporter participates in a demonstration in support of the organization
 
Leana Wen in April 2017

Following Margaret Sanger, Alan Frank Guttmacher became president of Planned Parenthood, serving from 1962 until 1974. During his tenure, the Food and Drug Administration (FDA) approved the sale of the original birth control pill, giving rise to new attitudes towards women's reproductive freedom. Also during his presidency, Planned Parenthood lobbied the federal government to support reproductive health, culminating with President Richard Nixon's signing of Title X to provide governmental subsidies for low-income women to access family planning services. The Center for Family Planning Program Development was also founded as a semi-autonomous division during this time. The center became an independent organization and was renamed the Guttmacher Institute in 1977.

Planned Parenthood began to advocate abortion law reform beginning in 1955, when the organization's medical director, Mary Calderone, convened a national conference of medical professionals on the issue. The conference was the first instance of physicians and other professionals advocating reform of the laws which criminalized abortion, and it played a key role in creating a movement for the reform of abortion laws in the U.S. Focusing, at first, on legalizing therapeutic abortion, Planned Parenthood became an increasingly vocal proponent of liberalized abortion laws during the 1960s, culminating in its call for the repeal of all anti-abortion laws in 1969. In the years that followed, the organization played a key role in landmark abortion rights cases such as Roe v Wade (1973) and Planned Parenthood v Casey (1992). Once abortion was legalized during the early 1970s, Planned Parenthood also began acting as an abortion provider.

Faye Wattleton became the first African American president of the Planned Parenthood Federation of America in 1978. Wattleton, who was also the youngest president in Planned Parenthood's history, served in this role until 1992. During her term, Planned Parenthood grew to become the seventh largest charity in the country, providing services to four million clients each year through its 170 affiliates, whose activities were spread across 50 states.

From 1996 to 2006, Planned Parenthood was led by Gloria Feldt. Feldt activated the Planned Parenthood Action Fund (PPAF), the organization's political action committee, launching what was the most far reaching electoral advocacy effort in its history. The PPAF serves as the nonpartisan political advocacy arm of PPFA. It engages in educational and electoral activity, including legislative advocacy, voter education, and grassroots organizing to promote the PPFA mission. Feldt also launched the Responsible Choices Action Agenda, a nationwide campaign to increase services to prevent unwanted pregnancies, improve quality of reproductive care, and ensure access to safe and legal abortions. Another initiative was the commencement of a "Global Partnership Program", with the aim of building a vibrant activist constituency in support of family planning.

On February 15, 2006, Cecile Richards, the daughter of former Texas governor Ann Richards, and formerly the deputy chief of staff to the U.S. Rep. Nancy Pelosi (the Democratic Leader in the United States House of Representatives), became president of the organization. In 2012, Richards was voted one of Time magazine's 100 Most Influential People in the World.

Richards' tenure as president of the organization ended on April 30, 2018. Current Planned Parenthood board member Joe Solmonese was appointed as transition chair to temporarily oversee day-to-day operations of Planned Parenthood after Richards’ departure.

On September 12, 2018, the organization announced that Leana Wen would take over as president, effective November 2018. Wen was removed as president of Planned Parenthood by the organization's board of directors on July 16, 2019. Alexis McGill Johnson, a board member and former chairwoman, became the organization's acting president.

Data breaches

In October 2021, a hacker gained access to the Los Angeles branch of Planned Parenthood network and obtained the personal information of approximately 400,000 patients. On December 1, 2021, The Washington Post reported that the breach was a ransomware attack. The organization did not say if they paid the ransom or if the perpetrators made any demands. There was no indication as to who was responsible for the hack. The Metropolitan Washington branch of Planned Parenthood was also hacked in 2020 with donor and patient information compromised, including dates of birth, social security numbers, financial information, and medical data.

Margaret Sanger Awards

In 1966, PPFA began awarding the Margaret Sanger Award annually to honor, in their words, "individuals of distinction in recognition of excellence and leadership in furthering reproductive health and reproductive rights." In the first year, it was awarded to four men: Carl G. Hartman, William Henry Draper Jr., Lyndon B. Johnson, and Martin Luther King Jr. Later recipients have included John D. Rockefeller III, Katharine Hepburn, Jane Fonda, Hillary Clinton, and Ted Turner.

Services

The services provided by PPFA affiliates vary by location, with just over half of all Planned Parenthood affiliates in the U.S. performing abortions. Services provided by PPFA include birth control and long-acting reversible contraception; emergency contraception; clinical breast examinations; cervical cancer screening; pregnancy testing and pregnancy options counseling; prenatal care; testing and treatment for sexually transmitted infections; sex education; vasectomies; LGBT services; and abortion. Contrary to the assumption of some, Planned Parenthood conducts cancer screenings but does not provide mammograms.

In 2013, PPFA reported seeing 2.7 million patients in 4.6 million clinical visits. Roughly 16% of its clients are teenagers. According to PPFA, in 2014 the organization provided 3.6 million contraceptive services, 4.5 million sexually transmitted infection services, about 1 million cancer related services, over 1 million pregnancy tests and prenatal services, over 324,000 abortion services, and over 100,000 other services, for a total of 9.5 million discrete services. PPFA is well known for providing services to minorities and to poor people; according to PPFA, approximately four out of five of their clients have incomes at or below 150 percent of the federal poverty level. Services for men's health include STD testing and treatment, vasectomy procedures, and erectile dysfunction services. Education is available regarding male birth control and lowering the risk of sexually transmitted diseases.

Planned Parenthood won the 2020 Webby Award for Machine Learning and Bots for their Sex Education chatbot.

Facilities

Location in Houston, Texas

PPFA has two national offices in the United States: one in Washington, D.C., and one in New York City. It has three international offices, including a hub office in London, England. It has 68 medical and related affiliates and 101 other affiliates including 34 political action committees. These affiliates together operate more than 700 health centers in all 50 states and the District of Columbia. PPFA owns about $54 million in property, including real estate. In addition, PPFA spends a little over $1 million per year for rented space. The largest facility, a $26 million, 78,000-square-foot (7,200-square-metre) structure, was completed in Houston, Texas, in May 2010.

Worldwide availability

PPFA's international outreach and other activities are performed by Planned Parenthood Global, a division of PPFA, and by the International Planned Parenthood Federation (IPPF) which now consists of more than 149 Member Associations working in more than 189 countries. The IPPF is further associated with International Planned Parenthood Federation affiliates in the Caribbean and the Americas, and IPPF European Network, as well as other organizations like Family Planning Queensland, Pro Familia (Germany) (de) and mouvement français pour le planning familial (French Movement for Family Planning) (fr). Offices are located in New York, NY; Washington, D.C.; Miami, FL; Guatemala City, Guatemala; Abuja, Nigeria; and Nairobi, Kenya. The organization's focus countries are Guatemala, Nicaragua, Costa Rica, Ecuador, Peru, Senegal, Burkina Faso, Nigeria, Sudan, South Sudan, Uganda, Ethiopia, and Kenya. The Bloomberg Philanthropies donated $50 million for Planned Parenthood Global's reproductive health and family planning efforts in Tanzania, Nicaragua, Burkina Faso, Senegal and Uganda. Among specific countries and territories serviced by Planned Parenthood Global's reproductive planning outreach are Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Peru, Suriname, Venezuela, Puerto Rico, U.S. Virgin Islands, Dominican Republic, Barbados, Bolivia, Ecuador, Guadeloupe, Saint Martin, Guyana, Cape Verde and Samoa.

Funding

Planned Parenthood has received federal funding since 1970, when President Richard Nixon signed into law the Family Planning Services and Population Research Act, amending the Public Health Service Act. Title X of that law provides funding for family planning services, including contraception and family planning information. The law had support from both Republicans and Democrats. Nixon described Title X funding as based on the premise that "no American woman should be denied access to family planning assistance because of her economic condition."

Donors to Planned Parenthood have included the Bill & Melinda Gates Foundation, the Buffett Foundation, the Ford Foundation, the Turner Foundation, the Cullmans, and others. The Bill & Melinda Gates Foundation's contributions to the organization have been specifically marked to avoid funding abortions. Some donors, such as the Buffett Foundation, have supported reproductive health that can include abortion services. Pro-life groups have advocated the boycott of donors to Planned Parenthood. Corporate donors include CREDO Mobile.

In the fiscal year ending June 30, 2014, total revenue was $1.3 billion: non-government health services revenue was $305 million, government revenue (such as Medicaid reimbursements) was $528 million, private contributions totaled $392 million, and $78 million came from other operating revenue. According to Planned Parenthood, 59% of the group's revenue is put towards the provision of health services, while non-medical services such as sex education and public policy work make up another 15%; management expenses, fundraising, and international family planning programs account for about 16%, and 10% of the revenue in 2013–2014 was not spent.

Planned Parenthood receives over a third of its money in government grants and contracts (about $528 million in 2014). By law (Hyde Amendment), federal funding cannot be allocated for abortions (except in rare cases), but some opponents of abortion have argued that allocating money to Planned Parenthood for the provision of other medical services allows other funds to be reallocated for abortions.

A coalition of national and local anti-abortion groups have lobbied federal and state governments to stop funding Planned Parenthood. As a result, federal and state legislators have proposed legislation to reduce funding levels. Eight states‍—‌Alabama, Arkansas, Indiana, Kansas, Louisiana, New Hampshire, Ohio, and Utah‍—‌have enacted such proposals. In some cases, the courts have overturned such actions, citing conflict with federal or state laws; in others the federal executive branch has provided funding in lieu of the states. In some states, Planned Parenthood was completely or partially defunded.

In August 2015, Louisiana Governor Bobby Jindal attempted to end Louisiana's contract with Planned Parenthood to treat Medicaid patients at a time when there was an epidemic of sexually transmitted diseases in Louisiana. Planned Parenthood and three patients sued the state of Louisiana, with the United States Department of Justice siding with Planned Parenthood.

On February 2, 2016, the U.S. House failed to override President Obama's veto of H.R. 3762 (Restoring Americans' Healthcare Freedom Reconciliation Act of 2015) which would have prohibited Planned Parenthood from receiving any federal Medicaid funds for one year.

Late in 2016, the Obama administration issued a rule effective in January 2017 banning U.S. states from withholding federal family-planning funds from health clinics that give abortions, including Planned Parenthood affiliates; this rule mandates that local and state governments give federal funds for services related to sexually transmitted infections, pregnancy care, fertility, contraception, and breast and cervical cancer screening to qualified health providers whether or not they give abortions. However, this rule was blocked by a federal judge the day before it would have taken effect. In 2017, it was overturned by new legislation.

The proposed American Health Care Act (H.R. 1628), announced by Congressional Republicans in March 2017, would have made Planned Parenthood "ineligible for Medicaid reimbursements or federal family planning grants."

On August 19, 2019, Planned Parenthood voluntarily withdrew from Title X funding due to a regulatory gag order stating that medical institutions that receive Title X funding cannot refer patients for abortions.

Political advocacy

Planned Parenthood activists meeting with Senator Kamala Harris in 2017.

Planned Parenthood is an advocate for the legal and political protection of reproductive rights. This advocacy includes helping to sponsor abortion rights and women's rights events. The Federation opposes restrictions on women's reproductive health services, including parental consent laws for minors. To justify this position, Planned Parenthood has cited the case of Becky Bell, who died following an illegal abortion rather than seek parental consent for a legal one. Planned Parenthood also takes the position that laws requiring parental notification before an abortion can be performed on a minor are unconstitutional on privacy grounds.

The organization opposes laws requiring ultrasounds before abortions, stating that their only purpose is to make abortions more difficult to obtain. Planned Parenthood has also opposed initiatives that require waiting periods before abortions, and bans on late-term abortions including intact dilation and extraction, which has been illegal in the U.S. since 2003. Planned Parenthood supports the wide availability of emergency contraception such as the Plan B pill. It opposes conscience clauses, which allow pharmacists to refuse to dispense drugs against their beliefs. Planned Parenthood has been critical of hospitals that do not provide access to emergency contraception for rape victims. Citing the need for medically accurate information in sex education, Planned Parenthood opposes abstinence-only education in public schools. Instead, Planned Parenthood is a provider of, and endorses, comprehensive sex education, which includes discussion of both abstinence and birth control.

Planned Parenthood's advocacy activities are executed by the Planned Parenthood Action Fund, which is registered as a 501(c)(4) charity, and files financial information jointly with PPFA. The committee was founded in 1996, by then-president Gloria Feldt, for the purpose of maintaining reproductive health rights and supporting political candidates of the same mindset. In the 2012 election cycle, the committee gained prominence based on its effectiveness of spending on candidates. Although the Planned Parenthood Action Fund (PPAF) shares some leadership with the Planned Parenthood Federation of America, the president of PPAF, Cecile Richards, testified before Congress in September 2015 that she did not manage the organization. The Planned Parenthood Action Fund has 58 active, separately incorporated chapters in 41 states and maintains national headquarters in New York and Washington, D.C. Planned Parenthood has received grants from the Obama administration to help promote the Patient Protection and Affordable Care Act, or ObamaCare.

Political spending

Planned Parenthood spends money on politics and elections through the Planned Parenthood Action Fund (its federal political action committee), through its Super PAC, and through a variety of related 501(c)(4) entities. Planned Parenthood endorsed Obama in the 2008 and 2012 presidential elections. In the 2014 election cycle, Planned Parenthood spent $6,587,100 on contributions to candidates and political parties (overwhelmingly to Democrats) and on independent expenditures.

Before the U.S. Supreme Court

Former Planned Parenthood President Gloria Feldt with Congressman Albert Wynn in front of the U.S. Supreme Court

Planned Parenthood regional chapters have been active in the American courts. A number of cases in which Planned Parenthood has been a party have reached the U.S. Supreme Court. Notable among these cases is the 1992 case Planned Parenthood v. Casey, the case that sets forth the current constitutional abortion standard. In this case, "Planned Parenthood" was the Southeast Pennsylvania Chapter, and "Casey" was Robert Casey, the governor of Pennsylvania. The ultimate ruling was split, and Roe v. Wade was narrowed but upheld in an opinion written by Sandra Day O'Connor, Anthony Kennedy, and David Souter. Harry Blackmun and John Paul Stevens concurred with the main decision in separately written opinions. The Supreme Court struck down spousal consent requirements for married women to obtain abortions, but found no "undue burden"—an alternative to strict scrutiny, which tests the allowable limitations on rights protected under the Constitution—from the other statutory requirements. Dissenting were William Rehnquist, Antonin Scalia, Clarence Thomas, and Byron White. Blackmun, Rehnquist, and White were the only justices who voted on the original Roe v. Wade decision in 1973 who were still on the Supreme Court to rule on this case, and their votes on this case were consistent with their votes on the original decision that legalized abortion. Only Blackmun voted to maintain Roe v. Wade in its entirety.

Other related cases include:

  • Planned Parenthood of Central Missouri v. Danforth (1976). Planned Parenthood challenged the constitutionality of a Missouri law encompassing parental consent, spousal consent, clinic bookkeeping and allowed abortion methods. Portions of the challenged law were held to be constitutional, others not.
  • Planned Parenthood Association of Kansas City v. Ashcroft (1983). Planned Parenthood challenged the constitutionality of a Missouri law encompassing parental consent, clinic record keeping, and hospitalization requirements. Most of the challenged law was held to be constitutional.
  • Planned Parenthood v. ACLA (2001). The American Coalition of Life Activists (ACLA) released a flier and "Wanted" posters with complete personal information about doctors who performed abortions. A civil jury and the Ninth Circuit Court of Appeals both found that the materials were indeed "true threats" and not protected speech.
  • Gonzales v. Planned Parenthood (2003). Planned Parenthood sued U.S. Attorney General Alberto Gonzales for an injunction against the enforcement of the Partial-Birth Abortion Ban Act of 2003. Planned Parenthood argued the act was unconstitutional because it violated the Fifth Amendment, namely in that it was overly vague, violated women's constitutional right to have access to abortion, and did not include language for exceptions for the health of the mother. Both the district court and the Ninth Circuit Court of Appeals agreed, but that decision was overturned in a 5–4 ruling by the Supreme Court.
  • Ayotte v. Planned Parenthood of Northern New England (2006). Planned Parenthood et al. challenged the constitutionality of a New Hampshire parental notification law related to access to abortion. In Sandra Day O'Connor's final decision before retirement, the Supreme Court sent the case back to lower courts with instructions to seek a remedy short of wholesale invalidation of the statute. New Hampshire ended up repealing the statute via the legislative process.

Other court cases

Some state attorneys general have subpoenaed medical records of patients treated by Planned Parenthood. Planned Parenthood has gone to court to keep from turning over these records, citing medical privacy and concerns about the motivation for seeking the records.

In 2006, Kansas Attorney General Phill Kline, a Republican, released some sealed patient records obtained from Planned Parenthood to the public. His actions were described as "troubling" by the state Supreme Court, but Planned Parenthood was compelled to turn over the medical records, albeit with more stringent court-mandated privacy safeguards for the patients involved. In 2007 Kline's successor, Paul J. Morrison, a Democrat, notified the clinic that no criminal charges would be filed after a three-year investigation, as "an objective, unbiased and thorough examination" showed no wrongdoing. Morrison stated that he believed Kline had politicized the Attorney General's office. In 2012, a Kansas district attorney found that the practices of the Kansas City-area Planned Parenthood clinic were "within accepted practices in the medical community" and dropped all of the remaining criminal charges. In all, the Planned Parenthood clinic had faced 107 criminal charges from Kline and other Kansas prosecutors, all of which were ultimately dismissed.

In 2006, the Indiana Court of Appeals ruled that Planned Parenthood was not required to turn over its medical records in an investigation of possible child abuse. In 2005, Planned Parenthood Minnesota, North Dakota, and South Dakota was fined $50,000 for violating a Minnesota state parental consent law.

In 2012, a Texas state court judge, Gary Harger, denied Planned Parenthood request for a temporary restraining order against the State of Texas, concluding that the State may exclude otherwise qualified doctors and clinics from receiving state funding if the doctors or clinics advocate for abortion rights.

Impact

A 2020 study found that closures of Planned Parenthood clinics resulted in increases in the maternal mortality rate: "Planned Parenthood clinic closures negatively impacted all women, increasing mortality by 6%–15% across racial/ethnic groups."

A 2016 study found that the exclusion of Planned Parenthood-affiliated clinics from Texas's Medicaid fee-for-service family-planning program was linked to reductions in the provision of contraception and an increase in child-bearing for women who used injectable contraceptives and who were covered by Medicaid.

Debate and opposition

Margaret Sanger and eugenics

In the 1920s, various theories of eugenics were popular among intellectuals in the U.S. In her campaign to promote birth control, Sanger teamed with eugenics organizations such as the American Eugenics Society, although she argued against many of their positions. Scholars describe Sanger as believing that birth control and sterilization should be voluntary, and not based on race. Sanger advocated for "voluntary motherhood"—the right to choose when to be pregnant—for all women, as an important element of women's rights. As part of her efforts to promote birth control, however, Sanger found common cause with proponents of eugenics, believing that she and they both sought to "assist the race toward the elimination of the unfit".

Critics of Planned Parenthood often refer to Sanger's connection with supporters of eugenics to discredit the organization by associating it, and birth control, with the more negative modern view of eugenics. Planned Parenthood has responded to this effort directly in a leaflet acknowledging that Sanger agreed with some of her contemporaries who advocated the voluntary hospitalization or sterilization of people with untreatable, disabling, or hereditary conditions, and limits on the immigration of the diseased. The leaflet also states that Planned Parenthood "finds these views objectionable and outmoded" but says that it was compelled to discuss the topic because "anti-family planning activists continue to attack Sanger [...] because she is an easier target" than Planned Parenthood.

Abortion

Planned Parenthood has occupied a central position in the abortion debate in the U.S., and has been among the most prominent targets of the U.S. pro-life movement for decades. Some members of Congress, overwhelmingly Republican, have attempted since the 1980s to end federal funding of the organization, nearly leading to a government shutdown over the issue in 2011. Planned Parenthood has consistently maintained that federal money received by Planned Parenthood is not used to fund abortion services, but pro-life activists have argued that the federal funding frees up other resources that are, in turn, used to provide abortions.

Planned Parenthood is the largest single provider of abortions in the U.S., but pro-choice advocates have argued that the organization's family planning services reduce the need for abortions; in the words of Megan Crepeau of the Chicago Tribune, Planned Parenthood could be "characterized as America's largest abortion preventer". Pro-life activists dispute the evidence that greater access to contraceptives reduces abortion frequency.

Undercover videos by anti-abortion activists

Periodically, pro-life advocates and activists have tried to demonstrate that Planned Parenthood does not follow applicable state or federal laws. The groups called or visited Planned Parenthood health centers posing as victims of statutory rape, minors who by law need parental notification before abortion, racist donors seeking to earmark donations to reduce the African-American population, or pimps seeking abortions for underage prostitutes. As a result of some of these videos, several Planned Parenthood workers have been disciplined or fired. However, a 2005 review by the Bush administration's Department of Health and Human Services "yielded no evidence of clinics around the nation failing to comply with laws on reporting child abuse, child molestation, sexual abuse, rape or incest".

Live Action videos

Beginning in 2010, Live Action released several series of undercover videos filmed in Planned Parenthood centers. Live Action said one series showed Planned Parenthood employees at many affiliates actively assisting or being complicit in aiding a prostitution ring, advising patients on how to procure sex-selective abortions, while one who said they would immerse a child born alive after a botched abortion in a chemical solution to make it stop moving and breathing. No criminal convictions resulted, but some Planned Parenthood employees and volunteers were fired for not following procedure, and the organization committed to retraining its staff. Additionally, one center was placed on probation.

Center for Medical Progress videos

In 2015, an anti-abortion organization named the Center for Medical Progress (CMP) released several videos that had been secretly recorded. Members of the CMP posed as representatives of a biotechnology company in order to gain access to both meetings with abortion providers and abortion facilities. The videos showed how abortion providers made fetal tissue available to researchers, although no problems were found with the legality of the process. All of the videos were found to be altered, according to analysis by Fusion GPS and its co-founder Glenn R. Simpson, a former investigative reporter for The Wall Street Journal. The CMP disputed this finding, attributing the alterations to the editing out of "bathroom breaks and waiting periods". CMP had represented a longer version of the tapes as being "complete", as well as a shorter, edited version. The analysis by Fusion GPS concluded that the longer version was also edited, with skips and missing footage. Nonetheless, the videos attracted widespread media coverage; after the release of the first video, conservative lawmakers in Congress singled out Planned Parenthood and began to push bills that would strip the organization of federal family planning funding. No such attempts by Congress to cut federal family planning money from Planned Parenthood have become law. Conservative politicians in several states have also used this as an opportunity to cut or attempt to cut family planning funding at the state level.

Officials in twelve states initiated investigations into claims made by the videos, but none found Planned Parenthood clinics to have sold tissue for profit as alleged by CMP and other anti-abortion groups. An investigation by the U.S. House of Representatives Oversight and Government Reform Committee found no evidence of wrongdoing by Planned Parenthood. A select committee, the U.S. House Committee on Energy and Commerce Select Investigative Panel on Planned Parenthood, was formed to further investigate Planned Parenthood. The Republican-controlled Select Investigative Panel released its final report on December 30, 2016, recommending that Planned Parenthood be defunded. The report was heavily criticized as partisan and inaccurate by Democratic members of the committee, Planned Parenthood, and some news media.

In January 2016, a Texas grand jury chartered to investigate Planned Parenthood found no wrongdoing by Planned Parenthood but instead indicted CMP founder David Daleiden and member Sandra Merritt for creating and using false government IDs and attempting to purchase fetal tissue. The charges against Daleiden and Merritt in Texas were dismissed six months later on the grounds that the grand jury's indictment authority had extended only to Planned Parenthood. In March 2017, Daleiden and Merritt were charged with 15 felonies in the State of California – one for each of the people whom they had filmed without consent, and one for criminal conspiracy to invade privacy. In June 2017, all the invasion of privacy charges (but not that of conspiracy) were dismissed with leave to amend,

Violence by anti-abortion activists

In the U.S., abortion providers have been threatened with death, and facilities that provide abortions have been attacked or vandalized. Planned Parenthood clinics have been the target of a number of instances of violence by anti-abortion activists, including bombing, arson and attacks with chemical weaponry. In 1994, John Salvi entered a Brookline, Massachusetts Planned Parenthood clinic and opened fire, murdering receptionist Shannon Elizabeth Lowney and wounding three others. He fled to another Planned Parenthood clinic where he murdered Leane Nichols and wounded two others. In 2012, a Grand Chute, Wisconsin, Planned Parenthood clinic was subject to a bombing perpetrated by an unknown individual. In 2015, a Planned Parenthood clinic in Pullman, Washington was heavily damaged by arson.

2015 shooting

On November 27, 2015, a gunman shot and killed two civilians and a police officer during a five-hour gun battle at the Colorado Springs, Colorado clinic. The 57-year-old gunman, Robert Dear, surrendered to police and was taken into custody. During his arrest, he gave a "rambling" interview in which, at one point, he said "no more baby parts", echoing language used in the news media about the clinic following the Center for Medical Progress videos. Dear was declared incompetent to stand trial for the shooting, citing experts' finding that he suffers from "delusional disorder, persecutory type."

Recurrent neural network

From Wikipedia, the free encyclopedia

A recurrent neural network (RNN) is a class of artificial neural networks where connections between nodes form a directed or undirected graph along a temporal sequence. This allows it to exhibit temporal dynamic behavior. Derived from feedforward neural networks, RNNs can use their internal state (memory) to process variable length sequences of inputs. This makes them applicable to tasks such as unsegmented, connected handwriting recognition or speech recognition. Recurrent neural networks are theoretically Turing complete and can run arbitrary programs to process arbitrary sequences of inputs.

The term "recurrent neural network" is used to refer to the class of networks with an infinite impulse response, whereas "convolutional neural network" refers to the class of finite impulse response. Both classes of networks exhibit temporal dynamic behavior. A finite impulse recurrent network is a directed acyclic graph that can be unrolled and replaced with a strictly feedforward neural network, while an infinite impulse recurrent network is a directed cyclic graph that can not be unrolled.

Both finite impulse and infinite impulse recurrent networks can have additional stored states, and the storage can be under direct control by the neural network. The storage can also be replaced by another network or graph if that incorporates time delays or has feedback loops. Such controlled states are referred to as gated state or gated memory, and are part of long short-term memory networks (LSTMs) and gated recurrent units. This is also called Feedback Neural Network (FNN).

History

Recurrent neural networks were based on David Rumelhart's work in 1986. Hopfield networks – a special kind of RNN – were (re-)discovered by John Hopfield in 1982. In 1993, a neural history compressor system solved a "Very Deep Learning" task that required more than 1000 subsequent layers in an RNN unfolded in time.

LSTM

Long short-term memory (LSTM) networks were invented by Hochreiter and Schmidhuber in 1997 and set accuracy records in multiple applications domains.

Around 2007, LSTM started to revolutionize speech recognition, outperforming traditional models in certain speech applications. In 2009, a Connectionist Temporal Classification (CTC)-trained LSTM network was the first RNN to win pattern recognition contests when it won several competitions in connected handwriting recognition. In 2014, the Chinese company Baidu used CTC-trained RNNs to break the 2S09 Switchboard Hub5'00 speech recognition dataset benchmark without using any traditional speech processing methods.

LSTM also improved large-vocabulary speech recognition and text-to-speech synthesis and was used in Google Android. In 2015, Google's speech recognition reportedly experienced a dramatic performance jump of 49% through CTC-trained LSTM.

LSTM broke records for improved machine translation, Language Modeling and Multilingual Language Processing. LSTM combined with convolutional neural networks (CNNs) improved automatic image captioning.

Architectures

RNNs come in many variants.

Fully recurrent

Compressed (left) and unfolded (right) basic recurrent neural network.

Fully recurrent neural networks (FRNN) connect the outputs of all neurons to the inputs of all neurons. This is the most general neural network topology because all other topologies can be represented by setting some connection weights to zero to simulate the lack of connections between those neurons. The illustration to the right may be misleading to many because practical neural network topologies are frequently organized in "layers" and the drawing gives that appearance. However, what appears to be layers are, in fact, different steps in time of the same fully recurrent neural network. The left-most item in the illustration shows the recurrent connections as the arc labeled 'v'. It is "unfolded" in time to produce the appearance of layers.

Elman networks and Jordan networks

The Elman network

An Elman network is a three-layer network (arranged horizontally as x, y, and z in the illustration) with the addition of a set of context units (u in the illustration). The middle (hidden) layer is connected to these context units fixed with a weight of one. At each time step, the input is fed forward and a learning rule is applied. The fixed back-connections save a copy of the previous values of the hidden units in the context units (since they propagate over the connections before the learning rule is applied). Thus the network can maintain a sort of state, allowing it to perform such tasks as sequence-prediction that are beyond the power of a standard multilayer perceptron.

Jordan networks are similar to Elman networks. The context units are fed from the output layer instead of the hidden layer. The context units in a Jordan network are also referred to as the state layer. They have a recurrent connection to themselves.

Elman and Jordan networks are also known as "Simple recurrent networks" (SRN).

Elman network
Jordan network

Variables and functions

  • : input vector
  • : hidden layer vector
  • : output vector
  • , and : parameter matrices and vector
  • and : Activation functions

Hopfield

The Hopfield network is an RNN in which all connections across layers are equally sized. It requires stationary inputs and is thus not a general RNN, as it does not process sequences of patterns. However, it guarantees that it will converge. If the connections are trained using Hebbian learning then the Hopfield network can perform as robust content-addressable memory, resistant to connection alteration.

Bidirectional associative memory

Introduced by Bart Kosko, a bidirectional associative memory (BAM) network is a variant of a Hopfield network that stores associative data as a vector. The bi-directionality comes from passing information through a matrix and its transpose. Typically, bipolar encoding is preferred to binary encoding of the associative pairs. Recently, stochastic BAM models using Markov stepping were optimized for increased network stability and relevance to real-world applications.

A BAM network has two layers, either of which can be driven as an input to recall an association and produce an output on the other layer.

Echo state

The echo state network (ESN) has a sparsely connected random hidden layer. The weights of output neurons are the only part of the network that can change (be trained). ESNs are good at reproducing certain time series. A variant for spiking neurons is known as a liquid state machine.

Independently RNN (IndRNN)

The Independently recurrent neural network (IndRNN) addresses the gradient vanishing and exploding problems in the traditional fully connected RNN. Each neuron in one layer only receives its own past state as context information (instead of full connectivity to all other neurons in this layer) and thus neurons are independent of each other's history. The gradient backpropagation can be regulated to avoid gradient vanishing and exploding in order to keep long or short-term memory. The cross-neuron information is explored in the next layers. IndRNN can be robustly trained with the non-saturated nonlinear functions such as ReLU. Using skip connections, deep networks can be trained.

Recursive

A recursive neural network is created by applying the same set of weights recursively over a differentiable graph-like structure by traversing the structure in topological order. Such networks are typically also trained by the reverse mode of automatic differentiation. They can process distributed representations of structure, such as logical terms. A special case of recursive neural networks is the RNN whose structure corresponds to a linear chain. Recursive neural networks have been applied to natural language processing. The Recursive Neural Tensor Network uses a tensor-based composition function for all nodes in the tree.

Neural history compressor

The neural history compressor is an unsupervised stack of RNNs. At the input level, it learns to predict its next input from the previous inputs. Only unpredictable inputs of some RNN in the hierarchy become inputs to the next higher level RNN, which therefore recomputes its internal state only rarely. Each higher level RNN thus studies a compressed representation of the information in the RNN below. This is done such that the input sequence can be precisely reconstructed from the representation at the highest level.

The system effectively minimises the description length or the negative logarithm of the probability of the data. Given a lot of learnable predictability in the incoming data sequence, the highest level RNN can use supervised learning to easily classify even deep sequences with long intervals between important events.

It is possible to distill the RNN hierarchy into two RNNs: the "conscious" chunker (higher level) and the "subconscious" automatizer (lower level). Once the chunker has learned to predict and compress inputs that are unpredictable by the automatizer, then the automatizer can be forced in the next learning phase to predict or imitate through additional units the hidden units of the more slowly changing chunker. This makes it easy for the automatizer to learn appropriate, rarely changing memories across long intervals. In turn, this helps the automatizer to make many of its once unpredictable inputs predictable, such that the chunker can focus on the remaining unpredictable events.

A generative model partially overcame the vanishing gradient problem of automatic differentiation or backpropagation in neural networks in 1992. In 1993, such a system solved a "Very Deep Learning" task that required more than 1000 subsequent layers in an RNN unfolded in time.

Second order RNNs

Second order RNNs use higher order weights instead of the standard weights, and states can be a product. This allows a direct mapping to a finite-state machine both in training, stability, and representation. Long short-term memory is an example of this but has no such formal mappings or proof of stability.

Long short-term memory

Long short-term memory unit

Long short-term memory (LSTM) is a deep learning system that avoids the vanishing gradient problem. LSTM is normally augmented by recurrent gates called "forget gates". LSTM prevents backpropagated errors from vanishing or exploding. Instead, errors can flow backwards through unlimited numbers of virtual layers unfolded in space. That is, LSTM can learn tasks that require memories of events that happened thousands or even millions of discrete time steps earlier. Problem-specific LSTM-like topologies can be evolved. LSTM works even given long delays between significant events and can handle signals that mix low and high frequency components.

Many applications use stacks of LSTM RNNs and train them by Connectionist Temporal Classification (CTC) to find an RNN weight matrix that maximizes the probability of the label sequences in a training set, given the corresponding input sequences. CTC achieves both alignment and recognition.

LSTM can learn to recognize context-sensitive languages unlike previous models based on hidden Markov models (HMM) and similar concepts.

Gated recurrent unit

Gated recurrent unit

Gated recurrent units (GRUs) are a gating mechanism in recurrent neural networks introduced in 2014. They are used in the full form and several simplified variants. Their performance on polyphonic music modeling and speech signal modeling was found to be similar to that of long short-term memory. They have fewer parameters than LSTM, as they lack an output gate.

Bi-directional

Bi-directional RNNs use a finite sequence to predict or label each element of the sequence based on the element's past and future contexts. This is done by concatenating the outputs of two RNNs, one processing the sequence from left to right, the other one from right to left. The combined outputs are the predictions of the teacher-given target signals. This technique has been proven to be especially useful when combined with LSTM RNNs.

Continuous-time

A continuous-time recurrent neural network (CTRNN) uses a system of ordinary differential equations to model the effects on a neuron of the incoming inputs.

For a neuron in the network with activation , the rate of change of activation is given by:

Where:

  •  : Time constant of postsynaptic node
  •  : Activation of postsynaptic node
  •  : Rate of change of activation of postsynaptic node
  •  : Weight of connection from pre to postsynaptic node
  •  : Sigmoid of x e.g. .
  •  : Activation of presynaptic node
  •  : Bias of presynaptic node
  •  : Input (if any) to node

CTRNNs have been applied to evolutionary robotics where they have been used to address vision, co-operation, and minimal cognitive behaviour.

Note that, by the Shannon sampling theorem, discrete time recurrent neural networks can be viewed as continuous-time recurrent neural networks where the differential equations have transformed into equivalent difference equations. This transformation can be thought of as occurring after the post-synaptic node activation functions have been low-pass filtered but prior to sampling.

Hierarchical

Hierarchical RNNs connect their neurons in various ways to decompose hierarchical behavior into useful subprograms. Such hierarchical structures of cognition are present in theories of memory presented by philosopher Henri Bergson, whose philosophical views have inspired hierarchical models.

Recurrent multilayer perceptron network

Generally, a recurrent multilayer perceptron network (RMLP) network consists of cascaded subnetworks, each of which contains multiple layers of nodes. Each of these subnetworks is feed-forward except for the last layer, which can have feedback connections. Each of these subnets is connected only by feed-forward connections.

Multiple timescales model

A multiple timescales recurrent neural network (MTRNN) is a neural-based computational model that can simulate the functional hierarchy of the brain through self-organization that depends on spatial connection between neurons and on distinct types of neuron activities, each with distinct time properties. With such varied neuronal activities, continuous sequences of any set of behaviors are segmented into reusable primitives, which in turn are flexibly integrated into diverse sequential behaviors. The biological approval of such a type of hierarchy was discussed in the memory-prediction theory of brain function by Hawkins in his book On Intelligence. Such a hierarchy also agrees with theories of memory posited by philosopher Henri Bergson, which have been incorporated into an MTRNN model.

Neural Turing machines

Neural Turing machines (NTMs) are a method of extending recurrent neural networks by coupling them to external memory resources which they can interact with by attentional processes. The combined system is analogous to a Turing machine or Von Neumann architecture but is differentiable end-to-end, allowing it to be efficiently trained with gradient descent.

Differentiable neural computer

Differentiable neural computers (DNCs) are an extension of Neural Turing machines, allowing for the usage of fuzzy amounts of each memory address and a record of chronology.

Neural network pushdown automata

Neural network pushdown automata (NNPDA) are similar to NTMs, but tapes are replaced by analogue stacks that are differentiable and that are trained. In this way, they are similar in complexity to recognizers of context free grammars (CFGs).

Memristive Networks

Greg Snider of HP Labs describes a system of cortical computing with memristive nanodevices. The memristors (memory resistors) are implemented by thin film materials in which the resistance is electrically tuned via the transport of ions or oxygen vacancies within the film. DARPA's SyNAPSE project has funded IBM Research and HP Labs, in collaboration with the Boston University Department of Cognitive and Neural Systems (CNS), to develop neuromorphic architectures which may be based on memristive systems. Memristive networks are a particular type of physical neural network that have very similar properties to (Little-)Hopfield networks, as they have a continuous dynamics, have a limited memory capacity and they natural relax via the minimization of a function which is asymptotic to the Ising model. In this sense, the dynamics of a memristive circuit has the advantage compared to a Resistor-Capacitor network to have a more interesting non-linear behavior. From this point of view, engineering an analog memristive networks accounts to a peculiar type of neuromorphic engineering in which the device behavior depends on the circuit wiring, or topology. 

Training

Gradient descent

Gradient descent is a first-order iterative optimization algorithm for finding the minimum of a function. In neural networks, it can be used to minimize the error term by changing each weight in proportion to the derivative of the error with respect to that weight, provided the non-linear activation functions are differentiable. Various methods for doing so were developed in the 1980s and early 1990s by Werbos, Williams, Robinson, Schmidhuber, Hochreiter, Pearlmutter and others.

The standard method is called "backpropagation through time" or BPTT, and is a generalization of back-propagation for feed-forward networks. Like that method, it is an instance of automatic differentiation in the reverse accumulation mode of Pontryagin's minimum principle. A more computationally expensive online variant is called "Real-Time Recurrent Learning" or RTRL, which is an instance of automatic differentiation in the forward accumulation mode with stacked tangent vectors. Unlike BPTT, this algorithm is local in time but not local in space.

In this context, local in space means that a unit's weight vector can be updated using only information stored in the connected units and the unit itself such that update complexity of a single unit is linear in the dimensionality of the weight vector. Local in time means that the updates take place continually (on-line) and depend only on the most recent time step rather than on multiple time steps within a given time horizon as in BPTT. Biological neural networks appear to be local with respect to both time and space.

For recursively computing the partial derivatives, RTRL has a time-complexity of O(number of hidden x number of weights) per time step for computing the Jacobian matrices, while BPTT only takes O(number of weights) per time step, at the cost of storing all forward activations within the given time horizon. An online hybrid between BPTT and RTRL with intermediate complexity exists, along with variants for continuous time.

A major problem with gradient descent for standard RNN architectures is that error gradients vanish exponentially quickly with the size of the time lag between important events. LSTM combined with a BPTT/RTRL hybrid learning method attempts to overcome these problems. This problem is also solved in the independently recurrent neural network (IndRNN) by reducing the context of a neuron to its own past state and the cross-neuron information can then be explored in the following layers. Memories of different range including long-term memory can be learned without the gradient vanishing and exploding problem.

The on-line algorithm called causal recursive backpropagation (CRBP), implements and combines BPTT and RTRL paradigms for locally recurrent networks. It works with the most general locally recurrent networks. The CRBP algorithm can minimize the global error term. This fact improves stability of the algorithm, providing a unifying view on gradient calculation techniques for recurrent networks with local feedback.

One approach to the computation of gradient information in RNNs with arbitrary architectures is based on signal-flow graphs diagrammatic derivation. It uses the BPTT batch algorithm, based on Lee's theorem for network sensitivity calculations. It was proposed by Wan and Beaufays, while its fast online version was proposed by Campolucci, Uncini and Piazza.

Global optimization methods

Training the weights in a neural network can be modeled as a non-linear global optimization problem. A target function can be formed to evaluate the fitness or error of a particular weight vector as follows: First, the weights in the network are set according to the weight vector. Next, the network is evaluated against the training sequence. Typically, the sum-squared-difference between the predictions and the target values specified in the training sequence is used to represent the error of the current weight vector. Arbitrary global optimization techniques may then be used to minimize this target function.

The most common global optimization method for training RNNs is genetic algorithms, especially in unstructured networks.

Initially, the genetic algorithm is encoded with the neural network weights in a predefined manner where one gene in the chromosome represents one weight link. The whole network is represented as a single chromosome. The fitness function is evaluated as follows:

  • Each weight encoded in the chromosome is assigned to the respective weight link of the network.
  • The training set is presented to the network which propagates the input signals forward.
  • The mean-squared-error is returned to the fitness function.
  • This function drives the genetic selection process.

Many chromosomes make up the population; therefore, many different neural networks are evolved until a stopping criterion is satisfied. A common stopping scheme is:

  • When the neural network has learnt a certain percentage of the training data or
  • When the minimum value of the mean-squared-error is satisfied or
  • When the maximum number of training generations has been reached.

The stopping criterion is evaluated by the fitness function as it gets the reciprocal of the mean-squared-error from each network during training. Therefore, the goal of the genetic algorithm is to maximize the fitness function, reducing the mean-squared-error.

Other global (and/or evolutionary) optimization techniques may be used to seek a good set of weights, such as simulated annealing or particle swarm optimization.

Related fields and models

RNNs may behave chaotically. In such cases, dynamical systems theory may be used for analysis.

They are in fact recursive neural networks with a particular structure: that of a linear chain. Whereas recursive neural networks operate on any hierarchical structure, combining child representations into parent representations, recurrent neural networks operate on the linear progression of time, combining the previous time step and a hidden representation into the representation for the current time step.

In particular, RNNs can appear as nonlinear versions of finite impulse response and infinite impulse response filters and also as a nonlinear autoregressive exogenous model (NARX).

Libraries

  • Apache Singa
  • Caffe: Created by the Berkeley Vision and Learning Center (BVLC). It supports both CPU and GPU. Developed in C++, and has Python and MATLAB wrappers.
  • Chainer: The first stable deep learning library that supports dynamic, define-by-run neural networks. Fully in Python, production support for CPU, GPU, distributed training.
  • Deeplearning4j: Deep learning in Java and Scala on multi-GPU-enabled Spark. A general-purpose deep learning library for the JVM production stack running on a C++ scientific computing engine. Allows the creation of custom layers. Integrates with Hadoop and Kafka.
  • Flux: includes interfaces for RNNs, including GRUs and LSTMs, written in Julia.
  • Keras: High-level, easy to use API, providing a wrapper to many other deep learning libraries.
  • Microsoft Cognitive Toolkit
  • MXNet: a modern open-source deep learning framework used to train and deploy deep neural networks.
  • PyTorch: Tensors and Dynamic neural networks in Python with strong GPU acceleration.
  • TensorFlow: Apache 2.0-licensed Theano-like library with support for CPU, GPU and Google's proprietary TPU, mobile
  • Theano: The reference deep-learning library for Python with an API largely compatible with the popular NumPy library. Allows user to write symbolic mathematical expressions, then automatically generates their derivatives, saving the user from having to code gradients or backpropagation. These symbolic expressions are automatically compiled to CUDA code for a fast, on-the-GPU implementation.
  • Torch (www.torch.ch): A scientific computing framework with wide support for machine learning algorithms, written in C and lua. The main author is Ronan Collobert, and it is now used at Facebook AI Research and Twitter.

Applications

Applications of recurrent neural networks include:

Online school

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