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On May 26, the nation’s largest abortion fund and support service went dark for a day. Normally, workers answer calls and chat messages from abortion seekers in need of information and financial assistance, but they were on a 24-hour strike as they bargain their third contract. Callers instead encountered a voicemail message that made no mention of the strike, but directed patients to contact clinics directly for support, according to a source who works for a local abortion fund and dialed the hotline that day.
The National Abortion Hotline is a project of the National Abortion Federation (NAF), a professional organization for abortion providers that also offers security resources, medical guidelines, and other services. According to financial filings, the hotline distributed nearly $56 million in financial assistance in 2024, the most recent year for which data is available. That translates to help for more than 110,000 people, per NAF’s website. When contacted for comment by Autonomy News, NAF declined to provide an estimate of how many patients may have been affected by the one-day shutdown.
In addition to patients who might not be able to access care without this assistance, many abortion clinics are heavily reliant on NAF funding. Changes or disruptions at the hotline can have cascading effects for providers, patients, and grassroots abortion funds, which often step up when patients can’t afford care, despite working with significantly smaller budgets. While the strike only lasted one day, the ongoing dispute between workers and management raises the possibility of further disruptions.
Autonomy News reported in April that artificial intelligence had emerged as a sticking point in contract negotiations between management and the National Abortion Hotline Union, organized with the Washington-Baltimore News Guild. Specifically, workers said they asked that management agree to negotiate with the union prior to implementing any AI technology that could result in members losing their jobs. This proposal already represented a significant compromise on the workers’ side, a union spokesperson told Autonomy News: Initially, the union asked to bargain over any implementation of AI technology that would “substantially affect our workflow and patient care more broadly.”
“We have made tremendous concessions despite our concerns,” wrote the spokesperson, who didn’t want to be identified for fear of retaliation. “We are not asking for a ban on new technology. We are asking for a voice in a decision that has the potential to eliminate our jobs and directly impact the lives of millions who [will] rely on our hotline to help them navigate accessing abortion care.”
According to the union, NAF management asked that the two sides meet with an outside mediator in April to help reach an agreement on AI protections. But at the start of the first mediation session, management “communicated to us that they were unwilling to move on the AI provisions,” the spokesperson said. After a second session, management emailed a final offer and refused to continue bargaining, they said.
This led the union to file an unfair labor practice charge with the National Labor Relations Board—an official accusation that an employer has violated labor law. Specifically, the union alleges that NAF management is running afoul of worker protections through “their refusal to continue the bargaining process, and then, their insistence that we need to make concessions before they will continue to bargain,” the spokesperson said.
NAF management characterizes the strike—and the circumstances leading up to it—differently. “At this point, the disagreement is more about process than substance,” reads a May 29 email NAF sent to its members—which include abortion clinics, individual providers, and some grassroots abortion funds. The email was one of three about the strike shared with Autonomy News.
“NAF has given the Union seats on its Al task force and is committed to providing advance notice of any potential layoffs related to new technology and offering retraining to help affected employees continue working at NAF,” the email reads. The union had previously criticized the AI task force, saying that it seemed more focused on training staff to use AI than tackling ethical issues regarding its use, including job losses as well as accuracy and data privacy.
“NAF is also committed to bargaining over how new technology affects staff,” the email continues. “The Union is asking to bargain over decisions about whether and how new technology is introduced in the first place. Like many organizations navigating these issues, NAF believes it needs to maintain the ability to make certain operational decisions for the organization.”
The email also reiterates what NAF president and CEO Brittany Fonteno told Autonomy News in April—that NAF has no plans to replace staff with AI. It touts progress made during bargaining on other issues, including additional paid time off, larger annual salary increases, and increased severance and notice period in advance of any layoffs.
The union spokesperson said these are important pieces of the contract, and management has treated them as such. “We have seen consistent, incremental movement on both sides and have every confidence that we can get to an agreement,” they said. “However, we have not seen the same effort to find a way forward when it comes to the AI provisions, which concerns us given the potential for dire consequences for patient care and job security for our staff.” The spokesperson also disputed the idea that the union’s proposals interfere with NAF’s ability to implement new technologies, saying management will retain “overwhelming freedom” to do so.
The union spokesperson said its AI proposals were drawn from contracts already in place at other unionized workplaces. “I don’t think any of us expected that NAF management would not align with our ethical concerns around AI or that they would view our caution and request to be a part of decisions as an unreasonable restriction on their ability to innovate,” they added.
“While we strongly disagree with the Union’s characterization of recent events, NAF has been engaged in productive conversations with the Union this week and is optimistic about reaching an agreement soon,” a representative for the organization said in a statement provided to Autonomy News. “Although we will not attempt to correct or respond to all of the Union’s allegations, we do want to clarify that NAF management took significant steps to ensure the continuity of abortion access for patients who rely on the Hotline, even during the strike, making every effort to minimize disruption or delay.”
The choice to strike for just 24 hours was intentional, given how much callers rely on the hotline for time-sensitive support. “This work is not just a paycheck for us. Each and every caller matters, so it was extremely difficult for us to come to the decision to strike,” the spokesperson said. “We hope to avoid longer, more disruptive actions and instead return back to the table with both sides sharing the intent to bargain in good faith towards a reasonable solution.”
"This is life-saving work that AI cannot be trusted to take over."
Union members were locked out of their email accounts and computers Monday evening after leadership received notice of the Tuesday strike, they said, so hotline staff had limited visibility into what happened while they were offline. A NAF email obtained by Autonomy News confirms that patients were unable to reach the hotline by phone or chat on the day of the strike. Abortion clinics were encouraged to switch to “on-site” intakes—meaning they were asked to screen patients for eligibility for NAF funding, a task often done by hotline workers. According to the email, some clinics already do this, a fact that multiple abortion providers confirmed to Autonomy News. It’s not clear what proportion of NAF member clinics currently rely on the hotline for eligibility screening. Another email offered members the option to stick with the on-site intake process even after the hotline reopened, explaining that clinics could email a NAF staffer “to discuss making this change permanent.” NAF did not respond to specific questions about these events.
Hotline supervisors who were not engaged in the work stoppage were still coordinating travel support, per the pre-strike email. However, this is a smaller part of what the hotline does. NAF expanded its travel funding and patient navigation services in the wake of the Dobbs decision that overturned Roe v. Wade, but grassroots abortion funds still provide the bulk of this type of support to abortion seekers across the country.
Earlier this week, 19 such abortion funds signed an open letter in support of the union. “AI cannot replicate care from experienced staff and will become a barrier rather than an innovative tool,” the letter reads. “These calls are often the only interaction that is free from judgement, where fears can be expressed without risk, and the nuances of each caller's experience can be held in their full complexity. This is life-saving work that AI cannot be trusted to take over.”
This story was edited by Susan Rinkunas and copy edited and fact checked by Nandita Raghuram.
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