A South Jersey nurse practitioner is suing Planned Parenthood alleging race discrimination. Her case is one of many against the reproductive health giant.

A patient’s urine test landed on Michelle Fisher’s desk with a warm, wet splash.

Fisher, a Black nurse practitioner, remembers looking up from her lunch to see the white manager of Planned Parenthood’s Bellmawr clinic in Camden County.

The clinic manager often berated Fisher for asking questions the nurse practitioner thought were necessary to do her job — including this time, when she’d asked to see a urine test before authorizing birth control, she says in a federal discrimination lawsuit. Fisher claims that the supervisor frequently ended their terse exchanges by flicking a fisted hand at her, making a whip-cracking sound and ordering, “Now get back to work.”

Such interactions were emotionally draining, Fisher said in an interview, but she continued to show up, day after day, for almost three years because she wanted to provide for Black women and girls what she’d rarely had: a medical provider who looked like her.

When she was laid off in spring 2021 in what she believes was retaliation for filing multiple discrimination complaints to human resources, Fisher decided to do more.

In May 2022, Fisher sued Planned Parenthood of Northern, Central and Southern New Jersey for race discrimination and wrongful termination and was deposed in March of this year. The case is ongoing.

“What if this is someone else’s dream job and they look like me?” she said in an interview. “I want other people to be able to go in there and not be treated like that.”

Over the last five years, discrimination lawsuits have been filed by at least two dozen former and current employees of Planned Parenthood’s 49 affiliates, which employ thousands across the country and are a leading source of reproductive health care in almost every state, according to an Inquirer analysis of publicly available national case databases.

In court records and interviews, employees said they faced racist comments from coworkers and were held to a different standard than white colleagues. Many said supervisors were more critical of their work, while valuing their contributions less, compared with white coworkers.

“If we can’t count on Planned Parenthood to respect Black employees, how can we count on them to care for people of color as patients?”

In New York alone, a current chief operating officer for a Planned Parenthood affiliate claims he was subjected to an unusually personal background check that delved into his religion. An administrative staffer says she was labeled “angry,” a racist stereotype of Black women, when she complained of being given more work than her white peers. A Jewish marketing director claims she was told the employee resource group she wanted to create should focus on teaching Orthodox Jewish women about contraception because they’re “birthing factories.”

In every discrimination case The Inquirer reviewed, employees said they sensed that reporting issues had enlarged the targets on their backs. All but one said they believed that they were terminated in retaliation for complaining, court records show.

For every former employee who has sued, many more likely have experienced discrimination but stayed quiet for fear that it will affect their ability to find new employment, lawyers representing workers told The Inquirer. The number and geographic spread of the cases suggest a systemic problem, according to a University of Pennsylvania expert in diversity in health-care workplaces.

Planned Parenthood Federation of America, the national umbrella organization, has publicly confronted its racist past in recent years. Its CEO in 2021 denounced Planned Parenthood founder Margaret Sanger, who had white supremacist ties, and vowed that the national organization and its affiliates would root out racism. In a statement to The Inquirer, the national organization said that its affiliates operate independently, but that employees are “at the core of who we are, and we must stand with them when they speak out about failures to uphold our mission and values.”

The New Jersey affiliate Fisher worked for declined to comment on ongoing litigation but in court records denied Fisher’s claims of discrimination.

“We take any allegation of racism or misconduct extremely seriously and expect everyone at Planned Parenthood to take immediate steps when concerns are raised,” Cory Neering, CEO of Planned Parenthood of Northern, Central and Southern New Jersey, said in a statement.

Yet employees say the organization isn’t responding with the urgency needed at a critical moment in history. Planned Parenthood’s work as the largest abortion provider in the country and a leading source of reproductive health has come under intense focus since last summer, when the U.S. Supreme Court ruled that states should decide whether and when someone can terminate a pregnancy.

In some places, Planned Parenthood is the only abortion provider for hundreds of miles, and elsewhere, vulnerable communities rely on the organization for basic health care.

“If we can’t count on Planned Parenthood to respect Black employees, how can we count on them to care for people of color as patients?” said Valerie Shore, Fisher’s Cherry Hill-based lawyer.

Planned Parenthood’s employees of color have been raising concerns about racial and ethnic discrimination for years.

An Inquirer analysis of court cases filed in federal courts since 2017 found repeated complaints of discrimination against employees at Planned Parenthood affiliates.

The cases detail how inappropriate behavior, racist tropes, microaggressions, and unequal expectations went unchecked, even after employees complained. A few examples:

Thirteen of 24 cases reviewed by The Inquirer alleged discrimination on the basis of race. In three cases, Planned Parenthood reached a settlement with its former employees. Four cases were dismissed; six are ongoing. The 11 other cases alleged age, gender, or disability discrimination.

Numerous complaints that spur legal action suggest the organization isn’t doing enough to train employees on racism and bias when they are hired, said Eve J. Higginbotham, the vice dean for inclusion and diversity at University of Pennsylvania Perelman School of Medicine.

“If I’m at the executive leadership level of an organization like Planned Parenthood, I would certainly look at the processes we have in place if I got even one complaint like that,” she said. “Having several suggests there is a systemic issue.”

Her research has found that Black, Hispanic, and female employees were more likely than white men to experience unprofessional behavior from coworkers, while their own professionalism was more closely scrutinized.

“People are expecting there to be some direct racial comment, someone being called a name,” said Shore, the lawyer representing Fisher in New Jersey. “What it really is is the Black employees are being treated one way, the white employees are treated another.”

Fisher, who has worked as a nurse practitioner for 16 years, alleges that she was harassed and intimidated for asking questions about medical protocol and patient cases, while her own medical expertise was discounted. When she complained, she was called a “pain in the ass,” according to court records.

She was routinely assigned to clinics farther from her South Jersey home and required to work more hours, while white nurses with less experience were given preferential schedules, she alleges in her lawsuit.

“I kept sitting there saying, ‘Maybe it’s me,’” Fisher said, shaking her head. “It’s not me.”

After hearing of other Black nurses who had made similar allegations, she became convinced that the institution itself had a problem.

Alysa Jeffers, a Black nurse practitioner who worked for the same New Jersey affiliate but is not involved in Fisher’s case, says she was also asked to travel more often than her white colleagues to far-away clinics for less desirable shifts. When she refused a last-minute reassignment an hour away, she was put on leave and then fired, she said in an interview.

Jeffers thought it was unfair, but had never complained because she was young and early in her career, she said. She didn’t file a legal complaint.

“I just felt like my little voice wasn’t going to make a difference,” Jeffers said. Fisher’s lawsuit made her feel empowered to speak out, more than two years later, she said.

» READ MORE: Many abortion providers say they chose their specialty out of fear that if they didn’t, patients would go without care.

Planned Parenthood Foundation of America was founded in 1916 by Margaret Sanger, an early advocate for contraception who believed in eugenics, a practice of involuntarily sterilizing people who were deemed unfit to be parents because of physical or mental health disabilities. More than a century later, an internal survey of the national organization’s current and former employees in 2020 found that racism and discrimination persist.

Employees of color who responded to the survey said their performance was more closely scrutinized than that of their white colleagues. They reported being treated as if they couldn’t work independently and were repeatedly passed over for promotions that instead went to white colleagues, BuzzFeed News reported after obtaining a recording of a presentation of the survey findings to staff.

Management knew that employees of color were less engaged in their work, more stressed, and had lower retention rates, according to an employee discrimination lawsuit in New York that quoted an all-staff email from Planned Parenthood Federation CEO Alexis McGill Johnson.

The employee, Nicole Moore, a former director of multicultural brand engagement for Planned Parenthood Federation of America, is suing for discrimination and wrongful termination, and her case is ongoing.

“It was the most public secret,” Moore said in an interview.

McGill Johnson publicly denounced Sanger in a 2021 New York Times op-ed, writing that the founder’s legacy had caused harm to generations and vowed to expunge systemic racism within the organization.

“By privileging whiteness, we’ve contributed to America harming Black women and other women of color,” McGill Johnson wrote. “We are committed to confronting any white supremacy in our own organization, and across the movement for reproductive freedom.”

She said Planned Parenthood would invest in anti-racism training for everyone “from the boardroom to the exam room,” and establish new diversity, equity, and inclusion standards for affiliates.

This extended to the New Jersey clinic where Fisher worked from 2018 to 2021.

In 2022, Planned Parenthood of Northern, Central and Southern New Jersey named a director of diversity, inclusion, equity and belonging, whose job is to “hold us accountable every day,” Neering said in a statement to The Inquirer.

Even as Planned Parenthood confronted its racist past, something still felt broken, said Anna Flores, a Latina community organizer, who is suing a Tennessee affiliate.

When Flores began work in 2021 as part of a team tasked with strengthening Planned Parenthood’s community relationships, she was encouraged by the national organization’s openness about equity problems.

But she was disappointed by the reaction from management when she questioned the organization’s approach to diversifying its board of directors by tapping an immigration group that didn’t support abortion rights. When her team hired a Spanish-speaking employee, Flores was expected — not asked — to translate, a task that became burdensome on top of her own work, she claims in her lawsuit.

She broke down in tears when, in front of colleagues at a team retreat, her supervisor accused her of being hostile and having a “snarky look” on her face, she alleges in the lawsuit.

“People have been commenting on my face — not just my expressions but the way it looks — since I was a child,” said Flores. “In that moment, I knew I was never going to be taken seriously.”

In a lawsuit filed earlier this year, the current chief operating officer at Planned Parenthood of Greater New York, a Black man who is an ordained pastor, alleges that the organization made his religion an issue during his hiring process. Since taking the job, Samuel Ricarlos Mitchell Jr. has been repeatedly mocked by coworkers for his race, religion and gender, all in an effort to “minimize his authority as a Black man in a leadership role,” his lawyer said in an interview.

In New Jersey, Fisher said she believes racism played a role in her termination from Planned Parenthood. During her three years at the organization, she’d filed multiple formal complaints of discrimination, but believed that they were ignored and made supervisors dislike her more, she said.

On a call regarding one of her complaints, the head of human resources “yelled at me and told me I should shut up and just listen,” Fisher said.

Fisher was put on leave in May 2021, days after an incident in which a patient began screaming at Fisher for questioning the necessity of a Pap smear test she had requested because the patient wasn’t due for one. A supervisor later berated Fisher for disagreeing with the patient, she alleges in her lawsuit.

She was fired a month later.

In its reply to Fisher’s lawsuit, Planned Parenthood denies reprimanding her for the way she handled the patient’s test, and says she was put on leave for “discussing a patient’s medication condition with various employees,” then terminated due to her performance.

Fisher said she never talked about patients inappropriately and never received a warning about her performance.

The experience has galvanized Fisher’s resolve to promote diversity in health care. Research shows patients are more trusting of medical providers who look like them, feel better able to communicate and are more likely to follow prescribed treatment. Yet just under 10% of nurse practitioners are Black, according to the U.S. Department of Labor’s Bureau of Labor Statistics.

» READ MORE: How do we improve diversity in medicine? Black female physician-leaders answer

After Planned Parenthood, Fisher routinely took on temp jobs and had several interviews for permanent positions. But she thinks prospective employers were turned off when they eventually learned about her lawsuit and why she left her last position.

Almost two years later, she has finally landed another full-time job in health care.