The Primary Care Initiative (PCI) seeks to inform policy changes that allow a broad range of clinicians to provide first-trimester aspiration abortion as a component of primary health care. The Initiative activities focus specifically on certified nurse-midwives, nurse practitioners and physician assistants as providers of abortion care.
The long-term goal of the Initiative is to integrate early abortion provision within women’s primary health care. The Primary Care Initiative includes a variety of multidisciplinary projects focused on health workforce development, including:
- The HWPP Project—a training and evaluation project for certified nurse-midwives, nurse practitioners and physician assistants in early aspiration abortion
- The APC Toolkit—Providing Abortion Care: A Professional Toolkit for Nurse-Midwives, Nurse Practitioners, and Physician Assistants—is a professional guide for clinicians who would like to provide abortion care, and for the advocates who support them
- APCs: Advancing Access to Abortion—development of materials examining some of the myriad legal, clinical and educational issues that affect and frame the provision of abortion by advanced practice clinicians
- The development of standards of care and clinical competencies to ensure adequate training requirements for primary care clinicians as abortion providers
- Analysis of the state laws and regulations that govern abortion provision and the health professions
The Early Abortion Project sought to increase access to early abortion services by addressing barriers that prevent providers from offering abortion services. Project efforts focused on four areas:
- Consensus building, dissemination of information, and promotion of evidence-based abortion practice
- Economic analysis and health care systems improvement
- Physician and advanced practice clinical training
- Research to improve and expand abortion services
A consensus monograph, which describes options for management of the termination of early pregnancy, was distributed to over 40,000 health care providers (Early Medical Abortion: Issues for Practice; also available in Spanish). ANSIRH’s Early Abortion Training Workbook was also made available online. Studies of the economics of abortion provision included an analysis of the cost to providers of offering medication abortion services and a study of out-of-pocket costs to women undergoing a medication abortion. A model insurance coverage policy and a detailed analysis of malpractice coverage of medication abortion were also produced as components of this project.