Many advanced practice clinicians are interested in abortion training

Published April 21, 2020

Abortion provision in Colorado by advanced practice clinicians—nurse practitioners, certified nurse midwives and physician assistants—is legal. Although many APCs are interested in abortion training, two-thirds believe their clinical facility is not likely to allow them to provide abortions.

Key Findings

Colorado does not have a law restricting abortion provision to physicians, potentially expanding access to patients throughout the region.
However, only 12% of Colorado APCs surveyed by researchers were aware they could legally provide abortion, and only 6% reported currently providing it.
30% of the sample said they were interested in training to provide medication abortion. Half as many were interested in aspiration abortion training.
Those who were not interested cited abortion being out of their specialty practice scope—such as orthopedics—and religious or personal objections.
The majority of participants interested in abortion training perceived that their clinical facility would not allow them to provide abortion care. Due to restrictions around abortion care, facilities may need to make substantial and costly changes.
Certified nurse midwives and women’s health nurse practitioners were more likely to know they could legally provide abortion and were more likely to express interest in abortion training.

Study Design

Researchers mailed letters explaining the study purpose and containing a secure individual link to a survey to 2,290 APCs in Colorado, having oversampled certified nurse midwives and women’s health nurse practitioners. Data were collected between June 2018 and June 2019, and a total of 512 participants completed the survey.

“Abortion training interest does not guarantee the ability to provide abortion, and participants reported a number of facility barriers that must be addressed to increase access to abortion services with APCs.”

Implications

As states continue to restrict or eliminate access to abortion, there may be a greater need for providers to ensure abortion is accessible in states where it remains legal. In rural areas, where there are no specialized family planning clinicians and where primary care may be difficult to access, abortion provision by urgent/emergent care clinicians in particular may be a promising area of exploration. The next step to expanding access to abortion care with APCs is to identify and decrease facility-level barriers to abortion provision and design evidence-based training programs for APCs.

This study, Interest in Medication and Aspiration Abortion Training among Colorado Nurse Practitioners, Nurse Midwives, and Physician Assistants, is available in Women's Health Issues.

Areas of Research