WASHINGTON, DC (April 22, 2020)—As a growing number of states enact restrictions that make it increasingly difficult to obtain abortions, states with fewer restrictions may see a growing demand for abortion care and need to increase the number of providers who offer it. A survey of advanced practice clinicians (APCs) in Colorado, which does not limit abortion provision to physicians, found that 45% were interested or possibly interested in training to provide medication abortion, and 26% were interested or possibly interested in training to perform aspiration abortion. These are among the findings of a new study published today in Women’s Health Issues.
Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based at the Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.
Kate Coleman-Minahan, of the University of Colorado College of Nursing, and colleagues surveyed 512 APCs—nurse practitioners (NPs), certified nurse midwives (CNMs), and physician assistants (PAs)—about their attitudes towards and interest in training to provide abortions. They found that only 12 percent of the complete weighted sample were aware that APCs could provide abortions, but 36 percent of those who were CNMs or women’s health nurse practitioners (WHNP) knew they could do so.
Interest in training to provide medication and aspiration abortion was also higher among CNMs/WHNPs: 52 percent of CNMS/WHNPs were interested and 19 percent possibly interested in training to provide medication abortion (34 and 13 percent for aspiration abortion), compared to the total sample, where 29 percent were interested and 16 percent possibly interested in medication abortion (15 and 11 percent for aspiration abortion).
Among respondents who expressed an interest or possible interest in providing medication abortion but not aspiration abortion, the authors found that nearly half (48 percent) cited clinical facility barriers as a reason. APCs also mentioned legal, scope of practice, or malpractice concerns, Coleman-Minahan and colleagues report. “Greater APC interest in medication abortion than aspiration abortion training and fewer reported facility barriers for medication abortion suggest expansion of medication abortion is more feasible than aspiration abortion,” they write. “Facility barriers must be addressed to expand abortion services with APCs.”
“Access to abortion care has become even more challenging during the COVID-19 pandemic,” said Amita Vyas, Editor-in-Chief of Women's Health Issues and Associate Professor of Prevention and Community Health at Milken Institute SPH. “This study shows a pathway to expanding abortion access in a time when we desperately need such access expansion.”
“Interest in Medication and Aspiration Abortion Training among Colorado Nurse Practitioners, Nurse Midwives, and Physician Assistants” has been published online as an article in press and will appear in the May/June issue of Women’s Health Issues.