Abortion Access Is A Public Health Issue

Since 1967, the American Public Health Association (APHA) has acknowledged access to abortion services is a public health issue [1].

Abortion Care Is A Human Right

add material to this section

Abortion Care Provided by Advanced Practice Nurses and Physicians Assistants

In 2011, Approved APHA Policy Statements included Provisions of Abortion Care by Advance Practice Nurses and Physician Assistants [1]. The APHA Policy statement [1] cites the relatively lower number of abortion care providers, laws mandating "only licensed physicians" are legally allowed to provide abortion care (originally intended as a safety measure, however which now fails to recognize the expertise and ability of NPs [nurse practitioners] , PAs [physician assistants], and CNMs [certified nurse midwives] to provide comprehensive reproductive health care services), and laws restricting abortion care being provided according to gestation [2].

NPs, PAs and CNMs are primary care providers whose patients include individuals with the ability to become pregnant and could be providing comprehensive reproductive health services, including pregnancy option counseling, medication abortions, aspiration abortions, post-abortion follow-up care and other aspects of comprehensive reproductive health care. As primary care providers, NPs, PAs, and CNMs are more likely to provide care to disadvantaged and underserved populations which are the populations who are presenting with an increasing need for abortion care [2]. In recognition of NPs, PAs and CNMs as valuable assets to public health by providing necessary care to populations most in need, these qualified clinicians are able to integrate pregnancy options counseling and abortion care into primary care settings [4]. Allowing NPs, PAs, and CNMs to provide abortion care would increase access to abortion care and prevent delays in seeking abortion care, decreasing the health risks associated with abortion care at later gestation.

To ensure the health of our communities, increased access to abortion care by inclusion of NPs, PAs and CNMs in provision of abortion care is an imperative. Legislation limiting abortion care to physicians unnecessarily restricts access to abortion care and fails to recognize the education and ability of NPs, PAs and CNMs to provide safe and knowledgeable care. Medically accurate education and clinical training in abortion care need to be provided to NPs, PAs, and CNMs to make improved access to abortion care a reality. NPs, PAs, and CNMs have been found to be proficient in safely providing all components of medication abortions and aspiration abortion care with comparable risk as physician-provided aspiration abortions [2, 5].

Defunding of social services contributing to increased need for expansion of access to abortion services

add material to this section

At and After 20 Week Abortion Care: Research and Policies

An article by Diana Greene Foster and Katrina Kimport published in 2013 [3] sought to shed light on the reasons and demographics of women who seek abortion care at and after 20 weeks. The authors concluded:

"Women aged 20–24 were more likely than those aged 25–34 to have a later abortion (odds ratio, 2.7), and women who discovered their pregnancy before eight weeks’ gestation were less likely than others to do so (0.1). Later abortion recipients experienced logistical delays (e.g., difficulty finding a provider and raising funds for the procedure and travel costs), which compounded other delays in receiving care. Most women seeking later abortion fit at least one of five profiles: They were raising children alone, were depressed or using illicit substances, were in conflict with a male partner or experiencing domestic violence, had trouble deciding and then had access problems, or were young and nulliparous [an individual who identifies as a woman who has never given birth before]."

A woman's decision to seek abortion care should be respected regardless of her reason. No one reason should be considered more legitimate or "understandable" than another. Women should be trusted to make the right decision for themselves and for their families.

1. American Public Health Association. APHA Policy Statement 200314: Support for Sexual and Reproductive Health and Rights in the United States and Abroad. 2003
2. American Public Health Association. APHA Policy Statement 20112: Provision of Abortion Care by Advanced Practice Nurses and Physician Assistants. 2011
3. Diana Greene Foster and Katrina Kimport. "Who Seeks Abortions at or After 20 Weeks?." Perspectives on sexual and reproductive health 45.4 (2013): 210-218.
4. Susan Yanow. "It Is Time to Integrate Abortion Into Primary Care." American Journal of Public Health 103.1 (January 2013): 14-16. doi: 10.2105/AJPH.2012.301119
5. Tracy A. Weitz, Diana Taylor, Sheila Desai, Ushma D. Upadhyay, Jeff Waldman, Molly F. Battistelli, and Eleanor A. Drey. "Safety of Aspiration Abortion Performed by Nurse Practitioners, Certified Nurse Midwives, and Physician Assistants Under a California Legal Waiver." American Journal of Public Health 103.3 (March 2013): 454-461. doi: 10.2105/AJPH.2012.301159
Unless otherwise stated, the content of this page is licensed under Creative Commons Attribution-ShareAlike 3.0 License