Study finds provider capacity to expand abortion, implications for access during COVID-19

Researchers at the University of Colorado Anschutz Medical Campus have found that interest in abortion care among advance practice clinicians (APCs) in Colorado is substantial, though barriers must be addressed in order to increase access with APCs (nurse practitioners, nurse midwives, physician's assistants).

The study, out today in Women's Health Issues, surveyed APCs in Colorado on their interest in and ability to provide abortion. Of the 512 participants, 45% say they are interested, or possibly interested in medication abortion training—the use of oral medications to end a pregnancy up to 10 weeks. Moreover, one-quarter are interested in, or possibly interested in, training for procedural abortions that occur in the clinic up to 12 weeks of pregnancy. "Both types of first-trimester abortions are 13 times safer than carrying a pregnancy to term and delivering, and 90% of abortions in Colorado occur in the first-trimester," said lead author and Associate Professor with University of Colorado College of Nursing Kate Coleman-Minahan, Ph.D.

Colorado is one of ten states and the District of Columbia that allows APCs to provide abortion care. Only 12% of respondents in the study indicated they knew that they can legally provide abortion services. "Our study included providers in all types of practice, including primary care, urgent/emergency care and specialty care, like orthopedics. Even though most were not aware they can provide, the fact that almost half have some interest in training to provide abortion shows Colorado has the provider capacity to expand abortion access," says Coleman-Minahan.

But training providers might not be enough. Few study participants believed their facility would allow them to provide. Administrative and regulatory barriers, such as the need to physically separate abortion provision from other services receiving certain federal funds, must be addressed.

Recently, state-level abortion ban attempts have picked up steam because of the COVID-19 pandemic. Eleven states are currently restricting or eliminating abortion care due to "non-essential care" designations and stay-at-home orders. Colorado is not one of those states, however. According to Coleman-Minahan, "Colorado has not restricted abortion access during this pandemic. However, training providers won't be helpful unless more facilities allow them to provide abortion care."