Facilitating Abortion Services in Primary Care Settings After the Loss of Federal Protections.

Abstract

Abortion care access became more restricted following the 2022 US Supreme Court decision, Dobbs vs Jackson Women's Health, that eliminated federal protection. We sought to engage healthcare clinicians in states in the Northwestern U.S. with varied abortion regulations to develop strategies for primary care involvement in access to and follow up for abortion care. The "Won't Go Back" initiative began in July 2022, recruiting members from the five state WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice Based Research Network (WPRN), Family Medicine Residency Network (FMRN) and Washington state family planning clinics. We completed a cross-sectional needs assessment survey (winter 2022) and virtual convenings (summer 2023). We used descriptive statistics to describe participant demographics, reproductive health services offered, documented needs, and proposed solutions including abortion care education and referral networks. 193 surveys were sent to individual clinicians with 40 responses (21% response rate) from Washington, Idaho, Montana and Alaska. All participants' provided reproductive health services, and 25% offered abortion care. All clinicians wished to support their patients seeking abortion care. Barriers faced by convening attendees included obtaining mifepristone, federal funding restrictions and navigating anti-abortion views. Proposed solutions from survey and convening representatives included creation of a learning collaborative and regional networks of primary care abortion clinicians. Survey and convening representatives were interested in enhancing abortion access for their patients. Clinicians faced barriers due to federal and state legal restrictions. Creation of an abortion learning collaborative and referral networks addressing identified barriers can potentially support patients.