First Trimester Abortion Training in the US: A mixed methods analysis

Given that the number of clinicians in the U.S. who provide abortion services has been in decline, women who choose to terminate an unintended pregnancy may face issues in accessing abortion. To enhance our understanding of the issue preventing providers from entering the field, the Training and Access Work Group (TAWG), a coalition of national, state and local reproductive health, rights and justice organizations conducted research on abortion training.

Qualitative in-depth interviews were conducted with 20 clinicians to assess their pathway to becoming an abortion provider. In addition, surveys were conducted with 15 organizations involved in various aspects of abortion training to assess training opportunities within their organizations.

Four predominant 1st trimester abortion training models were identified. For each model the analysis identified strengths, weakness, geographic distribution and outcomes. Gaps persist across the models. For example, training is not available at all OB/GYN and family medicine residency programs and there is a scarcity of training opportunities available to NPs, CNMs, and PAs. The tracking of and support for trainees is limited after exiting training, despite recognition that many trainees are not well positioned to immediately provide. Trainee competency is difficult to achieve with some models that do not haveaccess to high-volume training opportunities.

The findings could be used to expand the number of abortion providers, address geographic gaps in access, expand access in underserved communities and increase the number of non-traditional providers.