Since medication abortion is most effective early in pregnancy, women will need to know as soon as possible when they are pregnant, understand where to get the medication, what to expect from the process and how to know it has worked. Providers can play an important role by providing this care before and after medication abortions, especially in cases where the medication would not be available legally . Such an approach is considered a “harm-reduction” model and has been shown to decrease maternal mortality outside of the United States. Additionally, many women will be too far along for a medication abortion or might prefer a non-medication abortion. And some women, because of lack of access to safe abortion methods, may become desperate and seek unsafe options, and will need post-procedure care.

For these women, we need clinicians trained and ready. We will need clinicians skilled in providing abortions in border areas to serve women who are forced to travel across state lines. We will need providers who are trained in more complex second-trimester abortions, because travel and other hurdles will cause delays in care. We will need clinicians of all specialties to treat the inevitable complications that will come when women without options seek unsafe methods of ending their pregnancies. We will need clinicians in all states to employ the harm-reduction model and be a resource for women to seek help in managing their own abortions without fear of criminalization. Current and future medical and nursing students should commit to not just learning these skills themselves but also pushing for this training within their institutions so that all graduates will be prepared to address the many situations in which a woman may need abortion care.

States with legislatures that support reproductive health can step up to clear hurdles to increasing the number of trained abortion providers. Here in California, we showed that certified nurse-midwives, nurse practitioners and physician assistants can safely provide first-trimester abortions. The state legislature responded by passing the Early Access to Abortion bill that allowed these advanced-practice clinicians to offer abortion services. Forty-one states still have “physician only” requirements. Nurses are making headway challenging this unnecessary requirement in court in Montana and Maine. Following California’s lead could significantly improve availability of abortion care across the country.

Everyone can play a part in making it easier for people to serve their communities as abortion providers. Support organizations like Medical Students for Choice that work to ensure abortion training. Contribute to local funds that provide financial assistance to women needing abortion, including support for travel to other states when necessary. Call your state legislators and tell them to eliminate obstacles that block trained clinicians from providing care and patients from getting it. Volunteer and support your local clinics to become part of the community that helps abortion providers overcome the obstacles that politicians and protesters throw their way.

Our country needs to act now to have providers ready for the challenges ahead. Advances in medication abortion are vital and important, but not enough. In the darkest times for abortion access in this country in decades, women still need providers capable of providing quality, compassionate care that both protects their health and honors their autonomy. As we confront the uncertain future of Roe and fight to preserve it, we must train, inspire and come together to support the next generation of clinicians to carry out this mission.

Dr. Jody Steinauer is an obstetrician-gynecologist, the director of the Bixby Center for Global Reproductive Health at the University of California, San Francisco, and the founder of Medical Students for Choice, a nonprofit that advocates abortion training in medical school curriculums.

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