Addressing a Crisis in Abortion Access: A Case Study in Advocacy

Area of Science:

• Public Health
• Reproductive Health
• Healthcare Policy

Background:

• Nationwide abortion restrictions necessitate ongoing access to abortion care throughout pregnancy.
• Patients may seek abortions later due to financial, legal, or personal circumstances, including new fetal diagnoses.
• New York State's abortion laws faced challenges post-Roe v. Wade, with institutions hesitant to provide later abortions.

Purpose of the Study:

• To describe the expansion of abortion services at NYC Health + Hospitals following the Reproductive Health Act.
• To identify and address barriers to providing later abortion care within a large public health system.
• To establish a model for ensuring abortion access for vulnerable populations, including those needing later-term care.

Main Methods:

• Internal review of existing abortion care practices and patient pathways.
• Identification of barriers in public and internal communication, procedural skills, and referral systems.
• Implementation of improvements in communication, clinical skills training, and referral network enhancement.

Main Results:

• Increased visibility and accessibility of abortion services within NYC Health + Hospitals.
• Expanded system capacity and increased gestational age limit for abortion procedures.
• Successful translation of policy changes into expanded clinical practice.

Conclusions:

• NYC Health + Hospitals successfully expanded abortion care access, particularly for later-term procedures.
• The implemented strategies provide a replicable model for other healthcare systems facing similar challenges.
• Ensuring access to abortion care, especially for vulnerable populations, remains critical amidst ongoing threats to reproductive rights.