Abortion restrictions result in increased geographic and cost-related barriers to abortion care, and higher odds of remaining pregnant with an undesired pregnancy, further perpetuating health inequities. Novel models of community-based abortion care delivery are urgently needed. Guidelines support medication abortion provision by advance practice clinicians (APCs) including nurse practitioners (NPs), certified nurse midwives (CNMs) and physician assistants (PAs). While it is widely accepted that APCs are capable and qualified to provide abortion care services, most of the existing data in the peer-reviewed literature focuses on the safety and effectiveness of APCs providing procedural abortion rather than medication abortion. The primary objective of this study is to assess the effectiveness and safety of provision of medication abortion by APCs for people seeking abortion care.

This is a retrospective analysis of electronic health records from Planned Parenthood of the Pacific Southwest (PPPSW) from December 2021 – December 2023. The study aims are to evaluate the effects of provision of medication abortion by APCs on: (i) effectiveness (the proportion of participants who experience a complete abortion without the need for repeat misoprostol or a follow-up procedure) and (ii) safety (unscheduled abortion related visits and adverse outcomes). Study findings will provide data that may be used to support needed national and state-level policy authorizing APCs to provide abortion care. In addition, this data will be well positioned to produce evidence that can be cited to a court to fight ongoing attacks on medication abortion provision by APCs.