Collaborative pathways: Optimizing later abortion care between independent, affiliated, and hospital-based sites
Awarded 2023
Later abortion service delivery, post-Dobbs
Abigail Liberty, MD, MSPH
Oregon Health and Science University

Most abortion care occurs through 2 pathways: independent clinics and Planned Parenthood affiliates. A minority of care occurs in hospital systems, most often academic centers. Recently, these 3 pathways have been portrayed as having fraught and competitive relationships, particularly in light of differing approaches to abortion restrictions post-Dobbs (1-3). All 3 pathways exist in Portland, Oregon: the independent Lilith Clinic which offers care through 22 weeks gestation, Planned Parenthood Columbia Willamette (PPCW) which offers care through 20 weeks gestation and Oregon Health & Science University (OHSU) which offers care through 34 weeks. These sites have historically operated as independent silos. As each site experienced increased demand for later abortion care following Dobbs, the sites adapted clinical care, from intake of referrals to cervical prep options to post-abortion care. The purpose of this grant is twofold: to describe how these sites evolved to serve distinct populations between 2021 and 2024 through generations of an innovative database across care sites and to identify ways in which the sites collaborated to manage the increased complexity of later abortion care.