New York State laws have historically been supportive of abortion, and permitted its provision since 1970. The state’s Reproductive Health Act of 2019 allows abortion for any reason as long as the pregnancy has existed for less than 24 weeks and later ‘when necessary to protect a patient’s life or health.’ Even with these supports in place, later abortion care can still be difficult to access. We propose a study of facilities in New York City that offer abortions beyond 13 weeks requiring at least a two-day procedure. We will characterize how the demand for later abortion has changed and efforts to meet these needs by:

(1) Detailing changes in care pathways, policy changes, referral patterns;
(2) Describing later abortion volume and characteristics of individuals receiving it; and
(3) Elucidating facilitators and barriers with service delivery and change implementation.

This is a cross-institutional collaboration among clinical leaders in New York City. Our team consists of leaders from one of its largest freestanding clinics (Dr. Gabriela Aguilar); teaching hospitals with well-established training programs for residents and Complex Family Planning fellows (Drs. Jessica Atrio, Monica Dragoman, and Erika Levi), and its vast network of safety net hospitals (Drs. Marisa Nádas and Siripanth Nippita). Challenges exist even where abortion provision is legally supported. We will explore how later abortion provision has changed in our city, and share this knowledge with fellow clinicians, policymakers, and health care leaders — however different our respective legal settings may be.