Lifesaving abortion options that don’t put physicians at legal risk

By Kristen Fuller, MD | Fact-checked by Jessica Wrubel
Published September 13, 2022

Key Takeaways

  • Abortions, whether banned or allowed, will happen; the difference will be the number of safe vs unsafe abortions, according to research.

  • Although abortion is illegal in some states, there are still ways physicians can provide the best care for pregnant patients without risking their medical license.

  • Out-of-state abortions, training mid-level healthcare professionals (HCPs) in abortion-friendly states, and providing abortion pills online through informational websites and online pharmacies are legal ways to protect access to safe abortions.

The overturning of Roe v Wade places physicians in some states in a tough situation: Do what's best for patients or risk losing your medical license.

Abortion is now illegal in multiple states unless the patient faces "a life-threatening physical condition aggravated by, caused by, or arising from a pregnancy."[] But there are still safe ways physicians can provide the best care to pregnant patients without putting themselves at legal risk.[]

The consequences of not providing care

It’s nearly impossible to flip through a medical journal or scroll through social media without hearing about this ruling and how it’s affected physicians and patients in nearly every state—including those where safe abortions are allowed.

Banned or allowed, abortions will happen.

With an increase in bans, there will be more unsafe abortions and preventable maternal morbidity and mortality, according to research. Pregnant patients who want an abortion are now at risk of financial burdens due to out-of-state travel and time off work. Many patients may engage in unsafe abortions, potentially risking their lives.

States that have restricted or banned abortion may see fewer abortions. However, other states where abortions are still accessible may compensate, possibly resulting in the same number of abortions overall while exhausting HCPs in those states.

Research shows that banning abortion does not reduce the number of abortions occurring annually; rather, doing so results in a greater number of unsafe abortions performed.[] Additional research indicated that 25% of American women are expected to get an abortion during their lifetime, and nearly 630,000 abortions were documented in the US in 2019.

Planned Parenthood reported a nearly 800% increase in Texans seeking abortion care in surrounding states during the short life of the Texas Heartbeat Act, which banned abortion after the detection of fetal cardiac activity.

Providing care without risking your license

There’s a fine line between caring for a patient seeking an abortion and breaking the law in a trigger state.

Providing care in these states doesn’t necessarily mean breaking the law by performing an abortion. It can mean providing emotional support to patients and providing them with the many resources available to help them obtain the care they need.

These options include seeking abortions in other states, as well as obtaining abortion pills before pregnancy occurs.

Out-of-state abortions

If a patient has the means (transportation, money, time off work, etc.), an abortion in a state where abortions are legal is the best option—but these states are bracing for a likely flood of patients traveling from trigger states to get an abortion.

Clinics and HCPs in these states are therefore stretched thin. Waiting times can be so far out that patients may miss the window for second-trimester abortions. So some states are working to change their laws to allow mid-level HCPs, such as nurses and midwives, to provide abortions.

Some believe that allowing non-physicians to handle simple, very early abortions that involve prescribing a pill could free up more physicians to handle complicated procedures that usually occur late in pregnancy or complications from recent abortions.

Laws have been enacted in Connecticut, Maryland, Washington, and Delaware to allow non-physician clinicians to perform certain uncomplicated, early-term abortions.[] In addition, lawmakers in California are considering a bill that would update a 2013 law that allows nurse practitioners to perform abortions without the supervision of a doctor, as currently required.[]

Abortion pills before pregnancy

For many pregnant individuals who cannot afford to travel out of state, at-home abortions may be an alternative option.

Plan C is a website that provides resources to pregnant individuals, but doesn’t give medical or legal advice or provide abortion pills. Instead, the site partners with the following organizations that can direct pregnant individuals to the help they need.

It’s possible to obtain abortion pills if an individual isn’t pregnant to keep on hand in case their period is late.

They can then take the pills immediately. Some services listed in The Plan C Guide to Abortion Pill Access allow individuals to order pills in advance.

Aid Access offers this "advance provision" in all states. The site will also help with instructions and follow-up support. And Plan C allows patients to access resources specific to their state—even in those that have banned abortions.[]

What this means for you

Physicians should not have to decide between providing safe abortions or risking the loss of their license. Research shows that patients will still obtain abortions regardless of the law; the only difference is they may be risking their health and life to do so. There are resources you can provide to your colleagues and patients to help them obtain a safe abortion without going against state laws.

Read Next: How Roe v Wade reversal could affect training in abortion and reproductive health

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