LEADERSHIP, ADVOCACY, AND POLICY

Advocacy is essential to keeping reproductive healthcare safe, legal, and accessible. Educational and advocacy organizations have created advanced curricula and structured electives to help programs integrate these opportunities into training (see Organizational Resources Table).

LEADERSHIP

Consider collaborating with faculty or reproductive health organizations to tap into other teaching, research, or advocacy projects during training. For example:

• Work with faculty to help lead didactic sessions for incoming trainees, such as values clarification or papaya workshops.
• Speak at a meeting of Medical Students for Choice or Nurses for Sexual and Reproductive Health. Consider mentoring other trainees.
• Work with faculty to expand reproductive health services in your clinics. Successful projects have included protocols for EC access, management of EPL in outpatient settings, and clinic integration of medication abortion.
• Collaborate on a research project, conference presentation, or article publication with guidance from faculty and community mentors.
• Consider participating in the Leadership Training Academy (PRH)
• Consider joining your local RHAP cluster or the national AAFP Reproductive Health Member Interest Group (MIG).
• Connect with Doctors for America, a multi-speciality organization focused on physician advocacy with webinars, an annual conference as well as the Copello Health Advocacy Fellowship.

ADVOCACY AND POLICY

Access to abortion care has been under increasing threat due to state and federal legislative restrictions, and religious mergers. Laws that increase disparities in abortion access have included public and private insurance prohibitions, required waiting periods, mandated counseling, and targeted regulation of abortion provider (TRAP) laws, and even outright bans. In spite of data suggesting that early abortion safety, efficacy and acceptability are equivalent between physicians and advanced practice clinicians (WHO 2022), states have varying policies or limitations on practice by by specialty. For example, at the time of this writing, over half of U.S. states prohibit APCs from performing any abortions, and one state (MS) only allows OBGYNs to perform abortions (Guttmacher 2022). Regulations like these are not applied to provision of comparable medical services, such as uterine aspiration for early pregnancy loss.

As a provider, your opinions and expertise are highly respected by both the public and legislators. You have the potential to influence policy and legislation on a local and national level. Providers can be effective and powerful advocates with their wealth of patient stories, medical knowledge, understanding of research, and experience advocating on behalf of patients (Earnest 2010). Patient stories can humanize patients and shift the way lawmakers think about the complexity of abortion care and access. Be sure to utilize ethical storytelling practices and obtain consent before sharing people’s private experiences. More resources on ethical stortytelling and working with abortion storytellers can be found at Planned Parenthood Advocacy Fund of Massachussets and WeTestify, an organization founded and led by abortion storytellers.

Examples include:

• Join your relevant professional organizations, both locally and nationally. Your dues help organizations lobby and advocate for you and your patients.
• Join a lobby day coordinated by a reproductive rights organization. Scheduling and talking points are usually provided by the organization. There are now many virtual lobby days in addition to in-person visits to legislators.
• Join a clinic or hospital committee on practice, training or quality to influence institutional policies.
• Write an op-ed about your experiences as a trainee or provider.
• Provide written or oral testimony when your state or municipality is considering policies to expand or restrict reproductive health services.
• Work within the state or national chapter of your professional organization to pass resolutions to influence policy.
• Join a curriculum advisory for your specialty or ACGME Residency Review Committee to ensure curricular inclusion of sexual and reproductive health.
• Advocate within your organization to develop and expand scope of practice
• Advocate for transparency in medical education regarding faith-based restrictions that may interfere with training.

Many organizations have chapters for trainees or early career clinicians, and provide funding for meeting attendance. For organizations that provide materials, support, and training for clinician advocates, see Organizational Resources Table below.