1. ABORTION IN PERSPECTIVE

^{Updated 2025 by Amy Alspaugh CNM, MSN, PhD, Cathy Obando NP-C, MSN, & Jillian MacLeod JD}

The Supreme Court of the United States (SCOTUS) gutting of nearly 50 years of federal reproductive protections and the subsequent devolution of the reproductive health care and training landscape has caused devastating health consequences for people with reproductive potential. More than ever, we are committed to training, supporting, and mobilizing all primary care clinicians to help ensure equitable access to sexual and reproductive health care, including abortion, for all.

Primary care clinicians globally serve an important role in the provision of reproductive health services as they practice in diverse, rural, and underserved areas (Graham Center 2005), receive procedural training, and care for people throughout their reproductive years. While this text is U.S.-focused, we continue to expand global perspectives for a growing global audience.

This curriculum can help you be a better primary care provider for people with reproductive potential. There are many skills to gain including options counseling, pregnancy dating, timely referrals, miscarriage management, and abortion care. It is beneficial to read Chapters 1 and 2 before beginning your clinical experience to explore your personal values about pregnancy outcomes, how they may differ from a patient’s values, and to consider professional judgments you may be asked to make.

Chapter Learning Objectives

Following completion of this chapter, you should be able to:

• Explore your personal values and feelings about pregnancy options

• Clarify your individual training goals and strategies to achieve these goals

• Describe constraints on reproductive care and access globally

• Be familiar with data on abortion safety and access factors that promote or limit safety

• Understand the influence of abortion-related stigma on patients and providers

• Understand professional ethics within a justice-based & public health framework

Videos

• Overview of abortion in the international context (IERH)
• Global Perspectives: video interviews with U.S. and international experts
• SisterSong/RHEDI-Reproductive Justice 101 Webinar

Resources

• Advancing Equity & Justice in SRH (Structures & Self Series; IERH)
• Pregnancy Options (NAF)
• State and Global Policy Updates
  • States Laws and Policies (Guttmacher 2025a)
  • International Laws and Policies (Guttmacher 2025b)
• Reproductive Justice Resources (Sistersong)
• When Abortion is Not Available (IERH)
• Holistic Abortions