Who Are Abortion Providers?
Trained doctors and other health professionals provide abortions. Providers can have backgrounds in obstetrics, gynecology, family medicine, internal medicine or other fields. In Illinois, advance practice clinicians (including physician assistants and advanced practice nurses) are allowed to provide medication abortion.1 Doctors and health professionals who provide abortions may offer a range of health services in their practice or specialize in abortion provision. Providers choose to perform abortions for many reasons. However, every abortion-seeking patient should expect care without judgment.
With the advancement of technology and the introduction of medication abortion, first trimester abortion care could become more available in the primary care setting. One study found that 69% of the Chicago respondents would theoretically choose to receive abortion care at their primary care clinic, with the most commonly cited reasons being greater comfort and the clinic’s knowledge of the patient's medical history. The main reason these respondents would prefer care at an abortion clinic is the possibility of more privacy and anonymity.2 A related study found that 67% of patients at a university-based clinic in Chicago indicated a preference for abortion services from their regular health care provider.3
Abortion providers can be found in free-standing facilities where abortion care is the primary service, family planning clinics like Planned Parenthood, private and public hospital clinics (like the University of Chicago's Ryan Center), and private physician practices. Different settings offer different services and benefits. The best place for a person to seek care will depend on a number of factors including preference for clinic setting, gestational age, insurance options and out of pocket costs, hours of the clinic or office, and logistical concerns such as transportation options and child care needs.
The National Abortion Federation (NAF) is the professional association of abortion providers in North America. NAF sets quality standards for abortion care through evidence-based Clinical Policy Guidelines (CPGs), which were first issued in 1996 and are revised annually. Providers can apply to become Provider Members of NAF. Prior to acceptance and regularly thereafter, NAF's Clinical Services Department conducts Quality Assurance and Improvement (QAI) visits. NAF’s Provider Members adhere to the Clinical Policy Guidelines.
Health and social service providers may benefit from keeping a list of providers available for referring patients. Research has shown that individuals seeking information about abortion from facilities that do not provide them often do not receive referrals even after prompting a staff member to give one.4
Navigating Crisis Pregnancy Centers
“Crisis pregnancy centers” (CPCs) can impact the experience of seeking abortion care. CPCs offer free pregnancy tests, pregnancy and health care information, and sometimes ultrasound imaging; however, they generally do not provide licensed medical care, abortion services, referrals to abortion services, or a full range of contraceptive options.5 They sometimes look like medical clinics or have similar names, but are often established by individuals who oppose abortion. A number of CPCs exist in Illinois and the confusion they can cause by their presence and practice can lead to delays in care for an individual who wants to consider abortion. A 2006 study commissioned by Representative Henry Waxman on federally-funded CPCs found that 87% provided false or misleading information about the health effects of abortion and grossly misrepresented the medical risks of abortion, “telling the callers that having an abortion could increase the risk of breast cancer, result in sterility, and lead to suicide and ‘post-abortion stress disorder’.”6
Navigating Religiously-Affiliated Hospitals & Clinics
Health care professionals can refuse to provide care related to abortion, though health providers still have some duties to provide emergency medical care. The Illinois Health Care Right of Conscience Act states that health professionals and organizations cannot be discriminated against, coerced or punished civilly or criminally if they choose not to offer a health or medical service because of their conscientious convictions.7
At the same time, religiously-affiliated hospitals and clinics can place restrictions on providers, both those educated and employed by the institution. For instance, when following religious directives, Catholic hospitals cannot provide abortion services or counseling, and sometimes cannot even provide referrals. According to a report by MergerWatch and the ACLU, depending on the local bishop, Catholic hospital guidelines can also restrict the provision of emergency contraception for rape victims and reproductive health emergency treatment, such as ectopic pregnancy and miscarriages.8
Health and social service providers counseling individuals seeking abortion and other reproductive health services may want to research clinics and hospitals in their region to better understand which institutions and providers may refuse to provide care.