Strategies to Protect, Defend, and Expand Access to Care
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Advocates have been working to improve access to abortion care since Roe v. Wade was first passed in 1973, and have not stopped despite the hostile political landscape. There are several actions you can take in your state to expand and protect access abortion care. Even if your state is already seemingly protective of abortion care, it likely still has room to truly become an abortion care safe haven.
TLDR: Why we need new and proven strategies
Non-legislative strategies to protect, defend, and expand access:
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Healthcare institutions may limit abortion care more than state law to protect themselves from legal disputes. It’s thus critical to advocate within your institution to make sure you are not only able to provide care to the fullest extent of the law, but also protected by your institution if state officials question that care.
Resources:
SMFM - Driving Change at Your Institution or Practice
ProPublica - Why Hospital Policies Matter in States That Ban Abortion
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As states continue to ban abortion care and restrict access to training, it is critical that our next generation of healthcare providers are equipped with the skills necessary to provide abortion care.
Resources:
ACOG - Abortion Training and Education in a Post-Dobbs Landscape
American Journal of Obstetrics and Gynecology - Abortion providers in the United States: expanding beyond obstetrics and gynecology
Journal of Graduate Medical Education - Turning Rage Into Action: Abortion Care and Residency Training in the United States
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State advocacy doesn’t have to always mean engaging your state legislators. Your Governor has the power to pass executive orders, and local municipalities can pass local resolutions.
Resources:
Guttmacher Institute - How Governors Used Executive Orders to Protect Abortion Access in a Post-Roe United States
In Our Own Voice - Advancing Reproductive Rights, Health, and Justice with Local Resolutions
Innovative legislative strategies:
Shield Laws
Shield laws began popping up after the Dobbs decision in June 2022 and are now quite popular. They are laws that aim to protect patients, providers, and/or other healthcare entities from out-of-state criminalization so that patients can safely travel for abortion care and providers can safely take care of patients from other states.
Shield Laws
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Guttmacher Institute - Shield Laws Related to Sexual and Reproductive Health Care
Center for Reproductive Rights - Interstate Shield Laws
New England Journal of Medicine - Abortion Shield Laws
Data Privacy and Security
Now more than ever, ensuring privacy and security for patients who seek or have sought abortion care is vital. Anti-abortion activists will go to great lengths to surveil, identify, and punish patients and providers - which is made easier now that our medical decisions leave an increasingly large digital footprint that can be exploited.
Data Privacy and Security
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Center for Reproductive Rights - Reproductive Health and Data Privacy After Roe: Threats and Opportunities for State Action
The Network for Public Health Law - Federal, State and Local Efforts to Protect the Privacy of Abortion Health Records
Digital Defense Fund - Keep Your Abortion Private and Secure
Telehealth Access
Telehealth Access
Telemedicine for abortion care is an important step to expanding abortion access, and should be protected. However, the practice should be closely examined as “integrating telehealth within an inequitable health system undermines its potential.” While telemedicine has improved patient access to abortion care, it only does so for those who can access telemedicine.
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RHITES - State of Telehealth Medication Abortion
Ibis Reproductive Health - Resource toolkit: Telemedicine for medication abortion and abortion-related services in the United States
Reproductive Health Access Project - Telehealth Care for Medication Abortion Protocol
Other Strategies
Other Strategies
In addition to the above strategies, we should still strive to:
Repeal bans and restrictions, including ultrasound restricted access for minors
Make abortion care more affordable, including expanding insurance coverage and allocating state funding for abortion care
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Guttmacher Institute - Act on the Evidence: Policy Solutions to Protect and Advance Abortion and Contraception Access in the United States
Guttmacher Institute - Eight Ways State Policymakers Can Protect and Expand Abortion Rights and Access in 2023
Center for American Progress - Expanding Access and Protections in States Where Abortion Is Legal