New Bill Aims To Increase Abortion Training Services in Healthcare

At a time when states across the country face threats to abortion rights, Democratic state lawmakers in Albany are stepping in to bolster access for New Yorkers.

"This is urgent fundamental healthcare. We have the laws, we need to make sure we have enough providers,” said State Sen. Liz. Krueger (D-Manhattan) at a recent press conference.

Kruger also stressed the need for New York to ensure abortion access for both residents and those seeking refuge from other states.

Some advocates said they are deeply concerned about reproductive rights.

“I can’t remember a time in my decades of reproductive justice activism when our communities were under greater threat than they are right now,” said Rose Mitchell, a licensed midwife and the northeast region representative of New York State Midwives.

State lawmakers intend to improve access by addressing abortion care provider shortages and training gaps through a re-introduced piece of legislation that would establish a state abortion clinical training program within the Department of Health.

The bill was first introduced last year but didn’t make it out of committee. Krueger, the bill sponsor, said this year the bill has more political will with Donald Trump’s return to the White House setting off alarm bells and exacerbating the current reproductive healthcare and training crisis.

“There are many new needs in reproductive healthcare that the state needs to address, including a shortage of trained providers, and I think legislators want to make sure we're doing everything we can to ensure broad access to abortion care. That, combined with a big push from advocates, is why this bill is moving this year," Krueger said in a statement to WMHT.

The bill is also co-sponsored by other reproductive advocates in the Senate such as Samra Brouk, a Democrat representing parts of Rochester.

The proposed program would provide funding and structure for medical residents and providers to receive comprehensive training in reproductive healthcare, including abortion care.

Under New York State law, physicians and advanced practice clinicians, physician assistants, nurse practitioners, and licensed midwives are authorized to perform abortions within their scope of practice. However, training is not as widely available to most medical specialties.

Mitchell said structured training has not been made available for licensed midwives, physician assistants, and nurses since they were authorized to perform abortions by law in 2019.

“We are expected to learn on the job, but that can only happen if we work for organizations that provide this type of care,” she said.

Mitchell added that anti-abortion stigma has resulted in an insufficient number of clinics and clinicians.

At a press conference, several lawmakers said they are very concerned about the lack of comprehensive abortion care in medical schools and residency programs which leaves providers without the necessary skills and knowledge to provide these services.

“I can’t emphasize enough that there are deserts in parts of New York State where you can’t find a provider already. And we’re supposedly the state with all the right protections,” said Krueger.

In New York there are community-based abortion facilities in every region of the state; however, only seven out of ten regions have facilities that perform abortions beyond 15 weeks of pregnancy. In three regions, only two facilities provide abortion care for up to 20 weeks.

Consequently, the lack of training programs for abortion care providers can exacerbate this issue.

According to the American College of Obstetricians and Gynecologists, half of the U.S. counties lack a single OB-GYN–counties that are home to millions of individuals in need of OB-GYN primary care.

Dr. Taylor Walker, MD, an abortion provider emphasized this is a crisis and it is not hypothetical.

“This is affecting real patients and real providers right now,” she said.

Walker said this is the time to act because every day that passes, groups of medical residents are graduating without the full scope of their training.

“This will have negative, deleterious, life-threatening consequences for decades to come,” she said.

The proposed legislation aims to address these gaps with a $10 million allocation in the state budget. Assembly Member Harvey Epstein (D-Manhattan), the Assembly sponsor, emphasized the importance of this measure, with the state budget getting closer to the finish line.

“We are three weeks away from one house budget and five or six weeks away from a final budget; this is a critical time for reproductive care in New York,” Epstein said.

The Assembly Member stressed that lawmakers must ensure the Governor allocates the $10 million in the budget to provide access to these essential services, warning that without action, the state will face a crisis as doctors providing reproductive care continue to age.

"We talk about New York being such a great place for reproductive care, but what does it mean when people who need access to reproductive care don't have access to a medical professional?" Epstein said.

Krueger said despite the governor's proposed budget including several items related to abortion care, it's still not enough, and they need to keep pushing for more.

She said $10 million in the state’s $252 billion budget is a drop in the bucket.

“We need to put more money into abortion care services in a variety of ways," said Krueger.

Krueger said pregnancy management and proper miscarriage care are also addressed in this bill, noting that lack of access to such care can have life-threatening consequences for women.

“Imagine if you have a miscarriage and no one knows how to take care of you,” the senator said.

Walker told WMHT that abortions can be used to address different medical circumstances throughout pregnancy such as miscarriage. She said the term abortion simply means to empty the uterus.

“There are a wide range of issues that may necessitate the emptying of the uterus. Early pregnancy loss is exceptionally common, complications during pregnancy happen all the time and it is really important that doctors and providers are able to provide safe, comprehensive, evidence-based care throughout pregnancy,” she said.

According to a recent report CDC, from the U.S. Centers for Disease Control and Prevention (CDC) in 2022, more than 600,000 legal abortions were reported, with an abortion rate of 11.2 per 1,000 women aged 15-44. Medication abortions were the most common method, accounting for 53.3% of all abortions in 2022.

Walker added in addition to the technical skills for physicians to be able to provide abortion care, physicians also need training on patient care in this space.

Walker said the reason she became a doctor is because of her experience having an abortion in Tennessee, where she felt unsupported. She recalled being told, after finding out at five weeks,

that she had to wait two weeks so she could have an ultrasound and listen to the heartbeat before being allowed to access medication abortion services.

“The provision of the medication abortion was extremely difficult and I will say it takes training and thoughtfulness and resources to be able to provide a medication abortion that feels grounded and kind and patient-centered,” Walker said.

The legislation is undergoing technical amendments before it can be brought to the floor for a vote.

While some Democrats are supportive of this measure and see no issues with it passing in the Senate, some Republicans seem to be a no-vote.

State Sen. George Borrello (R-Finger Lakes) said the idea of the legislation seems unnecessary to him.

“When it comes to abortion in the state, there’s no lack of training, there’s no lack of access. We’re giving abortion tourism a try here in New York State,” the senator said.

Krueger argued that having the best laws on the books is not enough if there aren't providers available to offer these services.

“We need to keep pushing and making noise to help understand that we can have the best laws in the books,” said Krueger.

Moving forward, the bill is scheduled to go to the Senate floor for a vote, likely in the next week or so. Krueger said she is very confident the bill will pass the Senate with no major challenges.