Outcomes from a procedural abortion training program for providers in underserved areas: findings from a four-year evaluation

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TITLE: Outcomes from a procedural abortion training program for providers in underserved areas: findings from a four-year evaluation. BACKGROUND: In 2019, the Clinical Abortion Training Centers (CATC) program was initiated in collaboration with the National Abortion Federation to address gaps in abortion training for a diverse array of clinicians, not limited to ob-gyn specialists. The program aimed to increase the number of clinicians providing procedural abortion care, especially in underserved areas. Five abortion clinics, including independent and Planned Parenthood affiliates, trained physicians. The training was tailored to individual goals around proficiency with specific gestational ages. We aimed to evaluate whether trainees in this program provided abortion after training. METHODS: An evaluation team assessed the program’s impact on the ability of physicians to provide abortion care, particularly to later gestational ages, over a period of four years from 2020 to 2024. Data sources included application data, semi-structured interviews, and surveys. The study followed trainees annually up to four times post-training to evaluate their job trajectories and abortion care provision. RESULTS: Sixty-nine physician trainees completed the program, with 44 completing at least two surveys. Post-training, 57% of trainees who completed at least two surveys were providing abortion care regularly, with increased proficiency over time. Trainees expanded access by working in underserved areas, increasing clinic hours, and raising gestational age limits for procedures. However, some trainees faced barriers such as institutional policies and state restrictions, and some needed or wanted additional training to provide independently. CONCLUSIONS: The CATC program demonstrated potential for expanding abortion access but highlighted the need for additional training to ensure independent provision, especially for higher gestational ages. Despite challenges, the program contributed to comprehensive reproductive health care by enhancing procedural skills and advocacy. The study’s limitations include potential selection bias, small sample size, and external influences like the COVID-19 pandemic and the Dobbs decision.

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