photos_9_1Clinicians in Abortion Care (CIAC) is a membership organization affiliated with the National Abortion Federation (NAF), representing pro-choice certified nurse-midwives (CNMs), nurse practitioners (NPs), physician assistants (PAs), and nurses working to increase access to comprehensive reproductive health care.

CIAC members support the greater involvement of CNMs, NPs, PAs, and nurses in all aspects of abortion care. Our dedicated membership works and volunteers in diverse settings, and provides care to women, men, and children. The individual and combined efforts of CIAC members positively impact the lives of women and their families all across the U.S. and Canada, every day.

Eighty seven percent (87%) of U.S. counties have no abortion providers. One effective way to increase the number of providers is to permit appropriately trained certified nurse-midwives, nurse practitioners, and physician assistants to provide first-trimester abortions. These clinicians have a long history of responding to health care needs, especially the needs of under-served populations.

It is imperative that clinicians be aware of the medical reality of abortion care and be prepared to:

  • respond to patients’ needs for medically accurate information,
  • offer timely referrals, and
  • provide needed care whenever possible.

Download “About CIAC” in a printable version you can distribute (PDF file, 29K)

Mission Statement

Clinicians in Abortion Care supports the greater involvement of nurse practitioners, certified nurse-midwives, and physician assistants in all aspects of abortion service delivery.

CIAC Goals

  1. Support the involvement of nurse practitioners, certified nurse-midwives, physician assistants, and nurses in comprehensive reproductive health care.
  2. Increase education and training for clinicians in areas of reproductive choice and health.
  3. Advocate for the removal of restrictions for nurse practitioners, certified nurse-midwives, and physician assistants in providing a full range of abortion services.
  4. Support inter-professional team based education, training, and practice in abortion care.

Connecting with the CIAC Advisory Committee

The CIAC advisory committee is a small group of national experts from each of the three disciplines. The advisory committee helps to identify the areas in which CIAC works.

Contacting these CIAC members can help pro-choice clinicians who might otherwise feel isolated in their commitment to reproductive choice. Connect with CIAC members in your state »

In addition to CIAC State Contacts, the CIAC Advisory Committee is a small group of volunteers who help to provide leadership in setting the goals of CIAC and spearheading activities aimed at achieving those goals. Advisory Committee members participate in periodic conference calls with staff at the NAF office and on a private listserv.

The current members of the CIAC Advisory Committee are:

Jessica Dieseldorff, MSN, WHNP-BC began her career with Planned Parenthood Association of Nashville as a community educator and abortion clinic counselor.  After receiving her MSN at Vanderbilt University, she has been in clinical practice with Planned Parenthood Mar Monte for 20 years, including medication abortion since 2006 and first trimester surgical abortion since 2009.  In her role in the medical management department, she coordinates and develops PPMM’s abortion program, and provides training and consultation on patient-centered practices in abortion and contraceptive care.

Phyllis Schoenwald is a Women’s Health Physician Assistant .  She has worked in reproductive health in the San Francisco bay area over 40 years including 29 years with Planned Parenthood (PP) affiliates. Previous to working at PP she worked in community clinics and a private practice specializing in second trimester abortion. Her introduction to women’s health was as a health educator and medical assistant where she developed her passion for abortion care.  Phyllis attended a unique women’s health program in 1979/80 at North Country Clinic for Women and Children in Arcata, California and certification as a PA at Harbor UCLA Torrance. Her PP career began in 1986 as the Director of Quality Management at Planned Parenthood of San Mateo County which merged into Planned Parenthood Golden Gate in 1995. She joined Planned Parenthood Northern California in 2003 as Vice President of Medical Services until 2015. Phyllis is currently a Consultant Surveyor with the PPFA Accreditation & Evaluation Department.

Whitney Wriston obtained her Bachelor of Science from UCLA and her Masters degree in Physician Assistant studies from Oregon Health & Science University. She worked for Planned Parenthood of the Pacific Southwest for 6 years in various clinical roles including program director for the early pregnancy evaluation and management initiative. She currently works in family practice in the Pacific Northwest.

Amanda Ferguson has been an LPN at PPNYC for 12 years and will finish her RN this spring. In that time Amanda has helped our surgical abortion services evolve while keeping us all organized. Amanda is a strong advocate for her patients and a key training presence for new RNs, and sometimes new MDs. Amanda supports our team with her institutional knowledge and experience as well as her desire to learn and grow. I know Amanda would offer a different perspective to the Advisory Committee and is the best person I can think of to represent nurses in abortion services.

Katrina Lipinsky is a nurse-midwifery student at the University of Pennsylvania School of Nursing. She has been a birth and abortion doula since 2013. She serves as one of the chapter leaders for Nurses for Sexual and Reproductive Health, connecting nursing students and providers in the community with access to abortion education and opportunities for activism. She is a co-lead of the Eastern Pennsylvania cluster of the Reproductive Health Access Network where she enjoys bringing the nurse-midwifery perspective. Before coming to nursing school, Katrina served two years with AmeriCorps Community HealthCorps in New York City where she became passionate about the integration of abortion into primary care, and then helped One Medical New York offices launch their medication abortion services. Katrina hopes to be able to provide miscarriage and abortion care in her future midwifery practice. Katrina uses she/her/hers pronouns.

Ciara Thomson-Barnett, MSN, CNM/WHNP is a dual certified nurse midwife and women’s health nurse practitioner, with a masters degree from Yale School of Nursing. She has been a clinician at Planned Parenthood Columbia Willamette since 2016. In 2017, she completed training to become a uterine aspiration provider and now provides care in Central Oregon. She has conducted Papaya Aspiration Training Workshops at conferences. She has formerly served as co-chair of Nursing Students for Sexual and Reproductive Health. She currently provides OB, gynecological care and management of early pregnancy complications in private practice. She is passionate about training and instructing other midwives and APC in abortion provision.

To contact CIAC or a member of the Advisory Committee, please email naf@prochoice.org.

Legal Practice Issues

Certified nurse-midwives (CNMs), nurse practitioners (NPs), and physician assistants (PAs) are currently involved in abortion care across the U.S. Clinicians for Choice (CIAC) seeks to ensure that these three professions are encouraged to practice to the full extent of their scope of practice. However, scope of practice differs from state to state as do laws affecting the provision of abortion care. The legal and regulatory situation controlling who may provide abortions is exceedingly complex and in most cases there is not a simple answer to the question of whether these clinicians can provide abortion services in any given state. Furthermore, the situation can change positively or negatively as laws are passed and power in the legislature, administration, and/or nursing boards shifts.

Many states have “physician-only” laws that prohibit anyone other than a licensed physician from performing an abortion. At the same time, state practice acts authorize specific health care providers, such as certified nurse-midwives, nurse practitioners, and physician assistants, to prescribe and/or dispense certain medications and perform certain procedures. In most cases these state practice acts are more recent and more specific than physician-only laws. As a result, it is unclear in many instances to what degree a physician-only law limits the ability of certified nurse-midwives, nurse practitioners, and physician assistants to provide abortion care.

Legislation, administrative rule changes, and/or attorney general opinions in various states have specifically established abortion provision within CNM, NP, and/or PA scope of practice in those states. However, in the absence of clarifications such as these, a physician-only law could limit the ability of certified nurse-midwives, nurse practitioners, and physician assistants to provide abortion care.

NAF supports the participation of these qualified health care professionals in various aspects of abortion care for which they are trained, and as permitted by state regulations. CIAC, an organization of NAF, works in collaboration with partner organizations to explore different strategies for expanding scope of practice in states, depending upon the legal situation. If you have a question about a particular state, please email naf@prochoice.org. We can let you know what other work is taking place in your state so efforts are not duplicated, and we can put you in touch with partner organizations and CIAC members working on these issues nationally.

For more information on legal practice issues, please see Providing Abortion Care: A Professional Toolkit for Nurse-Midwives, Nurse Practitioners, and Physician Assistants, available at www.apctoolkit.org.

Other Sources

In addition to NAF and CIAC, there are several organizations that can provide guidance in evaluating the laws and regulations in your area:

Advancing New Standards in Reproductive Health (a program of the University of California, San Francisco)

Abortion Access Project

American Civil Liberties Union Reproductive Freedom Project

Center for Reproductive Rights

New York Civil Liberties Union Reproductive Rights Project

Planned Parenthood Federation of America

Further information on legal issues regarding certified nurse-midwives, nurse practitioners, and physician assistants and abortion care can be found in the NAF-sponsored August 2000 American Journal of Obstetrics and Gynecology supplement on medical abortion.

Read our symposium report, “The Role of Physician Assistants, Nurse Practitioners, and Nurse-midwives in Providing Abortions” (PDF file, 209K).

Order hard copies of this report and the report from the first symposium, “Who will Provide Abortions?: Ensuring the Availability of Qualified Practitioners.”

 

Conferences

As part of our ongoing efforts to advocate for and support the inclusion of abortion content in conference programs, we encourage CIAC members to submit proposals for panels, scientific papers, and other sessions. If you would like ideas for abstracts, visit our resource center or if you are interested in holding an informal CIAC meeting, please contact the CIAC national office.