Clinicians 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.
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- Support the involvement of nurse practitioners, certified nurse-midwives, physician assistants, and nurses in comprehensive reproductive health care.
- Increase education and training for clinicians in areas of reproductive choice and health.
- Advocate for the removal of restrictions for nurse practitioners, certified nurse-midwives, and physician assistants in providing a full range of abortion services.
- 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:
Sarah Macrorie, BS
Sarah Macrorie, BS, is the program manager at Nursing Students for Sexual and Reproductive Health. Prior to joining NSSRH, Sarah was assistant research faculty at the University of Oregon as a fellow of the American Physiological Society, where her research focus was the epigentics of obesity and metabolism in NHP and murine models. Sarah practiced midwifery in private practice for 10 years, and has 18 years of clinical abortion experience. She is a founding member and former board member of Oregon’s independent abortion fund, Network for Reproductive Options. She is committed to the expansion of sexual and reproductive health content in medical education, and supports the expansion of scope of practice for APC’s to include abortion.
Liz Banks, FNP
Liz Banks obtained her Bachelor of Science from Texas A&M University and her Masters degree from the University of Florida as a Family Nurse Practitioner. She pursued her desire to specialize in family planning and reproductive health by joining Planned Parenthood Columbia Willamette in May of 2000. She has been providing medication abortion since FDA approval of Mifepristone and first trimester uterine aspiration since 2004. She is currently the PPCW Director of Clinical Services; where she continues to provide direct patient care and also trains clinicians in first trimester surgical abortion. She is a member of the NAF Board of Directors as well as the Oregon Board of Nursing Rules Advisory Committee.
Loren Fields, MSN, NP-C, WHNP-BC
Loren Fields is a dual certified Adult and Women’s Health Nurse practitioner, with a Masters degree from the Yale School of Nursing. She has been a nurse practitioner with Planned Parenthood of Southern New England (PPSNE) since 2010. In 2015 she joined the Yale School of Nursing Faculty as a lecturer in the Midwifery and Women’s Health Nurse Practitioner program. She continues to provide patient care at PPSNE one day at week as well as participate in PPSNE’s training and quality initiatives. She provides comprehensive gynecologic care, limited primary care for women, medication abortion, and care for early pregnancy complications. She is currently pursuing her Doctor of Nursing Practice degree at the University of Connecticut.
Dr. Amy Levi
Dr. Amy Levi is the Albers Endowed Professor of Midwifery at the UNM College of Nursing. She has undergraduate degrees in Nutrition from Hampshire College (1975) and in Nursing from Widener University (1985). Her MSN (1986) and PhD (2000) are from the University of Pennsylvania. Prior to her appointment at UNM in 2012, she was engaged in full scope midwifery practice and on the faculty at the University of Pennsylvania School of Nursing, the University of Vermont School of Medicine, and the University of California San Francisco (UCSF) School of Medicine, where she was the Director of the Nurse-Midwifery Education Program. Her research and professional interests encompass interprofessional care in sexual and reproductive health, unintended pregnancy management, and midwifery education. She was the Clinical Education Consultant to the Health Workforce Pilot Project at UCSF, and developed an interprofessional education program in obstetrics at the San Francisco General Hospital before relocating to New Mexico. Recent publications address the development of competencies in sexual and reproductive health, patient-centered miscarriage management, and updating the annual gynecological exam. Dr. Levi is a Fellow in the American College of Nurse-Midwives and the American Academy of Nursing.
Reesa Roberts is a Physician Assistant who has dedicated her seventeen years of practice to serving communities where access to reproductive health care was a concern. She currently works at NAF as a Quality Assurance Clinician. Before NAF, she worked at Planned Parenthood of New York City for ten years as the Director of Clinical and Surgical Services at the Manhattan site. She received her undergraduate degree from City University of New York in Physician Assistant Studies and a Master of Science degree from Stony Brook University. Reesa has provided a range of services in her eighteen years of practice including performing sonograms for purposes of gestational age, aspirations for miscarriage management, medical abortions, as well as difficult IUD insertions and removals.
Phyllis Schoenwald is a Women’s Health Physician Assistant and has worked in reproductive health in the San Francisco bay area for almost 40 years; including 29 with Planned Parenthood (PP). 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. She 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 – then Planned Parenthood Golden Gate in 1995. She joined Planned Parenthood Northern California in 2003 as Vice President of Medical Services until 2015. Phyllis joins the PPFA Affiliate Evaluation Department as a Consultant Surveyor in Fall 2016.
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.
Bree Ferrin, RN
Bree Ferrin, RN, is the current CIAC advisory board student member. She is currently pursing an FNP degree at Frontier University. Bree’s nursing experience includes the emergency department, abortion care, and sexual assault exams. She also has international experience in Sierra Leone in an Ebola treatment unit and in Haiti working in HIIV and TB. Bree is the past-president of the board and a past coordinator for the Haven Coalition, a non-profit that provides a shelter and transportation assistance for women traveling to New York City for two-day abortions. Bree plans to provide abortion care after graduation.
To contact CIAC or a member of the Advisory Committee, please email firstname.lastname@example.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 email@example.com. 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.
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)
American Civil Liberties Union Reproductive Freedom Project
New York Civil Liberties Union Reproductive Rights Project
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.
Order hard copies of this report and the report from the first symposium, “Who will Provide Abortions?: Ensuring the Availability of Qualified Practitioners.”
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.