Why Primary Care Providers Like Me Must Become Abortion Providers

It cannot be that if a patient wishes to continue a pregnancy, then they are my patient, but that I should not care for them if they want an abortion.

Illustration of a uterus, pregnancy test, and pills against a pink background. Quote overlay reads,
Primary care providers must care for the whole patient—including when they need abortions, Dr. Christine Dehlendorf says. Rewire News Group illustration

As a family physician, I am committed to caring for patients of all ages, from cradle to grave, in all the complexity of their lives and their families. I see patients with all manners of concerns and illnesses—from pediatric asthma to adolescent sport injuries to depression, diabetes, and untreatable cancer. And, of course, pregnancy.

Some of my patients rejoice in the news of a pregnancy, others are conflicted, and still others are dismayed. Regardless, for all of them, it is a moment with implications on their lives and their health. As their family physician, it is both my job and my calling to be there with them as they face this experience and support them—whatever they choose to do next.

For my patients who wish to parent, I can begin prenatal care immediately. For those who want to have an abortion, I can provide them with that care too. And for those who are unsure, I counsel and support them to make the decision that is right for them.

Unfortunately, politicians who want to ban abortion are threatening this commitment to supporting patients in all their reproductive health decisions. Now that the Supreme Court has decimated the constitutional right to abortion, clinics in hostile states will no longer be able to provide abortions. States will be free to pass more onerous restrictions. Clinics in supportive states will be overwhelmed with demand from both people in their area and from patients traveling for care. We’re seeing some of this already.

In the face of this need in our communities, primary care providers must join the struggle and normalize and integrate abortion. I chose family medicine to care for the whole person, to be a partner in my patients’ lives, and to trust them in their decision about their health care. The increasing regulation of abortion care strikes at the core of who we are as primary care physicians.

It cannot be that if one of my patients becomes pregnant and wishes to continue to pregnancy, then they are my patient, but that if they wish to have an abortion, I should not care for them. Refusal to provide that care continues a stigmatizing narrative that abortion is different than other health care and leaves our patients with dwindling options.

Abortion care, especially medication abortion, is a safe and simple procedure that primary care providers can learn to integrate into their practices.

But while access to abortion has been attacked in state houses and court rooms, too many of us in medicine have been silent. My colleagues and I in family medicine have a particular role to play in this fight—to work to ensure patients have the option to receive this care as part of an ongoing relationship with a trusted provider. And there is a need for those in a wide range of medical specialties— including pediatrics, internal medicine, and emergency medicine—to join us.

Right now, only a fraction of abortions happen in physicians’ offices. Abortion care, especially medication abortion, is a safe and simple procedure that primary care providers can learn to integrate into their practices. Primary care offices are located all over the country, including in places that don’t have any abortion providers. It’s our responsibility to our patients to provide it.

Providers can learn how to provide medication abortion and start providing this care with support from organizations like the Reproductive Health Access Project. Professional organizations like the American Academy of Family Physicians can speak out in favor of abortion access and invest resources in training providers. The Biden administration can make it easier for primary care providers to offer medication abortion by removing the remaining unnecessary FDA regulations.

Together we must work to expand access in a critical time. Those of us who maintain the legal ability to provide this care for our patients need to do so in our community, so that others can get the care they need.

Our country is entering into a challenging time where restrictions on reproductive autonomy will reverberate through families and communities. Providing abortions to our patients is a concrete thing we can do to lessen the harm that can and will be done. Our commitment to our patients and the values of our profession will be tested in this crisis, and we must rise to the challenge.