A decision from the Supreme Court to overturn Roe v. Wade would also have the indirect effect of shrinking the pipeline of trained abortion providers.

More than half of states are prepared to ban abortion outright if the majority-conservative Supreme Court rules to overturn Roe, the 1973 decision legalizing abortion nationwide, which would also shut down all abortion training programs in those states.


"We're anticipating with the fall of Roe that 26 states that have essentially trigger laws will make abortion illegal, and along with that there are going to be a huge loss in training environments and training sites for all providers," said Dr. Suzan Goodman, who directs the California-based TEACH abortion training curriculum used to train nurse practitioners, midwives, and physician assistants nationwide.

Doctors receive that training as part of their residency programs, though it is not a requirement. Nurse practitioners, midwives, and physician assistants, also known as advanced practice clinicians, receive clinical abortion training on the job through training programs at their universities or with abortion-specific training programs alongside physicians, residents, and medical students.

Abortion training options are already dwindling, especially for those in residency programs at teaching hospitals in southern states that have pursued anti-abortion laws, according to a study by the Law, Rights, and Religion Project at Columbia University Law School.

Over 90% of young doctors in OB/GYN residency programs in 2020 had access to abortion training, but Roe being overturned would whittle that down to 56% at most, according to a recent study by the University of California San Francisco and UCLA. A 2020 Stanford study also found that half of the medical schools in the United States include no formal training in performing an abortion or only a single lecture on the topic.

Some blue states, anticipating a surge in patients coming from states with bans, are making up for losses in providers by lifting requirements that only trained physicians can perform abortions or prescribe abortion-inducing medication. Connecticut and Maryland have new laws on the books that give nurse practitioners, midwives, and physician assistants the authority to perform procedural abortions. In Delaware, Democratic Gov. John Carney recently approved a measure that lets nurse practitioners and midwives prescribe abortion-inducing medication to women in the first 10 weeks of pregnancy.

A growing number of blue states are also spending millions of dollars on abortion training for physicians and advanced practice clinicians. For instance, the Maryland bill, which was finalized after the state legislature overruled Republican Gov. Larry Hogan's veto, directed the state to invest $3.5 million annually into abortion training. In New York, the state legislature is considering a bill that would direct $50 million to establish the Reproductive Equity and Freedom Fund, part of which would be spent on educational resources for providers in the state.


Anti-abortion groups have railed against states' efforts to broaden the pool of authorized abortion providers, arguing that nonphysicians are less qualified.

"These abortion expansion efforts by the abortion industry put to rest their lie that they care about women," said Lauren Enriquez, deputy media strategist at Students for Life. "And you certainly don't show a woman you care about her by removing the legislative guardrails put in place explicitly with her well-being in mind — such as permitting only trained physicians to commit abortions."