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This summer, Maryland will begin training some nurses and physician assistants to perform abortions, in addition to doctors, with the goal of expanding access around the state.
The $10.6 million state-funded program will be administered by the University of Maryland School of Medicine and the University of Maryland, Baltimore.
“We’re working on our curriculum right now, as well as a mobile simulation unit,” said Dr. Jessica K. Lee, associate professor of obstetrics, gynecology and reproductive sciences in the school of medicine and co-principal investigator on the training program.
“We will encourage the learners to begin this practice immediately upon completion” she said of the semester-long course.
The effort stands in contrast to those in more conservative states that moved to limit abortion access since 2022, when the Supreme Court overturned the nearly 50-year-old Roe v. Wade decision granting the right to the procedure.
In anticipation of that move, lawmakers in Maryland expanded who could perform abortions and budgeted funds for training over the objections of then-Gov. Larry Hogan, a Republican. Gov. Wes Moore, a Democrat, released the initial funding last year that had been held up by Hogan.
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The $10.6 million funding will last three years. Initially, the Maryland abortion training program will focus on medication abortions that account for more than half of all abortions across the country. Typically, women are given a prescription for two medications, which they are guided to take at home.
Lee said the students will also be given some initial instruction in how to perform first trimester surgical abortions, but they will need additional clinical training that the Maryland program plans to add in a second phase.
Providers in Maryland saw an influx of pregnant people from other states after Roe was overturned. Data from KFF, formerly the Kaiser Family Foundation, shows a steady rise in procedures in the state since 2022. And Lee said officials are prepared for the legal landscape to continue evolving.
Courts in Alabama, for example, recently ruled frozen embryos are children, throwing fertility treatments into question. More directly, the Supreme Court is slated to hear oral arguments March 26 in a case that challenges the long-ago federal approval of mifepristone, one of two abortion pills.
Lee said the Maryland curriculum could be altered to account for such changes. For now, the instructors will adapt the TEACH Abortion Training Curriculum to suit Maryland law, among the more lenient nationally.
There is no certificate necessary to perform abortions, but providers must be deemed competent by whomever trains them. The training program will also include ongoing mentoring and other support services for technical questions and other needs.
Lee said officials at Maryland also are assessing the number of providers now offering abortions and the need for more. There are approximately 30 facilities statewide offering abortions, but health officials found in 2020 that 60% of Maryland counties did not have one.
The first Maryland training class will include 10 to 12 students, and any advanced practice nurse, physician assistant or doctor with interest can provide their contact information. There will be a stipend for students to cover the costs of missing work or other expenses.
Officials specifically hope to increase the racial and ethnic diversity among abortion providers and add to the workforce in underserved areas.
“This funding represents a major step toward fortifying reproductive rights with abortion training and education,” said Dr. Laura Herrera Scott, Maryland’s health secretary, in a statement. The training programs “will help keep abortion care in Maryland safe and accessible for generations.”
Dr. Kyle Bukowski, chief medical officer at Planned Parenthood at Maryland, said the group has been working with the University of Maryland, Baltimore, to potentially assist with some of the training. But it has also been helping train students and residents from other educational institutions for years in abortion care and general sexual and reproductive health care.
That takes time and money from Planned Parenthood staff, and the new training program is “very needed.” Bukowski said in fiscal 2023, abortions at its Maryland facilities rose by 45% and out-of-state patients accounted for about 9% of visits.
“It is crucial not only to train new providers in abortion care,” he said in a statement, but to ensure abortion providers, like Planned Parenthood of Maryland, “have the resources to scale up capacity, expand regional footprints, and deliver care in innovative ways, like telehealth, to respond to the healthcare crisis that was created with the overturn of Roe v Wade.”
Meredith Cohn is a health and medicine reporter for The Baltimore Banner, covering the latest research, public health developments and other news. She has been covering the beat in Baltimore for more than two decades.
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