March 2020

In honor of Abortion Provider Appreciation Month, we are highlighting clinical champions from our community who exemplify the three areas of RHAP’s work: train, support, and mobilize.

Train: Spotlight on a RHAP Fellow

Jaquelyn Yeh, MD is RHAP’s Reproductive Health Care and Advocacy Fellow in Washington State.

I was a medical student who loved every rotation – I didn’t know what I wanted to focus on, but I knew connecting and developing relationships with patients was really important for me. I knew Family Medicine was the specialty for me once I realized that you can concentrate on the full spectrum of your patient’s needs throughout their lifetime.

Family Medicine made me feel like the world was my oyster. I wanted to be the doctor who provides a listening ear and an unwavering support system. I wanted to be the doctor who supports their patients throughout all of their life stages – from first wellness check-ups to abortion care to geriatric screenings.

Abortion care is basic health care. However, the stigmatization and politicization of abortion in our country means providers like me have to scrounge for additional training when this should be foundational to our education. Less than 6 percent of family medicine residencies provide training in abortion care – which made it that much harder for me to become the doctor I wanted to be.

I was lucky to attend a supportive residency in Pennsylvania and connect with clinicians in the Pennsylvania Cluster who are tireless advocates for abortion access. I had found a community of like-minded clinicians, but I was in a state hostile to abortion. My residency supported my interests in full-spectrum reproductive health care but did not provide abortion care on-site. Consequently, I was dependent on a patchwork of outside clinical rotations for my abortion care education.

During my third year of residency, I had a patient who got pregnant and didn’t want to be. She had come to me for support and access. I was her doctor and I had the skills to provide the care she needed, but my hands were tied. This broke my heart. Due to Pennsylvania’s anti-abortion laws, all I could do was give her a phone number to another clinic. She trusted me and I could not be there for her in the way that she needed.

I believe advocacy in medicine is critical. I am a RHAP Reproductive Health Care and Advocacy Fellow in Washington because I believe we need leaders in primary care who are both skilled providers and strong advocates. For me, being the best doctor is being both a provider and an advocate for my patients’ rights. It is critical that I use my privilege as a doctor to fight anti-abortion policies at the institutional, state, and national levels.

RHAP’s Fellowship provides me with a robust community of strong abortion providers where training in abortion care, early pregnancy loss management, and contraception is not a patchwork of experiences but at the core of my learning. It is an amazing feeling when I am able to independently perform a new skill from start to finish. I am excited to complete my fellowship and move to a medically underserved area as a clinical leader and advocate equipped to defend and provide my patients with the safe and trusting health care environment they deserve.

The Reproductive Health Care and Advocacy Fellowship is a year-long intensive clinical training program that develops family medicine leaders who provide, teach, and advocate for comprehensive reproductive health care. We have sites in Massachusetts, Michigan, New Jersey, New York, and Washington. If you are interested in the Fellowship, please email fellowship@reproductiveaccess.org.

 

Support: Abortion in Primary Care

The ability to provide abortion care requires more than just being trained. RHAP also works with health centers and clinicians to help them navigate the logistical, bureaucratic, and legislative challenges that come with offering this care. We help them figure out how to schedule appointments, make sure their medical records are set up correctly, that their protocols are up to date, and most importantly, that their colleagues are on board. We offer clinical resources, answer questions, and even provide funding to order medication abortion and other start-up supplies.*

When health centers and clinicians overcome these challenges and provide abortion, patients are positively impacted. Here is what our Medical Director, Dr. Linda Prine, had to say about the importance of supporting primary care sites to provide abortion care.

“What really matters for providing safe abortion care is having a good relationship with our patients, and having a system in place for after-hour questions or problems. In addition, getting abortions in a continuity practice, like a family health center, contributes to de-stigmatizing and normalizing the process. When a patient’s own primary care clinician provides them with their abortion they are less likely to feel shamed. And when that clinician also provides their follow up contraception they are more likely to come back to the same clinician when they have side effects or need refills or have questions. In every other area of medicine, we have come to realize that continuity of care and clinician/patient relationships are the key to good medical care. Why would abortion care be any different?

In my practice, we offer many procedures that are also offered by specialists: mole removals, wart treatments, ingrown toenail removals, ear lobe repairs, IUD insertions, abortions, and so on. We do give our patients the option of having these procedures done elsewhere, by specialists. They almost always choose to stay with us, and often say, ‘I know and trust you. Why would I want to go somewhere else to see someone I don’t know?’”

RHAP is proud to support primary care clinicians and their health centers to provide abortion care in their communities. If you are a clinician looking to integrate abortion into your practice, let us know! We’d love to support you in integrating abortion care to your community.

 

*We do the same to support health centers to provide comprehensive early pregnancy loss care. Check out last month’s feature on how we supported Affinia Healthcare to integrate full-spectrum early pregnancy loss care into practice in St. Louis.

 

Mobilize: An Interview with Katrina Lipinsky

Katrina Lipinsky is a midwifery student at the University of Pennsylvania and co-leader of RHAP’s Philadelphia Cluster.

When did you start organizing?

My undergraduate degree is in Public & Community Service, which is interesting because I went to a conservative Catholic institution. However, because of this – or perhaps in spite of this – I developed a foundational knowledge of working in teams and communities on advocacy issues. When I graduated, the 2012 election was in full swing and I decided to take a job as a field organizer on the Obama campaign in New Hampshire. This was grassroots, boots-on-the-ground work mobilizing communities. After the election, I worked for Organizing For Action (the nonprofit that grew out of the campaign) and organized volunteers to take action on the issue of gun violence. And then I decided to take a job in New York City with Community HealthCorps, a program of AmeriCorps, at the Institute for Family Health. I am inherently a political person; organizing has come relatively naturally to me.

Why reproductive health care?

I became interested in reproductive health care in college after taking a few health policy and women’s studies courses, and I completed birth doula training before graduating. Part of the reason I wanted to work on the Obama campaign is that I knew we had to re-elect a president who was supportive of reproductive health care. But I knew I wanted to return to working in health care. My AmeriCorps position focused on coordinating prenatal care for patients in a Centering Pregnancy program at the Institute for Family Health, and this is also how I got introduced to RHAP. I still think this is the best job I’ve ever had. I was able to work directly with primary care providers – including RHAP Medical Director Linda Prine – who were offering full-spectrum reproductive health care, all in their primary care offices. I was lucky to be working alongside medical students and residents in a teaching program; everyone was so open to supporting my learning and encouraging my curiosity. I would not feel nearly as confident now as a midwifery student in my clinical rotations had I not been given the opportunities and mentorship I received at IFH.

How are you continuing to organize while in school?

It was important for me to stay connected to the abortion access movement while I was in school. In 2018, I became one of the chapter leaders of Nurses for Sexual and Reproductive Health. I also started going to the RHAP Philadelphia Cluster meetings and I was elected to the Clinicians in Abortion Care (a project of NAF) advisory board. The day-to-day experience I was having in my nursing program wasn’t what was getting me up in the morning – it was all of the other work that I was getting involved in that kept me motivated while I was working on my nursing degree. I wanted to be better connected to the local community, and so I let the RHAP Cluster leaders know I was willing to do anything they needed help with. And shortly thereafter I found myself co-leading the Cluster (along with Martha Simmons, MD)! I wouldn’t change anything about all of the time and commitment I spend on this work because it’s driving my energy towards finishing my degree and becoming a licensed CNM.

Organizing in Philly is very different than in New York. It’s a liberal city, but we are subject to Pennsylvania’s restrictive state-wide laws. It’s not like at the Institute for Family Health, where a person can get their abortion the same day they find out they are pregnant. Our patients do not have Medicaid coverage for their abortions, and they generally have to go through a one- to two-week process, at minimum. I saw all this firsthand during my clinical rotation at Philadelphia Women’s Center.

What’s next?

I love getting other people excited about contraception and abortion and destigmatizing and demystifying it all. I have a joke with one of my friends, a law student also involved in abortion work. When someone asks us, “Hey, do you want to get drinks?” there’s a good chance we already have plans doing something related to abortion activism. This work brings me joy! I love connecting people to each other and helping to foster community – it comes naturally to me and I know I’ll keep doing it.

Getting Penn students and the Philadelphia community connected to provider networks like RHAP and NAF is so critical. I want to introduce other clinicians to this work and make sure that they have the resources and information they need to provide the best care possible to patients and find community support on an issue that can be so contentious. I know that I wouldn’t be where I am without having been brought into the community by the providers I worked with in New York. I wouldn’t have found my way into those spaces alone, so I appreciate the importance of being that connector for others. Wherever I end up after finishing my midwifery program, I know I will stay connected to the RHAP network. I will continue being a mentor for students – perhaps as a clinical preceptor – and I will continue leading workshops and encouraging folks to join our movement. I also want to mention that I think a lot about the fact that people who look like me are already in positions of leadership, and I would like to be part of bringing more black, indigenous, and people of color into organizing roles with decision-making power.

What is your dream future for abortion care?

I want people to be able to walk into any primary care clinic and receive their abortion from the clinician that they feel the most comfortable with – including from their midwife! I want to see a world where a patient coming in for an abortion can feel like any other patient coming in for any other type of health care, without any feelings of stigma. I want to see a world where abortion is free.

Get Involved

On March 10, 1993, Dr. David Gunn was murdered by an anti-abortion extremist. Three years later, to honor his life and his work, the 10^th of March became the National Day of Appreciation for Abortion Providers. Every day, we are thankful and honored that abortion care providers all over the country put their lives at risk to provide comprehensive health care. Abortion care providers are faced with threats of violence against them and their families, aggressive legislative limitations, and emotional harassment. These are just a few of the intimidation tactics that are used to deter clinicians from providing full-spectrum patient-centered health care. We at RHAP are fortunate to work with caring, dedicated, and passionate providers located all over the country. Thank you to all the physicians, nurse practitioners, physician assistants, midwives, staff, volunteers, doulas, and advocates who ensure access to safe, compassionate abortion care in independent clinics and in the primary care setting.

As we celebrate and share our appreciation for abortion providers today and every day, here are some things you can do to show up for abortion access:

• Share your thanks and appreciation on social media using #CelebrateAbortionProviders
• Donate to help us continue supporting our work with clinicians like Jaquelyn and Katrina
• Stay updated on reproductive and sexual health, rights, and justice news here

 

And if you want to hear more from the clinicians who do this work, check out our 2014 blog post, “13 Ways Providing Abortion Care Makes Me A Better Doctor”