Legality is not Accessibility: Close the Gap in Abortion Training
New York State has 4.4 million people of reproductive age protected by state law guaranteeing the absolute right to abortion through the 24th week of pregnancy—or later when a fetus is not viable or a pregnant person’s life, physical health, or mental health is at risk. Legal protections are essential in supporting people with the capacity for pregnancy in exercising their reproductive autonomy, but the legality of abortion care alone fails to translate to sufficient access to care. With decreasing opportunities for providers to seek training in abortion care, access to reproductive healthcare becomes increasingly difficult even in permissive settings.
While New York healthcare providers are authorized to perform abortion procedures through 24 weeks, there is no comprehensive statewide training infrastructure to prepare them. A third of OB/GYN residency programs in New York lack robust abortion training. Midwives, nurse practitioners, and physician assistants – advanced practice clinicians (APCs) who could significantly expand access – typically receive little formal abortion training. Trainees in fields such as Family Medicine and Emergency Medicine increasingly encounter patients who need abortion care in urgent settings, yet many lack the training on how to do so. After the Dobbs v. Jackson Women’s Health Organization decision, nearly half of U.S. residency programs lost access to abortion training opportunities.
Several trends exacerbate already-restricted opportunities for abortion training nationwide and in New York State. Experienced providers are retiring, reducing the preceptor workforce. The increase in use of medication abortion is reducing procedural volume in many clinics, providing fewer learning opportunities for hands-on skills. Even within New York, care deserts where no abortion clinics exist mean that students in these areas do not have access to a clinic training site.
Training droughts translate directly into gaps in patient care. In New York, we are fortunate to host over 100 abortion clinics, but only seven of the state’s ten regions have community-based facilities that perform abortion care beyond 15 weeks of pregnancy. Many patients must drive hours to obtain needed care. Restrictions on abortion training also affect access to broader reproductive health services, including miscarriage management and treatment of pregnancy complications.
Programs across the country are putting band-aids on bullet holes to try to connect residents to the few remaining training sites. Resources such as the Ryan Residency Program and Medical Students for Choice help fill the gap but cannot solve a systemic problem.
New York has the chance to address this gap. Sponsored by Senator Liz Krueger and Assemblywoman Amy Paulin, S. 1438-A would sustain the Abortion Clinical Training Program, first funded with $4 million in the 2025-26 State Budget. The bill would codify the program within the Department of Health, helping to ensure that an adequate number of physicians, APCs, and medical residents in New York receive comprehensive abortion and related reproductive healthcare training. Continued funding is especially critical as Congress attempts to deny funding to hospitals that provide abortion training. We urge lawmakers to include this essential legislation and continuation of funding in this year’s State Budget.
New York is among a small contingent of states considered ‘most protective’ of abortion access. The bill’s passage would demonstrate tangible commitment to reproductive justice and provide a model for states seeking to translate legal protections into real access.
In a time when fundamental rights are under attack across the US, New York can lead. We urge lawmakers to include this legislation, as well as $5 million in this year’s State Budget as we ramp up toward a funding level that will fully meet the need. Sustaining the Abortion Clinical Training Program will ensure that access to abortion is protected in New York by expanding the clinician workforce needed to provide it.
Lily Dalke is President of New York Midwives, Lucy Frucht is a medical student at NYU Grossman School of Medicine and a member of Medical Students for Choice NY, and Dr. A. Taylor Walker is President of CIR-SEIU, a union representing more than 37,000 resident physicians and fellows nationwide.
