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EditorialBrief Report

Facilitating Abortion Services in Primary Care Settings After the Loss of Federal Protections

Kathryn Fine, Anna Fiastro, Ying Zhang, Grace Shih, Emily M Godfrey, Dinah Aldrich and Ian M Bennett
The Journal of the American Board of Family Medicine January 2026, 39 (1) 157919; DOI: https://doi.org/10.3122/jabfm.2025.250136R1
Kathryn Fine
1 School of Medicine University of Washington https://ror.org/00cvxb145
BS
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Anna Fiastro
2 School of Medicine, Department of Family Medicine University of Washington https://ror.org/00cvxb145
PhD, MPH, MEM
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Ying Zhang
2 School of Medicine, Department of Family Medicine University of Washington https://ror.org/00cvxb145
MD, MPH
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Grace Shih
2 School of Medicine, Department of Family Medicine University of Washington https://ror.org/00cvxb145
MD, MAS
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Emily M Godfrey
2 School of Medicine, Department of Family Medicine University of Washington https://ror.org/00cvxb145
MD, MPH
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Dinah Aldrich
2 School of Medicine, Department of Family Medicine University of Washington https://ror.org/00cvxb145
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Ian M Bennett
2 School of Medicine, Department of Family Medicine University of Washington https://ror.org/00cvxb145
MD, PhD
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Article Figures & Data

Tables

    • View popup
    Table 1. Description of Survey Respondents’ Clinic Practice Location and Setting.
     Total   FMRN  WPRN WA
    Title X 
    N%%%%
    Total Surveys Sent19345 94 54
    Total Survey Responses 40 18 6 16
    State      
    WA31 78 13 72 2 33 16 100 
    WY- - -- - - -- 
    AK 1 3 0 0 0 0 1 6 
    MT 4 10 3 17 1 17 0 0 
    ID 6 15 2 11 3 50 1 6 
    Other 2 5 0 0 0 0 2 13 
    Geographic descriptor         
    Urban 21 53 10 56 3 50 8 50 
    Suburban 15 38 8 44 2 33 5 31 
    Rural 25 63 8 44 4 67 13 81 
    Frontier 4 10 1 6 1 17 2 13 
    Proportion of population that is of reproductive age 
    10-25% 8 20 5 28 1 17 2 13 
    26-50% 13 33 10 56 3 50 0 0 
    >50% 18 45 3 17 2 33 13 81 
    Prefer not to answer 1 3 0 0 00 1 6 

    Abbreviations: FMRN: Family Medicine Residency Network; WPRN: WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice Based Research Network

      • View popup
      Table 2. Reproductive Healthcare Service Availability Across Surveys Clinic Sites.
       Total 
      N 
       
      %
      FMRN
       
       
      %
      WPNR
       
       
      %
      WA Title X
       
       
      %
      Total Surveys Sent193459454
      Total Survey Responses  40 18  6 16   
      Contraception          
      Pill, patch, ring40 100 18 100 6 100 16 100 
      Implant39 98 18 100 6 100 15 94 
      IUD 37 93 18 100 4 67 15 94 
      Tubal ligation14 35 10 56 2 33 2 13 
      Vasectomy22 55 11 61 3 50 8 50 
      Early pregnancy loss          
      Expectant management30 75 17 94 6 100 7 44 
      Medication management25 63 15 83 4 67 6 38 
      Uterine aspiration19 48 11 61 3 50 5 31 
      Ectopic pregnancy management 
      Medication management17 43 11 61 2 33 4 25 
      Surgical management6 15 5 28 0 0 1 6 
      Referral29 73 13 72 3 50 13 81 
      None of the above7 18 2 11 3 50 2 13 
      Obstetrics          
      Prenatal care28 70 18 100 6 100 4 25 
      Vaginal delivery25 63 18 1004 67 3 19 
      Surgical delivery18 45 12 67 3 50 3 19 
      Abortion          
      Medication management10 25 4 22 0 0 6 38 
      Uterine aspiration 7 18 2 11 0 0 5 31 
      Referral22 55 10 56 4 67 8 50 
      None of the above12 30 6 33 2 33 4 25 

      Abbreviations: FMRN: Family Medicine Residency Network; WPRN: WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice Based Research Network; IUD: Intrauterine Device

        • View popup
        Table 3. U.S. Supreme Court Decision on Abortion Protections: Changes in Practice and Interest in Incorporating Abortion Care Services and Referral Networks
        TotalFMRNWPNRWA
        Title X
        N % % % %
        Total Surveys Sent193459454
        Total Survey Responses 40 18 6 16
        Has your clinical practice changed any services based on the supreme court decision overturning federal protections for abortion care access? 
        Yes513%16%233%213%
        No3178%1583%467%1275%
        Unsure38%211%00%16%
        Prefer not to answer13%00%00%16%
        Is there concern that people in your community will have increased difficulty accessing abortion and/or miscarriage care as a result of this legal change? 
        Yes1948%633%583%850%
        No1025%633%00%425%
        Unsure1128%633%117%425%
        Interest in developing
        Abortion care40100%18100%6100%16100%
        Abortion referral networks
        Education:
        40100%18100%6100%16100%
        Webinars 1435%739%350%425%
        Learning Collaborative 1743%1056%467%319%
        Not interested820%528%00%319%
        Prefer not to answer513%00%00%531%

        Abbreviations: FMRN: Family Medicine Residency Network; WPRN: WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice Based Research Network

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        The Journal of the American Board of Family   Medicine: 39 (1)
        The Journal of the American Board of Family Medicine
        Vol. 39, Issue 1
        1 Jan 2026
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        Facilitating Abortion Services in Primary Care Settings After the Loss of Federal Protections
        Kathryn Fine, Anna Fiastro, Ying Zhang, Grace Shih, Emily M Godfrey, Dinah Aldrich, Ian M Bennett
        The Journal of the American Board of Family Medicine Jan 2026, 39 (1) 157919; DOI: 10.3122/jabfm.2025.250136R1

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        Facilitating Abortion Services in Primary Care Settings After the Loss of Federal Protections
        Kathryn Fine, Anna Fiastro, Ying Zhang, Grace Shih, Emily M Godfrey, Dinah Aldrich, Ian M Bennett
        The Journal of the American Board of Family Medicine Jan 2026, 39 (1) 157919; DOI: 10.3122/jabfm.2025.250136R1
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        Keywords

        • Abortion
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        • Continuity of Care
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        • Health Disparities
        • Needs Assessment
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