The APC Abortion Provider Toolkit

by NAF’s Clinicians in Abortion Care Program

The Abortion Provider Toolkit is an evidence-based resource designed to help advanced practice clinicians (APCs)—including Midwives, Nurse Practitioners (NPs), and Physician Associates (PAs)—practice to their full scope. It frames abortion care as a standard and integral facet of primary, sexual, and reproductive health care for all providers.

This Third Edition of the APC Abortion Provider Toolkit is published by Clinicians in Abortion Care, an Advanced Practice Clinician community and advocacy program of the National Abortion Federation.

This third edition updates, expands, and transforms the publication into a dynamic digital resource. For two decades, the toolkit has served clinicians, researchers, advocates, and educators. This version builds on that legacy while honoring the creators and contributors of past iterations.

The First Edition (2009)

In 2009, APCs could legally provide procedural abortion care in only four states. To address this, a team of clinicians, researchers, and advocates from the Abortion Access Project, Advancing New Standards in Reproductive Health Care (ANSIRH) at UCSF, and the National Abortion Federation (NAF) developed a dedicated resource for APCs.

Lead authors Diana Taylor, RNP, PhD, and Barbara Safriet, JD, LLM, leveraged decades of cross-professional collaboration to challenge outdated state practice laws. They were joined by co-authors Grayson Dempsey, Beth Kruse, MS, ARNP, CNM, and Courtney Jackson, PhD. Together, they published "Providing Abortion Care: A Professional Toolkit for Nurse-Midwives, Nurse Practitioners, and Physician Assistants."

This foundational edition shifted advocacy strategies away from abortion politics and toward scope-of-practice protections. It emphasized that abortion should be regulated like any other clinical procedure—based on education, professional standards, and competency—rather than being singled out by restrictive laws. Templates and checklists were created to guide clinicians in the development of a professional portfolio to document basic and abortion-specific education, knowledge, practice standards, and training for providing safe, competent care.

The Second Edition (2018)

By 2018, the landscape had shifted. Six states allowed APCs to practice fully, driven by grassroots advocacy, legislative victories in California and Colorado, and data from the California Health Worker Pilot Project. The safety and efficacy of APC care was further validated by the National Academies of Sciences, Engineering, and Medicine (NASEM) report, The Safety and Quality of Abortion Care in the United States.

To reflect new research, data, and regulatory changes, Lisa Summers, CNM, DrPH joined original authors Diana Taylor and Barbara Safriet, with continued input from Beth Kruse and Grayson Dempsey, to release the second edition. This update continued to guide current and future APC providers and advocates with key statistics, policy strategies, professional competencies, and navigating state licensing boards.

Policy & Regulatory Framework—Scope of Practice Protections

The toolkit establishes a critical regulatory framework that shifts advocacy away from exceptionalist abortion politics and toward standard scope-of-practice protections. It provides policy makers and clinicians with empirical evidence needed to align state practice laws with existing professional accountability mechanisms:

Standardized Regulation: Advocates for treating abortion care uniformly with other clinical procedures, regulated strictly by established educational preparation, clinical standards, and professional competencies.
Abolishing Exceptionalism: Demonstrates how specialized regulatory restrictions on qualified clinicians artificially limit patient access without clinical justification.
Professional Integrity: Leverages robust ethical requirements, licensing board standards, and national competencies already governing advanced practice nursing, midwifery and physician associate professions to justify scope expansion.
Coalition Building: Case histories from multiple states provide templates for APCs and advocates to effectively develop relationships within existing networks, counter challenges to scope of practice, and continue to meet the needs of the people they serve.

The Third Edition (2026)

The third edition is now housed within NAF’s Clinicians in Abortion Care (CIAC) program, passing leadership to a new generation of clinician-advocates. The lead authors of this edition are Julie Jenkins, DNP, WHNP-BC, and Stephanie Tillman, PhD, CNM, along with Collective Power Interns Myra Bajwa and Annabel Gold, and Senior Authors Meghan Eagen-Torkko, PhD, CNM, and, of course, Diana Taylor.

By 2026, the legal and regulatory landscape has altered radically. Advocates have successfully dismantled APC bans in roughly 25 states. Due to the high volatility and rapid pace of legal changes, this edition has been redesigned as a living document. It functions as an agile, up-to-date repository that can be instantly updated with new research, data, and resources as they emerge.

In this updated edition, the APC Toolkit provides practical, field-tested resources for students, clinicians, administrators and advocates as they pursue their goal of increasing access to abortion - an integral component of comprehensive reproductive health care.

Locations Where Advanced Practice Clinicians (APCs) Can Provide Abortion Care

Procedural and medication
Medication only
Neither

DC is included. Restrictions apply for some APC types in Kansas.

Who is the Toolkit For?

The Toolkit is intended to prepare clinicians, educators, administrators, collaborators, and advocates to play various roles in improving access to abortion care.

Clinicians

For clinicians in particular, the Toolkit is a professional development resource. Midwives, NPs, and PAs—working in independent clinical practice, primary care, or reproductive health specialty areas—can use the Toolkit to create individual plans for advancing clinical practice in abortion care.

Administrators

Administrators who are responsible for human resources and clinical policies and procedures can use the Toolkit to further build supportive clinical environments, and can be especially influential when addressing barriers faced by Advanced Practice Clinicians (APCs) as abortion providers.

Educators

Faculty and administrators within academic institutions and training programs that prepare health care professionals can use the Toolkit to ensure that comprehensive reproductive health care—including abortion care—is taught as an integral component of both gender-related health and primary care programs.

Learners

Learners can use the Toolkit to familiarize themselves with the roles of Advanced Practice Clinicians (APCs) in abortion care, and to better understand barriers to providing care throughout the United States. This helps prepare them to advocate for expanded abortion care curricula to support their educational mission and practice to their full scope.

Other Professionals

Other professionals who work alongside Advanced Practice Clinicians (APCs)—including physicians, nurses, and clinic staff—can use the Toolkit to further their understanding of and advocacy for APCs providing abortion care.

Policy Makers / Advocates

Advocates can use the Toolkit in their increasingly critical role helping to shape policy and working with clinicians and administrators to protect and expand access to reproductive health care.

Representatives

Representatives from professional associations and regulatory boards who recognize the value of professional determination of scope of practice can use the Toolkit as they seek to further their understanding of abortion care and ensure that the health and safety of patients are protected.

Acknowledgements

Gratitude for all those who have made this possible...

The APC AP Toolkit is the culmination of literal decades and communities of work. The Third Edition’s primary authors would like to acknowledge, first and foremost, the Indigenous healers and Black midwives who provided full scope abortion and birth care for communities and whose history and traditions carried forward the current models of midwifery and APC leadership in abortion care. Additionally, we thank the original authors of the first two editions, current and past members of the CIAC Advisory Committee (Mark-Christopher Adams, Molly Altman, Erika Bramlette, Alexi Child, Kiernan Cobb, Tanvi Gurazada, Kelly Nichols, Morgan Nuzzo, Kate Stevens, Ciara Thomson-Barnett), community members Bethany Golden, Amy Levi, Kathy Simmonds, and Ellen Solis, Collective Power intern Grant Walker, and the members of the Clinician Abortion Training Collaborative working group, as well as the Midwives, Nurse Practitioners, and Physician Associates who entrust us to reflect their clinical work, advocacy efforts, scope of practice, and educational activism in this resource. This is a living, dynamic document that will continue to be revisited, edited, and shaped in community, and we are indebted to those who contribute to making sure this Toolkit reflects the current APC community and the trainees and patients we all serve.

How To Cite This Toolkit:

Jenkins, J., Tillman, S., Bajwa, M., & Gold, A., Eagen-Torkko, M., Taylor, D. (2026, October 29). The Advanced Practice Clinician Abortion Provider Toolkit, Third Edition. National Abortion Federation: Clinicians in Abortion Care.