“Two days ago, in obstetrics triage, I had a Hispanic, non-documented patient with no financial support, [a miscarriage] and no resources, desperate for help. I felt so lucky to be able to use my manual vacuum aspirator (a medical instrument used for treating miscarriages) since the operating room (OR) and labor and delivery were booming, and we could not utilize the OR even if we wanted to. It worked great, and I got to train one of the other second-year residents on it. It’s great. The patient was so appreciative, and her family was so grateful. She almost had no pain. When I told her we were done, she could not believe it.” — Third-year obstetrics-gynecology r esident in a Texas hospital

Ipas's U.S. Program works to increase access to safe abortion care — including first-trimester abortion and miscarriage management — for women throughout the country, and advocates for policies that protect and advance women’s right to determine their reproductive futures.

Accessing high quality reproductive health care in the United States, a resource-rich country with one of the world’s most advanced medical systems, is not always possible for some women, particularly marginalized and economically disadvantaged women. This is due to many complex reasons, including the increasingly restrictive political environment that threatens access to abortion services; a decline in the number of hospitals, clinics and private health-care providers offering abortion services; limited public funding for abortion services for low-income women; and a shrinking number of individual health-care providers who are skilled in safe abortion care.

Since 2000, U.S. legislators have proposed more than 300 bills related to limiting women’s access to abortion. Directly threatening women’s health, state legislatures have limited abortion access by reducing public funding for abortions for low-income women, mandating parental consent or notification for minors seeking abortions, and requiring waiting periods for women of all ages before undergoing an abortion. At a time when many countries worldwide are loosening restrictions on abortion, abortion access is becoming more restricted in the United States, where the number of abortion providers fell by almost 40 percent between 1982 and 2001.

In some states, women are forced to cross state lines or travel far distances for an abortion because there are no local providers. In a country that has one of the highest rates of adolescent pregnancy in the world, where half of all women’s pregnancies are unplanned, and where about half of all unintended pregnancies end in abortion, access to high-quality, safe abortion care is critical.

Where access to safe abortion is not easily available and where women lack knowledge about their reproductive choices, some women are resorting to self-induced abortion in the United States. In May 2005, a Latina in South Carolina was jailed for four months after a self-induced abortion using unprescribed misoprostol, a drug used to treat gastric ulcers, that she had obtained from a relative in Mexico. In early 2007, another Latina, this time in Massachusetts, faced a possible homicide charge after self-inducing an abortion with misoprostol pills she obtained from a friend.

• Technical assistance and support to facilitate or improve safe abortion-care service delivery. Working with hospitals, clinics, and other health-care systems nationwide, we provide on-site and remote technical assistance for integrating state-of-the-art abortion and miscarriage management services into women’s reproductive health care services. This often involves moving services from an operating room to an outpatient area in order to improve quality, reduce costs and decrease patient waiting time. It also involves the use of manual vacuum aspiration (MVA), a hand-held, Ipas-manufactured uterine evacuation method that can be used for early pregnancy termination, miscarriage management, and endometrial biopsy. Ipas also provides tools and resources to help institutions with service-delivery improvement and connects institutions with our network of technical experts who have experience in facilitating and sustaining service-delivery changes.
• Reaching women directly. We strive to educate women, particularly highly vulnerable populations like Latinas, about abortion and miscarriage management options. Ipas has a special initiative that focuses on the Latino community in North Carolina, where we are headquartered. North Carolina has one of the fastest growing communities of Latino immigrants in the country. In this statewide effort, we are partnering with progressive organizations to build a network of advocates for Latino sexual and reproductive rights, including the Spanish- and English-language media. Ipas hopes these efforts will lead to a replicable model for increasing awareness among policymakers and public health officials and engaging Latino organizations in successfully advocating for sexual and reproductive rights and access to care.

Additionally, Ipas partners with U.S. reproductive rights groups and other key organizations to educate opinion leaders about the reproductive health issues confronting U.S. women and to advocate for change to ensure safe and high-quality abortion-care practices. Because Ipas has extensive global expertise in reproductive health and rights, we also disseminate information on how U.S. anti-choice policies impact human rights and the ability to access reproductive health-care services worldwide.