Who can provide abortion care? Considerations for law and policy makers.
For women who want to end their pregnancies, laws that allow only medical doctors to provide abortion are real barriers. Abortion can safely be provided by nurses, midwives, paramedical personnel and other midlevel providers. Women who have correct information can take pills to end a pregnancy safely outside a health facility. However, many abortion laws require the involvement of one or more medical doctors. These laws criminalize women and other health professionals who end pregnancies safely without a doctor. Under doctor-only laws, health systems—particularly in the global south—cannot train enough abortion providers to make abortion accessible to all women. Doctor-only laws discriminate against women who belong to vulnerable and disadvantaged groups and who are least likely to have access to medical doctors. Lawmakers need not designate who can provide abortion in the law. Documents such as national health standards and guidelines are better suited to clarify who are authorized providers. This publication explains how Standards and Guidelines, enacted by the Ministry of Health and ideally updated every few years, can reflect the latest scientific evidence in abortion care.