In rural northeastern Maryland where abortion care is scarce, nurse practitioner Samantha Marsee is now one of the few health professionals trained to offer abortion services. After the overturning of Roe v. Wade, Marsee joined a new training program launched by the University of Maryland School of Medicine and University of Maryland-Baltimore which equips healthcare workers like her to provide abortion services including medication and procedural abortions and effective contraceptive options.
Previously, Marsee had limited knowledge of abortion care but now feels better prepared to support her patients some of whom seek guidance on unplanned pregnancies.
“I have patients who come in for confirmation of pregnancies and then disclose they don’t want to continue with the pregnancy for whatever reason,” she said.
Expanding Access Outside Urban Centers:
The program aims to increase abortion care access outside Maryland’s cities where reproductive services are more readily available. Mary Jo Bondy, associate dean of the University of Maryland-Baltimore’s School of Graduate Studies emphasized the need for such training in rural areas.
“We have proof that receiving this care from an advanced practice clinician is safe,” she said, referring to similar models in other states.
Maryland’s Abortion Care Access Act passed in 2022, broadens the scope of practice for nurse practitioners, physician assistants and certified nurse-midwives to include abortion care. Over the next two years, the program plans to train 120 health providers many of whom will serve in communities less supportive of abortion rights.
Rising Demand and Persistent Barriers:
Maryland has seen a 29% increase in abortions from 2019 to 2023 mostly driven by out-of-state patients. The state recently voted to enshrine reproductive rights in its constitution, a move that underscores Maryland’s commitment to being a safe haven for those affected by abortion bans elsewhere. Despite this support, providers face local resistance: some rural pharmacies refuse to dispense abortion medication and providers worry about safety and employer backlash.
A family physician from Maryland’s Eastern Shore, who asked to remain anonymous described the need for broader support from medical schools and officials.
“This is just health care,” she said, urging efforts to make abortion care access more accepted and routine.
For Marsee, who operates in a conservative area, the next challenge is to spread the word about her new capabilities. She plans to inform her existing patients and hopes that word-of-mouth will help others learn about the services she provides without drawing too much controversy.
“I want people to know I’m here,” Marsee said, “but I don’t want to cause too much outrage and attention.”