AAP Board President Traci Baird sits in for Executive Director Melanie Zurek, currently on maternity leave.

Bold and needed. At the end of 2007, AAP launched the Least Access States Initiative. From my perspective as the President of the AAP’s Board of Directors, taking on the challenge of abortion access in the most restricted states in the US is a natural crescendo of AAP’s 10 years of work.

As a group of clinicians, researchers, and advocates, the Board is very proud of this new project.  AAP is an organization known for embracing new challenges and strategies; venturing into those states where women currently have the least access to abortion services is certainly within AAP’s assertive reach.

AAP has a track record of attaining difficult goals.  In its other projects, the organization has diversified the way abortion is provided by reaching out to family medicine doctors, nurse practitioners, and other advanced practice clinicians. In the past year, AAP tackled the complicated issue of self-induced abortion, convening partners to carefully address the immediate needs and the broader unknowns. Additionally, projects are now in place in rural areas, expanding abortion access in communities where general medical care is also scarce.

For the Least Access States Initiative, AAP takes on new challenges using proven strategies from existing work and embracing a model new to AAP and the United States:  the World Health Organization’s Strategic Approach to Contraceptive Introduction.  This model provides a participatory way to identify and meet a need; it is widely used with success in other countries around the world.

The expansion of abortion care can be slow moving; the most meaningful gains are hard won.  It is tempting to go for the “quick win”—for example, establishing an additional provider in New York State.  But AAP’s focus is on addressing the biggest need, not simply increasing numbers.

There is unquestionably a need for safe abortion care in ‘least access’ states.  Adding a provider in New York doesn’t make a difference to the women of West Virginia or Arkansas.  While women remain resilient and resourceful even when faced with the most difficult conditions, there are systematic barriers that block women in ‘least access’ states from the care they need:  waiting periods, long distances to abortion providers, lack of state funds, financial strain, tenuous employment, and lack of child care.

Women in ‘least access’ states will continue to fall through the cracks unless we focus systematically on identifying and implementing strategies to increase their access to abortion care.  It’s a certainty that the work of AAP’s new project will be challenging.  But with proven strategies, strong financial support, and intensive community involvement, I am confident that we will bring about significantly improved access in these states.  AAP stands ready to accept this challenge.

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