As restrictions on abortion increase nationwide, it is critical to ensure ongoing access to abortion care throughout pregnancy. People may seek abortions later in pregnancy as a result of financial or legal barriers that delay care or because of changing circumstances, such as the status of their partner, the health of other children, employment, or a new fetal diagnosis. New York State has been a beacon for abortion access since 1970. Yet, after Roe v Wade was decided, New York State abortion law was not in compliance with federal law, and risk-averse medical institutions hesitated to provide later abortions, forcing patients out of state for care. After years of advocacy, the Reproductive Health Act was passed in 2019. Clinicians and advocates collaborated to translate policy into expanded practice at NYC Health + Hospitals, the largest public health care system in the United States. NYC Health + Hospitals conducted an internal review, identified barriers to abortion care, and addressed these through improvements in public and internal communication, strengthening of procedural skills, and a better referral system. As a result, abortion services have become visible and the system's capacity and gestational age limit have expanded. The example of NYC Health + Hospitals is an instructive model to ensure that abortion care is provided to the most vulnerable patients, including those who need care later in pregnancy. Given the ongoing threat to reproductive rights, this example of expanded access is particularly timely.

中文翻译：

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解决堕胎机会危机：倡导案例研究。


随着全国范围内对堕胎的限制增加，确保在整个怀孕期间持续获得堕胎护理至关重要。人们可能会在怀孕后期寻求堕胎，因为经济或法律障碍导致护理延误，或者情况发生变化，例如伴侣的状况、其他孩子的健康状况、就业或新的胎儿诊断。纽约州自1970年以来一直是堕胎准入的灯塔。然而，罗伊诉韦德案判决后，纽约州堕胎法与联邦法律不符，规避风险的医疗机构对提供后期堕胎犹豫不决，迫使患者退出国家的照顾。经过多年的倡导，《生殖健康法案》于 2019 年获得通过。临床医生和倡导者合作，将政策转化为美国最大的公共卫生保健系统 NYC Health + Hospitals 的扩展实践。纽约市健康+医院进行了内部审查，确定了堕胎护理的障碍，并通过改善公共和内部沟通、加强程序技能和更好的转诊系统来解决这些问题。结果，堕胎服务变得可见，系统的容量和孕龄限制也得到了扩大。纽约市健康+医院的例子是一个指导性模型，可确保向最弱势的患者（包括那些在怀孕后期需要护理的患者）提供堕胎护理。鉴于生殖权利持续受到威胁，扩大生育权的这一例子显得尤为及时。