Offering abortion and early pregnancy loss (EPL) in Federally Qualified Health Centers (FQHCs) expands access to care, especially for people with the greatest barriers to care. While the Hyde Amendment prohibits federal funding (including federal Medicaid funding) for abortion care, FQHCs can still provide abortions, using non-federal funds, such as state Medicaid funds, local grants, and other sources. Currently, 17 states have policies that allow state Medicaid funding to cover abortion care. We conducted a mixed-methods study, in partnership with the Reproductive Health Access Project, to understand FQHC leaders’ interest in and experience integrating abortion and early pregnancy loss (EPL) care into their clinics.  

Participants were recruited through email and listserv outreach and completed an anonymous online survey about knowledge of abortion in FQHCs, services provided at FQHC, and interest and concerns related to medication abortion (MAB) and EPL care.​ Participants were invited to participate in an interview exploring these topics further.  

Ninety-three FQHC leaders participated in the survey and 19 participated in interviews. We found most participants (53%) did not know FQHCs can legally provide abortion care. Despite this, most participants (60%) at FQHCs not currently offering medication abortion were interested in providing this care.  

Top barrier to providing MAB that participants identified were fear of not complying with federal regulations and losing federal funding, challenges separating funds, and community pushback. Participants named the Dobbs decision, which overturned the right to abortion in the US, as a factor that made them more interested in expanding access in their FQHC. They also named the need for support with legal and financial compliance in order to provide this care.  

Learn more about how to provide abortion in FQHCs. For questions and support, reach out to the Reproductive Health Access Project at [email protected].