After nearly two decades as a nurse-midwife, I’ve seen firsthand how deeply patients trust nurses to walk with them through some of the most intimate, complex, and vulnerable moments of their lives. I’ve counseled people through pregnancies they celebrated—and pregnancies that brought fear, grief, or uncertainty. And in every case, what they needed most was honest information, compassionate care, and the freedom to decide what was right for them.
That’s why the 2024 ruling in Bryant v. Stein matters. The court affirmed what I and so many of my colleagues have always known: that advanced-practice nurses—like nurse-midwives and nurse practitioners—are fully qualified to provide medication abortion care in North Carolina. This decision corrected a politically motivated restriction that had no basis in clinical evidence and only served to make abortion harder to access, particularly in rural areas where physicians are few and far between.
In my years of practice, I’ve watched the demand for nurse-led abortion care grow—not only from providers eager to practice at the top of their scope, but from patients themselves. They want care from clinicians they know and trust. They want continuity, clarity, and support—not red tape and stigma. As a clinician, researcher, and policy scholar, I understand that expanding the role of nurses in abortion care is not only clinically sound—it’s essential to meeting the real-world needs of our communities.
Still, the dominant narrative around abortion continues to center the physician-patient dyad, ignoring the fact that reproductive healthcare—and abortion—is delivered by teams. Nurses are at the heart of that care team. We’re often the first to confirm a pregnancy, the first to provide options counseling, and the ones who stay with patients before, during, and after their procedures. We’re also the ones answering the hard questions, offering reassurance, and helping people navigate increasingly complex legal and logistical barriers to care.
Despite this, our role in abortion access is still constrained. Legal permission to provide medication abortion is only one part of the equation. We need supportive clinic infrastructures, reasonable reimbursement models, and protection from politically motivated attacks on our practice. We need to invest in training and pipeline programs that equip nurses—especially those from rural and underrepresented communities—to provide this care where it’s most needed.
The truth is, abortion restrictions don’t just harm patients. They demoralize providers. They interfere with our ability to give evidence-based care. They send a chilling message that our clinical judgment and professional expertise can be dismissed at the whim of a legislature or court. And in doing so, they undermine entire systems of care.
I became a nurse-midwife because I believe in people’s right to make decisions about their bodies, their families, and their futures. I became a researcher because I believe in evidence. And I stepped into policy work because I know that no matter how skilled we are as clinicians, laws can still keep us from doing our jobs.
As we face yet another wave of abortion restrictions across the country, I hope we start telling a fuller story—one that includes nurses. Because patients already know what the courts are just starting to acknowledge: that nurses are abortion providers, and we belong in this care.
Jill Sergison is the Pro-Choice North Carolina Board Chair and the founder of Nurses for Reproductive Rights