Access to Reproductive Health Care in the Emergency Department

Originally approved June 2023.

The American College of Emergency Physicians (ACEP) supports equitable, nationwide access to reproductive health care, procedures, medications, and other interventions for all patients.

ACEP supports the position that the early termination of pregnancy (publicly referred to as “abortion”) is a medical procedure, and as such, involves shared decision-making between patients and their physician regarding 1) discussion of reproductive health care, 2) performance of indicated clinical assessments, 3) evaluation of the viability of pregnancy and safety of the pregnant person, 4) availability of appropriate resources to perform indicated procedure(s), and 5) is to be made only by healthcare professionals with their patients.

ACEP specifically opposes the penalization of and or retaliation against patients, patient advocates, physicians, healthcare workers, and health systems for receiving, assisting, or referring patients within a state or across state lines to receive reproductive health services and medications for contraception, abortion, and pregnancy complications, and will further advocate for legal protection of said individuals.

ACEP opposes the statutory provision of criminal penalties for any medically appropriate care provided in the emergency department. ACEP also opposes mandatory reporting with the intent (explicit or implicit) to prosecute patients or their healthcare providers, which includes, but is not limited to, care for any pregnancy, pregnancy-related complications, or pregnancy loss.

ACEP affirms that: 1) abortion is a medical procedure that should be performed only by a duly licensed physician, surgeon, or other medical professional in conformance with standards of good medical practice and the Medical Practice Act of that individual’s state; and 2) no physician or other professional personnel shall be required to perform an act violative of good medical judgment and this protection shall not be construed to remove the ethical obligation for referral for any medically indicated procedure.

ACEP encourages hospitals and emergency medicine residency training programs to provide education, training, and resources outlining evidence-based clinical practices on acute presentations of pregnancy-related complications including miscarriage, post-abortion care, and self-managed abortions.

ACEP advocates for universal access to emergency contraception in the emergency department.

ACEP continues to develop clinical practices and policies that protect the integrity of the physician-patient relationship, the legality of clinical decision-making, and possible referral to additional medical care services, even across state lines, for pregnancy-related concerns including abortions.

ACEP supports clear legal protections for emergency physicians providing federally-mandated emergency care, particularly in cases of conflict between state and federal laws which include EMTALA and HIPAA.

ACEP supports an individual’s ability to access the full spectrum of evidence-based pre-pregnancy, prenatal, peripartum, and postpartum physical and mental health care, and supports the adequate payment from all payers for said care.