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WAREHAM — For nearly two decades, the South Coast was without a clinic that could perform abortions.
Accessing the procedure meant leaving one’s community, and spending the time and money — common barriers to abortion care — to travel farther to Providence, Attleboro or Boston.
That access gap closed this fall when Health Imperatives, a sexual and reproductive health organization, started offering the procedure at its Wareham clinic.
The service — termed a procedural, in-clinic or surgical abortion — had gone away locally in 2004 and 2008, when sites in New Bedford and Hyannis shuttered. Now, residents on the South Coast, cape and islands can shave anywhere from 15 minutes to an hour off the travel time.
The lower end might not seem like a lot, but experts say a half-hour can be the thing that keeps pregnant women from accessing the care they need. Half of the people Health Imperatives serves are also uninsured or underinsured, and some don’t speak English. With a location closer to their community, or even in it, and providers who can speak their languages, they face fewer hurdles.
Those reasons are critical in a practical sense, providers and abortion rights advocates say, but the added service also matters on a personal level.
As a matter of preference, “sometimes people don’t want a medication abortion,” said Cori O’Neill, a nurse practitioner at Health Imperatives.
Procedural vs. medication abortion
The in-clinic procedure can take a few to 10 minutes, and generally does not require a follow-up visit.
The procedure uses a speculum, a cannula (a thin plastic tube), and a manual vacuum aspirator (a handheld plastic device).
It also uses a local, injected anesthetic, and sometimes dilators — procedural steps for other services like intrauterine device insertions and endometrial biopsies. Because of that, O’Neill said she prefers the term procedural over surgical abortion, particularly because they are treating patients in their first trimester.
Sapna Khatri, an attorney and executive director of Boston University’s Program on Reproductive Justice, echoed this.
“When you hear surgical, yes it is normalized in the sense we know it’s medical. But surgery implies a certain level of fear and apprehension,” she said, adding the procedure will often happen in a clinic room, not an operating room.
The procedure room at the Wareham clinic is small and similar to exam rooms at doctors’ and dentists’ offices.
O’Neill, who also serves as director of quality assurance, brought out some of the instruments used. The plastic cannula is “bendy and soft,” she said, flexing it with both hands. The plastic manual vacuum, which attaches to the cannula, has a plunger. It’s pulled up to create a suction that removes the embryonic or fetal tissue. The metal speculum and dilators were in a metal box, wrapped in a sterile blue cloth.
After the procedure, the patient will sit in the recovery room, which has an emergency equipment cart, machines to monitor vitals, a mini fridge with beverages and snacks, and a speaker to play relaxing music. In there, the dimmed, incandescent lamplight is meant to provide a calming respite from the bluish LED overheads characteristic of most healthcare settings.
After being monitored for about 15 minutes by a nurse, the patient can leave with a packet of information about post-abortion care in hand.
Medication abortion, in contrast, is done in part or fully at home. The two medications are taken 24 to 48 hours apart.
In some cases, O’Neill explained, a person may need to return to their provider after taking the medication to have the remaining pregnancy tissue removed, which could make procedural abortion (which has a slightly higher success rate) a more appealing option.
Medication abortion is also limited to around 10 weeks gestation. By offering procedural abortion up to 14 weeks, Health Imperatives has added another local option if a patient is past that gestational window.
As context, about 96% of the more than 49,000 abortions reported by health providers to the state in 2024 occurred by 12 weeks gestation. About 82% of abortions used the medication method, while the suction method that’s employed by the Wareham clinic was used in just under 5% of cases.
“In-clinic care as an option is really critical,” Khatri said. “We can’t just rely on telehealth and medication [abortion] in this landscape.”
In 2022, The Light reported that anti-abortion pregnancy centers (🔵 blue dots) outnumbered abortion providers (🟢 green dots) in the South Coast. Years later, with Health Imperatives’ adoption of medication abortion in 2023, and the procedural option in 2025, abortion providers now outnumber these centers in and near the region.
The Massachusetts Attorney General’s Office, which also calls the anti-abortion sites crisis pregnancy centers, has issued warnings to residents about how the centers do not provide abortion care or referrals, and may attempt to delay care. Many are affiliated with religious organizations.
The centers provide services to pregnant women and mothers, such as free ultrasounds, parenting classes and supplies. But the American College of Obstetricians and Gynecologists warns they may try to dissuade women from accessing certain types of reproductive care, including abortion and contraception.
One state has sought to limit the mailing of abortion pills through a federal lawsuit, while the Trump administration’s Food and Drug Administration is conducting a review of the safety of the medication, mifepristone. The FDA approved the drug for abortion in 2000, and the American Medical Association says the drug’s “safety profile” is comparable to that of ibuprofen.
According to the American College of Obstetricians and Gynecologists, both abortion methods carry risks, as do most medical procedures, but both are safe with complications rare.
More than 100 patients served so far
Between last October and this month, the Wareham location has provided procedural abortions to 105 patients (at least 30 from New Bedford). It’s a small subset of the services the organization provides, including sexually transmitted infection and HIV testing, cervical cancer screenings, gender-affirming care and contraception.
Over the same period, Health Imperatives provided 454 medication abortions, and attended to patients with nearly 8,000 appointments.
Emily Gold, Health Imperatives’ director of medical services, said it’s been “heartening” to serve the diverse population of women in the South Coast, who come from Cape Verde, Haiti, Brazil, Guatemala, El Salvador and other Central and South American countries.
The office provides translation services, either through staff who are on site or can be reached by phone, or a third-party translator.
O’Neill said the patients who receive abortions return to Health Imperatives for other care, including STI testing or birth control counseling: “There’s a lot of continuity with care… the experience is a safe enough experience that they come back for other things.”
Health Imperatives offers financial support for the procedure, as well as transportation, helping organize and pay for the rides to and from the clinic.
“No one is denied based on the inability to pay,” said Gold.
The added service was made possible, in part, by donations and a $2.5 million grant from the Melinda French Gates Foundation to support women’s health, received last year. The grant is also supporting other services at the clinics.
The organization operates seven sites in Southeastern Massachusetts, including in New Bedford, Nantucket and Martha’s Vineyard, but chose the Wareham location as it was most equidistant. For now, that will be the only site offering procedural abortions. However, every location has been offering medication abortion since mid-2023.
At the Wareham site, art hand-picked by the staff lines the walls. They include pastel floral prints, and illustrations from the Repeal Hyde Art Project, an effort to raise awareness of the Hyde Amendment. The provision, passed in 1977, prohibits the use of federal Medicaid funds to cover abortion.
“You deserve to choose not to parent regardless of the circumstances of your pregnancy and how much money you make,” reads a framed piece hanging in the hall just past reception. “Affordable abortion access is reproductive justice.”
The path to the procedure room is marked with more art from the project, displaying messages about justice and empowerment.
The staff said their goal was to create an environment in which patients feel comfortable and not judged.
“Our clients are in a very vulnerable stage of their lives and they trust us,” said Eni Grant, associate director of sexual and reproductive health services. “It’s hard going to someone you’ve never met to have an abortion. You’re disclosing everything in your life.”
That mission could explain what patients see not just on the walls, but with the staff themselves.
Grant wears a crocheted vagina, gifted by a colleague, that dangles over her ID badge.
Jessica Cisternelli, director of sexual and reproductive health services, wears two badge clips: one is a uterus, and the other is a circle with the colors of the LGBTQ+ and transgender pride flags that reads, “You are safe with me.”
Clasping O’Neill’s badge to her scrubs is a bright pink heart (not the anatomical kind).
Recently, a Haitian woman came in for a procedural abortion. She was stoic, Gold said, but got to talking with staff about cooking plantains and what she missed about home. Gold walked her into the recovery room, and after sitting down, she said the patient put her hands together in the shape of a heart.
“We care so much about the work,” Gold said, “and I hope it shows to our patients.”
Email Anastasia E. Lennon at alennon@newbedfordlight.org.
This is a blessing for many women. The choice is theirs and no one else! To others, people who live in glass houses should not throw stones. This also helps with a woman’s mental health, no longer in fear! The choice is theirs!
I agree it’s important to have a place that is safe with no judgement. Also seems to be staffed with caring, supportive, and qualified professionals.
I am so grateful women have the right to choose in Massachusetts. Thank you for this article and thank you to the nurses who are staffing this clinic. All Americans likely know someone who has had an abortion, but because of the stigma most people keep the procedure a secret. Women from all walks of life choose to have this procedure including me. I had an abortion at age 40 because my birth control failed. I already had two kids, a stable marriage, and a full time job. It was my choice. I went to Providence’s Planned Parenthood to have the procedure done. I felt safe, respected, and cared for during my experience. I’m so glad access has been expanded for women on the southcoast. Wonderful article!
Your choice is your choice. No reason or need to explain to anyone. No need to feel ashamed, there is nothing to be ashamed of. Glad to know you are healthy now in body and mind!
Amazing news for our community! Manual Vacuum Aspiration is an extremely safe procedure and it’s great to increase local options. It’s a shame that our local health system has blocked its providers from offering comprehensive reproductive health care. Thanks also to the MFG foundation for supporting women on the Southcoast.
Now if only there could be some legislation to regulate or do away with the so-called crisis pregnancy centers that seem to exist for no other reason than to assuage Catholic guilt.
May God forgive the women who dismember and or otherwise kill unborn children. May God forgive the mothers who kill their unborn. The womb should be the safest place. Sad that this slaughter house is going to be in Wareham.