Santa Fe only has one abortion provider-which puts it way ahead of most New Mexico counties.

Since the US legalized abortion in 1973 a smattering of City Different abortion providers have come and gone. Dr. Lucia Cies is the one provider who has stayed. Cies has performed abortions in Santa Fe since 1977 and has no plans to cease practicing in the near future.

Due to a national dearth of medical students receiving training in abortion procedures,

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it's likely that once

existing providers in the state retire, there will be few or no one to replace them. "Certainly those of us who started doing abortions in the '70s are getting older," Cies says. "We are concerned about training new providers."

If Cies were to retire, Santa Fe would become another county in New Mexico where women do not have abortion access. Currently, nearly 90 percent of the state's counties have no abortion providers, according to the Alan Guttmacher Institute, a researcher of worldwide reproductive health issues.

"Globally, I think the major concern around reproductive rights of women have to do with access to safe effective measures for women to choose when, where and how many children they want to have," Dr. Justina Trott, director of Women's Health Services, says.

In addition to access to abortion services, Trott and others also are concerned about access to contraception. "In other states where I have worked in Catholic hospitals, we were encouraged not to provide emergency contraception," Dr. Jamie Gagan, head of the medical sexual assault nurse examiners' program at St. Vincent Hospital, says. "Most of the physicians didn't listen and gave it out anyway."

St. Vincent Hospital is not affiliated with a Catholic organization and openly provides emergency contraception to women who have experienced sexual assault, faulty condoms or other difficulties. Such contraception may stop pregnancy from occurring up to 72 hours after sexual intercourse but has sometimes been equated with abortion and, subsequently, opposed.

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A woman's financial predicament also can prevent her from accessing contraception or abortion. "I think the Medicaid program in the state is doing the best job they can to take care of women's reproductive needs," Cies says. "But many women fall between the cracks. They don't have an adequate income, but their income is too high to qualify for Medicaid." The population makeup of the state may also factor into why women in the majority of counties here have limited access to contraception and abortion alike. Because New Mexico is sparsely populated with large rural areas, some women lack the transportation necessary to visit an abortion provider. Merideth Prevost, a third-year medical student at the University of New Mexico Medical School, says one reason there are so few abortion providers in rural areas is that the stigma of providing such a service rises markedly in agrarian settings. Prevost, a member of a group called Medical Students for Choice, aims to increase women's access to abortion providers by making sure medical students are not only exposed to reproductive issues in school but also receive training in performing abortions. "We're actually one of the few medical schools that offers the opportunity to perform both medical and surgical abortions in residency," Prevost says of UNM. "Our faculty advises about getting curriculum reform."

While Prevost worries about the lack of abortion providers, Samantha L Johnson, president of Las Adelitas Women in Politics, worries about the lack of pro-choice female legislators in New Mexico. When Adelitas began in 1993, Johnson says there were no pro-choice female legislators. Now, she says, there are eight, but that number is still too few for Johnson's comfort. During the most recent legislative session, a bill that would have required minors seeking abortions to obtain parental notification almost passed. "It made it onto the Senate floor with a 13-39 vote," Johnson says. "Luckily it didn't end up passing the House of Representatives." Another bill that concerned Johnson would have allowed women who suffered miscarriages to obtain death certificates for fetuses. "Once you define what life and death are it's easier to outlaw abortion," Johnson says of her concern with the bill.

But proposed and existing federal policies have pro-choice advocates up in arms as well. Trott says the abstinence-only curriculum promoted by the Bush administration limits students' access to knowledge about reproductive health and is therefore dangerous. Cies is particularly concerned by the proposed Teen Endangerment Act. "It really discourages abortion providers from taking any chances," Cies says. But Cies primarily dislikes the law because she feels it unfairly focuses on those who seek or provide abortions. "When teens can access reproductive healthcare for STDs without parental consent, abortions shouldn't be singled out," she says.