Three residents pointing to a computer monitor

ExPAND Mifepristone Learning Collaborative

ExPAND Mifeprisone, or Excellence in Providing Access to New Directions in Mifepristone Use, is a learning collaborative developed to support evidence-based use of mifepristone for early pregnancy loss (EPL) and/or abortion in primary care settings. Mifepristone is part of a two-drug regimen for medication abortion care that has been shown to improve the treatment of EPL. Yet, research with primary care providers (PCPs) in Illinois revealed that PCPs face numerous barriers in providing this medication for patients, including restrictions imposed by the Risk Evaluation and Mitigation Strategy (REMS) and abortion stigma.

Informed by this research, ExPAND Mifepristone’s Co-Directors, Dr. Debra Stulberg, a family physician, and Elizabeth Janiak, ScD, a public health researcher, developed the program to support primary care clinics in overcoming barriers to evidence-based reproductive healthcare. ExPAND Mifepristone is run by the University of Chicago Department of Family Medicine. The learning collaborative provides expert guidance and technical assistance in the form of specialized resources and tools, hands-on training, in-clinic didactics, and individualized administrative coaching.

The pilot year of ExPAND Mifepristone included two FQHCs who successfully implemented mifepristone for EPL and devised new abortion referral protocols. The following cohort (2022-2023) included three additional clinics, two of which are now offering mifepristone for EPL and abortion care. Future directions include continuing to expand the evidence-based provision of reproductive health services in primary care and analyzing the effectiveness of the learning collaborative in terms of improved patient-centeredness and clinical outcomes.

As ExPAND Mifepristone continues to grow, we hope to cultivate a longstanding network of PCPs and clinical sites equipped with the resources and training needed to expand and protect access to essential reproductive healthcare.

Participation Opportunities

ExPAND Learning Collaborative (12 months) Cohort 3 launched November 2023

  • One-year virtual learning collaborative
  • Participating clinics receive expert clinical, policy/regulatory, and technical assistance with individualized support throughout the program, according to a customized workplan
  • Clinics participate in evaluation activities, including pre-course assessment and staff engagement in pre- and post- surveys and interviews
  • Small grants to each site defray start-up costs and protect participants’ time to participate

ExPAND Condensed Course (4 months) –applications released late January 2024

  • Four-month program with monthly synchronous virtual sessions
  • Participants complete asynchronous pre-work before each session and participate in evaluation activities, including pre-course assessment and staff engagement in pre- and post- surveys

If your clinic is interested in learning more about ExPAND Mifepristone or discussing possible participation in the next cohort, please contact Artria Johnson at

Rasmussen KN, Janiak E, Cottrill AA, Stulberg DB. Expanding access to medication abortion through pharmacy dispensing of mifepristone: Primary care perspectives from Illinois. Contraception 2021;104(1):98-103. (In eng). DOI: 10.1016/j.contraception.2021.03.022.

Calloway D, Stulberg DB, Janiak E. Mifepristone restrictions and primary care: Breaking the cycle of stigma through a learning collaborative model in the United States. Contraception 2021;104(1):24-28. (In eng). DOI: 10.1016/j.contraception.2021.04.002 

Schreiber CA, Creinin MD, Atrio J, Sonalkar S, Ratcliffe SJ, Barnhart KT. Mifepristone Pretreatment for the Medical Management of Early Pregnancy Loss. The New England journal of medicine 2018;378(23). DOI: 10.1056/NEJMoa1715726.

Chu JJ, Devall AJ, Beeson LE. Mifepristone and misoprostol versus misoprostol alone for the management of missed miscarriage (MifeMiso): a randomised, double-blind, placebo-controlled trial. The Lancet 2021;396(10253):770-778. DOI: doi:10.1016/S0140-6736(20)31788-8.

Nagendra D, Koelper N, Loza-Avalos SE, Sonalkar S, Chen M, et al. Cost-effectiveness of Mifepristone Pretreatment for the Medical Management of Nonviable Early Pregnancy. JAMA Netw Open. 2020;3(3):e201594.

Amico JR, Cheng TL, Godfrey EM. Providing Abortion Services in the Primary Care Setting. Primary Care: Clinics in Office Practice. 2018;45(4):599-613. DOI:10.1016/j.pop.2018.07.010

Prine L, Shannon C, Gillespie G, et al. Medical Abortion: Outcomes in a Family Medicine Setting. J Am Board Fam Med. 2010;23(4):509-513. DOI:10.3122/jabfm.2010.04.090229

Godfrey EM, Rubin SE, Smith EJ, Khare MM, Gold M. Women's preference for receiving abortion in primary care settings. J Women’s Health. 2010;19(3):547-53.

Logsdon MB, Handler A, Godfrey EM.  Women's preferences for the location of abortion services: a pilot study in two Chicago clinics. Maternal Child Health J. 2012;16(1):212-6.


Dr. Debra Stulberg

Dr. Stulberg is a Co-Director of ExPAND Mifepristone. Her research explores racial and socioeconomic disparities in reproductive health in the United States. She has a special interest in understanding the effect of religiously-sponsored health care in reproductive health, medical decision-making, and the doctor-patient relationship. Dr. Stulberg is also Associate Professor and Chair in the Department of Family Medicine, The University of Chicago with secondary appointments at the Department of Obstetrics and Gynecology Section of Family Planning & Contraceptive Research, and the Maclean Center for Clinical Medical Ethics.

Elizabeth Janiak, ScD

Elizabeth Janiak a Co-Director of ExPAND Mifepristone. She is an interdisciplinary public health researcher and Assistant Professor at Harvard Medical School and the Harvard TH Chan School of Public Health. Her research traces how public and institutional policies perpetuate inequities in access to and quality of sexual and reproductive health care including contraceptive, abortion, and obstetric services. Current projects include several studies of evidence-based mifepristone use for abortion and early pregnancy loss. Dr. Janiak completed her undergraduate and graduate training at Harvard. She is a recipient of the Society of Family Planning's Junior Investigator Award, the preeminent career development grant for abortion researchers in the United States. Her research has been cited by the National Academies of Sciences, Engineering and Medicine, and covered in dozens of media outlets including The Boston Globe, Salon, and National Public Radio. 

Our Team

Artria Johnson

Artria Johnson

Artria Johnson is the Program Coordinator for ExPAND Mifepristone's Learning Collaborative. She assists with all aspects of study activities including study coordination, regulatory compliance, data collection, and manuscript preparation. She also is a RHOADs Research Coordinator. Artria has a B.A. in Human Development & Learning and is currently working on a MBA in Healthcare Management. Her past work involves coordinating research on the impact of oral health on overall health, aiding in the treatment and compliance for HIV positive patients, and educating elementary school children. She hopes to continue focusing on families and women's reproductive healthcare.

Ashley McHugh, MBA

Ashley McHugh is the Director for Research and Finance for the Department of Family Medicine, The University of Chicago. She manages research operations including study management and regulatory compliance, grants and contracts over the life cycle, and serves as a resource for collaborators and research staff. Ashley has a Master’s in Business Administration with a background in Psychology. She is passionate about access to reproductive healthcare, maternal and child health, and gender equity in the workplace.

Hannah Shireman Photo

Hannah Shireman, MA

Hannah Shireman is the ExPAND Mifepristone Senior Research Analyst. She supports all aspects of study implementation including regulatory compliance, data collection and analyses, and manuscript preparation. Hannah has a Master of Human Rights with a background in legal advocacy. She is particularly interested in understanding and addressing inequities across systems and public policy. Hannah is also a Senior Research Analyst for the Department of Family Medicine, The University of Chicago.

Valeria Hernandez

Valeria Hernandez

Valeria Hernandez is a Research Assistant for the Department of Family Medicine, The University of Chicago.. She assists with all aspects of study activities including regulatory compliance, data collection and analyses, manuscript preparation, and programmatic support. Valeria has a B.S. in Psychology and her past research involved topics such as optimism-pessimism, coping, sex, sexuality, and relationships. She hopes to continue studying societal inequities and has a special interest in developing her skills in data science.

Collaborators and Consultants

  • Lisa Wu
  • Lorna Sanchez
  • Gabriela Betancourt
  • Lee Hasselbacher, JD
  • Kristie Monast, MS Ed
  • Julie Chor, MD, MPH
  • Kelly Fitzgerald, NP