Lack Of Medical School Training On Abortion Contributes To Decline In Providers, Salon Opinion Piece Says

Main Category: Medical Students / Training
Also Included In: Abortion
Article Date: 16 Jun 2009 - 7:00 PDT

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Salon contributor Kate Harding on Monday examined how a lack of training in medical schools is affecting the availability of abortion providers in the U.S. Harding reports that 87% of all U.S. counties and 98% of rural counties have no abortion services. In addition, nearly two-thirds of physicians who perform abortions in the second trimester are older than age 50 and "bound to retire sooner rather than later," she writes. Harding also cites figures from PBS' "NOW" showing that the number of abortion providers has dropped by one-third in recent decades -- from 2,680 in 1985 to 1,787 in 2005. According to Harding, although a fear of violence and a tendency of younger doctors born after Roe v. Wade to "take abortion for granted" are "probably" factors in the drop in providers, another important issue is inadequate education in medical schools. According to a recent survey of Medical Students for Choice student members published in the journal Contraception, 33% of the students "'reported no coverage of elective abortion-related topics,'" Harding writes. MS4C reported that fewer than 50 U.S. medical schools, out of 130 accredited institutions, offer abortion training as part of their residency programs. Harding adds that family planning training that does exist is "often patchy and rife with misinformation."

The reasons for avoiding the issue of abortion in medical education vary, according to Harding. Mitchell Creinin, president of the Society for Family Planning, said that even though abortion is the second most common outpatient procedure in the U.S., many students will not pursue specialties that involve providing abortion and those who do might choose not to offer the procedure. Creinin also noted that doctors in many other specialties complain about the lack of medical school training in their particular fields. According to Harding, taking this view, "you could also argue that it's a waste of time in an already overburdened curriculum."

Another factor is that "the same relentless pressure" from abortion-rights opponents "that plagues practicing abortion providers is also directed at medical schools," Harding writes. According to Susan Wicklund, an ob-gyn in Montana, some antiabortion-rights groups pressure administrators and faculty at medical schools not to discuss abortion and threaten boycotts or picketing. Lois Backus, executive director of MS4C, said the lack of abortion training reflects a larger problem in medicine of focusing on men's health needs over women's. Backus said medical students report that they "'get two to three hours on Viagra and half an hour on every contraceptive method combined. That's the reality of American medical education.'" According to Harding, this fact is "even more troubling in light of research that shows exposure to comprehensive family planning education, including abortion, is a strong predictor of whether a medical student will go on to become a provider."

Creinin said comprehensive education in reproductive health is worthwhile, even for doctors who never intend to perform abortions. He noted that many physicians received training on cancer care, though they are much more likely to treat a patient with an unintended pregnancy. According to Wicklund, the lack of physicians trained in reproductive health also means that women who travel to access an abortion provider cannot get adequate follow-up care when they return home. Harding adds that such "ignorance often leads to overreaction on the part of doctors" who do not understand how to treat minor complications resulting from abortions, which results in "expensive, unnecessary hospital stays for women who might not have insurance" (Harding, Salon, 6/15).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

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