Check every medical dictionary and before you start appendectomy and anesthesia, you will find an abortion.
The first two procedures are part of the standard training of doctors. But for many medical students and residents in the United States who want to learn about abortion, opportunities are scarce.
And new restrictions are accumulating: In the past year, bills or laws aimed at restricting abortion education have been proposed or passed in at least eight states. The changes come from opponents of abortion, encouraged by new restrictions on the procedure itself, as well as a pending Supreme Court ruling that could change Rowe’s landmark decision against Wade to legalize abortion.
“It’s pretty horrifying what’s happening,” said Ian Peake, a third-year medical student in Oklahoma, where the governor signed a measure banning most abortions on April 12.
Abortion training is not offered at both medical schools in Oklahoma and education on the subject is limited. Prospective doctors who want to learn about this are usually looking for doctors who provide abortions outside the traditional medical education system.
Peak, 32, said that if he wanted to learn how to do colonoscopies, for example, he could work with school staff to monitor a doctor who was doing research or working in a clinic.
“That would be easy,” he said. “To do the same for abortion is almost impossible.” He said it took him six months to find a supplier who wanted to teach him.
Nevada medical student Natasha McGloon received external training and set up a seminar on how to perform a standard medical procedure used for abortions. He offers it at night, in his free time.
The 27-year-old is the daughter of “professional” parents and the mother of two young girls whose right to reproductive choice she wants to protect.
“It was a joke in my family: if people tell me I can’t do something, I’ll do it twice as hard,” she said. “I feel this moral, righteous desire to do so.
LESSONS FOR VISIBLE ABSENCE
Education for physicians in the United States typically includes four years of medical school, where students learn the basics of general medicine and practical patient care. They graduate with a medical degree, which officially makes them doctors. Most then spend at least three years in residency programs, where they receive intensive on-the-job training and special skills.
Medical schools in the United States require students to complete a clerical position in obstetrics and gynecology, but there is no mandate for this to include abortion training. At the postgraduate level, obstetrics and gynecology residency programs are required by an accreditation team to provide access to abortion training, although objecting residents may refuse to perform abortions.
Obstetricians perform most abortions in the United States, followed by family medicine specialists. But these are not always the first doctors women encounter when they learn about an unwanted pregnancy. Proponents of abortion rights argue that all physicians need to know enough about the procedure to inform and advise patients, and that such training should begin at a medical school.
In 2020, Stanford University researchers said they found that half of medical schools did not include formal abortion training or just one lecture.
“Abortion is one of the most common medical procedures,” they wrote. “Still, abortion topics are clearly missing from medical school curricula.
McGloon helped sponsor a measure last year that asked the American Medical Association to support compulsory abortion training in medical schools with a waiver provision. The influential group has long opposed the curriculum’s mandates and rejected the proposal, but said it supports giving medical students and residents the opportunity to learn about abortion and opposes efforts to intervene in such training.
Legislative efforts to limit abortion are targeted at all levels of medical education.
Idaho’s law passed last year illustrates the trend. It prohibits the use of tuition and abortion fees and related activities in school clinics in state-funded institutions.
Other efforts include a bill in Wisconsin that would ban employees of the University of Wisconsin and its hospitals from participating in abortions, including training. He failed to advance in March, but his sponsor plans to reintroduce the measure. Similar proposals are aimed at state universities in Missouri and Ohio.
Wild Jane’s introduction to abortion did not come at her medical school in Missouri – where she said the procedure is rarely discussed – but at a planned parenting clinic in Kansas. She volunteered at the clinic and saw the obstacles women outside the country face in receiving the procedure. Some mistakenly found themselves in a pregnancy crisis center across the street trying to change their minds, Jane said.
Jane, 23, said her first attempt at abortion was “anti-menopausal”, far from the gruesome image she had heard opponents describe.
“It’s just a normal internal procedure,” she said. “These are just patients seeking medical treatment.”
At that moment, she knew she wanted an abortion. “It was like snapping a finger. That changed things for me, “said Jane, who is studying public policy at Harvard while on leave from medical school at the University of Missouri-Kansas City.
A daughter of unbiased but traditional parents who immigrated to Kansas from India, Jane remembers growing up trapped in her family’s traditional culture and a conservative white community where abortion has never been discussed.
“I liked stirring the pot and pushing the boundaries,” she said.
Jane knows that the US Supreme Court’s decision to uphold the Mississippi ban on abortion after 15 weeks of pregnancy could drastically change the abortion landscape in the United States. Despite the decision – expected by the summer – Jane said her goal was to have abortions in “hostile” countries where suppliers were scarce.
“It’s really hard for patients to get the care that patients deserve and need, and I just think that’s wrong,” Jane said.
EXTENSION OF TRAINING
Dr Keith Reisinger-Kindle, 33, an associate director of the Obstetrics and Gynecology practice program at Wright State University School of Medicine in Dayton, Ohio, said his goal of stepping up abortion education was “a tough battle” due to legislative obstacles.
When he arrived at the school almost two years ago, he said he “had zero formal abortion education.” He has created and implemented abortion courses for medical students and residents, with the support of his university, and offers training at a nearby clinic, where he also performs abortions.
The doctor said the state legislature had lobbied university administrators to fire him. And in December, the Ohio governor signed a measure that restricts doctors working in government institutions from working as backup doctors in abortion clinics when rare complications arise. The clinic where Reisinger-Kindle works is suing to block the law.
“There are days that are certainly challenging,” Reisinger-Kindle said. Young doctors, eager to learn, help him continue. The program currently has 24 residents. They may opt out of abortion training, but he said almost everyone has chosen to participate “at least in some capacity”.
He fears new restrictions on abortion are coming, but added: “In the long run, I believe we will be able to deal with this. I just hope my students don’t have to suffer. “
Follow AP medical writer Lindsay Tanner at @LindseyTanner.
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Threatened abortion training for medical students, residents
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