The other abortion ban
I wanted to provide abortions for my patients. My med school wouldn’t teach me how.
By Stephanie Ho
January 4, 2019
FAYETTEVILLE, ARK.
Last year brought one of the toughest moments I’d ever faced as a family doctor. A woman had shown up for her appointment after a three-hour drive to one of our clinics in Arkansas, and we had to turn her away. A state restriction had gone into effect, requiring that abortion providers contract with a physician who has hospital-admitting privileges. It works by weaponizing antiabortion attitudes within the medical community.
Outlook • Perspective
Stephanie Ho is the director of primary care for Planned Parenthood Great Plains.
Illustration by Marina Muun for The Washington Post
My staff and I had been attempting to comply with the law since it was passed in 2015. We reached out to every OB/GYN we could find. Receptionists would hang up on us or refuse to take a message. The doctors who did answer said that while they might personally support a woman’s right to choose, their colleagues did not. One told me that for him to sign on as a backup, he’d need permission not only from his hospital administrator but also from the Diocese of Little Rock — “and after that,” he added, “the pope.” We finally found a willing obstetrician in November.
This fear doesn’t surprise me. Medication abortion is one of the safest procedures out there; it’s less risky than wisdom-tooth extraction (which requires anesthesia). But doctors and nurses in Arkansas are so afraid of abortions — and the attendant politics — that it’s almost impossible to learn about them as a medical student, let alone administer them. Where I grew up, in the River Valley of western Arkansas, nobody said the word “abortion” out loud. When I went to medical school at the University of Arkansas for Medical Sciences (UAMS) in Little Rock, that censorious silence didn’t relent. Over four years, the most exposure we got to the topic was a half-hour guest lecture. (At that time, 17 percent of medical schools offered no formal abortion education, according to a national survey published by the American Journal of Obstetrics and Gynecology.)
That implicit disapproval carried over to my residency in family medicine, which I began in 2008 at UAMS West in Fort Smith. Second-year residents gave presentations on a topic of their choice — and mine, on abortion, was the most highly attended and contentious that year. A senior faculty member vocally disagreed with my description of abortion as a common medical service, interrupting every few sentences and quoting the Bible at me. Someone dubbed me the “abortion chick,” and the nickname stuck. Whenever a patient at the clinic wanted to learn more about terminating a pregnancy, the staff would call me in to talk her through her options, even when I wasn’t scheduled on a shift. My fellow physicians didn’t feel comfortable sharing information about abortions.
More:
https://www.washingtonpost.com/news/posteverything/wp/2019/01/04/feature/i-wanted-to-provide-abortions-for-my-patients-my-med-school-wouldnt-teach-me-how/?utm_term=.df2d2eb92abc
The Scarcity of Abortion Training in America's Medical Schools
Many students who want instruction aren't able to find it. And those who get it, like me, often aren't willing to move to the areas of greatest need.
Mara Gordon
Jun 9, 2015
Last spring, I attended a conference for pro-choice medical students outside of St. Louis, and there I met the doctor who helped fill the void left by George Tiller. (I attended on a scholarship from Medical Students for Choice, which sponsored the conference. The organization also funds a reproductive-health externship, which I enrolled in earlier this year.*)
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When I started medical school at the University of Pennsylvania, the culture war surrounding abortion still seemed abstract and far away. I grew up attending pro-choice rallies with my physician mom in Washington, D.C., and all my parents’ doctor friends supported abortion rights.
My medical education seemed to confirm my false sense that everyone working in healthcare felt the way I did about abortion access: Abortion was discussed in class as openly as blood pressure and diabetes, and spending a day in family-planning clinic was an opt-out, not opt-in, part of our clinical education. Many of my professors who work in family medicine routinely perform abortions for their patients, so when I started to think more seriously about a career in primary care, I assumed that making abortion part of my practice would be an easy decision.
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Meeting these medical students made my own experience suddenly come into focus: They had to fight to learn about abortion, while my own educational opportunities in reproductive health had simply fallen into my lap. The stigma attached to abortion providers doesn’t just come from clinic protestors or grotesque billboards. It can come from within our own profession, too. It can be overt—like the heartbreaking story of that student’s father’s early death—but it can also be more subtle, like a medical curriculum that doesn’t cover abortion care.
More:
https://www.theatlantic.com/health/archive/2015/06/learning-abortion-in-medical-school/395075/
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