Will There Be Enough Doctors Who Can Provide The Next Generation Of Women Abortions?

In high school I read John Irving’s excellent book, The Cider House Rules, in which the protagonist, a young man named Homer, is raised in an orphanage under the care of a kindly physician, Dr. Larch, who he is shadowing and learning medicine from. Dr. Larch eventually reveals to him that he’s been performed illegal abortions all along and he’d like to teach Homer how to do the procedure, too. Homer balked at the suggestion, imagining that he could have been aborted instead of growing up happily in the orphanage. The response Dr. Larch gave him has always stuck in my mind: “You may disapprove, but you may not be ignorant or look away.”

That quote popped in my mind when I read Kate Harding’s piece on Salon.com, “Is There A Next Generation Of Abortion Providers?”, a frightening piece about how the ranks of abortion providers are thinning and pro-choicers worry they won’t be replaced.

Harding cited a recent PBS “NOW” special which said the number of overall abortion providers dropped by one-third in a decade: from 2,680 in 1985 to 1,787 in 2005. And the abortion providers who are practicing are getting up in years: two-thirds of second-trimester abortion providers who are in the National Abortion Federation in the U.S. or Australia who responded to a survey are over the age of 50.

There’s a few theories as to why the ranks of abortion providers appear to be thinning. Maybe youngsters in the post-Roe vs. Wade generation take things like abortion and the contraceptive pill for granted. Maybe young docs don’t want to specialize in a field that promises they will live with threats and harassment towards themselves and their families. (No doubt many will be scared by the recent murder of Dr. George Tiller, a Wichita, KS, physician who provided late-term abortions and was shot last month by an anti-choice extremist.)

OK, if newly minted physicians decided not to perform abortion procedures, that would be one problem. But the real problem may be education: Medical Students For Choice says less than 50 out of 130 accredited medical schools in the U.S. offer abortion training in their residency programs.

Of course, what students are actually being taught about abortion matters, too: one OB-GYN interviewed for the Salon piece said her professor expressed clearly anti-choice sentiments and taught a classroom full of medical students the myth—disproved by the National Cancer Institute—that abortion causes breast cancer, as if it were fact. (The piece does not mention which med school this was.)

That same OB-GYN also said her med school instruction on abortion only lasted one hour. The executive director of Medical Students For Choice told Harding that she frequently hears about med students spending only one half hour learning about every contraceptive combined. Is it any wonder Medical Students For Choice says 97 percent of family practice residents and 36 percent of OB-GYN residents have no experience in first trimester abortion procedures?

Sure, not every med student will go on to practice obstetrics or gynecology. But that isn’t the point. Harding asked:

“How can medical schools justify glossing over aspects of healthcare that affect half the population and, in the case of abortion specifically, close to 40 percent of women?”

It’s so true: abortions still happen anyway and most certainly general physicians, but preferably all doctors, should know at least basic care for women who have recently had one. Even if Doctor A doesn’t perform abortions but Doctor B, who practices 500 miles away, does, women who live closer to Doctor A will likely visit him or her if she has side affects, rather than make another trip to see Doctor B. But will Doctor A really be able to help her?

Dr. Mitchell Creinin, director of family planning at the University of Pittsburg, summed it up best: “You could argue that there’s no excuse for not being exposed to abortion, because it’s the second most common outpatient procedure in the U.S.”

Put another way, there is no excuse to deny reality—abortions exist—and no excuse to allow med students to be ignorant.