As we approach a deeply uncertain time for reproductive rights and justice in the United States, the larger conversations around what robust and accessible abortion access and care means for our healthcare system continues. And new research published in Obstetrics & Gynecology further backs up the reproductive rights movement’s argument that abortion is a valuable and necessary part of healthcare. Full stop.
According to a study of “self-assessed competence” in caring for patients experiencing a miscarriage among obstetric and gynecology residents, residents who were in programs without training in providing abortions felt less prepared to offer care to people experiencing pregnancy loss. Looking at survey data from an anonymous, virtual questionnaire given to fourth year residents that allowed them to self-assess their comfort and competence of counseling and managing patients experiencing early pregnancy loss as well as determining whether they had received abortion training during their program.
For those in the field, the data represent an important piece of the larger puzzle as more and more states enact anti-abortion restrictions and the future of Roe v Wade is up in the air.
“As states become increasingly hostile to abortion access, it’s imperative that people understand how essential abortion training is and find a way to get these residents trained,” said Dr. Jody Steinauer, Director of the Bixby Center for Global Reproductive Health at the University of California, San Francisco. “Without this training, people around the country will lose access to not only abortion care, but also to comprehensive, patient-centered care for pregnancy loss.”
Dr. Nikki Zite, a physician and another co-author of the paper adds that early pregnancy loss is very common, so it’s essential that OB-GYNs be trained to offer “all appropriate treatment options during an emotionally challenging time.”
Per the March of Dimes, about 10 to 15 of every 100 pregnancies (10-15 percent) end in miscarriage — with the majority of those miscarriages occurring the first trimester (before week 12 of pregnancy) and one in five of them occurring in the second trimester.
“If we’re sending residents out into the world less prepared to provide this type of care,” Dr. Zite says, “patients might not be offered all the options because their physician lacks the confidence to provide them.”
In a statement, Dr. Jema Turk, Director of Evaluation for the Ryan Residency Program, adds that the skill set that is necessary for abortion care “are the same ones necessary to care for someone experiencing early pregnancy loss,” adding that when such training is not required, the residents are less likely to say they plan to provide care for these cases in the future.
The accessibility of this kind of training is also an issue that lead author of the paper Dr. Sarah Horvath raised: “Abortion training is already hard to get for many residents around the country, and it’s only going to get worse with Roe hanging in the balance. This research shows the widespread collateral damage of these abortion restrictions for patient access to competent miscarriage care.” The lack of access to this training can be directly felt in a lack of access to competent and compassionate care.
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