The implications of overturning Roe v. Wade on medical education and future physicians

Traub, Ariana; Mermin-Bunnell, Kellen; Pareek, Priyasha; Williams, Sonya; Connell, Natalie; Kawwass, Jennifer F.; Cwiak, Carrie

doi:10.1016/j.lana.2022.100334

Cited by 7 publications

(12 citation statements)

References 7 publications

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“…Understanding contraception provision by physicians has become more important in the context of recent developments in state policies on access to abortion. Over the next few years, medical students’ training on this subject is expected to be constrained by state laws on abortions . In the future, physicians may have to optimize how they prescribe contraception (by prescribing it for longer durations), assess the possibility of contraception failure among its users, and recommend the use of tools such as app-based reminders or alarms .…”

Section: Discussionmentioning

confidence: 99%

“…Over the next few years, medical students' training on this subject is expected to be constrained by state laws on abortions. 41 In the future, physicians may have to optimize how they prescribe contraception (by prescribing it for longer durations), assess the possibility of contraception failure among its users, and recommend the use of tools such as app-based reminders or alarms. 42 Additionally, since a relatively smaller proportion of physicians provide contraceptives, more physicians and medical students may have to undergo training for effective, long-acting, reversible contraception methods such as IUDs.…”

Section: Jama Health Forum | Original Investigationmentioning

confidence: 99%

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Association of Primary Care Physicians’ Individual- and Community-Level Characteristics With Contraceptive Service Provision to Medicaid Beneficiaries

et al. 2023

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ImportanceLittle is known about primary care physicians who provide contraceptive services to Medicaid beneficiaries. Evaluating this workforce may help explain barriers to accessing these services since contraceptive care access is critical for Medicaid beneficiaries’ health.ObjectiveTo describe the primary care physician workforce that provides contraceptive services to Medicaid beneficiaries and explore the factors associated with their Medicaid contraceptive service provision.Design, Setting, and ParticipantsThis cross-sectional study, conducted from August 1 to October 10, 2022, used data from the Transformed Medicaid Statistical Information System from 2016 for primary care physicians from 4 specialties (family medicine, internal medicine, obstetrics and gynecology [OBGYN], and pediatrics).Main Outcomes and MeasuresThe main outcomes were providing intrauterine devices (IUDs) or contraceptive implants to at least 1 Medicaid beneficiary, prescribing hormonal birth control methods (including a pill, patch, or ring) to at least 1 Medicaid beneficiary, the total number of Medicaid beneficiaries provided IUDs or implants, and the total number Medicaid beneficiaries prescribed hormonal birth control methods in 2016. Physician- and community-level factors associated with contraceptive care provision were assessed using multivariate regression methods.ResultsIn the sample of 251 017 physicians (54% male; mean [SD] age, 49.17 [12.58] years), 28% were international medical graduates (IMGs) and 70% practiced in a state that had expanded Medicaid in 2016. Of the total physicians, 48% prescribed hormonal birth control methods while 10% provided IUDs or implants. For OBGYN physicians, compared with physicians younger than 35 years, being aged 35 to 44 years (odds ratio [OR], 3.51; 95% CI, 2.93-4.21), 45 to 54 years (OR, 3.01; 95% CI, 2.43-3.72), or 55 to 64 years (OR, 2.27; 95% CI, 1.82-2.83) was associated with higher odds of providing IUDs and implants. However, among family medicine physicians, age groups associated with lower odds of providing IUDs or implants were 45 to 54 years (OR, 0.66; 95% CI, 0.55-0.80), 55 to 64 years (OR, 0.51; 95% CI, 0.39-0.65), and 65 years or older (OR, 0.29; 95% CI, 0.19-0.44). Except for those specializing in OBGYN, being an IMG was associated with lower odds of providing hormonal contraceptive service (family medicine IMGs: OR, 0.80 [95% CI, 0.73-0.88]; internal medicine IMGs: OR, 0.85 [95% CI, 0.77-0.93]; and pediatric IMGs: OR, 0.85 [95% CI, 0.78-0.93]). Practicing in a state that expanded Medicaid by 2016 was associated with higher odds of prescribing hormonal contraception for family medicine (OR 1.50; 95% CI, 1.06-2.12) and internal medicine (OR, 1.71; 95% CI, 1.18-2.48) physicians but not for physicians from other specialties.Conclusions and RelevanceIn this cross-sectional study of primary care physicians, physician- and community-level factors, such as specialty, age, and the Medicaid expansion status of their state, were significantly associated with how they provided contraceptive services to Medicaid beneficiaries. However, the existence of associations varied across clinical specialties. Ensuring access to contraception among Medicaid beneficiaries may therefore require policy and program approaches tailored for different physician types.

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Section: Discussionmentioning

confidence: 99%

Section: Jama Health Forum | Original Investigationmentioning

confidence: 99%

Association of Primary Care Physicians’ Individual- and Community-Level Characteristics With Contraceptive Service Provision to Medicaid Beneficiaries

et al. 2023

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“…Overturning Roe v. Wade has significant implications for medical and nursing education and will reshape the knowledge, skills, and quality of care provided by future physicians and nurses [ 33 ], particularly in states with bans on abortion or pregnancy age restrictions. Medical school graduates without abortion training will be limited in the skills necessary to manage pregnancy complications including placental abruption, infection, ectopic pregnancy, and eclampsia, because the same medications and surgical techniques utilized for abortion also treat obstetric complications [ 33 ]. Moreover, without adequate abortion care education, long-term quality of reproductive healthcare in the U.S. will likely deteriorate, with negative consequences for women’s health [ 33 ].…”

Section: Unintended Pregnancy and Access To Full Array Of Reproductiv...mentioning

confidence: 99%

“…Medical school graduates without abortion training will be limited in the skills necessary to manage pregnancy complications including placental abruption, infection, ectopic pregnancy, and eclampsia, because the same medications and surgical techniques utilized for abortion also treat obstetric complications [ 33 ]. Moreover, without adequate abortion care education, long-term quality of reproductive healthcare in the U.S. will likely deteriorate, with negative consequences for women’s health [ 33 ]. At the same time, maternal-child nurses (and other health professionals) have long supported policies to reduce maternal mortality, promote health equity, eradicate structural racism, protect the patient-provider relationship, and improve health care delivery for all.…”

Section: Unintended Pregnancy and Access To Full Array Of Reproductiv...mentioning

confidence: 99%

Overturning Roe v. Wade: consequences for midlife women’s health and well-being

Berg

Woods

2023

womens midlife health

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In July 2022, the United States Supreme Court issued a decision in Dobbs v. Jackson Women’s Health Organization that overturned Roe v. Wade, the Supreme Court decision that legalized access to abortion in the United States. The overturning of Roe v. Wade means women’s ability to choose to have an abortion or continue a pregnancy is no longer protected by the constitution of the Unites States (Rohan, Editorial: Overturning Roe v. Wade: What are the implications for perinatal nurses?, 2021). Consequently, each state can now independently decide the legality of abortion. The purpose of this commentary is to discuss potential consequences of the overturning of Roe v. Wade for women’s health, particularly midlife women’s health, in the United States. The consequences discussed include unintended pregnancy, access to the full array of reproductive health services including abortion, impact on the reproductive health of poor women and women of color, and the impact on midlife women in their caregiving roles.

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“…3 The states that have or are considering abortion bans already have physician shortages. 4 These laws will be associated with expanding health care deserts, which lack adequately trained physicians, and worsening disparities across the country. Abortion laws that define life as beginning at fertilization are also problematic for those undergoing in vitro fertilization and will restrict access to infertility care.…”

mentioning

confidence: 99%