The ongoing crisis of abortion care education and training in the United States

Abstract

Purpose of reviewThe Dobbs vs Jackson case (Dobbs) decided by the Supreme Court of the United States (SCOTUS) in 2022 rescinded the constitutional right to abortion care, resulting in immediate state bans and severe restrictions on abortion care in almost half of the states at the time of submission. This article reviews the current state of abortion education and training as well as available curricula and programmes to support continued training. Recent findingsPrior to Dobbs, a national residency-level training programme, the Ryan Residency Training Program, has helped expand abortion care training in residency programs nationally, yet there remained many barriers to incorporating this training into practice, including practice and hospital restrictions. New state restrictions now additionally constrain almost half of all the Ob-Gyn residency programmes. Medical students benefit from education on options counselling and values exploration. SummaryAbortion care education and training is in crisis. Almost half of the Ob-Gyn residents are training in states that have banned or severely restricted abortion care. This threatens to create a workforce without critical early pregnancy management knowledge and skills. Residents are more likely to provide abortion care when they have scheduled routine training. Medical students can apply options counselling and values exploration knowledge broadly. Online education resources provide some patchwork solutions to continue abortion care education and training in this heavily restrictive landscape.

Attitudes and values towards decisions at the margin of viability among expectant mothers at risk for preterm birth

“…Values about preserving life and dealing with disability show similarities to the abortion debate in terms of framing and language (what is affordable, how people imagine their families, what kind of support is realistic, etc.) 19,20 . In a study by Einarsdóttir, parents argued similarly as the expectant mothers in our study about quality of life and living with disability.…”

“…Values about preserving life and dealing with disability show similarities to the abortion debate in terms of framing and language (what is affordable, how people imagine their families, what kind of support is realistic, etc.). 19,20 In a study by Einarsdóttir, parents argued similarly as the expectant mothers in our study about quality of life and living with disability. On the one hand, there were parents who did not want to 'torture' their infant, and on the other hand, there were parents who felt that they did not have the right to decide 'what a life worth living was'.…”

The Next Infodemic: Abortion Misinformation

“…This may result in a workforce that lacks skills and knowledge in early pregnancy management. In fact, nearly half of obstetrics and gynecology residents are currently in states that have banned or severely restricted abortion care, which means that a substantial proportion of the workforce may lack appropriate training and experience to provide the highest quality of care to patients for whom a pregnancy must be terminated [46]. Health care providers are a trusted source of health information for many people [47]; however, to the extent that medical training is compromised by abortion restrictions, health care providers may then be compromised in their ability to provide medically accurate information and health care, and this in turn may impact patient trust.…”

Editorial: Updates in contraception and abortion care: turbulence, upheaval, and chaos, but keeping calm and continuing to care

“…In this tour de force of a review, the authors find that at both the medical student and resident level, state-level abortion restrictions forcing both clinics and hospitals to cease providing abortion care, there is a real and present danger that students and residents will emerge from training without the skills to competently counsel clients in need of abortion-related care, even if it's for miscarriages or pregnancy loss. As a result of this extremely sobering review, they conclude that whether via 'away rotations' at centers where abortion care is available or even through simulations, academic institutions and their leadership must examine and create internal policies to see how to better support abortion care education and training and ensure the next generation of competent caregivers [6].…”