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Changes to abortion laws mean OB-GYNs have less opportunities to learn procedure


There are about 6,000 residents in the U.S. training to be OB-GYNs. The Supreme Court's decision to overturn Roe v. Wade has far-reaching implications for them. Katia Riddle has more.

KATIA RIDDLE, BYLINE: She was a third-year resident when Dr. Alyssa Colwill knew reproductive health was where she was meant to be.

ALYSSA COLWILL: Taking care of a woman who had four little children at home, was parenting alone, was in an abusive relationship.

RIDDLE: Providing her an abortion, says Colwill, helped this patient break free from that abusive partner.

COLWILL: You know, and it's stories like that that stick with you for the rest of your life.

RIDDLE: Today, Colwill is working to provide the same kind of experiences to her residents. She teaches obstetrics and gynecology at Oregon Health and Science University.

COLWILL: This is our clinic workroom.

RIDDLE: It's 8 a.m. In a few minutes, she and her team, including residents, will meet here to prepare for the day.

COLWILL: Yeah. This is where the magic happens.

RIDDLE: She'll see 14 patients today. Some will be seeking abortions. She'll bring residents with her to every appointment. Among other things, she's teaching these new doctors empathy and compassion.

COLWILL: There's only so much you can learn from a book. And medicine is truly an art. And it takes years of experience to become competent and not only competent but really good at our job.

RIDDLE: Oregon has strong laws protecting abortion rights, but the path forward is unclear for doctors at teaching institutions in states where abortion is now restricted.

LAURA JACQUES: When Roe fell, we texted each other, like, the moment that it fell, and we cried.

RIDDLE: Dr. Laura Jacques teaches obstetrics and gynecology at the University of Wisconsin-Madison.

JACQUES: And we don't cry very easily in medicine. We're pretty stoic people.

RIDDLE: Abortion is now virtually illegal in Wisconsin. Without patients, there is no training. Jacques says they've been working for years to cultivate comprehensive medical education for future OB-GYNs.

JACQUES: And to have that, just suddenly, all of that work that we put into it just erased in an instant was incredibly demoralizing.

RIDDLE: An estimated 44% of OB-GYN programs are in states where abortion is illegal or in jeopardy. The organization that accredits these programs says they are committed to requiring abortion training for OB-GYNs. Institutions still have to find a way to provide it in order to meet accreditation requirements. Teaching hospitals are exploring options like simulations or sending residents to other states. There are no clear solutions.

KAVITA VINEKAR: I truly cannot overstate how catastrophic the overturning of Roe v. Wade is for reproductive health at large and for medicine at large.

RIDDLE: Dr. Kavita Vinekar is with the group Physicians for Reproductive Health.

VINEKAR: There are aspects of what we do in abortion care that are used in so many other settings within OB-GYN and reproductive health more broadly that are often lifesaving.

RIDDLE: Vinekar says a doctor with limited abortion training may not know how to care for a patient experiencing a miscarriage, for example, or an ectopic pregnancy. Jessica Mecklosky is finishing medical school at Tulane University School of Medicine in Louisiana. She's not applying to residency in states where she can't get abortion training. She says many of her peers aren't either.

JESSICA MECKLOSKY: They're willing to risk not matching into a residency to be at a place that will give them the training that they need to become abortion providers.

RIDDLE: It's not just future OB-GYNs. Mecklosky is planning to become a pediatrician. She's especially interested in working with teenagers. It's a population that is extremely vulnerable to the lifelong impacts of unwanted pregnancies.

MECKLOSKY: I don't want to set up my patients for failure in the future because I'm not allowed to discuss things that will directly impact them.

RIDDLE: She says training in abortion is not just about learning clinical procedures. It's also about learning how to talk to patients.

MECKLOSKY: If I'm in a state that I could potentially be sued or worse for just discussing these things with a patient, it's really scary.

RIDDLE: Not just scary for the doctors, but scary for the people who need care. Advocates fear doctors will avoid training and practicing altogether in states where abortion is illegal. And that means real harm for patients. For NPR News, I'm Katia Riddle in Portland, Ore. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Katia Riddle
[Copyright 2024 NPR]