clinical care, medical education

How the repeal of Roe v. Wade will affect training in abortion and reproductive health

Stacy Weiner – Senior Staff Writer, AAMC
June 24, 2022

The U.S. Supreme Court decision will make it harder for future OB-GYNs and other providers to learn to perform abortions. But it will affect other forms of medical training, too, including miscarriage management, counseling patients, and emergency care.

“The widespread criminalization of an aspect of health care and the effect we expect on medical education is unprecedented,” says Scott Sullivan, MD, a spokesperson for the American College of Obstetricians and Gynecologists (ACOG), the country’s largest OB-GYN professional organization.

Some data help convey the post-Roe education picture: Nearly half of OB-GYN residency programs are located in the 26 states certain or likely to outlaw abortions following the Dobbs v. Jackson Women’s Health Organization decision.

That calculation is based on the projected response of state legislatures to the decision, which effectively permits states to outlaw abortions. Some states could enforce antiabortion laws dating back decades. Others recently passed “trigger laws” that ban most abortions after Roe is overturned.

Although it will take time to assess the fallout of the decision, medical educators — whether in OB-GYN or in other affected fields like family medicine and internal medicine — say the impact on medical training will be sweeping.

For one, restrictive laws could significantly reduce opportunities to learn a procedure that sometimes is lifesaving.

“Many people who generally oppose abortion still believe it should be available to save a mother’s life,” says Margaret Boozer, MD, a professor of obstetrics and gynecology at the University of Alabama at Birmingham Heersink School of Medicine. “I worry that limited opportunities to train mean that future patients may be cared for by providers who don’t have the skills necessary in such situations.”

Other educators worry that abortion bans would curtail training in related reproductive procedures.

“So much of abortion-related education is the same as or closely connected with other forms of OB-GYN care,” says Janis Orlowski, MD, AAMC chief health care officer. “This includes miscarriage management, emergency procedures such as excessive uterine bleeding, and in some cases, taking a biopsy. We now need to make sure that learners have access to the necessary training so they can continue to provide patients with high-quality care.”

Meanwhile, educators are quickly pivoting to assess the post-Roe fallout, including how to meet related professional recommendations and requirements. For example, OB-GYN residents unable to fulfill their required training might need to complete rotations in states that still allow abortions.

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