This is an oxymoron of an article. Doctors who deliver babies want nothing to do with killing them. Period! Stop the madness!
2
The State's monopoly over women's reproductive rights is authoritarian.
I never thought than in 2018 Margaret Atwood's "Handmaid's Tale" would be a tv hit. I truly thought that these many decades after Roe v. Wade a woman's right to make decisions over her own body would be obvious to all.
Why are so many, from the Catholic Church to the Republican Right to the Taliban, so obsessed with female sexuality and female reproductive organs?
Will we in America, one day, have to worry about female genital "cutting"? It's the norm in Middle Eastern countries and in much of Africa.
6
Number of US abortions since 1973: Roe vs Wade
60,683,382
Women already have a over 200 contraceptive choices- men have similar contraceptive control options - the innocent baby has no choice.its NOT the baby’s fault.they didn’t ask to be born so they certainly don’t deserve to be brutally slaughtered.
Certainly women with unwanted pregnancies deserve to be physically, emotionally and economically supported throughout the pregnancy and offered caring options post birth which may include choosing to adopt out their child
2
In the USA, despite recent falls, teenage pregnancies continue to remain at unacceptably high levels, the highest in the first world, particularly in the poorest African American and Mexican American communities, where teen pregnancy rates are twice as high as amongst whites. Obama opposed allowing girls access to the morning-after pill without the parents' permission, but was overruled by the federal court.
Teenage pregnancies blight lives, leading to perpetual cycles of poverty, poor educational outcomes, increased risks of delinquency, and juvenile and adult incarceration.
It is essential that all American teenage girls are given every incentive, financial and otherwise, not to get pregnant, easy access to free contraceptives and to the morning-after pill, and to chemical and non-chemical abortions.
https://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_12.pdf
9
"Want to protect the right to abortion? Train more people to perform them."
If that's what it takes, do it.
6
Want to end abortion? Support Free Universal Contraception.
7
Abortion is not a right. You don't have the right to kill babies. Its a human rights issue, not a women's right issue. How about teaching women responsible sex? Oh yeah, liberals don't like rules, only against conservatives, not themselves.
1
That is not going to work, because most health care providers do not want to performs abortions and do not want to be trained to do them.
2
@Alyce That is simply not accurate. Check your facts.
7
@Alyce Where is your evidence?
5
@Alyce
The only ones who don't are part of the frightening and expanding network of hospitals that have been bought up and merged with large conglomerate Catholic hospitals over the last 2 decades. They practice their voodoo medicine based on the edicts of Vatican Inc.
5
When I was a child growing up in Mexico, my parents had a servant that was pregnant with her fifth child. She wanted to go for an abortion, (I still remember that she was crying, but nobody told me at that time what was happening). My parents (who were very Catholic), took her to the priest for counseling. The priest said NO, because it was a terrible sin, so this poor woman died when she was giving birth. The baby survived.
Her last pregnancy had been very difficult, I learned that later on through my mother.
A few months later, her husband gave away the 5 children, (including the baby) to different people, (just like if they were puppies). My parents did not adopt any because they already had 4 of their own, but they believed in the "sanctity of life"). Now, when I think about it, I truly condemn the religion and the government for making the rules and giving strong opinions about something that they are absolutely ignorant. I AM PRO-CHOICE and I have been since a long time ago. I never went through an abortion and I have two children and I am absolutely convinced that going trough an abortion is no fun and it has to be a very difficult decision, but it has to be a woman's decision, not the government or the church's.
76
@Maria C. O'Brien A riveting example that every right-to-life advocate should read. I see these groups picketing outside of the local Planned Parenthood twice a week and I KNOW none of these men and women would be willing or able to raise someone else's baby.
15
The vast majority of aborted babies in the world are female. How does this square with promoting the training of more doctors to do this?
1
@Papa G.
First of all, this is false.
Second of all, you don't protect women's rights by forcing women to gestate. The pro-life position and position that femicide is acceptable/that daughters are less desirable stem from the same source: patriarchy. Hope that clears it up for you-- that's how it's squared up.
21
@Papa G. - please provide statistics and/or surveys to back up your assertion.
5
Abortion is a tool used by abusers and sex-traffickers, as well, to end an unwanted pregnancy that is not convenient for them. What is going on is wrong. We as a society who laments over a dolphin washed on shore, should be so moved to stop this heinous act of killing babies, because that is what it is. It sounds quite sophisticated to say it is a woman's right to do what she wants with her body...this is true before another life is involved. We must be smarter and more honest with ourselves. We must support the pregnant women who men have not decided to support that have no choice. We must support them with healthcare, education, and emotional support. Please watch video and tell me if this is the America and choice you want.
http://heart2heartedu.org/videos/catherine-adair/
Medical Doctors who take the Hippocratic Oath take an oath to do no harm. Perhaps they need to be educated more on counseling options such as adoption or social and healthcare services to provide to women who come to them asking to end the life within them, so they won't have to do something so unnatural?
3
@Laura
"Abortion is a tool used by abusers and sex-traffickers, as well, to end an unwanted pregnancy that is not convenient for them. "
And sometimes people use baseball bats to beat people to death.
Ban baseball bats.
"It sounds quite sophisticated to say it is a woman's right to do what she wants with her body...this is true before another life is involved."
It's sophisticated because it's true. It's also true after "another life" is involved, because that "life" doesn't have the right to use her body. Simple.
20
@C’s daughter
So you are saying it is a woman’s right to end a life she created?
The leading cause of maternal death in the world is unsafe illegal abortion. The World Health Organization estimates that over 70,000 women a year die of illegal abortions. One reason Roe v. Wade became law is because of the many doctors who testified about seeing young women and mothers die gruesome and unnecessary deaths from illegal back-alley abortions. Most women seeking abortion already have children, so illegal abortion not only kills women, it leaves children orphaned.
Legal abortions are far safer than childbirth, with fewer than 1 death in 100,000, compared to 26 deaths per 100,000 for childbirth in the USA. Further, with the availability of RU-486, the need for many surgical abortions can be eliminated.
With good sex education, an end to rape culture, the availability of the morning-after pill and RU-486, surgical abortion can become rare.
Those who profess to be pro-life are actually anti-woman and happy to leave a trail of dead women in their wake. They should be called pro-death antoi-womanists.
25
@Earthling We can also do something about those 26 deaths per 100,000. Universal access to prenatal healthcare would help but oddly, I don't see "pro-lifers" advocating for that.
10
Cider House Rules comes to mind... Homer eventually gets it & takes over for Wilbur. Despite his reservations, reality struck...
If men could get pregnant, abortions would be advertised like ED pills are. But instead, it's another way to keep women "barefoot & pregnant", so to speak.
No one likes or wants abortions - but those of us who live in reality understand the need. If you're opposed, then I expect to see you down at the foster kid center applying for adoption rights. That's where most unwanted children end up. Reality.
14
The point is "trained" abortion providers...your article's headline made it sound as if just anyone should be providing abortions....
It is still a medical procedure, and uterine perforation as well as infection are very real possibilities, even in the hands of a doctor.
@RLiss: it some states it's legal for other medical clinicians - nurse practitioners, midwives, physician assistants - to provide abortions and birth control. It's not just doctors who can perform abortions (medical, surgical and/or MVA). Also, medical abortions do not present uterine perforation.
6
"81 % offered first trimester abortion training". The numbers presented are confusing. The research referenced does not agree with the idea that trying is not offered..I suspect the number of residency programs that offer abortion training is 99%.The comment that it is elective and takes away from a residents time is confusing.Residents are not required to train for and perform abortions.
2
Also, more women who do not want babies should become pregnant for without pregnancy, there can be no abortions.
I know I am being sarcastic, but when fetus killing becomes some sort of holy project, those of us who actually have a head above our shoulders need to speak up.
Morality is not the same as religion. We very possibly can live without religion. But we surely cannot live without morality.
And killing the unborn is a violation of morality, just as executing gays for being gay is a violation of morality. No need to rely on any religion whatever.
When someone says, "execute gays" in the name of religion, we say NO, not in the name of religion but of morality. It is immoral to kill gays for being gay.
And those of us who say No to killing the unborn are also not speaking in the name of religion, but in the name of morality, without which no nation can survive.
3
This headline really gives the impression that you actively want abortions. Even the most vocal ‘pro choice’ advocates should be wary of promoting abortions. The standard of safe, legal and rare should always apply. Unless in the very early stages; you are talking of a viable human being that is being killed.
1
I find it much more likely that doctors simply don't want to perform abortions, because they find the procedure immoral and contrary to their code of doing no harm.
3
I learned to perform abortions in my Family Medicine residency (by my own initiative through an elective) and did quite a number of them. 12 years have passed, but I feel pretty confident I could still do them competently and safely. "But where?" was my cynical response to the title of this piece. Given that even if you can and will provide abortions, finding a practice that will let you and credential you is almost impossible. If you work in a Catholic health system (increasingly prevalent) you may not even be allowed to prescribe birth control! But even if you have the conditions met, you then have to deal with the protests and the threats - not the easiest life, especially with a family!
Of course, when you read the column the reality bleeds through - training providers is probably the easy part of the solution in this extraordinarily hostile political and social environment.
20
Abortions are about the only medical procedure I know that have been pushed out of most hospitals. This is another problem that needs to be addressed.
17
This article shares a common misconception. *All* obstetrician-gynecologists know precisely what to do to perform an abortion. (My wife is an OB/GYN.) The procedure is identical a dilation and curettage (D&C) which they perform regularly. Fewer modern OB/GYNs are willing to perform D&Cs for the express purpose of an abortion. It is often reported (incorrectly), that modern doctors do not know how to perform abortions. They would not pass their boards if they did not know the correct procedure to perform an abortion. The problem is that many modern OB/GYNs do not want to perform abortions for fear of social repercussions. The American College of Obstetricians and Gynecologists (ACOG) has offered one solution that *all* OB/GYNs be *required* to perform abortions. The main thrust of my comment is the problem is not that they don't know how to perform abortions, rather that we have created a social climate where many of them do not want to perform abortions because of other ramifications. (I should also disclose I am a psychologist.)
7
@Jim Ask your wife-a first trimester abortion is straightforward-unless it is not. Second trimester (D&E)procedures are more complex. It is a skill set that not all OB-GYN's have.
2
@fitzy321 D&E is exactly the same procedure *all* OB/GYNs perform for a "missed AB," which they regularly encounter at the emergency room. My wife does those all the time too.
2
All OB/GYNs are educated and trained in performing medication abortions (via 2 pills) because this exact procedure is required after failed miscarriages. The author is referring to medical abortions, which are needed after 12 weeks, that require the dilation of the cervix and vacuum evacuation of the uterus.
1
I'm a liberal and I absolutely want women to have the right to this CHOICE with viable options to execute their decision. But I'm not for abortion so when you say "more providers" that sounds very unhappy to me. My wife before me had a child and did not abort. I'm also for pushing the adoption side of this CHOICE equation. Otherwise I'm almost ready to side with the ANTI-CHOICE folks. This is especially true if we could wake up the fundamentalist Christian folks from their blindness to the TRUMP side non-Christian lies and behavior.
3
First order of business in protecting a woman’s hard-earned right to choose is to not let Republicans define it. A Republican wishes to convey that liberals are Pro-Abortion. We’re not, we’re Pro-Choice, and who better to levy that choice but the person who’s impacted the most by it. This very important right that provides women a say in a destiny altering decision is on the verge of disappearing - only to return once a liberal court can be had. And for those thinking abortion is a liberal form of birth control, hypocritical conservatives enjoy the benefit as well.
13
If the Supreme Court turns abortion back to states, those that are anti-abortion will no doubt pass laws making it impossible to train doctors in the practice. The legislators will argue that tax-payers shouldn't be forced to support training in a procedure they disagree with. But they will insist schools teach doctors to get training in "safe sex", meaning either chastity or birth control: the former has an incredibly high rate of failure (and how many women see a doctor to get a lesson in abstinence) and the second doesn't always work.
5
There is an organization called MEDICAL STUDENTS FOR CHOICE which works to keep abortion in medical schools' curricula, and also sponsors summer training programs in abortion for visiting medical students.
The name is misleading: it's not only med students. MS4C also represents pro-choice residents, attending physicians at teaching hospitals, and profs.
One of the best places to consider sending your pro-choice charity money is MS4C.
9
Better yet, make economic abortions unnecessary. Provide 6 months maternity leave mandatory, provide medicare for all, make preschool available to all at no or affordable cost, reduce student loan debt, Pay for it by reversing the Trump tax cuts for the wealthy.
7
Hopefully the courts will return to the settled law before the 5 to 4 unprecedented judicial legislative usurping of power by a liberal court coup.
To my liberal friends returning this matter to the proper legislative law making sphere will not outlaw abortions. California and New York will no doubt still allow abortion Mills to continue but other states will not.
2
One of my most vivid memories of High School during my Sophomore year in 1971 was walking in to school five days in a row and on each day another death of another female member of our graduation class was announced. Only one involved a bike accident, the rest we never heard why. Roe was decided one year later and we never had another week like it. What I don't understand is the fear some people have about providing accurate and safe information about sex, birth control, and responsibilities.
I hate to break it to many people, but sex between a man and a woman will happen. Would you rather it happen between people who have learned about sex from their friends and the internet, or via people who are providing accurate information?
23
Why can't these pregnant mothers have the babies and give them up for adoption? That's what happened to me. I was born 1973. It worked out well for all involved. If we educate the public about adoption rather than abortion maybe that would be a place to start. There are so many of us that feel that life begins at conception. Abortion should be legal but it should be a last resort. The hype about how terrible life will be for those kids that enter the system is untrue. Most kids that are given up for adoption as babies have great lives with great parents that really love them. There should be more balanced information out there. Young pregnant girls hear, you have to ruin your life or have an abortion. No middle ground.
3
@Mark, I can understand why you feel the way you do but giving a child up for adoption is traumatic. Childbirth itself is risky (we have a shockingly high maternal mortality rate) and changes your body forever. Since you'll never give birth, I'm guessing it's something you don't understand.
30
@Mark
Adoption is a solution to an unwanted child, not an unwanted pregnancy.
Why not? Because women aren't baby factories for infertile couples. Because I'm not derailing my life or putting my health at risk. Pregnancy and birth are a huge physical ordeal. Feel free to gestate all the babies you become pregnant with, Mark, but don't pretend that going through an unwanted pregnancy is not a tremendous mental, physical, and emotional burden on a woman. Moreover, even if a pregnancy is unplanned, you're asking a woman to just *give away her child* like it's not a big deal. Giving a way a baby is a huge ask.
24
@Mark
A woman who already has children could not give an unplanned baby up for adoption without causing serious psychological issues for her other children: they would always wonder if they could be given away as well.
13
Thank you for writing this column. I had no idea that the number of ob/gyn phisycians who are not trained in the abortion procedure was so low. Frankly, I had always assumed it was standard training for all physicians who opt for ob/gyn. I can only hope that, regardless of how SCOTUS jusges personally feel about abortions, that they honor what I believe to be rule of law.
3
A recent Guardian article describes a secret network of home abortion providers already doing this work. The providers believe that a physician is not necessary in the early stages of a pregnancy. No doubt the network will become much more extensive if Roe v. Wade is overturned.
5
@Kirsten S.
Wonderful article published this week (8/27) by The Guardian. It highlights many issues: 1. That the availability of safe abortions via midwives and herbalists was common before quack men re-invented themselves as doctors, organizing into medical associations to declare ownership rights to butcher female bodies and to influence their golf buddy judges; 2. Misoprostol and mifepristone ought be over the counter available in every nation so as to end the stranglehold the anti-female Catholic, Muslim and evangelical cults have over the 3.4 billion bodies of girls and women around the world.
https://www.theguardian.com/world/2018/aug/27/inside-the-secret-network-...
Quinacrine (originally used as an antimalarial) is a simple method with minimum risks. It is just a matter of having someone insert the pills into the uterus. But, many groups are opposed to this simple method, and they have consistently suppressed information on this process. The suppression has gone to the point where there are very few compound pharmacies in the U.S. that make the inexpensive pills and no lab is currently manufacturing it. And, doctors have lost the knowledge that quinacrine exists for birth control and abortion.
https://www.ncbi.nlm.nih.gov/pubmed/12318852
4
@Lily
You knowledge of female anatomy is severely lacking if you think inserting a pill into the uterus is a simple matter. The cervix firsts needs to be dilated and this is where trauma and hemorrhaging often happen.
Also, the method you refer to is not a method of abortion, but a method for female sterilization.
6
Britain just adopted a new law allowing doctors to prescribe abortion pills and sending the patient home afterward. This sounds like the way to go: no clinics means no lines of protestors, no ultrasounds. Let's not go back to the days of back alley dangerous abortions.
18
While abortion should be accessible, it should be a very rare occurrence in this day and age. Focus should be made on having both contraceptives and Plan B freely available to all. Funding for these alone would be quite a bit less than the combined funding of surgical abortions and/or the societal costs of unwanted children.
Low cost/free contraceptives and Plan B can prevent the known downstream affects of surgical abortions, which include a high incidence of depression and attempted suicide as well.
6
@Dan Let's talk about men being responsible for themselves and for contraception, too.
15
Not much chance where I live. Unlike even in Ireland these days, politicians here tout on their websites their affiliation with anti-choice groups as a means to gain the GOP nomination and almost assured election.
Their high-collared mind-masters lead marches in front of Planned Parenthood clinics to intimidate those who mght seek their service -- for any reason.
10
@Penseur,
those who mght seek their service -- for any reason.
Including HIV testing, which is why when Mike Pence as Gov. of Indiana defunded PP, one southern Indiana county that was already beset by an opioid addiction problem ended up with an HIV outbreak .
1
Women's reproductive rights are not a priority in today's America. All Roe v. Wade was say it was okay to have an abortion. It didn't say they had to be available, that all hospitals receiving federal funding had to allow them, or that the woman's life had to be considered a priority unless she indicated otherwise. Couple that with the lack of understanding on why women want an abortion and you have what we have today: chaos which doesn't help anyone but the people trying to prevent women from having abortions.
We do not have a decent social safety net in America. Why does anyone who claims to be pro-life think that penalizing women for having children they cannot afford by forcing them to carry a pregnancy to term is the answer? If you don't want women or young girls to have abortions, provide access to contraception. And remember that contraception can fail. So we're back to allowing abortions.
There's nothing as inhumane as forcing a woman to carry an unwanted pregnancy to term. There's nothing as sad as refusing to allow a woman a late term abortion when something serious is wrong with the fetus. But the "pro-life" groups refuse to consider that. Then they don't want to support the results. Every child should be wanted, healthy, etc. There are too many unwanted children in America. There are also handicapped children who will never be able to live independently but we refuse to provide for them. What's wrong with this picture?
18
@hen3ry
Actually, all Roe v. Wade stated was that it was legal for a doctor to administer an abortion within a set length of the pregnancy. That law still did not give rights to females.
1
Thank you Dr. Steinauer for raising the critical need to overcome barriers in medical and clinical training in abortion care. As an organization working to train healthcare providers in comprehensive sexual and reproductive health, Midwest Access Project knows these barriers first hand. But we also know from our trainees that Midwest Access Project's work has motivated a new generation of doctors and nurses to offer high quality, patient-centered reproductive health care to those in need.
5
A rather naive article. The hard right will outlaw abortion again if they can, and it will take thousands of dead and imprisoned women before the public starts to see sense, again. Politely colluding with the tacit understanding that abortion, like alcohol, is essentially evil is half the problem. In most of Europe we don't have this doublethink, and it is no coincidence that we have fewer problems with alcohol and unwanted pregnancy.
13
Sorry, but the Orwellian vocabulary of "Choice" still gives me the creeps, e.g. "full range of pregnancy options", "reproductive rights", "reproductive health", "abortion care", and the call for more "volunteerism" and charitable contributions in "support" of abortions. Trying to call attention to what she considers a national problem, the author seems to treat abortion like any elective "procedure".
3
@Martin Daly I'm pretty creeped out by people using "pro life" to push policies that result in used and dead women.
36
As it is ultimately a woman's right to make the decision whether or not to abort a fetus, it should be left to a MD's moral compass whether or not to perform them. Demanding that Obgyn's perform abortions is just as wrong as taking away a woman's right to have one.
4
Yes!
If you don't like abortion don't have one but we need to have enough properly trained docs.
Choice now, choice forever!
22
@Alan What about the innocent unborn child's choice. Who protects her rights?
MEDICAL SCHOOLS Have determined that it is in their interest to stay away from the never-ending Cultural Civil War, which, like the eternal flame, is never extinguished. Given the severe intrusion upon the rights of women to control their bodies, it seems that abortions are one of the options that are required. However, there are "single issue voters" who very mistakenly believe that the meaning of democracy, in Greek, is "power to the people." Meaning that anyone who chooses to disregard all but one single issue is not functioning in a democratic way, but relinquishing power to others. The idea at the bottom of democracy, is vigorous LOGICAL debate and compromise, based on the Philosophies of Enlightenment of the 18th century. Tragically for the US, the quality of the debate has become illogical, because of the intrusion of theology into the secular state. Thomas Jefferson so strongly disagreed with the idea of human divinity that actually edited the bible to remove all mentions of Jesus as divine. The book is still in print and can be easily purchased. Once people introduce the wild card of divinity into a debate, what is divine can Trump (pun intended) any logic, any sense of justice, any fairness or even decency. Indeed some fundamentalists believe in fighting to defeat evil by following the "tactics" of Hitler, Stalin and Mao. With Trump's attack on google and other search engines, complaining that they are biased against the conservative media, we're Trumped!
2
Abortion needs to stop being stigmatized. It is part of womans healthcare and no one should be ashamed . One in four women have or will have an abortion. In the late sixties a group of women called Jane learned how to perform first trimester abortions in Illinois. When they were busted by police the cops kept asking "where is the doctor", thinking the doctor HAD to be a man. We should have easy access to birth control and early sex ed, but until the right wing has no influence in government that will not happen. Abortion has been around forever and will continue to be. The more people who know how to perform abortion the better.
15
Let's work this on multiple fronts: better access to birth control and better access to drug induced miscarriages can lighten the load on existing doctors with no lag time for training!
9
When I used state insurance to get an abortion the doctor at a local hospital decided if he didn't use any pain meds, I wouldn't come back again. (He didn't know I was a rape survivor) Even trained doctors can be sadistic and judgmental around abortion. We need to train them in compassion and DPD (Difference Power and Discrimination) as well.
15
Please keep in mind, legal abortion is safer for obvious reasons, but also for one less obvious. When it is legal, scientists can perform and publish research to constantly improve the quality of care women receive. Providers can confer with each about women who present difficult cases, such as a woman with a history of 4 cesarean sections and has toxemia/pre-eclampsia, the same way other doctors confer with each other about complex patients, to share the collective experience and ensure the best outcome for their patients. If it becomes illegal, all that stops, the providers become an island without the ability to confer with other providers.
17
This well received column is proof that supporting Planned Parenthood in every state and on the national level is the best solution to abortion questions for the present. They supply expert advice to all women who seek it on not just abortion but birth control methods. Med Students for Choice is a group worthy of our support in all states, but right now PP provides safe medical advice to all women. Volunteer if you can and support it financially to the best of your ability.
15
As a Republican, I’m a strong supporter of Roe v. Wade, mostly based on the conviction that enslaving women to biological identity is barbaric in the 21st century and in America. However, this op-ed doesn’t read as ideas intended to protect the right to abortion but as one intended to artificially increase its incidence by making all its consequences trivial. And I can’t support that.
By all means, medical training programs should include the procedural details of performing abortions, but I don’t expect surgeons to be psychiatrists or “counselors”: yet that’s the perch on which Dr. Steinauer hangs her argument in an effort to justify creating demand by providing an abundance of supply. And I also question the practical aspects of the advice, since so many women, regardless of the religious convictions of states opposed to Roe, are moving to abortion pills rather than surgical procedures. It may be that some wish to defend a right that doesn’t exist in law to terminate a pregnancy after the second trimester, regardless of lawful regulation by a state to set conditions by which such an act is permissible – which likely would require surgical intervention -- but most Americans probably would condemn that intent as actually destructive of Roe.
I honestly got the impression that Dr. Steinauer was seeking to drum up business for the medical profession.
1
Richard — I love your first sentence, but then got confused. I can’t see where you’re finding a call for more unwanted pregnancies in this column, even after reading it a second time.
As a physician and medical educator, I have long been shocked that ANY ob/gyn residency wouldn’t REQUIRE all trainees to obtain abortion skills as part of their training. When fledgling obstetricians/gynecologists suggest they have moral objections to the procedure, I think there’s a simple response: choose another specialty, rather than choosing to provide only partial care for your patients. But this column’s suggestion is actually much more modest: just provide more training, and more providers, and more opportunities for women to avoid the enslavement of biology you so properly find objectionable.
19
As a primary doctor just out of residency training, I want to clarify that abortion training provides us with another important tool to meet the diverse medical needs of our patient population. For example, simply because I am well trained to perform toenail removal does not mean that I will be pushing all my patients to have their toenails removed.
A woman can have many different pregnancy outcomes in the course of her life such as miscarriage, birth and abortion. As her primary care provider, I want to be able to provide high quality care to her in any situation.
Dr Steinauer is highlighting the gaps in medical education and residency training, which leave vulnerable patients without access to the option of abortion in many areas of the country. It is true that many women choose the option of medication abortion. Medication abortion care can safely be performed by well trained primary MDs or nurse practitioners, which strengthens Dr. Steinauer’s argument that training access should be expanded.
13
@Paul Marantz
In five years, the likelihood is high that all women undertaking legal abortions won't be looking for surgical skills but for a swallow of water to chase down an abortion pill. They won't be any more enslaved than they are lawfully today, but there might be a lot less work for physicians who specialize in abortion.
In your background as a medical educator, do you still teach proto-physicians to apply leaches to draw off blood or to coax trolls out of stomachs?
2
The author is preaching to the choir, and her argument makes no sense. States w anti-abortion leanings are less likely to support medical training for abortions.
That said, the rate of abortions has reduced significantly in the past 30 years, in part because of better and more accessible family planning, so perhaps that's the reason why training is limited?
My mother almost died from an illegal abortion. With two kids already, my parents just couldn't afford another child. Both my parents had to work. My mother went to an apartment where she met her abortionist. The procedure was performed on a kitchen table. After the procedure, a "nurse" took her to a movie theater and forced her to sit there until the movie was over to provide cover for the "doctor/butcher." When my mom came home, she started to hemorrhage. My sister and I were only three and five years old. My dad called an ambulance and we were hysterical--screaming and crying. It was very traumatic. She survived, but do we really want to go back to those days?
117
@Bonnie Weinstein, Bonnie, you know the answer to your question. A powerful minority in this country DO want women to suffer as your mom did. To them it is collateral damage in their goals of subjugation of women, forcing women to have lots of children as their lord deems righteous, wishing for a time of mass virginity that never existed, their worship of the embryo even as they do not care for the live children of others, gearing up for their next battle which is the removal of contraception.
18
@Bonnie Weinstein: Some very much want to go back to those days. They call themselves, amazingly enought Pro-Life.
13
@Bonnie Weinstein
Did you read the article? Not sure what your point is, obviously abortions provided by the untrained are totally unsafe....but that is not the point of the article.
2
We must encourage more physicians to demand training in helping patients deal with unintended pregnancies. This includes assuring that physicians are trained to understand the full range of options, including how to help a patient successfully access abortion by any available method, chemical or surgical. This requires knowledge of the procedures involved, as well the resources in the community which can help patients enact their personal decision. To do anything less is to fail to fulfill our Hippocratic Oath.
Before this is likely to become a reality, we must take stronger measures to stop the harassment of physicians who have the courage to provide abortions. Physicians must not have to fear that they (like Doctors Gunn, Slepian, Tiller, et. al.) will be subject to stalking, intimidation, and murder by misguided anti-choice fanatics.
167
@Doctor B Thank you for mentioning Dr. Slepian. He was a friend of my family. I was thinking of him as I read this piece. For those unfamiliar with his story, in 1998, Dr. Slepian had returned from synagogue, where he was attending a memorial service for his father, and was preparing soup in his kitchen when he was shot by anti-abortion extremist James Kopp through a window. The bullet shattered his spine and tore his aorta, barely missing his son's head as it exited. He died two hours later.
8
@Molly Bloom
So sorry to hear of your personal connection to this senseless tragedy.
Such acts have a chilling effect on Medical Students and Residents who contemplate including abortion in their array of services performed. Those of us who are faculty at teaching hospitals must lead the way in helping them understand what is involved in fulfilling this legitimate need of their patients.
There is a network of "Pro-Life" extremists who are out to harass, intimidate, & murder any physician who stands up for their own conscience by performing an abortion when it is medically indicated. Your friend Dr. Slepian was one victim. George Tiller was shot in church while serving as an usher. So Warren Hern now has to practice behind layers of bulletproof glass.
These domestic terrorists are trying to stop abortions by making doctors afraid to perform them. Any time a Residency program decides to omit abortion training, we hand these terrorists a victory, which only emboldens them to try even more barbarous acts. We must stand up to those bullies by demanding that every Ob-Gyn Residency and Family Practice Residency make abortion training a mandatory part of their teaching.
5
Huh. Interesting. Here's the thing. Doctors on average actually DON'T want to perform them. So you can provide all the tools you want to kill the unborn , but after taking the hipprocratic oath, don't you think that's a little hypocritical ? This article was clearly written from a staunchly feministic POV by a part time physician who chose education over bedside patient care.
4
@Marie, you made this up out of whole cloth. Let's see your citations for "most doctors dont want to perform them."
18
@Marie
Give me a doctor by my bedside who chose education over anything else, please.
Give me a physician who takes a feminist point of view over any other -- let's say, masculine -- please.
Give me the results of your research on how many doctors want to/don't want to perform abortionists, please.
11
Although I believe that abortions should remain legal, it should not be promoted. Many women suffer deep emotional pain when they abort their baby. It shoul not be taken lightly.
5
@Pepperman: Please define "promoted".
Also, studies have shown the the opposite: many women are relieved post-procedure. Some do experience regret, sadness and/or other emotional pain (and some experience both). Your claim is an outdated myth according to recent studies. It's also a myth that women don't take pregnancy termination lightly. Some may, many don't. It shouldn't matter to you; it's a women's decision to make and her pain to own.
34
@Pepperman
No babies are involved in abortions. I hope that makes you feel better.
Abortion doesn't need to be "promoted." I assure you, women who don't want to be pregnant are able to think of this option themselves.
15
@Pepperman
Over the course of more than 50 years, I've met many, many women who had abortions, and heard their stories. Not one said a word about emotional pain; I didn't experience even a twinge of it, myself. (And everyone of us knew the clump of cells wasn't a "baby.")
13
I never thought I would live in a society which advocated teaching more people how to kill babies. I guess the only thing worse here is that this is written by a doctor.
6
@BC
No-one is advocating “teaching more people how to kill babies”. Your definition of “babies” is incorrect . Zygotes and fetuses are not babies.
19
@BC I never thought I would live in a society that would advocate tearing walking, breathing children from their parents who are doing everything they can to protect their children by getting them out of violent and unsafe environments. These children experience significant pain and suffering, a few have died. And it is on the otfrt of the "most pro-life President ever."
25
@BC I never thought I would live in a society that advocated enslaving women to forced childbirth.
1
Training doctors to do abortions is a great idea but what the public forgets is SAFE SEX should be trained in SCHOOL. Then there would be little need for abortion.
37
@Joanne Aloni, wrong. Contraceptives fail. There are rapes. There is incest. There are pregnancies that miscarry incompletely and need to be treated. There are pregnancies that have to be terminated to save the mother's life, or when the fetus dies in utero, or if the fetus has a defect that is incompatible with life.
Abortion will always be in demand and probably needed more often than we think.
16
@Joanne Aloni I agree sex education should be an integral part of education in schools, public and private. Unfortunately, there will still be unintended pregnancies. It is vital we make sure access to safe abortions remains legal . It is also important to make sure medical professionals who provide abortions can do so without losing their lives.
9
@Joanne Aloni YES! Thank you!
A major problem is that many residents, when offered advanced training in 2nd trimester abortions, often don’t elect to perform them. Doing a dilation and evacuation can be a very difficult emotional event, and many residents don’t want to do it. This is just my experience, but I suspect it is more prevalent than the author suggests.
3
@Steve Often residents trained in abortion care want to perform them after training, but are unable to do so.
https://onlinelibrary.wiley.com/doi/pdf/10.1363/4214610
The procedure itself is not a problem for most trained to perform them. There are a lot of pressures put on physicians who provide abortions, more than other procedures, that make it difficult to provide the care and stay in practice.
8
@Steve If doctors were that sensitive none of them would be able to endure performing surgery of any kind. Seeing all that blood, pain, knowing they might not be able to save the patient . . . It is part of their profession to accept all that and get on with the job.
8
I recall the Clinton's position that abortion should be safe, legal, and rare. And the way to make it rare is to ensure that woman have access to safe and effective contraception. Long acting reversible contraception (LARC), including both IUDs and implants, are safe, highly effective (less than 0.1% failure rate), and allow women the freedom to reversibly control their reproductive potential. Any trained health care professional — including mid-wives and nurse practitioners — can insert LARC. Support Title X.
98
@Hopeful Libertarian Most people who used the "safe, legal, rare" rhetoric have walked back on the "rare" piece of it, even HRC. It puts a lot of judgment on women for seeking abortions, and there are a lot of reasons one might seek an abortion. To start, women spend 30 years of their life (on average, if they want two kids and are of average fertility) trying to AVOID pregnancy. That is a tall order for any method of contraception.
12
@Hopeful Libertarian: Agreed, but this country has always had a twisted idea about sex. Too many parents believe in 'just say no,' but our corporately-owned culture uses sex to sell everything from toothpaste to shoes. We leave young people without proper guidance and information and then blame and punish them when things go wrong.
3
@Family Planning Nerd
Thank you for your comment. The good news is LARC can be used for 30 years or more. It is one of the huge success stories of modern medicine.
So I would disagree with your proposition that "there are a lot of reasons one might seek abortion". There is really only one common reason (other than crimes such as rape) -- and that is failed family planning. And failed family planning can be avoided through the use of LARC.
As a necessary adjunct to the burning need to train more physicians-to-be to be able to carry out these procedures, we also need a robust sex education program so as to help prevent unintended pregnancies in the first place. Teaching nothing more than complete and total abstinence is a guarantee for failure, as are those approaches that embrace, say, the rhythm method. For those youths who are offered this "educational" approach, there are also adverse psychological consequences that naturally flow from the message that sex outside of marriage is basically wrong and a sin. It only guarantees distortions in a persons developing character structure. Too, the more conservative approaches to sex education would, of course, very much like to gloss over the real life issues that adolescents encounter with respect to their sexual identities. Again, this takes away nothing from good Dr. Steinauer's thoughtful piece, but it is only one critical component in coming to deal with a basic human issue: who we are as sexual beings and how to channel such interests in a way that doesn't get us into intractable and potentially life threatening trouble.
14
There is this thing called the Hippocratic Oath, which all doctors supposedly obey and reads in part:
"I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly I will not give to a woman a pessary to cause abortion. "
Funny, we never hear abortionists talk about this.
3
@Robert
Funny, but we never hear anyone point out that the Hippocratic Oath is straight out of the "Patriarchal Man's Household", either.
I remember reading "Galen" a decade or so ago and running into the Hippocratic Oath. Having seen "I, Claudius" on PBS, I could understand about the "poison" part (Oh, that Lativia!) - but to perform NO abortions?
In the ancient world?
Where women were infibulated?
Where there was no birth control?
Where a woman's lifetime reproductive years could be 30, 40 or 50 years?
Oh, yes. Only a partriarchal society would dump "no abortion" in such an oath!
And, yes, I find it odd that no person has brought up such a glaring example of sexism and utter indifference toward women.
Funny, we never hear anti-abortionists talk about this.
26
@Robert
The modern version -- used by most today -- does not mention abortion (or pessaries) at all. Funny you don't know this.
8
@Robert - You are misinformed. Doctors today do not in fact take or obey the Hippocratic oath. You probably wouldn't want them to, anyway - not only does it include the injunction against providing a pessary to cause an abortion, it also entails the doctor swearing by Apollo, Aesclepius and all the gods and goddesses. Not quite the thing for a supposedly Judeo-Christian society.
5
Wait one minute!!! It’s my understanding the exact same method for abortion is used after failed discharge of a miscarriage. And that 50% of miscarriages need that added intervention. Ob/Gyns aren’t getting trained for that?!?! I call foul.
15
@Daria W. Devantier
You're correct! But that is only for abortions up to about 10-12 weeks. And there are other aspects of abortion care that need to be part of training like counseling, not to mention the certifications that are necessary to be a provider.
5
Despite big falls, the USA still has by far the highest rate of teenage pregnancies in the world. The rate of teenage pregnancy in the USA is far higher amongst African American and Mexican American girls than it is among other ethnic groups.
Children born to poor teenage mothers are far more likely to end up in prison and/or become teenage mothers themselves.
The solution? Pay these girls not to get pregnant in the first place.
6
@Colenso We could also...wait for it...address the *boys* about responsibility and contraception.
24
@Colenso,
How about we educate children about their bodies from an early age, instead of keeping them in the dark, and shaming them for their curiosity and desires?
The Dutch have the right approach: https://www.pbs.org/newshour/health/spring-fever
and their low rate of unintended pregnancy shows it.
The resurgence of abstinence education (proven to be ineffective) and the continued de-funding of birth control programs will result in more unwanted pregnancies.
6
Did everyone catch the news last week that the oldest ice sheet on Earth, up in Greenland, is breaking up?
The ocean's rise from that ice sheet is going to be 20 feet.
If the ice sheet in the Antarctic melts then the rise will be another 200 feet.
This week in California the proposed rise in temperature rise will be going up 8.8 degrees from 1900.
There are 320 million Americans and most live in cities on the coast.
In the upheaval to come within the next couple of decades, women will still get pregnant.
Like today, most pregnancies will be unplanned.
Like today, most of those will need abortion.
In the future the number of homeless will rise.
The added displaced persons from environmental reasons will be no better cared for and cared about than the homeless today.
I have read all the comments here (at this point).
They are all short-sighted.
A few are smugly mediocre.
What is coming - in your lifetime - is going to require you to up your game.
Unless you OB/GYN's are already working with the present homeless, then you need to get out more and check out your world.
The president and the Republicans, the Supreme Court and the religious have all turned their noses up at the coming catastrophe. When it comes to the future they have put their money on the Apocalypse. None other need apply.
(However, I will point out that the Pentagon has already mapped out their plans.)
Yes.
All medical staff need to be trained in aborting.
All of you need to wake up now.
22
Why are women forced to carry this burden alone and often have their lives damaged beyond repair? Why does our culture refuse to turn it's eyes on men? Why hasn't birth control medicine been devised for men, one that can be reversed like women's birth control? Again, why are women forced to carry this burden alone, while the co-perpetrator flies free with no consequences?
This fortifies strongly that women are second class citizens.
32
The Roe v Wade decision is in no danger of being overturned. Most of todays Chicken Little warnings are simply designed to instill fear in the population and motivate larger donations to the corporation known as DNC. Once again, the 14th amendment was used NOT to protect rights of Freedmen...but for another worthy cause. A right to privacy in INDIVIDUAL health care...including access to abortion services. The Supreme Court made no mandate on Federal Funding of Abortion Clinics.....it only agreed 7-2 that it was unconstitutional to restrict or outlaw abortion. Period. The serious problem begins when the DNC turned the abortion hysteria into a money raising phenomenon which then becomes acces to control of funding and POWER...more POWER to control people.
4
@Wherever Hugo
Conservatives are trying their hardest to pooh-pooh the very real danger of Roe v Wade being overturned, because they are desperate to see Kavanaugh get confirmed to the Supreme Court. Kavanaugh's recent statement that Roe is "settled law" is a smokescreen to give cover to those senators rightfully nervous about voting for him. Kavanaugh was nominated specifically to kill Roe v Wade, and he will carry out his mission.
29
@Wherever Hugo Republicans have been actively calling for overturning Roe since the day it was issued. And Republicans and conservatives have overwhelming used abortion and their hysteria over it into a money-raising phenomenon. I think you have your parties confused.
32
@Wherever Hugo
Why don't you read the Eleventh Circuit's recent decision and then come talk to us.
Pst- telling women that they're being *hysterical* and overreacting is really not a good look.
37
When I was growing up, I knew of friends of my parents who -- not wishing to add another child to their family for economic reasons -- availed themselves of the services of a very reputable general practitioner in our neighborhood who was willing to provide it, albeit illegally. I assume that back in the fifties this was a fairly widespread practice across the country that the courts and the cops were generally tolerant of. Now we have neighboring countries where the service is freely available. One way or another, abortions -- well managed or not -- will prevail.
28
@A. Stanton So as long as it is legal in countries connected to us, it is ok for the US to make it illegal? Can you afford to travel to Mexico or Canada within 1 week? Will your job let you take a week of sick leave? Do you have childcare (60% of women having abortions already are mothers)? In the 50s, we didn't have rapid pregnancy tests or ultrasound. So the doctor could, with a wink, do a procedure for menstrual regulation, without ever officially diagnosing the pregnancy. Now, we are obligated to do a pregnancy test on every women who missed a period, to not do so is negligence of the standard of care. And most will get an ultrasound. And Medicaid pays more for a D+C for a miscarriage than an abortion, so if the Gyn was to "diagnose" a miscarriage and bill the insurer, they commit fraud. So trying to do an abortion safely these days if it is illegal will be much more difficult than it was 60 years ago.
5
@Eve Levine
I take your point Ms. Levine. Your comment does a good job of pointing out the extraordinary hurdles that will stand in the way of women needing help if worst comes to worst and opponents of birth control and abortion have their way.
1
Most of us, as reflected in many of the comments for this article and the opinions presented by the author, are stuck in the paradigm thinking abortion is a medical procedure that must be performed by doctors. Doctors appropriated responsibility for abortion some time ago and defend their 'right' to perform abortions to the detriment of society. Acting as gate keepers, they narrow access preventing many women from obtaining what they need.
As Dr. Steinauer notes, there are initiatives to devolve the right to perform abortions to medical professionals other than physicians. Continuing to think of abortion as a medical procedure limits what can be done to provide widespread access. Dr. Steinauer is on the right track arguing for wider training to expand access. However, she does not go nearly far enough in her thinking.
Research shows clearly that abortion is safe and there are few medical complications. What is needed is a change in mindset about which professionals can and should perform them. We allow many professionals access to our bodies to perform services from dentistry to physiotherapy that are far more invasive and risky than abortion, without detriment to our health and safety. We should examine and promote a paradigm to train professionals to perform this service and ensure adequate medical backup is available when complications require medical treatment.
More ubiquitous provision of abortion services makes it more difficult for opponents to restrict access.
27
@Edinburgh Absolutely correct. Abortion is not a medical procedure, it's a gruesome form of murder. Maybe that's why so many doctors don't do them.
1
@Rob
Use condoms or get a vasectomy. Problem solved.
1
Excellent article; we need to do this.
12
I've never shied away from using the word "abortion." There are very good reasons for women to have abortions. Even the fact of a woman's age -- she is 16 years old, her boyfriend was insistent, even violent -- is a good reason to have an abortion.
My great-aunt, a Greek immigrant, a religious woman, and excellent mother, aborted what would have been her fifth child, some time in the late 1920s. How she did it no one in the family knows. She couldn't afford yet another child. It was the Great Depression. Religious she was, but she was practical and matter-of-fact all her life.
Her three sons grew up to serve in the various Armed Forces and fought during World War II. Her daughter became an artist. They all married and had children who are hardworking, good people.
They adored their mother.
No one suffered because of my great-aunt's abortion. Not even, I daresay, the embryo.
We all die and, when we do, for the most part we suffer. I cannot get very exercised about an embryo.
88
@B.
I'd like to add something to the last paragraph:
Watching my parents and cousins go through cancer treatments and dying anyway, watching another relative with advanced Parkinson's who can only just sit, understand for a long time now that death rarely occurs without months or years of suffering, I can only shake my head at people who would condemn a woman to nine months of misery carrying a child she does not want, or whom doctors say is not viable. And then to go through childbirth?
On the say-so of so-called religious people?
Life is hard enough.
No, I cannot get very exercised about the termination of a pregnancy.
3
As a lawyer, I doubt Roe v Wade will ever be overturned outright. This isn’t because many wouldn’t like to overturn it, philosophically, but because an outright reversal would threaten so many other decisions by undermining the principle of stare decisis. A lot of doctors don’t do abortions because they are fearful of the ramifications on their practice, or are morally opposed.
9
Doctors who could perform safe abortions but won't because they are morally opposed are putting their own opinions ahead of their patients' needs. They're focused on themselves only. How many more procedures might they decide to be morally opposed to, at the expense of their patients? Maybe they should choose another profession.
45
@E Good point. Ethics has no place in medicine.
1
@E
This is a difficult issue but I do not think you suggest someone not become a physician because they maintain their own moral scruples. Not yours necessarily, you have every right to your beliefs, but then so do physicians.
This would already be much less of a problem if the 1994 mandate for training in abortion services of OB-GYN residents by the independent Accreditation Council for Graduate Medical Education (AGME), which would have withdrawn accreditation of hospitals that opted not to provide it, had not been blocked by the 1995 Hoekstra-Coats federal "non-discrimination" law. The law provided for the withdrawal of federal funds to any hospital that mandated said training. The 58,000 member American College of Obstetricians and Gynecologists (ACOG) agreed with the AGME, though not until 2009. The 2500 member American Association of Pro-Life Obstetricians (AAPLOG) initiated the process that led to the Hoekstra-Coats law by appealing the AGME mandate in Congress after the Gingrich revolution put the GOP in the majority of both houses in 1995. As with the upcoming November elections, the Hoekstra-Coats law is another example of the axiom: elections have consequences.
25
@sleepdoc
Oh great, as a Former resident of Ottawa Co. MI (93-96) and as someone with parents living in Indiana since 2006 I get to see my former Representative's and my parents' former Senator's names on one more piece of sanctimonious, patronizing to women, make the public think all Christians are conservative jerks, legislation. (rolls eyes in a not again expression).
The example of chicago’s “Jane” group of brave women helping other women, prior to Roe v. Wade, shows that safe access to abortion need not depend on medical personnel being willing and trained to perform safe abortions. But it still does require training, ie medical providers willing to train others. It’s an idea whose time, Hans, sadly, come—again.
33
"With the nomination of Brett Kavanaugh to the Supreme Court, it appears more than likely that Roe will be overturned or severely undermined"
Considering that Judge Kavanaugh recently told Senator Susan Collins that Roe v Wade was established law, this entire piece is incendiary and otherwise off target.
There are more honest ways to try to get liberals to vote.
7
@G Laws can be nibbled away. Roe v Wade has not prevented states from enacting increasingly draconian restrictions: who can provide, what insurance and hospital privileges are required, what counseling can be done, waiting periods, multiple visit requirements, none-after dates, etc. These go to the courts for adjudication, and Kavanaugh has indicated where he stands on these tightening restrictions.
31
@G: Kavanaugh wasn't honest with Collins, and I think she knew it. He was giving her cover to vote for his appointment to the Court. After he gets there, he can do whatever he wants.
48
@G
Well, you know, conservatives almost always say that. But beware: They find ways to circumvent established law.
4
It would help to treat all women like adults. When I've been asking for a voluntary sterilization for 5 - 10 - 15 - 20 years, just maybe I've thought it through and won't be changing my mind. It's time this patronizing ends too. (Yes, I know it's all about the lawsuits, because someone will decide to sue for not understanding "permanent" means, well, permanent. That needs to change too.)
45
In Europe women are given a pill in 2 doses to induce an abortion. It can even be taken at home. Why isn't that happening here? Why is there no mention of this simple solution in the article or comments?
It seems to me that we are being deliberately kept uninformed.
49
@Laura
Dr. Steinauer refers to medication abortions in her article. I do think there needs to be more information available to the general public from all providers re advances in types of abortion available to women. She advocates for more providers who will inform women and provide them with the most appropriate type of abortion for them
9
@Laura
It is somewhat confusing, but the procedure you are referring to is called medication abortion. The author does mention medication abortion in the article. I agree that we need to get the word out about this service.
10
@Laura, the writer does indeed reference pill-based pregnancy termination. See paragraphs 4-5, and the last paragraph.
3
It would seem the Hippocratic Oath would be an impediment to the provision of more abortions, but this Op-Ed makes no mention of that. This Op-Ed is conspicuous for its complete lack of acknowledgment, or discussion, of the development of the child in the uterus. Dr. Steinauer, medically trained, will not even reference indirectly the physical development of the child who is to be aborted. Since I am a lawyer, not a doctor, my comments on the Hippocratic Oath are only an opinion - but as an attorney, and given the opportunity to do so, I would gladly appear in court to defend and advocate for the rights of the child which is slated for abortion through the efforts of medical providers like Dr. Steinauer. Her 'mission' - the termination of the lives of children - is tragic, misguided and hopefully, soon rightfully illegal.
5
@Tom Wolpert If the advance of technology were to make it possible for men to carry a fetus to term and give birth, and if a fetal transfer from woman to man were thus possible, would you support a woman's right to turn this birthing process and subsequent parental responsibilities over to the father? Or, if the technology merely provided an artificial womb, to which the fetus would be transferred for eventual birth and the father's subsequent paternal responsibilities, would that meet your approval (and tax increase limits)? Or are you insistent on penalizing only women for getting pregnant from rape, incest, or whatever?
19
@Tom Wolpert the Hippocratic oath prevents unnecessary taking of a human life. It does not prevent elective surgeries done to enhance the patient’s well-being. There is no “child” in the womb. There is a biological process, a follow-up to ovulation, that is part of the complex structure of human reproduction. As long as this proces takes place inside my body, I am in total control and can facilitate or interrupt in any way I choose. Contraception prevents the formation of a human life as well. Are you going to plead for the life of the ova that my contraception has prevented from developing into babies? I’m sure you would: people like you won’t rest until women are enslaved, once again, to our biology.
27
@Tom Wolpert Most abortions are extremely early. There is no "child" in the uterus. However, there is a woman, an actual person with rights, whose health and well-being matter.
13
The scenario imagined hereof how to assist women in getting ahold of abortion medication in states where abortion has been outlawed does not take into account how the laws against abortion will be structured.
The most likely legal mechanism under which states will outlaw abortion would be to eliminate the exception of abortion in regard to laws in 39 states, in addition to the federal government, that hold the killing of an unborn child is homicide. As things stand now 23 states apply this principle throughout the period of pre-natal development. So the only reason that abortion does not constitute outright murder in many states is only because of the exception made for the killing of an unborn child in an abortion procedure.
So if Roe is overturned those states that wish to criminalize abortion will do so by removing the abortion exception to laws that already hold killing a fetus, either by itself or in the case of the murder of a pregnant woman, is criminal homicide.
And so if abortion will be prosecuted as a homicide then providing any assistance to the performance of an abortion will be seen as being an accessory to murder. So if abortion is outlawed in certain states no doctor in his right mind would have anything to do with assisting women to carry out abortions in those states.
5
Thank you.....
Sound advise.
Btw.....1970’s on our surg. Schedules for the day
Abortions were called Dilatation and Curretage in first tri.
before the law was passed.
We managed but ......women have a right to address their own reproductive needs. No laws against us should survive the 21 st century!!!!
I am a college educated 66 yr. old republican.
Find more of me and lets vote together.
Down w trumpites and misogynists!
63
The doctor omits the main point. Abortion is not part of American culture. It has been forced on the country by Roe vs Wade, which was written by unelected judges who do not represent popular opinion. The article itself admits that 22 states are studying ways to circumvent the power of Roe vs Wade. And an unqualified idiot was able to garner thousands of votes by promising to get rid of the decision altogether.
Abortion lobbyists understand this perfectly well, and have devised nice-sounding euphemisms to avoid saying "abortion" out loud. The article uses "choice" and "reproductive health". They have been writing propaganda for 40 years, hoping that a new generation would grow up "accustomed" to abortion, and it has not been working.
5
@Charlesbalpha Hmmm.... when I read the article I see the word abortion written multiple times. Usually more than once in the same paragraph. Perhaps you are referring to a different article?
Also, last I understood we lived in a country that valued individual freedom and the separation of Church and state. Perhaps you are referring to a different culture?
I am being glib, but I think you are being disingenuous. You clearly misrepresent the authors words, and you ignore the true and deep divide in the American culture about this issue. Abortion is a part of American culture. It is as American as apple pie to have a strong opinion about abortion. We all just don't share the same opinion.
26
@Charlesbalpha
Forced on the country?
I wasn't aware that Roe mandated that you were forced to have an abortion. Please provide the pin cite. Thanks in advance.
Want me to say "abortion" out loud? Here you go: abortion abortion abortion abortion. I support the right to have an abortion, every woman should be able to access abortion, abortion rights are fundamental human rights and an integral part of reproductive health care. I am very glad that I have the right (and the means) to have an abortion.
27
@Charlesbalpha You are wrong. Abortion is part of EVERY culture that has women. It is just kept very quiet. Just because you don't hear about it, does not mean that it is not happening. Women will continue to do what they always have done and manage their pregnancies as THEY see fit. We just want to make it safe and rare.
23
Yes we need more providers who are trained and competent, and not just MDs.
We need trained nurses and also trained para-professionals.
We need a resurrection of JANE.
Because here are the roots of the problem, pulled from the article below:
"Midwives and homeopaths once provided a range of services, and abortion was one of them. In the mid-19th century, if a woman chose to miscarry in the first trimester, before the fetus had “quickened” or moved, she was thought to be restoring her period, and it was legal. “Abortion” referred only to a termination after the fourth month. In the early weeks of a pregnancy, midwives helped women restore their periods with plants like pennyroyal, savin, tansy and ergot, and doctors, among others, sold drugs made from herbs.
Then, after the American Medical Association formed in the 1840s, it launched a campaign to make abortion illegal at all stages of pregnancy. The AMA’s campaign painted abortion as immoral, and by 1880, it secured criminal abortion laws in nearly every state, granting doctors the authority to decide when the procedure was acceptable. The effort grew, in part, out of physicians’ interest in limiting competition from midwives and homeopaths."
https://www.theguardian.com/world/2018/aug/27/inside-the-secret-network-...
62
@Ellen
Dig deep enough into any issue and you'll find how it was influenced by someone's self-interest.
17
@Ellen
Abortions are not risk free and, were I a women, I would not let anyone other than a board certified OB/GYN do the procedure. There are many procedures that can be done by less trained and experienced providers. This isn’t one of them.
No, providers are only a small, small part of the issue. The anti-abortion movement must be forced to become about more than protecting the fetus. Some fetuses become living breathing children (not all and not persecuting women when they don’t is important too). The anti-abortion movement must make as its goals providing every woman with health care, lodging, and nutritious food, every child must have the same and a good education. All it takes is money. Time to undo Trump’s tax cut which was intended not just to help the swamp, but to force the US into BK so as to create a need to sell protected federal lands to Trump and friends, for pennies on the dollar. The anti-abortion movement is really just a reflection of greed and control politics as usual...there is a small fringe group that actually cares about the children, none of them appear to hold office in this country.
10
Want LESS abortions, like I do? The solution is: provide women with lifelong, local, affordable reproductive healthcare. Obamacare mandated birth control coverage, and the result was the lowest teen pregnancy rate ever. Imagine, 4 in the morning, a hard working married couple with three teenage children waking up thinking:"did what I think just happen, happen?", and having no local access to birth control, or the morning after pill. Republicans will vote away all their rights and protections for this one, hot button issue. Republicans will guarantee MORE abortions when their legislations goes through.
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@4Average Joe, Thank You for posting!
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@4Average Joe, thanks for painting realistically.
You are defending abortion, as well as access to birth control/preg prevention.
As others have posted, unplanned pregnancy is not the domain of only the young and inexperienced, nor of only the poor and uninformed.
On whose behalf are antiabortionists speaking? Has every one of them never been in the circumstances described here?!
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As a supporter of Medical Students for Choice, I am comforted by the positive change in the medical system created by thousands of medical students in hundreds of medical schools pushing for more education around abortion. In the past 20 years, doctors of all specialties have become more open about abortion and although we still have huge barriers, mainly political and legal, having (now) many doctors who have been educated will, I hope, help keep women alive if we lose legal protections in much of the country.
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Many physicians take the oath " First, do no harm". It would be difficult for them to do abortions and remain loyal to that commitment.
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@Aaron Adams pshaw
there are all sorts of harm...carrying an unwanted pregnancy is one
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@Aaron Adams: And if the woman has complications that endanger her life? If the fetus is not viable? If you really want to have less abortions, make birth control readily available, also to teens without parental consent, and provide support to the mother and her child AFTER birth.
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@Aaron Adams
...excuse me, but does the life of the mother have no meaning? How successful are infants born to unprepared and unsuccessful mothers? Certainly, you are not naive enough to believe that all fathers are even in the picture. This is the reality of abortion..."do no harm", indeed.
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Good luck with this. Years ago my gynecologist had a memo posted in her changing rooms explaining how legal law suits are discouraging medical students away from that speciality. I asked her about it and she said the legal liability was scaring people away from the practice of obstetrics and gynecology. On the way home I listened to a radio ad from a local law firm asking "Does your child suffer from a learning disability? Maybe it was something done by the doctor at birth. Contact us at..." . Meanwhile my doctor mentioned she has patients that are overweight and refuse to watch their diet, refuse to quit smoking, etc. Between legal jeopardy, a public unwilling to take accountability for themselves and wack jobs threatening to kill you this field will have trouble recruiting new doctors.
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And doctors and nurses who object to this should not be forced to learn how to perform this procedure as a cindition of graduation or of obtaining employment.
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“Condition.” I am typing on an iPad.
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@Bookworm8571
Why should they not be required to have the knowledge even if they personally decide not to use it? So now religious affiliation can be used to avoid medical training? Does that mean lesbian separatists can claim that they don't need to learn about male urology because they will never touch a male body?
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@Bookworm8571
Good idea; students should be allowed to refuse to learn the things they don't like. /s/
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And then protect them.
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since abortions best performed the first trimester, it would be relatively inexpensive to provide free pregnancy testing to all, say once every 2 months. and then provide free medication for a medically induced termination.
of the many foundations some should be willing to fund such a valuable program.
at least until the sale of pregnancy test kits are outlawed. but here, the vested financial interests of the manufacturers might be an effective lobbying ally
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Are you under the impression that the reason people get abortions after 8 weeks is that they can't afford pregnancy tests? Seems like a classic " if the state would just buy something for somebody then no personal responsibility would have to be exercised."
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Personal responsibility includes not having a child you cannot take care of.
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Now with medical abortions, there is less need for doctors to do them. Still, as another commenter said, advanced practice nurses should be trained, too, so there are providers in areas where there are not doctors
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Nurse practitioners and nurse midwives should receive training as well.
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It is time that residents who do have objections to performing abortion, be allowed to finish their residency without any hassle because of their objections. I was a member of a teaching faculty where being not willing to perform abortions would get you blackballed from the program. Those who are so gung-ho for abortion should be forced to watch how horrible it is to end a life and see if that does not have some effect on them.
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@JBC Most abortions are early on and with new drugs, indistinguishable from miscarriages - which occur at higher rates than abortions. Stop demonizing women who choose to have children when they are capable of providing them a good life.
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@JBC in that case they are not fully trained as physicians , and are limited in the scope of how well they can serve their patients. Leaving oneself ignorant of the full range of practice is a disservice to their clients.
A D&C and/or D&E are done for many non-pregnancy related issues.
And how are they going to manage abruption or miscarriage if they skipped class that day?
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If you are not willing to be trained in legal medical procedures then don’t become a doctor, nurse, or nurse practitioner. This article is an incredibly cogent articulation of the real-life need for comprehensive reproductive services, including termination of a pregnancy. As a woman raised when abortion was illegal I deeply resent the simplistic thinking and, frankly, moral self righteousness of too many in the “prolife” camp.
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There are also pharmaceutical options (not Plan B) for abortions which do not require women to find a provider
in areas where there are none and the travel expenses or personal circumstances make it very difficult.
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Trained ob/gyns may work at hospitals that do not allow them to do abortions. My former employer was this type of hospital, not a religious institution, but the CEO imposed his beliefs on the medical staff because he could. It is the only hospital in town, so abortions were denied to both the local women and as a procedure that the doctors could do. I don't know how this can be legal and not duscriminatory.
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@nellie Once upon a time, hospitals were governed by doctors and nurses and the "suits" were fewer and existed to ensure the professionals could do their jobs. Now, it's the tail wagging the dog. Believe me, administrators do not share the same values as the healthcare professionals. I speak from experience.
PhD, RN who took courses with administators.
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As an ob-Gyn, I counsel all patients on all options. However, I do not perform elective abortions. I have been harangued by groups like Medical Students for Choice, who tell me that I should not be an ob-Gyn unless I perform abortions. 80% of ob-gyms do NOT perform abortions, many for ethical reasons, many because they find the actual procedure gruesome. Those who perform abortions often derive most of their income from abortion procedures, and often tell patients that have complications to go to the nearest Emergency Room (to be cared for by doctors who don’t perform abortions but know well the treatment for bleeding, perforation, infection, etc.).
Doing abortions is lucrative: a suction curettage for an abortion pays twice as much as a suction curettage for a miscarriage, even though the miscarriage patient often presents at 3 am, requires much more emotional support, and has a higher risk of complications. The abortion clinics run daytime hours only and the abortionists are not available after-hours.
All ob-guns get training on doing suction curettage for patients with miscarriages. It is the same procedure as an abortion. The counseling for an abortion can be learned in 10 minutes, and the procedural counseling is the same for procedures done for miscarriages. My point with all this is that physicians are pro-choice on performing abortions, some choosing not to do abortions. Stop the haranguing and guilt trips, Medical Students for Choice.
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The anti-choice movement likes to paint abortion providers as being in it for the money. Please stop spreading these, along with many other, lies.
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What's your point?
That you are for abortion to be legal but because it pays well to perform them you won't do it? That it is too painful to perform? That abortion should be illegal? That abortions should be cheaper? That abortion providers are lazy because they don't work at night?
That you don't want to be guilt tripped because you are a good person and shouldn't be forced to do something that is too emotionally difficult?
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@anappleaday
I do not think the harangues are unilateral. There are many reasons to support the student protests.
Training for abortion is, in fact, actively suppressed in some states: https://www.theatlantic.com/health/archive/2015/06/learning-abortion-in-... ("The Scarcity of Abortion Training in America's Medical Schools," 9 June 2015).
These arguments are not going to cease, nor should they. Your lopsided view of harangues and guilt trips are not constructive and do not address the problems of accessibility. Your skewed view on the profitability of abortion is a longstanding, distorted right-wing talking point.
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