OB-GYN Residency Programs Face Tough Choice on Abortion Training

Oct 27, 2022 · 455 comments
Chris (Detroit)
How do "hospitals" that refuse to provide full-scope OB-GYN services maintain Joint Commission accreditation?
Seth (Brooklyn)
Don't people know the difference between abortion in first 5 weeks than abortions' in month 6 ?
leslied (Charlottesville)
Your professional code of ethics comes first.
Tim (VS)
Then OBGYNs and sane people need to leave red states and the government needs to stop funding them. Until this happens nothing will change
RN (Toronto)
Sorry boys- I want an OB/Gyn who knows how to do a D and C. This is insanity.
George (USA)
This is what results from absurd religious fervor. A bygone generation of white Americans adamantly unhappy with the presence of the country and its direction using their political block to reset the country 50 years in the past. Bigotry, narrow mindedness and religion subverting decency and common sense. The system was fine when it benefited them, but now it doesn’t cater to their whim so the country must be in dire straights???
Susan (Michigan)
Extremists cannot stop interfering. Next, political leaders will require psychiatrists to tell women they are blessed to sacrifice their dreams, not depressed, and pediatricians to monitor which toys children choose or what color patients might be wearing or what churches families attend. Politicians should not interfere with medical care.
Tamara (Albuquerque)
“Your values are put to the test,” she said. “Of course abortion matters, but first of all we just want to be trained as OBs.” The most common surgical abortion procedure, the D&C, is also used to diagnose and treat fibroid tumors, hormonal conditions and cancer. When I experienced postmenopausal bleeding, my gynecologist performed a uterine biopsy and found no cause for concern--in the tissue biopsied. When the bleeding continued, I had a D&C for diagnostic purposes, followed by a hysterectomy for endometrial hyperplasia, a precancerous condition the D&C revealed. D&Cs are also common following miscarriages in order to clear the uterine lining and help prevent infections. OB/GYNs should be trained in the procedures their patients may need. Trained on female bodies--not guavas.
Cookies (Washington state)
So let me put in some perspective into this mess. The fallout from roe v wade is much larger than most people realize. It is still evolving by the day. Take this scenario: how many people have hypertension? How many of those are female of child bearing age? Did you know that some of the blood pressure medicines can cause abortion? So what if the patient forgot her birth control, got pregnant while still on her meds, and now her fetus is aborted. Who gets in trouble?
observer (nyc)
Sooner or later, some "pro-life" zealot will suffer the preventable loss of a wife, daughter or other loved one for lack of emergency medical care. They'll call it god's will, I suppose.
Jennifer Hoult, J.D. (New York City)
Do not donate to medical organizations an medical schools that do not require abortion care training for their hiring or training. Do not seek care from these anti-science, anti-women's-health institutions. Put them out of business. Birth rates in the red states will stay the same, because women will turn to self-managed abortions. But death rates of girls and women who needed abortions to survive medically-treatable life-threatening conditions will skyrocket. The truth of the "pro-life" movement is it is pro-femicide.
George (New York)
This was inevitable. No woman should risk being cared for by an OB GYN without adequate training. Even wanted pregnancies can have dire outcomes and when they do, having a doctor who has no or minimal experience could quickly become lethal.
Pixie (NJ)
Many comments about how red states will lose the best trained & educated students. Guess what? That’s what red states actually want is for their residents to be uneducated. It harkens back to the Chinese revolution (a red state).
Some woman (Southern California)
A lot of the states with abortion bans/restrictions are the same places already having trouble attracting and keeping doctors. Now it's only going to get worse.
Dr. M (SanFrancisco)
Think about your car for a moment. If you have a brake problem, would you want a mechanic who had 2 weeks of brake training, years ago? How about your beloved dog, who suddenly needs a surgery. Your vet says the procedure is very safe and easily done, but some dogs have to wait and suffer and become septic and possibly die, before treatment is begun. Then the vets adds that only female dogs have to suffer like that, due to his religious views. Why should women and girls be treated as less than cars or dogs?
WJG (Canada)
So here's a scenario: Some states decide that heart transplants fall under the same moral approbation as abortions - after all a viable beating heart is removed from a donor, and if heartbeat is the indicator of protected life it should never be done. But heart transplants involve training in vascular surgery, as do cardiac bypass operations and many other medical procedures. So, hospitals in the restrictive states no longer offer training in vascular surgery since it is a necessary technique for the now illegal heart transplants. So no more trained vascular surgeons in that state. How are all those older white men who rely on this technique for continued well being going to feel about this? Yeah, I didn't think so.
Reta Harrington (Charleston)
Add in the power to dictate medical treatment based on Catholic doctrine in many catholic hospitals and the nightmare expands. Only the Democrats are willing to ensure women and her medical providers make their own choices based on sound medical protocol. Vote out the GOP and their constant obstruction as policy. Vote in a filibuster-proof Democratic majority and see women's rights codified.
Dr. M (SanFrancisco)
If some medical students don't want to care for ALL of women's medical needs - then they should not enter that specialty. They are free to pick one of many another specialties, hopefully one where their personal beliefs don't result in withholding care. There is no justification for running a medical specialty program according to politics and the religious demands of some of the providers.
Madeline Conant (Midwest)
Here's a question for you. During all those years when elective abortion was legal all over the U.S., why wasn't that service available at local hospitals? Why was there ever even a need for Planned Parenthood? Hospitals provide all kinds of other elective surgeries and procedures, major and minor, why not abortions? Hospitals have abdicated their responsibility to women and to their communities.
Kate (Wisconsin)
@Madeline Conan-- Medical abortion for miscarriages, moderate to severe fetal abnormalities, and maternal health were performed at hospitals. Abortion as an elective procedure was, generally, offered at specialty clinics. This has been the case since abortion was legalized. However, since hospitals handled the vast majority of complicated pregnancies, including abortion, the fact that they will no longer perform the procedure in states where it is now illegal is, in my opinion, malpractice. Hospitals and doctors should be at the forefront of lobbying state and national government for clearly written laws concerning pregnancy complication and abortion. This would include advocating, educating, and lobbying for maintaining legal status for medications that women need for ailments other than pregnancy termination. These forced birth laws are an abomination and a human rights violation. What will be the next casualty in the was against women; voting???
Susan (CT)
@Madeline Conant Spitballing here, I imagine it wasn't that profitable, you know how hospital management is.
Diana (Texas)
It's absolutely NOT true that abortion training is "required" to graduate an ob/gyn residency program. Residents can and do opt-out on religious grounds and that is a REGULAR occurrence. It IS required for ob/gyn residency programs to offer the OPTION for abortion training at another site, out of state if needed. But for the resident, pursuing abortion training is OPTIONAL. I'm sick and tired of the authors of these articles not understanding that distinction.
HT (Ohio)
@Diana Here's a direct quote from the article: "Although programs must offer that training, the council permits a resident to opt out for religious or moral reasons." The authors also made it clear in the first two paragraphs that they were discussing accreditation and the broad impact of medical schools NOT offering this training.
Allison (NC)
@Diana The author makes this quite clear in more than one instance in the article. Have you read it?
dap (San Marino, CA)
I wonder if part of the technical training on how to become a locksmith should be illegal and land the instructors into jail: how to open a safe, without knowing the combination. Ob-gyn doctors, with limited training probably do not qualify for malpractice insurance and should be unemployable.
artusan (Sydney Australia)
Both evil and medieval. How can any doctor, let along an OB/Gyn be ignorant of the most important function of the human body: i.e. making the next generation. That is all we are there for, in essence. Abortion, termination and pregnant women's care is fundamental to medical care for women. Without this knowledge and practice women who become pregnant are at risk of injury, disease and death. Say nothing of the risks to the unborn who may need specialist care or if the fetus puts the mother life at risk, what then? both will die. Women, half the population, deserve medical services which are fully accredited for their care.
cowalker (Ohio)
In the current environment, what woman is going to go the hospital if she's miscarrying? She'll opt to ride it out at home to avoid being investigated for attempted abortion. Obviously such cases as seen by residents are already scarce. There will be some tragic cases of women who SHOULD have seen a doctor, and who will suffer complications, and possibly death. More victims of this poisonous anti-choice decision by the packed SCOTUS.
KO (MI)
@cowalker This is already happening. It's not a possible foreseen bad outcome. It's a reality.
LHH (London)
Abortion is a medical procedure that tightly belongs in medical school curricula, like any other procedure that might be necessary to care properly for a patient. The only reason to exclude such teaching is to favor religious beliefs and political ideology over the best patient care. But since this overwhelmingly affects women and girls, sacrificing their health and welfare is palatable. I would add “shameful,” but Americans st large are incapable of shame.
Diana (Texas)
@LHH It belongs in ob/gyn residency programs, not in medical school. For example orthopedic surgeons and pediatricians have zero need to learn abortion services and there is ZERO chance they would perform one after graduating.
MS (CA)
@Diana As a physician, I believe it should be included in the medical school curricula. Having it be part of the medical school curricula does NOT mean the medical student will be performing it after graduation. It just means students get exposed to as many facets of medical practice as possible. For example, in medical school, I rotated through pediatrics and surgery - both specialties I had no intention of going into. Yet, I learned something from both. Surgery taught me that when faced with a patient with abdominal pain whether and how urgent I need to call in a surgeon versus handling it on my own as an internist. To this day, I recall that an active, playing, sick child is much less worrisome than a quiet, immobile, sick child. Being exposed to abortion would help students understand what their patients undergo when they suffer an ectopic pregnancy (which also shows up as abdominal pain) or a miscarriage.
Kathy (SF)
Men wouldn't accept these absurd threats to their health and lives. A lot of people think of women as chattel, property, lesser than, unworthy of study. A lot of people think of black people as punching bags and shooting targets, less worthy of study and less deserving of pain relief. Bigoted people and those who try to impose their belief systems and delusions into others' lives should have no impact on public policy.
Mask Of Comedy/Tragedy (Northeast)
Can hospitals where abortion is currently legal find a way to train more ob-gyns? Is that possible. I know this is not a long term solution, but until we get a better solution
John Mardinly (Chandler, AZ)
For lack of properly trained doctors, people will die. This is all just nuts.
Kathy (SF)
@John Mardinly I wonder if Americans will ever face the fact that the Republican Party and its members are profoundly misogynist. They depend on the patriarchy to maintain their positions at the apex, because they are both afraid and too often incapable of fairly competing with women (and everyone else they oppress). It's sad that they expect so little from themselves that they're content to expend all their energy trying to subjugate us instead of trying to improve themselves, and thus, the country and our effects on the rest of the world. Of course only people without any standards could possibly support Donald Trump or any other seditionist.
Chris (Huntsville)
SCOTUS and the Rs have certainly opened Pandora's Box, eh??!! Didn't think things through--at all. What a disaster for the country. I thank all the gods I'm way past childbearing age. I'm horrified on behalf of all the women and girls this affects.
Stereosound (NYC)
A year ago I gave birth to a very healthy baby and then began to bleed incessantly. After a few hours, and losing 2.6 liters of blood, with my heart rate at about 180, (and feeling that I was freezing to death) I was wheeled into an operating room and given a D&C. It was imperative that the doctors see if there was a rupture in the wall of my uterus. Despite being an emergency, the operation was routine and the only risk in this procedure was whether my body could withstand the anesthesia. Everything went fine. I was treated, got a massive blood transfusion, and was reunited with my baby the following day. Amen. I wouldn’t be so lucky if I lived in a place where I either couldn’t access this care or was treated by doctors who didn’t know how to perform the operation. I think of the women in these states who are in my position now.
Kathleen (Atlanta)
Again, why are lawmakers, who overwhelmingly are NOT licensed medical doctors, being allowed to practice medicine via deciding what care is allowed for which patients? Keep Congress and the Supreme Court out of medical decisions that belong to the patient and her doctor.
Sollozzo (NJ)
@Kathleen ....And the FDA and the AMA and PPH
Newsreader (Chicago)
The ACGME permits residency programs and trainees who have a conscientious objection to not participate in abortion. And this is without penalty to their accreditation status. For example many religiously-affiliated programs have an exemption. Residents who object can still go onto practice Ob-gyn without having to practice abortion. Still, it's necessary that many Ob-gyn be prepared to manage miscarriage, and extra-uterine pregnancies. Sadly, state policy that doesn't permit exceptions for the health of the mother will soon reveal a need to train more coroners.
Doug R (Michigan)
Not really. Physicians will be taught how to do them as part of their training. Whether they do them on the job will be determined by the facility they work at.
WJG (Canada)
@Doug R How to will residents learn to do these procedures if those procedures are, by law, prohibited in the hospital in which they are training. Do you really want a physician performing a procedure (any procedure) on you that they "never did it, but read about it in a book"?
M (Albany, NY)
States in which abortion and the full array of reproductive services are legal and available should offer internships for Ob/Gyn residents to learn skills necessary to become board certified. And, the medical community including professional organizations should demand that these procedures be taught in all states regardless of legal status of abortion.
Jon T (Pittsburgh)
The decertification of many prominent OBGYN residencies should proceed. The disruption and dissolution of OBGYN care in states where abortion is banned will effect a dose of reality upon its residents who only then will be able to think clearly. Yes it should be left to the states to determine the legality of abortion. I totally agree. It should also be upon state governments to compare their public health statistics with each others. The differences will be predictably significant.
Dr. M (SanFrancisco)
@Jon T I see your point, and agree with it in theory. But not everyone in banned abortion states agreed to have it banned. Nobody agreed to die due to pregnancy. I wish I had a better answer.
Dr. M (SanFrancisco)
@Jon T Why do you feel that politicians, mainly male, should basically own and control the sexual parts of all females' bodies in ANY state? This country already tried that body-owning philosophy, including waving the Bible as justification. Fortunately, that ended 157 years ago. Let's not repeat it.
RPU (NYC)
One needs to be impressed that a Boarded Ob-Gyn states that training for an abortion is not needed but training residents to manage a miscarriage is okay. It's the same procedure. I guess they have a lot of "miscarriages" in Ft Wayne.
akamai (New York)
@RPU With many more now.
LG (NYC)
Graduating medical students should boycott residencies in these states with laws that threaten the life of women. Loudly advertise why. An acute and severe shortage of qualified MDs should wake these moron legislators up. Sorry for the good women who are hurt along the way, but radical laws require radical reactions.
Newsreader (Chicago)
@LG this is a silly idea. Then there would be no medical care for women who need gynecology care, including those who intend to deliver a child.
C.A. (Oregon)
@Newsreader Unfortunately, this may be the only reason for the state's residents to vote for complete women's reproductive care, including termination of pregnancy. They decide - they put up with the consequences. Hard, I know, but we can't keep rescuing them from their choices or we won't have choices.
Kim Susan Foster (Charlotte, NC)
Honestly. people who are at the Top Of Their Class, are going to choose a Blue State. And not just Ob-Gyn MDs. Wealthy people in Red States are going to end-up having to go to a Blue State for top medical care. The best and the brightest are choosing Blue States! The longer this MAGA Republican Red State unintelligent stuff continues to happen, the worse it is going to get for everyone living in those Red States. ---- Including for those White Nationalist Male Republican State Legislature Politicians. Those men are going to damage themselves, and their families. The well-educated pipeline is definitely going to dry-up for years to come in those Red States. Futures are at stake.
Diana (Texas)
@Kim Susan Foster Mehhh.... Texas has been a red state forever and has always had abortion restrictions. Yet in spite of how deep red it is, Texas is #2 in the country for medical license applications. There are still plenty of doctors trying to move to Texas.
lourad (Alabama)
It's a War on Women. From the Right we get loss of bodily autonomy, from the Left we get erosion of our protected spaces and fair play. "Pregnant people" my foot. Both sides deny biological reality for half our population.
Blossom (The Buckeye State)
@lourad Girls can and do become pregnant too. They aren't women. Pregnant people is absolutely correct.
HellsKitch (NYC)
This is seriously alarming, a female Gyn who is anti-choice! —— lots of reasons for terminating a pregnancy, very sad for the generations of women who will suffer
Prof (Michigan)
@HellsKitch I didn't realize there were any OB/Gyn's who were so anti-abortion. I would never want to see any Dr. who brought their religious views into the practice of medicine.
Diana (Texas)
@Prof Here's a little nugget of info that these news stories won't tell you. There's a big percentage of ob/gyn residents who say they are "pro-choice" yet choose not to provide abortions. This isn't just in red states either, this is just as true in New York and San Francisco as it is in Dallas. Even liberal ob/gyn doctors are not very enthusiastic about offering the procedure at their very own clinics.
Jane K (Northern California)
@Diana, I work with doctors that choose not to provide elective abortions for personal reasons. However, when patients have miscarriages, fetal demise, retained placenta, hemorrhage or abnormal bleeding when not pregnant, these same physicians perform the same procedure used in elective abortion. They do it because they know the women can die in many instances without the procedure. They were trained to perform Dilation and Curettage during their residencies before Roe vs Wade because it is a commonly needed procedure. To be an OB-Gyn and not be proficient in Dilation and Curettage is to be an emergency room physician who doesn’t know how to perform CPR.
David (Portland, OR)
Another unintended consequence will probably be fewer obstetricians available in states that criminalize women's health care, given the options of training for another specialty or moving to another state.
Dorothy Wiese (San Antonio)
@David Many of the other specialties will have problems.Treatment for cancer and autoimmune diseases involve the same drugs used for abortions and miscarriages. Many drugs advertised on TV say to use BC due to harm to the developing fetus.
Brigipit (Miami, FL)
Is this for real or just speculation of what might happen if abortions restrictions ate put in place. D&Cs have been part of Ob-gyn training for years, even in countries were there is a total ban for elective abortions. The training that I see beong restricted is for the procedure of removing a fetus that has been killen on ourpose and needs to be removed piece by piece.
PM (NYC)
@Brigipit - Even fetuses not "killed on purpose" sometimes need to be removed piece by piece. If the thought of that bothers you, better not read anything else about medicine. Lifesaving procedures can seem pretty darn gross to those who don't perform them.
Patricia (California)
@Brigipit, a reading of the article makes clear that this problem is for real. It's a problem OB-GYN residency programs are already grappling with in states with total bans. The unintended consequence is that many of these residency programs will lose students, and some will close. I think we all expected that there would be fewer OB-GYNs in states where practicing medicine puts them in legal jeopardy. We didn't anticipate that residents would also be in short supply. A D&C is abortion, as we all knew in the '60s. When attorneys general in Oklahoma, Tennessee and Texas were asked whether they would press charges against programs that taught residents how to evacuate the uterus, they did not respond. It's reasonable for the board to deny accreditation to programs that leave out essential training for managing miscarriages and hemorrhaging.
barbara (santa cruz ca)
@Brigipit hate to tell you this but pregnancies fail and a dead fetus will rot inside the woman and kill her. a bad way to die as your system is poisoned..
firlfriend (usa)
If you are not trained in this procedure, used also, for older women who are having bleeding problems due to menopausal bleeding, or other gyn problems. If a medical school does not teach this, how can they give health care to all women, not just those that are starting families.
Patricia (California)
@firlfriend, exactly. How can any hospital or clinic hire an OB-GYN who isn't trained in this most basic medical procedure? Or an OB-GYN who isn't accredited?
Diana (Texas)
@firlfriend To be clear, these procedures are taught in residency, not medical school. Orthopedic surgeons get zero training in D&C/abortion care, nor should they get that training because there's zero percent chance they will use it in practice.
hen3ry (Westchester, NY)
This was the ultimate goal of the anti abortion/pro life supporters. Make abortion impossible to get no matter what the reason is for needing it. Pregnancy is always risky for the woman. Things can and do go horribly wrong. Women and fetuses die. Are women now supposed to be the ultimate sacrifce for a pregnancy with problems? Are we supposed to resign ourselves to being the throwaways here? It seems like it.
David J. Krupp (Queens, NY)
All doctors should unite to tell the American people that the republicans are a danger to your heath and should be voted out of office.
Ahuva (10504)
This is a national health crisis travesty and tragedy. I suppose we'll have to start wearing hijabs soon.
akamai (New York)
@Ahuva And that's just the men. Kidding. This is literally deadly serious.
Ken G (Oklahoma)
Choice is a matter for a woman and her well trained doctor. Nobody else - certainly not politicians, nor preachers, nor self righteous busy bodies.
Shirley (NC)
If I were applying for OB/GYN residencies, I would NEVER consider a state where abortion is banned (or about to be banned). I don't think it's practical or even credible to ship your residents out of state for 2 weeks to "learn abortion". If I didn't get into a blue state program, I'd go into another specialty not OB. What about all the miscarriages, ectopic PG, fetal demise cases that these residents will encounter in their RED state during residency? The students can't manage these patients in their RED state by doing abortion - the patient would have to be referred to states where abortion is legal. Would you really want to go to an OB trained in a red state where so many clinical scenrios couldn't be managed and they may not be adequately trained? One could even argue that red states should not have OB residencies anymore.
Diana (Texas)
@Shirley Applying to multiple specialties in the residency match is difficult to virtually impossible. So it's not very realistic at all to use a different specialty as a "backup" if you don't match to a blue state ob/gyn program.
mole (Springfield)
I guess they could learn on animals, but then would you want to have a doctor that got their training on animals, not people?
firlfriend (usa)
@John Not true. NPs at certain fetal development can do an abortion by giving them medication abortions.
Samuel (Berkeley)
@firlfriend what Isn't true? Your reply to John doesn't actually contradict anything in John's statement.
kathkern (PA)
@John proof?
LK (NY)
Well maybe the people in these red states who are planning to have children, or care about those planning to have children, should stop electing politicians who will make their pregnancies more dangerous because doctors won't have had enough experience dealing with problems. And yes medical schools should move out of states that won't let them teach medical procedures.
Blossom (The Buckeye State)
@LK Of course. Yet another "blue" state resident victim blaming. The reality of it is that MILLIONS of Dems live in "red" states. Yet, due to GOP gerrymandering and voter suppression, their votes don't count fairly, if it all.
DPT (Ky)
It is called a DnC for patient like me for excessive bleeding during a regular period. There are plenty of us out there. A build up of endometrial tissue that sloughs off during a normal period but is not normal .it I’d dysmenorrhea and requires a dilatation and curitage to remove the excess build up to stop the excessive bleeding . The procedure is basically the same as an abortion. I had to have a pregnancy test before the procedure. God forbid the right wing women’s body controllers stop this procedure. I would have potentially bled to death every month during my period. Too bad old white men don’t suffer like women .
firlfriend (usa)
@DPT I worked in the OR for 19 years. When someone came in for tying tubes, some ob-gyns will do a D and C before they do the tubal ligation. D and Cs are often used if a woman is having excessive bleeding to test the tissue to make sure there is no endometrial cancer. Also, read the article in NPR today, a couple who wanted their child, but she is 35 years old. She had an amniocentesis, the fetus had a genetic abnormality. They did not know if she would be able to talk or walk normally. Also, fetus had a cystic hygroma which is not normal either. She had the abortion at 19 weeks and 6 days. Many birth defects and genetic abnormalities, are not discovered until after 15 weeks.
Josephine Golcher (Fountain Valley)
50 years ago, I was married with 2 children, 3 and 6. I had an IUD fitted. A few months later, I became pregnant. Even though unexpected, the baby was welcomed by us all. After 4 months, I had a miscarriage which was devastating to us all. My son, particularly, was stricken. Even after all these years, we are still heartbroken. We did welcome a baby girl a year later. 2 years ago, we lost our 53 year old girl. That still hurts terribly. My baby girl is now grown up and has 2 teen age boys of her own. Doctors can’t and shouldn’t legislate for other adults. They can help very much in the decisions. My miscarriage occurred in the UK and the final decision to terminate was made by the doctors and us only, weighing carefully all the considerations. I have no concerns over our decision, even though I still mourn. That is a different issue.
kirk (kentucky)
Fear not ! Senator Paul, also a doctor, accredited himself.So these new 'do no harm obies' don't need to know how to abort to be a 'good ' doctor.They can simply accredit themselves.What a wonderful country we have that so loves the unborn .
Dolores Deluxe (balto md)
It is time for every female who believes she has the right to control her bodily functions make a plan to leave that country. The USA is going down hard & fast. I’ve had over 70 years to observe this & am now convinced that unless you are already rich beyond compare- you are not wanted there.
David J. Krupp (Queens, NY)
@Dolores Deluxe No, no, no! Stay and fight by voting every single republican out of office.
George Acs (Clarksville, MD)
The American Board of Obstetrics and Gynecology, which grants Board Certification to graduates of accredited OB/GYN programs should move its headquarters out of Texas and do so with the kind of fanfare that Governor Greg Abbott can understand
Little Miss Muffet (Wide wide world)
@George Acs Go team go!
MM (Chicago)
I think as many have commented on below, we need to replace the word "abortion" with the words "uterine evacuation". There are so many reasons to perform an "uterine evacuation". Let the OB/GYNS decide.
drbets2004
@MM I totally agree! The ability to perform a uterine evacuation encompasses everything from excessive bleeding post partum with retained placentas, to retained products with a miscarriage. Even for menopausal women, the ability to have your hands "know" the edges of uterine contours is imperative. I am an Ob/Gyn and train students, It is not a simple procedure, not something you can say "one and done"
firlfriend (usa)
@MM However, ACOG states what the term has to be when you fill out paperwork in the OR or clinic. If the diagnosis is not written right, then the procedure, which is incomplete abortion, spontaneous abortion, missed abortion, blighted ovum and molar pregnancy. When you feel the paperwork out you cannot write uterine evacuation. Depends on ACOG and how they want it defined. Also, if you don't write the correct procedure, the health insurance will not pay. They have coding which tells you what the procedure is.
MN (Michigan)
@MM Exactly. or call it D&C, dilation and curettage
Lewis Sternberg (Ottawa, ON.)
Move your medical schools to states whose law allows you to teach medicine and leave those who prefer to live in ignorance & denial in ignorance & denial. Take all your medical school jobs with you as well.
drbets2004
@Lewis Sternberg I believe that education should be just that, education. About all eventualities. You would not want a general surgeon that decides to only practice in locations where everyone is perfectly healthy, because god forbid, there is a multi car accident and you need a trained doctor who knows what they are doing. You don't pick and choose your patients for the most part. It is going to make medical care worse for those in the South
RSP (NY)
This country has become dumb. How stupid that laws made by politicians are now interfering with doctors' education? There are countless procedures that require uterus evacuation - what, there will be police/lawyers/authorities in every operating room? If they want to ban abortions legally, why not leave it up to a woman and her doctor, so women don't need to flee their home city to get the care they need? Decriminalize!
Valerie Elverton Dixon (East St Louis, Illinois)
Every woman or pregnant person living in the United States ought to have access to the same quality of healthcare. They ought to have the same freedoms.The United States Constitution says the federal government exists, among other things, to "secure the blessings of liberty to ourselves and our posterity." Liberty means choice. The 13th amendment prohibits involuntary servitude.There is no expedition for pregnancy. Forced pregnancy, forced labor, and forced birth constitute involuntary servitude. Vote for Democrats so abortion rights can be codified into federal law. See: "No Compromise" at http://www.justpeacetheory.com Click on essays.
FreedomRocks76 (Washington)
@Valerie Elverton Dixon The mid term elections will indicate whether or not choice is seriously considered by the voters.
Earthling (Earth)
One thing these training programs can do is to send the residents out of state for a couple of weeks to learn abortion skills.
MCM (Ohio)
@Earthling According to the article, that's already happening. However, there are a finite number of hospitals and clinics where residents can perform abortions and they're already filled with residents from those states. You can't send a resident to an out-of-state rotation if there's no space available.
Michele (DC)
As the article discusses at length (did you read it?), there are practical, logistical and legal problems to do doing this, e.g., living expenses, insurance, whether some deranged Texan is going to sue the program for facilitating abortion out of state, etc.
Dr. M (SanFrancisco)
@Earthling Would you someone work on your car brakes who years ago had "a couple of weeks" of training? Would you take your dog to a vet for surgery who only had 2 weeks, years ago? WHY should women and girls be considered less than cars or dogs or men or less than anything else?
CJANE (Midwest Suburbia)
The medical community needs to stand up to these fervent anti choice legislators and clearly state they cannot effectively treat their patients with these laws and stop cowing to the idiots of the country. Clearly, no doctor can effectively “do no harm” without having that option. What’s next, stop education for kids because they might learn something?
Brandon (Oregon)
Looks like there is a health crisis for women underway while America collectively yawns.
100panthers (Miami)
This is the fantasy world the GOP lives in; 'I am qualified to perform a D&C for your miscarriage because I practiced on a PAPAYA! But not just one papaya, many papayas!! Now I need you to sign this consent form!'
H Munro (Western US)
Women might die in childbirth, young girls (because that's really who we are talking about, aren't we?) victimized by predatory creepy lowlifes will be forced to give birth when they are far too young and forced into an emotional bond with the lowest sort of "man", you won't be able to travel to Disney World without peeing on a stick first because of this supposed "state's interest". It's all so disgusting. Maybe we can grow a poor and ignorant population uncared for, susceptible to drugs and then that narcissist Putin will feel the injury to his pride has been returned tenfold and he can die happy. It is to retch.
FerCry'nTears (EVERYWHERE)
@H Munro Women of all ages are affected by this. Please don't divide us!
roger (Cambridge)
simple stop accrediting medical educational programs in states where abortion is not legal.
Barb (Chicago)
@roger So you must be a proponent of Buyer Beware in all things. Take a few moments to explore the concept of accreditation and licensing to understand why it exists
Camille Favale (Florida)
Where is the AMA? The AMA is s very powerful organization who should be speaking up for the doctors who now have to question their medical knowledge if and when a woman needs an abortion. As if that isn't enough, the doctors need to consult with local politicians about the decision to perform an abortion. This is ridiculous! What happened to the privacy law - HIPPA law? How can non-medical people, politicians, make medical decisions? This is absolutely absurd! I know the economy is a major concern but the Republicans have no plans to improve the economy, in fact, they want to cut Social Security, Medicare, Medicaid, raise the prescription prices that the Democrats lowered, and more things that will hurt Americans instead of helping them. If the Republicans gain control of Congress they will ban Abortion in the whole United States taking away women's rights. If the Democrats keep control of Congress they will vote to make Abortion a law.
Blossom (The Buckeye State)
@Camille Favale Agreed. Abortion is an economic issue too though. Especially in a country where millions are uninsured or underinsured and where even with good insurance. childbirth can result in thousands in out of pocket expenses. A country where there is no mandatory maternity leave. Where those lucky enough to get maternity leave at all often don't get paid for it, or only get partially paid. A country where there is little subsidized child care. A country where women are still fired from jobs for being pregnant or being a parent. A country where parents get little financial or practical help with eighteen years of childrearing, especially those who are just above the poverty line, making them over income for public assistance benefits. Unplanned and unwanted pregnancies are detrimental to many girls and women's economic situations.
L.P. (Canada)
@Camille Favale Privacy law is something that puzzles me. I don't understand how people (ex: a neighbor) or law enforcement can access medical files to bring someone to court. I don't understand how the Texas law could permit someone to have access to medical information or to personal conversations, etc.
Jane K (Northern California)
Knowing how to perform a D&C is not just for the purpose of aborting a pregnancy. Post menopausal women and need D&C’s for abnormal bleeding. It is a diagnostic tool for endometrial and uterine cancers. Women who deliver normal healthy babies need the same procedure for retained placenta and postpartum hemorrhage. If not completely removed, severe blood loss and infection can be possible complications. Not teaching future Ob-gyns how to deliver appropriate medical care is ridiculous and is like not teaching a cardiologist how to perform CPR. It is not used every day, but they should be proficient and able to determine when it is necessary and have the skill to do it correctly. Just another example of how politicians are in over their heads when it comes to legislating medical care without having full knowledge of how different procedures and medications are used.
Another woman (Austin TX)
Three days after giving birth, I hemorrhaged, due to placental accretion. Without a D&C, I would have died. Or, if my OB hadn't known how to do one, I imagine I would have received an emergency hysterectomy, preventing the birth of my second child. Reproductive Justice for all.
Sam (Seattle)
Don't get pregnant in this country, it may cost you your life. Go to a healthy, sane country if you can, while you can. This place is increasingly unhealthy and downright dangerous.
drbets2004
@Sam but it's obviously only the wealthy that can choose to go to another country to have children. The rest of the American population is stuck here.
CJANE (Midwest Suburbia)
All women in this country deserve better and my hope and prayer is that voters turn out like they did in Kansas and vote down the Republican agenda. If I were still ovulating, I would get my tubes tied. No paid leave, no maternity care, no support system, no right to my own body and choices would make me leave this country if I wanted to have children. This country is an embarrassment every single day.
David J. Krupp (Queens, NY)
@CJANE You don't have to leave the country. Most states still follow the Roe ruling.
FerCry'nTears (EVERYWHERE)
@CJANE They are going after getting your tubes tied as well
Audrey (Denver)
For me, the real issue is that people that need reproductive care in states that outlaw abortion are the real victims. Their quality of care will go down even further than it is now. Unfortunately, not everyone can chose to leave those states. Possible death by political overreach is the new mantra in many states now.
pb (calif)
Obstetricians can always go to other states. I certainly wouldn't risk my training for a radical hospital.
benny (new hampster)
Ok so doing a D&E is not rocket science You train to do substantially similar procedures anyway
Barb (Chicago)
@benny And what would those be?
Patricia (California)
@benny, I don't think I'd want you practicing on me.
Jane K (Northern California)
@benny, is this coming from someone who has had one? Having had a D&C myself, I sure wouldn’t want someone with limited training doing it on me. Why do you think so many women died of illegal abortions before Roe made abortion legal in this country? One of the risks of D and E, as well as D&C is perforated uterus. That means the instrument goes through the wall of the uterus and with it, a woman can be infected as well as hemorrhage. D and E is even riskier due to a thinner uterine wall.
CPMD (Bozeman,MT)
Run for the hills young residents! Switch! Change directions! Abort, Abort! Medical Students: this is not the time to think about doing OB/GYN Martyrdom residency! You have so many options and can do great things as any kind of physician! And you can help by refusing to be a part of the broken system! If we OBGYN physicians who are the backbone of women's health are telling you that this is the beginning of the end of women's healthcare and will upend healthcare for all in America: Believe it. The vitriol is not just in red states like Texas,..it is in the very Supreme Court that oversees our constitutional rights and sets the agenda for our future. It is about to get very ugly. Very dark. We're not just going back..we're going down. You have the power, youth and voice at this point to change yourself and change healthcare. If there are not enough OBGYN doctors and not enough OBGyn residents, and not enough nurses in Texas....and Louisiana...and Idaho...and .Indiana...and California..and even less tomorrow and the day after...we will have the power to change the system and make healthcare what it truly should be. Don't be the canary in the coal mine.
Cassandra (Sacramento)
Hmm. I've heard the expression "blessed be the fruit of thy womb" in scripture but never expected that fruit to be a papaya. For goodness' sake! Shaking my head here . . .
Emily Penfield (Italty)
For the past 10 or 15 years I've been saying the Republicans are conducting a war on women. One more example will be lack of adequate, well-trained women's health practitioners. The lack of response from states with abortion bans on this issue speaks volumes. Either they did not think this through, or more frighteningly, they did.
Blossom (The Buckeye State)
@Emily Penfield I believe it was thought through. This is step one to returning America's girls and women back to official second class status. I fear what's coming next.
Doctor B (White Plains, NY)
I held a high faculty position at a major medical school for over 30 years. I typically spent at least 8 hours per week doing direct clinical supervision of Resident physicians & medical students. I had detailed conversations with hundreds of these trainees regarding their choice of specialty & choice of hospital for Residency. The Dobbs decision nullifying Roe v. Wade has had a profoundly chilling effect upon medical education. No doctor can be adequately trained to practice Ob-Gyn without learning how to perform abortions. Performing a procedure on a papaya or watching a video is no substitute for performing the procedure on a real patient. Residency training programs in those states outlawing abortion will see a precipitous drop in the number of applicants they receive. They will be unable to attract the best candidates. It will not be long before there is a shortage of Ob-Gyn's, both nationwide & particularly in those states. Many Ob-Gyn residencies may be forced to close. There is an impending crisis in the delivery of obstetrical care in the US. This is totally predictable as a consequence of the tragically misguided Dobbs decision. Anti-choice extremist politicians have no business sticking their noses into the field of medical education. These matters are properly left in the hands of medical professionals, rather than someone like Ken Paxton, who is under criminal indictment. Keep your laws off of my patients!
Little Miss Muffet (Wide wide world)
@Doctor B It is time for ALL physicians, nurse practitioners, PA's, etc tot and up & say, "Hell no, we won't go!" Set up your own licensing boards, out of state control/ Tell corporate medical entities if they want to continue their billion of dollars profit they better do something to withdraw campaign funds to those state legislators who voted in the abortion bans, Since when has the medical professio been so wimpy? Use your clout & use i strategically. It won't be the 1st time.
Patricia (California)
@Doctor B, judging from the comments, most of the anti-choice radicals have no idea that abortion bans might affect other kinds of healthcare for women. Thank you for your valuable insights.
Kathy (SF)
The Dobbs decision was not misguided in my opinion. It was made by people who want to oppress and marginalize girls and women to maintain the patriarchy. Concern for "babies" is always a charade to fool voters. Not much effort is needed: people who vote for Republicans and against this most basic human right don't care about Republicans' contempt for women or for children and what they need to survive and thrive.
SpeakingTruth (Seattle)
I think this issue reflects a leading edge to the larger one that banning states will lose many of the best and brightest who have choices. It reminds me a bit of the talent flow we are reading about in Russia. But it is far easier for a young American setting up their life, or a company deciding where to expand, to just say no to abortion banning states. Likewise conventions, vacations and many other opportunities. If this occurs expect to widen our polarization. Specific to women’s’ health, some women may find themselves unable to find qualified practitioners for the majority of Ob-Gyn conditions that have zero to do with abortion.
Kevin Niall (CA)
Add to this the problem questions about in vitro fertilization and personhood, states that banned abortion might see increase maternal mortality and flight of couples wanting to get pregnant.
FerCry'nTears (EVERYWHERE)
@Kevin Niall I was shocked to find out that my 27 year old niece has been a surrogate mother twice. While delivering the last baby she had complications and now cannot have any more children. My religious sister (her mother) was delighted she could help a childless couple until that point. I am livid about it! She was turned into a baby making machine and now before age 30 her life has been profoundly changed
Dorothy Wiese (San Antonio)
No mention of the other diseases and conditions that affect women’s reproductive health. Drugs and treatments that cause harm to fetuses but save the women’s life. Like cance and autoimmune diseases. Will theses be ignored and also?
barbara (santa cruz ca)
i would not want dr francis as my teacher or dr i would not trust her. neither would i choose a residency in obgyn if i planned to practice in america. and if i did choose it i would be visiting the canadian embassy to check on immigration opportunity
Jonna Datz (Tennessee)
@barbara My understanding is that Canada has no laws about abortion. Could we see a "brain drain" of doctors from US to Canada where the government chooses to stay out of intimate, personal business between patient and physician?
C (New York)
The Accreditation Council for Graduate Medical Education in Obstetrics and Gynecology clearly states (page 29/61) “Residents who have a religious or moral objection may opt out and must not be required to participate in training in or performing induced abortions.” Although “residents must participate in the management of complications of abortions”, these physicians (and those in private practice ) cannot be forced to terminate a pregnancy. Last I checked, only 14% of US OB- GYNS performed abortions.
Jan Hoffman (New York)
@C From our article: Although programs must offer that training, the council permits a resident to opt out for religious or moral reasons.
hen3ry (Westchester, NY)
@Jan Hoffman, and every OB\CYN should have to make that clear to the patients they treat or might treat. I would not want to be treated by any OB\GYN whose sole experience with abortion came from videos or mannaquins.
Patricia (California)
@C, you fail to mention that relatively few abortions are performed past the first trimester. The vast majority of abortions are medical. However, OB-GYNS who aren't trained in how to evacuate the uterus aren't prepared to deal with an incomplete miscarriage, hemorrhaging, or ruptured membranes, among other crises. In other words, they're not really prepared to be OB-GYNs.
Vince (NJ)
All OBGYN doctors should immediately leave states that restrict women’s rights. Elections have consequences and it’s time to give the voters what they voted for.
Lois Ruble (San Diego)
Let those residency programs in states outlawing abortion lose their accreditation. Then those states can have the second-rate obstetric care their laws mandate, and their maternal/child death rates can climb even higher above the national average than they already are. For those looking high and low for a third-rate country, looks like they're finding it. Or, more pointedly, making it.
Emily Penfield (Italty)
@Lois Ruble unfortunately I feel it was part of the plan. Men first women and children last. Especially if they're poor.
Tawaki (Detroit, MI)
@Lois Ruble If those universities lose their OB/GYN programs, meh? If doctors and med students don't want to work in states that hamstring women's reproductive rights, I'm good with that too. If OB/GYN care is basically a mom bleeding to death in the emergency department because of no prenatal care/no OB/GYN to be found, I guess that's what those states want. It's all fun and games until it's your female relative who dies from lack of decent care.
Loves Mountains (Alta UT)
Universities in red states like mine — and not just in their medical schools — will face major challenges in recruiting faculty and doctoral students (as they deserve to I suppose). And anyone who is bold enough to be interested in a position in such an institution better be sure not to be pregnant while visiting. In fact anyone even just flying over such states (not just to them) is at risk: what if you’re flying from coast to coast and the plane lands in SLC or Kansas City or Memphis because of a pregnancy related emergency — your water broke early, say? You are in big big trouble.
MM (North Carolina)
@Loves Mountains Kansas, an overwhelmingly GOP state, voted this past summer to uphold a state constitutional right to abortion care
Susie (The Suburbs)
And so it goes, physicians now being trained to provide incomplete or sub-standard care for women. If I was applying to an ob-gyn residency program, the first thing I would do I find out which states will allow me to get a complete education (without having to jump through hoops like going out of state for such training) and that is where I apply. I expect there are aspiring ob-gyns who don't worry about comprehensive health care for their patients and they can apply to programs in states that refuse necessary treatment to pregnant women. And if hospitals lose their accreditation for failing to provide a complete education they can always do a "Rand Paul" and set up their own accreditation board. I'm sure Dr. Francis of the American Association of "Pro-Life" Obstetricians and Gynecologists will be only to happy to assist in this deception.
Sunshine (PNW)
Imagine the scenario. Doctor: "Don't worry. I've performed this procedure dozens of times... on papayas!" Unacceptable. In this country, in this age.
RAL (San Francisco, CA)
I just terminated a pregnancy because the fetus had several developmental issues making it incompatible with life. I'm 41 and married--this was such an incredibly wanted pregnancy. I don't know if it will happen again. This was my first pregnancy, and my first abortion. Despite the devastating fallout of termination for medical reasons, every day I thank whoever/whatever that I live in California, a state that believes women's lives matter. The pregnancy was safety terminated quickly after diagnosis, and I was treated by a very experienced attending OB-GYN and her resident, who got to see what terminating for medical reasons looks like on multiple levels. I am so grateful to medical professionals who devote their lives to providing this care. Much of the country loves to dump on California, but they also make their women carry babies that will die--or live very painful lives--to term and deliver. I will never leave this state, and if I'm ever lucky enough to be pregnant again, I will not travel to these backwards states until the baby is delivered, despite having family there. I cannot risk what may happen to my health, or the fetus's, if there is a medical emergency.
Jonna Datz (Tennessee)
@RAL I find that your story, which is an account of a painful decision to terminate a wished-for pregnancy, out of mercy...., illustrates that the legal choice to abort, or not to abort... if the law/government MUST be involved... should depend on the evaluation of the two lives involved. What is the value of a brief(?) life in physical and mindless, hopeless, crippled pain? Clearly the mother, or the potential mother's life, is the more valuable.....unless one's religion insists that the unchristened(?) soul will perish and thus must be saved at ALL cost. Perhaps we should look to Canada, where, to my understanding, there are NO laws concerning abortion...., before we politicize and meddle in matters of such extreme personal nature?
Joe (USA)
@RAL I'm so sorry. My wife also had to terminate a pregnancy earlier this year because the baby was not developing lungs. Access to an abortion took about a month and this was even prior to the Dobbs ruling. In some states they would now force her to carry the baby to term and deliver it, just to watch it suffocate to death. Severe fetal abnormalities are more common than people realize.
de'laine (Greenville, SC)
I was laying on the examination table after experiencing bleeding during a pregnancy I wanted. After a pelvic exam and internal ultrasound performed by my OB/GYN, he said everything looked fine, I spontaneously aborted. There was a whoosh and that was the end of that. My doctor immediately took me into another room where he performed what I imagine most people would call an abortion. What he did was make sure that I did not suffer from any sort of infection caused by remaining tissue. I wanted that baby, but for some reason, it was not meant to be. My OB/GYN looked after my health.
Loves Mountains (Alta UT)
I am so sorry for your loss. These days they would send you home if you aren’t lucky about where this happens. Once you get septic they could treat you. It is barbaric.
MHW (Raleigh, NC)
I am a physician. Training to perform abortions should absolutely be a component of OB/GYN training. Such training is not merely about performing abortions, but is a necessary part of training to handle the full range of OB/GYN situations. I believe that a physician without this training should not be board-certified in OB/GYN.
Diana (Texas)
@MHW Sorry but the ACGME disagrees with you. Would it shock you to know that the majority of pro-choice ob/gyns choose NOT to provide abortions? This is in New York and San Francisco too, not red states.
Russ (Whatcom County, WA)
It may make sense for some medical schools to consolidate with medical schools in states that allow comprehensive training. Even for state universities, the level of operational funding provided by states is often appallingly low, so the cost of moving may not be as great as one might think. It doesn't make sense for an OB-GYN doctor to practice in states with a full abortion ban, since they run the risk of prosecution for procedures that a layman prosecutor might consider to be abortion. This issue is another example of the harm of poorly educated legislators making laws in an era that rejects expertise. As is common, it is women who are treated in this country as second-class citizens who are the victims.
Loves Mountains (Alta UT)
You can bet that red state funds will not be able to be used for these kinds of arrangements.
Barb (Chicago)
@Russ I also imagine the lawyers who would sue a physician who had some training in abortion care, but who did not routinely do it, but was pressed into one due to medical emergency, and it didn't go perfectly well. Better to let the woman die waiting for air transport to the nearest state that could care for her.
jackie (Canton, NY)
This just gets better and better...
Aaron Wasser (California)
Politics aside, what the article doesn't make clear is whether the accrediting agency noted in the article is the only agency in the United States accrediting OB-GYN programs. If there is another, or others that don't require training on how to perform an abortion, the medical programs could very well likely turn to those organizations to obtain accreditation. But politics included, I have been reading that a very large portion of the OB-GYN doctors coming from medical programs are turning down positions at hospitals in states that have banned or significantly restricted abortions. And I suspect there are a lot of nurses also rejecting offers from those hospitals. When hospitals become so understaffed they aren't able to provide healthcare to their constituency, the state politicians will have to rethink their policies.
C (New York)
@Aaron Wasser The article did not mention this, but the accreditation body cited in the article (ACGME) does not require training in induced abortion for those OB-GYN residents who have a moral or ethical objection. Those doctors may opt out.
Kathryn Robinett (Maryland)
But from a program point of view, you have to offer this training to maintain certification. There is currently only one body through which programs can be accredited.
mmmaier (NYC)
@Aaron Wasser I'm guessing there will be some group handing out accreditations to programs that don't require abortion training but are the doctors graduated from them really a full doctor? If you are an orthopedics but refuse to study or work on leg bones what happens when you are the only doctor there when someone comes in with leg fracture... or a dentist that refuses to deal with cavities. I certainly wouldn't want that doctor. This type of incomplete training will lead to women being maimed or dying. If you want to be an ob/gyn you need to know how to do it all. Otherwise go into a different field.
Russ (Whatcom County, WA)
It may make sense for some medical schools to consolidate with medical schools in states that allow comprehensive training. Even for state universities, the level of operational funding provided by states is often appallingly low, so the cost of moving may not be as great as one might think. It doesn't make sense for an OB-GYN doctor to practice in states with a full abortion ban, since they run the risk of prosecution for procedures that a layman prosecutor might consider to be abortion. This issue is another example of the harm of poorly educated legislators making laws in an era that rejects expertise. As is common, it is women who are treated in this country as second-class citizens who are the victims.
Cornstalk Bob (Iowa City)
I'm so glad they decided that performing surgery on a papaya would not be sufficient training for physicians whose skills will be necessary to save women's lives.
Dana (Queens, NY)
As a retired Ob/Gyn who trained in NYC, and worked one day a week at PPH in the S. Bronx for 3 years under one of the finest physicians I have ever known, Dr. Irving Rust, I totally agree with the Accreditation Council for Graduate Medical Education. Performing safe uterine evacuations is a critical Ob/Gyn skill that requires extensive training. No Ob/Gyn training program should be accredited without providing that training. Abortion is basic medical care for women. Unlike other surgical procedures, abortion is performed blind. One cannot see the tip of the instruments or the tissue one is removing in a 1st trimester abortion, the most common procedure. One has to literally learn to see with his fingers the anatomy with its many variations in order to safely perform the procedure. This is a skill that requires repetition under guidance of an experienced surgeon to fully master whatever the purpose for the uterine evacuation. One cannot learn the procedure adequately by evacuating incomplete spontaneous abortions. For one thing the cervix is always partially dilated in incomplete abortions. Starting with a tightly closed cervix in a nulliparous patient, often with a flexed uterus, is a different thing altogether. A few of my fellow residents did not go on to perform abortions in their private practice. All of us however trained thoroughly in performing the procedure because we all realized it was an essential skill.
Bob Kale (Texas)
@Dana. You started out OK, but then went into the weeds. You are retired, and as we say about the military, “Thank you for your service.” However, in your day, you might not have been trained to perform ultrasound-guided D&C’s in cases with challenging anatomy, so the procedure is no longer “blind.” So that argument goes out the window. As far as the cervix in a spontaneous abortion (miscarriage) being easer to access than a voluntary termination of pregnancy, this is also very misleading. I’m sure you have had to perform endometrial biopsies to rule out cancer in a postmenopausal woman. Nothing is more challenging than dilating a stenotic cervix in an older woman to access the uterine cavity - it is WAY harder than dilating a pregnant cervix. But now we have drugs like misoprostol to soften the cervix to make the procedure easier and safer. I imagine you know about that but declined to mention it in your comment. Every single OBGYN residency in America trains its residents to perform uterine evacuations and always will. To say otherwise is a vicious lie. The only difference is whether you are performing the procedure where the fetus is viable or not, and residents can get plenty of practice on the latter and not be forced to perform it on the former. As I mentioned in another post, most OBGYN’s trained today are extremely poor surgeons. You can run away to any state in the US if you like, but you’d be hard pressed to find a competent gynecologist under the age of 40.
Patricia (California)
@Bob Kale, why do you say that most OBGYNs trained today are poor surgeons? My OBGYN is under 40 and a good surgeon. I'm genuinely curious about what you think is missing in today's training. This article isn't talking about prohibiting programs from training for late-term abortions. The prohibitions are against any kind of evacuation of the uterus.
Diana (Texas)
@Patricia Bob Kale is right. OB/GYNs and surgeons in other specialties are not as good as prior generations, mainly because they get many fewer cases than they used to, due to work hour restrictions. A typical gen surg resident in the 1980s would have completely DOZENS of appendectomies by the time he/she is done with PGY-5. Now? A PGY-5 is lucky to have done 3 or 4, tops.
Kathy (SF)
In the civilized countries, openly misogynist politicians would not serve for long, much less be able to use the law to bully and abuse girls, women and others with uteruses. They get away with it here because our statehouses and Congress are still infested with men who have to marginalize others to get and keep their jobs. Physicians and those in training should not have to worry about religious busybodies and people who like to abuse, subjugate and oppress women. If we allow degenerates to further impact women's lives don't come crying to me if the next group that has their rights to private medical decisions might include you.
One of seven (USA)
Glad to see the responses of all those upset by this issue. Any naysayers should read the previous linked NYT article “What Does ‘Abortion’ Mean? Even the Word Itself Is Up for Debate. In medical terms, the definition is clear. But when disputes arise, opponents argue that not every termination is an abortion.” All OB/GYNs medical residents must have this training! It’s woman’s health care!
Ithaca Reader (Ithaca)
Medical schools should close in forced birth states, and relocate to pro-health states. It’s really the only solution.
Ahuva (10504)
"...One student wrote that performing an abortion violated the professional oath to do no harm to life." What about protecting the known life of the mother whose life might be AT RISK from the unknown cluster of cells growing awry perhaps in her fallopian tube or with a mess of chromosomes that are too few, too many, or cut off? That's a specious argument from a "medical" student with a political agenda.
Kevin Niall (CA)
@Ahuva If a doctor refuses to abort an ectopic pregnancy that doctor condemns his patient to almost death. So the that "medical" student is no medical student!
Larry (Herndon, VA)
@Ahuva Why is violating a professional oath evidence of a political agenda?
organic farmer (NY)
Recently, I was ‘innocently’ asked by a white male conservative, “what freedoms does a white male billionaire have that a white female billionaire doesn’t have?” I said “the confidence to walk alone without fearing rape” He replied with a rude, dismissing emoji. The astounding insensitivity of the privileged few in red states is beyond understanding. They don’t know, but they really don’t care. Another reality, another experience, another plan for the future, or even just keeping their opinions private and out of others business just isn’t a thing. They don’t care. Herchel Walker and his ilk have no interest in adopting and parenting unwanted kids. They only want the power of control, the power of intimidation, the power of selfishness
Laurie (Chicago)
Well, so what? 1) Removing access to healthcare for women is the actual goal. Well played Republicans! 2) We will soon be able to grow babies in test tubes. Male babies. There will be no women in the Republican future.
Kevin Niall (CA)
@Laurie In vitro fertilization posses its own set of pro-life problems ....
Sam (Seattle)
@Laurie Then they can all get their guns and have at it until the last male is standing. Game over. USA dies.
Madge (NE)
Was Dr.. Francis trained in performing abortions and evacuations during her residency? Or did she opt out? The article doesn’t say, but I think it’s relevant whether antiabortion activists like Dr. Francis benefitted from training they now want to deny to other young doctors. Personally, I would want to be able to assume an OB/GYN treating me is fully trained in all the relevant skills of their specialty.
KMW (New York City)
I am unapologetically opposed to abortion. I am at an age where I am not afraid to voice my opinion on this subject. I had a wonderful OB/GYN Doctor Who would not work at a well-known New York hospital after his Catholic hospital closed. The reason? He was afraid that he would be forced to perform abortions and it went against his religious beliefs. He continued to see patients in his office but no longer would work in any hospital for fear of being forced to do abortions. I admire this doctor greatly and it was the hospitals loss. He had a wonderful bedside manner that is rare In the medical profession today.
MS (CA)
@KMW Well, I don't have a problem with you having personal opinions. The issues is when your opinion interferes with the my healthcare, my family and loved one's healthcare, and my patients' healthcare. The story you relay might be true for that physician (maybe he doesn't know the law) but there are no laws forcing any physician to perform abortions (or any procedure for that matter). I know because I looked this up previously for a related matter. If an MD or healthcare provider feels uncomfortably knowledge/ skills-wise or morally/ ethically about something, the main legal/ ethical duty they have is to refer the patient to someone who can offer the appropriate care/ procedure (much as a primary care doc would refer to a heart surgeon for heart surgery). What the MD cannot do is pretend there are no other options, lie to the patient about the patients' situation, etc. I've been on the other side: had a relative's doctor at a Catholic hospital deny appropriate end-of-life care to my relative. Were I not an MD, he would not have known there were other options, i.e. transfer to another doc/ hospital. RE: abortion, the main issue aren't docs being "forced" to do abortions but rather anti-abortion folks lying to patients about what abortion is, what the consequences are, where they can get care, etc. The problem is today, docs cannot even refer for abortions in some states without being labelled a criminal.
teresa (Eugene, Oregon)
@KMW I don't care. No need to be apologetic about your opinion about abortion. No need to be "afraid", either. Most of the women's rights advocates aren't armed or dangerous. We just feel strongly that, like you, we need to be in control of our own healthcare. Unfortunately a minority of right-wing misogynists are putting state politicians in charge of our reproductive health. We hate that so much.
Kathy (SF)
@KMW Competent doctors do what is in their patient's best interest, which may be evacuation of the uterus. They would never compromise care to prioritize their personal beliefs that have nothing whatsoever to do with their patient.
Ithaca Reader (Ithaca)
In Pennsylvania, Mehmet Oz wants women, their physicians, and the local politicians to make decisions about a woman’s health care. Looks like the exam room is getting pretty crowded. Oz, in the recent debate: “As a physician, I’ve been in the room when there’s some difficult conversations happening. I don’t want the federal government involved with that at all. I want women, doctors, local political leaders…”
mmmaier (NYC)
@Ithaca Reader I can just see the city council sitting around the examining table checking out whoohahs to see who gets to have an abortion.
Sue (PA)
@Ithaca Reader And this is the reason why we in Pennsylvania need to make sure that he and his republican co- hort, Mastriano, do NOT win!
barbara (santa cruz ca)
@Ithaca Reader local political leaders? like marjorie greene or herschel walker. no thank you. or maybe walker has an md degree to go with his lawmans badge
Get Vaccinated (USA)
Dr. Francis is entitled to her opinion, whatever the basis for that might be. She is not morally or ethically entitled to take a position that would degrade the training of other physicians who do not agree with her on the matter of a woman's choice with respect to medical procedures. Attempting to prevent the training of physicians to perform procedures that may be life-saving is hateful and hideously inhumane. If a physician cannot countenance therapeutic abortion, she does not automatically somehow acquire to a right to prevent other physicians from providing healthcare that is appropriate for the patients of others.
Patch Faa (Lucerne)
Move to Canada, young women. Canada does not have laws against abortion. They consider such a matter to be between a woman and her physician, a matter of personal choice and full health-care. Don't waste your time getting half an education or half a certification. One commenter suggested that persons not fully trained have an asterisk after their name. I agree. In my long life I have wasted time and money on "Dr.s" who were half-baked. And, then again, I have had others who were top-notch. There was no way to tell the best from the quacks.... and if you are not fully trained, then you may consider yourself a quack, because I do. Get your training in another country --- and don't come back. Incidentally, SC Justice Amy has a $2 million dollar contract with Penguin for her autobiography. All of this is working out very well for her. It is not going to work out well for anyone else. Leave and become the person you were meant to be. No one does well in a theocracy.
NM (Virginia)
I was at my annual gyn appt last week and my doctor said she and her peers have not trained in how to treat patients who will invariably self abort using all sorts of horrendous means. I had to have a life saving D&C when I miscarried and I can’t believe my own daughter may give birth in this type of society. We’re encouraging our highly educated children to leave the US if they plan to raise families. Between this and gun violence, the US is no longer the land of the free and there will eventually be a brain drain.
Patricia (California)
@NM, you bring up an important point. Illegal abortions will result in complications that will require doctors trained in evacuating the uterus. In the '60s hospitals used to have entire wards dedicated to women who had suffered botched illegal abortions. There were lots of women whose abortions were incomplete. States that ban abortions will have more need of these doctors, not less.
Diana (Texas)
@NM There are literally millions of foreign doctors who will just replace the American docs if the american docs go elsewhere. Ob/gyn residency programs in deep red anti-abortion states, aren't going anywhere.
Comp (MD)
Abortion is health care: WOMEN'S health care. D& Cs are health care; many miscarriages require them to avoid sepsis. Any doctor or resident who feels that it's not health care, should choose another specialty--and maybe invest in some leeches. Women are going to die if these procedures aren't taught.
Brigipit (Miami, FL)
No one claims that D&Cs after miscarriages should be illegal. They have never been.
SJ (NYC)
@Brigipit As a recent NY Times article "What is Abortion?" pointed out, the term used by medical personnel for a D&C after a miscarriage is abortion and is so entered in a patient's medical record. In states where abortion is illegal, D&Cs after a miscarriage are illegal and there are, in fact, states where such procedures are identified as abortion and are considered to be, and prosecuted as, illegal.
mmmaier (NYC)
@Brigipit Women in some southern states have been jailed for suspicious miscarriages. And this was when Roe still stood. Now it's going to be open season on miscarriages. Women are going to have to prove it was a spontaneous miscarriage. And if she can't the best she can hope for is to have to pay 10k to her accuser. Just wait, it'll happen
Dorothy Wiese (San Antonio)
Like Dr Oz said, “ local” and state politicians will decide appropriate women’s and girls’ healthcare decisions. Please vote.
Cathy H (Pittsburgh)
@Dorothy Wiese For what it’s worth, my whole family already did. Debate or not, we are protecting our daughters and they are protecting themselves. We do not seek the input of local politicians. And for the record, I’ve had a D&C.
LNB🌗 (CT Shoreline)
Stephen It’s like those saying they don’t wanna pay HO taxes cause they either don’t have kids or their kids are outa school already: A mentality I feel that will be our doom. Under all my anger is grief. What a state of affairs; the GOP is pursuing the death spiral of our nation. What comes to mind? A libertarian realm of no taxes, no regulations ( except abortion, LGBTQ , school curricula - plus privatization of all public realms) that will last until the last dog has finished eating.
Just Curious (Oregon)
It’s a strange juxtaposition, when women in Iran are willing to die to be free of politicians ruling their personal choices, while in the U.S. we are moving closer to a theocracy like Iran’s . . . All at the same time.
teresa (Eugene, Oregon)
@Just Curious It is stunning. Vote. Our very lives depend on it!
Sparky (NYC)
Are there the same issues with respect to reproductive endocrinologists? I imagine there have to be, ultimately with a grave effect on people who who need assistive reproductive technology to become parents. There are high numbers of miscarriages among this cohort, and the question arises as to what to do with unused eggs/zygotes.
CTMD (Nashville, TN)
@Sparky Yes. It’s a huge problem and is likely to have serious impact on assisted reproductive care.
. (midsouth)
I almost lost my life when a resident did a d&c incorrectly in my antiabortion state. In that case I lost the baby when an ear doctor prescribed a DNA-gyrase disrupter for an ear infection (the antibiotic works by preventing cell division). It took a year to fully regain my health, but I’m alive. My sympathy to all women who will be in the same situation.
S. Butler (New Mexico)
Abortion training is a vital component of the overall training for doctors, nurses, and other professional medical personnel. If you don't teach people how to do it the right way, others will take over and do it the wrong way. No law will stop abortions from happening.
KMW (New York City)
It is discouraging to think that many of our colleges today offer abortion training in the residency programs. This is not healthcare. I admire those doctors in training who do not participate due to conscientious objections and religious beliefs. It is nice to know that there are some who still exist. Right now they are not required to do so but hopefully in the future they will not be forced to take part. Hopefully, they will stand their ground and continue to say no to abortion training. No one should be forced to do something that they are against due to their principles.
S. West (Bronx)
@KMW Sometimes bad things happen to pregnant people and an abortion is the best way to save the person's life, as well as preserving their fertility. Abortion absolutely is healthcare and our doctors should be trained to perform the procedure. People with religious or moral objections to the procedure should pick a different specialty.
Lissa (Virginia)
@KMW I am a clinician; a mother; and I've had one abortion. Define healthcare. Because if you are only a consumer of healthcare, your definition does not matter. Abortion is healthcare. Yes, you read that correctly. Shockingly, not every opinion is fact; nor based in the reality of anyone but ones self. Second, if folks who enter into the clinical professions: MD, RN, NP, PA are not comfortable (or believe) in doing something against their principles, they should understand that when choosing those professions, they are licensed and bound to serve the patient. That includes the patient's beliefs, and ONLY the patient's beliefs, within the confines of the license to which the clinician is trained. I don't drink, that doesn't mean I do not assist with a liver transplant for an alcoholic. Irresponsible gun ownership is a public health issue and I am tired of treating children with gunshot wounds, but I do. I also care for the shooters. Folks can have opinions, but if people are going to choose to 'live' their opinions, best choose lighthouse maintenance as your career.
Robbiesimon (Washington)
@KMW “No one should be forced to do something that they are against…” True. Women and girls shouldn’t be forced to give birth.
Just Curious (Oregon)
At this point in time, in the U.S. it feels immoral to bring a baby girl into the world. I have an adult daughter whom I love more than my own life; but I would never have children today, simply because it might be a girl, born to suffer.
Stephen (Chicago)
A reporter in Pennsylvania (or perhaps Georgia) asked a prospective voter about his view on abortion, and if the issue would be a factor when he voted on November 8th. He replied: "I'm not concerned about abortion, since it has nothing to do with me."
Blossom (The Buckeye State)
@Stephen Sadly that's the mentality of too many American men.
Suzanne Swanson (Stillwater, MN)
Who does that sound like…the men with the guns aren’t here to hurt me….
Comp (MD)
@Stephen How fortunate he doesn't love anyone who stands to die because 'Jesus' and 'heartbeat'.
Blossom (The Buckeye State)
I wish just for once that "blue" state residents, while cheering that "red" state residents are going to be harmed by abortion bans, consider that millions of Dems live in "red" states. That includes me, my husband, and my adult son and daughter. We do vote. My state, while being GOP controlled, is in fact nearly half Dem. Please do some reading on gerrymandering and voter suppression, before saying that voters in these states are getting what they voted for. Also consider that many people who will be harmed by these laws simply cannot vote. Those under eighteen, prisoners, incapacitated people, and in some states, felons who served their sentences, yet are still barred from voting. Do they deserve this?
Ithaca Reader (Ithaca)
@Blossom We feel for your situation and support progressive causes in the Buckeye state, but really what can we do? Medical schools in states that restrict abortions may have to move to blue states. What is the alternative?
Blossom (The Buckeye State)
@Ithaca Reader What Dems comfortably ensconced in "blue" states can do is stop imagining that all "red" state residents voted for this, for starters. You can donate to help get progressive candidates elected in "red" states. Or campaign for them. Like how people all over the U.S. helped get Warnock and Ossoff elected in Georgia. You can financially contribute to abortion access funds to help "red" state residents.
Ithaca Reader (Ithaca)
@Blossom I discovered Sally’s list, a PAC, on a recent trip to Oklahoma City and was pleasantly surprised by its effectiveness in getting progressive women there elected to state offices. It gave me hope that we can hold back the red tide even in red states.
JimmySerious (NDG)
A social conservative talking point is, women use abortion as birth control. The only person I know who uses abortion as birth control is Herschel Walker.
Blossom (The Buckeye State)
@JimmySerious Bravo!! And he's a Republican, at that.
barbara (santa cruz ca)
@JimmySerious actually since he doesn't want children and ignores them if born and keeps causing pregnancies why does he not get a vasectomy?
Betsy (Idaho)
Physician here. Agreeing with everything stated and this IS the tip of the iceberg. Ignorant legislators making poorly throughout laws without consulting with experts ( who would have predicted this?) will get to witness the fallout. In many urban/ suburban areas high risk pregnancies are managed by high risk OB practices. This is better for complex patients and takes a burden off other OB providers, who may not have the experience or resources to manage these patients. In a state like Idaho, one that mirrors Texas law criminalizing abortion care, high risk OB providers who can are retiring or looking to relocate, recruiting replacements will be impossible, general OB will have to start taking care of these tough cases and many will leave because legally it is too perilous and again recruiting will be impossible and in a year or two there will be drastically reduced availability of all pregnancy care. When these legislators have wives, sisters, or daughters who can’t find care maybe then they will understand what chaos they put in play. Rural locations will be even worse off. Welcome to America circa 1900.
Juarezbear (Los Angeles)
@Betsy I'm wondering if all Idahoans who seek abortions already travel to Washington or Oregon? The problem is some states are passing laws where their residents can't go out of state for the procedure and return. Very crazy times.
DDH (VA)
Any medical care provider who has refused training and/or refuses to provide certain kinds of care for religious or moral reasons needs to have a big asterisk next to their name on any diploma, work name tag and license. Below their name it should specify what they are unqualified and/or refuse to do. I'd be happy to provide temporary housing to a resident in need of training in Virginia. A vote for any conservative is a vote against women, science and rational thought.
TM (Miami)
I guess Republican voters should have thought about that earlier. Too bad, those schools in red states have choices, they can send their residents to train in states (or provinces) to learn the "outlawed" procedure. Otherwise there is no free movement of physicians after they graduate.
Juarezbear (Los Angeles)
@TM Not necessarily as some states will outlaw their residents from performing the procedure out of state. In their mind abortion is murder. Period.
Madeleine McKenzie (Manhattan)
@TM It’s not clear to me why a hospital in another state would take on the responsibility of providing this training to residents from another hospital: hospitals already have their own residents to train, and having new unskilled outside residents on a biweekly basis is going to be a huge burden. And before you start talking about the first hospital paying the second, you need to be aware that residents are primarily paid (badly) by the US government, not by the hospital. The US government sets the limit on the number of residencies available. This doesn’t seem workable.
ksb36 (Northville, MI)
Move. You have to be able to give the care that patients need and deserve and if you don't have the skills, you are going to find yourself in really big trouble one day.
Robbiesimon (Washington)
Trying to find something positive: It is going to be somewhat entertaining watching the anti-abortion states aggressively pursuing a path toward “developing world” status.
Blossom (The Buckeye State)
@Robbiesimon It's not entertaining for pro-choice people who are trapped in these states.
Nancy (USA)
@Robbiesimon Unfortunately they make up a good portion of the USA: which is fast becoming a 3rd world country.
Brigipit (Miami, FL)
Have you checked the laws in first world nations? Mist of them pkace very reasonable restrictions on abortion, same as the one on which Dobbs was decided.
XXX (Somewhere in the U.S.A.)
Republican states will end up with few practicing ob-gyns, and serious problems for medical training for medical schools located in those states, and everyone who thought about it even for ten seconds after the Dobbs draft was leaked knew that that must be the inevitable result. It ain't rocket science. Maybe it wasn't Republican thoughtlessness at all. Maybe it's the desired result, just an expression of nihilsm. Break society down. Degrade it. How can it be that this party of both treason and medical malpractice is favored to win one or both houses of Congress? A tilted playing field is only part of the explanation. The major part of the explanation is a population in which many are living in a fantasy world where you can act out your resentments and lose nothing as a result.
Diana (Texas)
@XXX Not really. Let's assume for a second that all the ob/gyn residency programs in Texas get ZERO american MD applicants next year. You know what happens? The ob/gyn programs start letting in foreign medical grads to replace them. There are MILLIONS of FMGs who don't give a rpi about abortion, they are desperate to get any opportunity they can to move to the USA, even if it's in a deep red anti-abortion state. Red state ob/gyn programs will keep operating as usual, even if they get shunned by 100% of american MDs.
Deirdre (New Jersey)
Is America going to let that little slip of truth that Oz spit out about local politicians deciding your healthcare choices? It’s not too late to vote out the republican “deciders”
bakereast (Pennsylvania)
The anti choice Obstetricians can choose to not perform procedures but they have zero right to dictate to the rest what constitutes good training and medicine. Just as surgeons must perform procedures on people who they would rather see pass away in terms of terrorism or crimes, these obstetricians must get real and stop putting their religious views on the rest. This is akin to Iran and Saudi Arabia. I’d personally love to see the anti choice states become wastelands of OB/GYN care and have their citizens suffer the consequences of their Radical Right politicians interfering with personal medical decisions. Teach the citizens that there are consequences for their votes to their own care
Blossom (The Buckeye State)
@bakereast Really?? What about pro-choice Dems in these states, who cannot move?? What about female children in these states, who can get prefer but cannot vote?? As horrific as these bans are, what is nearly as bad is Americans wishing death and harm upon their fellow Americans, who didn't choose this.
Juarezbear (Los Angeles)
@Blossom I agree with you. The only solution is for Dems in purple states to organize and change local law. Sadly, the deep red states in the deep south and parts of the prairie region are probably too far gone. Interestingly, many super conservative folks are moving from places like Seattle or Portland to Idaho or Wyoming, which pushes these states even further to the right. I'm afraid this is what our future will look like - differing standards on all kinds of issues from state to state and those standards will attract more like-minded folks to move there. This country has been cleaved almost in half, and unfortunately, the electoral college which is a remnant from a bone thrown to slave-holding states, will hold the majority population hostage to the radical right.
teresa (Eugene, Oregon)
@bakereast No. It is not ok for women to suffer at the hands of these thugs. There are a lot of democrats there, too. Don't abandon them.
Ellen (West Orange NJ)
Once again men are not addressed when abortion is discussed. 'A responsible man would use protection or better yet get a vasectomy.
mmmaier (NYC)
@Ellen that doesn't touch on high risk pregnancy or IVF though.
SR (New England)
After a joyous delivery of my first and only grandchild, it turned out the placenta could not be expelled because it had taken ‘root’ in my daughter’s uterus. I don’t remember the medical name for this condition, but it was dangerous and totally unknown to any of us lay people in the room. The doctor pulled it out by hand, [excruciating] and then ‘cleaned up’ with what I believe was a D&C. What would have happened if the doctor, and my daughter, had just committed a crime? What would Samuel Alito have asked to be done if this had been his wife?
Brigipit (Miami, FL)
For the 1000th time, D&C is not abortion after muscarriage or delivery of a live baby or still birth. D&C is only objectionable for those in the pro-life camp when it’s done to remove a healthy fetus from a healthy woman.
barbara (santa cruz ca)
@SR have read terrible stories of the placenta separating before birth and the woman bleeding to death of a pregnancy that could not survive the loss of placental fluid
mmmaier (NYC)
@SR he'd let her die and as she was dying he would sanctimoniously lecture her about how it was all her fault.
teresa (Eugene, Oregon)
Are doctors lobbying in Washington DC? Are wealthy hospital administrators doing all they can to counter this red state misogyny? Are you fighting for us? You have a lot more power in politics than I do (thanks Citizen's United) so I trust you're using your power to try to overturn these bans and elect democrats? Are you fighting for us?
Alyson Lloyd (Philadelphia PA)
Well, Dr. Oz won't be if he becomes PA's next Senator.
Kathryn Robinett (Maryland)
We are working 60 hours a week to take care of patients who are unvaccinated, perpetrators of gun violence, and whose personal decisions during the pandemic literally stole time we wanted to spend with our families. We cannot count on physicians lobbying as well. The AAMC and AMA have made clear statements that this harms the patient - physician therapeutic relationship and harms our ability to care for patients. The Deans of all of the Michigan medical schools wrote a 1.5 page letter about the harm of these invasive and unjust laws. We don’t have the money to pour into campaigns like the NRA and Koch brothers. We need every individual to vote and for politicians to be held accountable.
MN (Michigan)
@Kathryn Robinett What do you have the money for?
Brian (Denver)
Imagine your wife or daughter literally bleeding out, with an incompetent / hamstrung medical staff just making excuses. The cruelty is the point.
DVR (MD)
This is terrible. Feel sorry for residents stuck in these states.
Mary Jane (Give Us Back Our northeast Tax Dollars)
Good. These stars should reap what they sow
barbara (santa cruz ca)
@Mary Jane alas it will be the very poor women who will suffer in a country with the highest maternal infant mortality rate of any developed country
Disillusioned (PA)
It’s a new social determinant of health: are you female, and do you live in a red state? Then your chances of dying during pregnancy are likely going to go up in coming years as the distribution of talented OB-GYNs leaves a dearth in your states. Thanks, unscientific and medically illiterate lawyers who got appointed for life to a court that is supremely ignorant!
Rachel (Holyoke, MA)
First, do no harm.
Dolly Patterson (Silicon Valley)
This makes me hate most pro-lifers. They are drastically compromising women's healthcare bc of their stupid self-righteousness. Remember the Louisiana, black woman whose fetus had no skull? She was going to die if she did not get an abortion last August. In addition to the fetus dying, the woman could also have died but Louisiana was too stupid and arrogant to save her. https://www.cnn.com/2022/08/20/us/louisiana-abortion-fatal-condition/index.html
M.R. Sullivan (Boston)
Women are not papayas.
Blossom (The Buckeye State)
@M.R. Sullivan Imagine the uproar there'd be if doctors were taught how to treat testicular problems using coconuts. instead of actual males.
Clay (Maryland)
@M.R. Sullivan Republicans would disagree.
GBR (The Northeast)
I am adamantly pro-choice. Miscarriages are extremely common - everywhere of course - so I’m not seeing how OB residents in red states would not receive training in uterine evacuation. That procedure needs to be performed all the time in the setting of miscarriage….
Irina (backstage)
@GBR Far from all miscarriages are treated with 'uterine evacuation' (D&C) but practitioners do need to be skilled in doing so when it is the indicated treatment.
GBR (The Northeast)
@Irina Good point - my phrasing was misleading. I’ll rephrase: 1/4 of all known pregnancies end in miscarriage… and only some of those require uterine evacuation. That’s still a whole lot of uterine evacuations in every state, including those with abortion bans.
S. West (Bronx)
@GBR The question becomes, when is a D&C "medically necessary" versus when it is an illegal abortion? Texas has already seen cases of women miscarrying past the 8-week limit who are sent home from the emergency room to complete their miscarriage at home -- hoping they actually do, and don't retain tissue, become infected, and turn septic. A D&C would spare both physical and mental anguish, but the doctors are protecting themselves (and their licenses) from prosecution by waiting and not intervening until a situation becomes undeniably life-threatening -- THIS is how residents don't get the appropriate training they need in an extremely common, safe, necessary medical procedure.
Bob Kale (Texas)
This article is misleading, but not for the reasons either the author or the doctors or the commenters have stated. The sad fact is that OB/GYN doctors today are all insufficiently trained in many, if not most procedures. If the doctors interviewed for this article are truthful, they will admit that graduates from virtually all residency programs do not receive enough experience in surgical procedures, such as hysterectomies, fibroid surgery, endometriosis, laparoscopy, or any other gynecologic procedure to do so competently. A resident need complete only fifteen vaginal hysterectomies in four years to graduate. That’s not nearly enough! And those are all done under close supervision. Many graduates don’t even feel competent to treat abnormal Pap smears, so they send them to the gynecologic oncologists for biopsies and therapy. Scandalous. For many decades, residents have been given the choice to opt out of doing abortions if it violates their personal or religious beliefs, and yet they had the same experience treating miscarriages, which as any woman knows, is a very frequent occurrence, so the residents can get plenty of practice in every program. As for the doctors or hospitals who are afraid to treat miscarriages, or ectopic pregnancies, or intrauterine fetal deaths because they are afraid of abortion laws in a particular state, any lawsuit against them would get thrown out in a minute. Any sane juror understands the difference between a viable pregnancy and a dead baby.
Cameron (USA)
@Bob Kale Respectfully, there is simply no way that most OBGYNs are referring their pap smears to gyn onc. There just aren't that many gyn oncologists out there. I am a medical oncology fellow in a large, urban, west coast city and I have never heard of anything like this.
Bob Kale (Texas)
@Cameron You are correct. Not "most" OBGYNs are doing this, but many recent graduates are, which is unbelievable but true. It certainly it at one of the major medical schools here in Houston. And if they don't refer them to the GYN oncologists, they refer them to the more "senior" gynecologists in their group who were properly trained, back in the day. Thanks for your comment!
Joe (USA)
@bob kale Most miscarriages happen early in pregnancy. Abortions for incompatible with life fetal anomalies and medical emergencies often happen late in pregnancy and are more complicated procedures needing and D&E and intra-uterine lidocaine to be administered under ultrasound guidance.
G F (Lawrenceville NJ)
My fervent wish is that medical care choices could be made by those in the profession, and their patients. Politicians have no business legislating health care, as they often know little about conception and pregnancy. This is all a movement to take us back to the 1950's; we are living in dangerous times.
Avery (NYC)
"Dr. Christina Francis, an obstetrician in Fort Wayne, Indiana who opposes abortion, said residents can get sufficient training by managing miscarriages." Either Dr. Francis has not been paying attention, or she is being deliberately misleading. Surgical procedures and medication for miscarriages are identical to those for abortion, and health care providers are delaying and denying miscarriage care because they fear running afoul of abortion bans.
MS (CA)
@Avery Yes, I hope we don't end up like Dubai or Saudi Arabia, where women are routinely jailed for alleged abortions and where women with miscarriages are often mistakenly jailed, only release after several weeks or month's effort to "prove" their situations were miscarriages.
PB (Northern Utah)
Is abortion a medical decision, or a political decision? Should this decision to train future doctors of America be determined by the medical profession or by politicians? What if politicians have no understanding, no medical knowledge, or even a basic understanding of women's reproduction? How can they be competent to make decisions about the legality of abortion, and the health and medical consequences of performing or not preforming an abortion in an emergency situation? If a medical student has no training on performing an abortion, and never saw an abortion performed even to save the life of a mother, how is that physician able to make medical decisions about the need, or not, for an abortion, or able to perform an emergency abortion if she is the only MD in some given emergency situation? The Dobbs decision will eventually go the way of the Prohibition decision, because it is completely unrealistic and unworkable. One set of religious dogma cannot impose its minority beliefs on a pluralist society with many other religions that hold a contrary set of beliefs with regard to the abortion issue.
Bill Brasky (USA)
@PB So spot on! It's a if astrophysics was being infiltrated by people who believe the world was created in 6 (7 including a day of rest) days and is less than 6,000 years old.
RG (Massachusetts)
@PB Wait, wait, don't tell me. It's a political decision. Regards, Dr. Oz
Brigipit (Miami, FL)
According to the data, the majority of abortions are not done for medical reasons and seldom are they discussed with a physician. At abortion clinics, the patients have not for the mist parte even seen the doctor who performs the abortion. That is not healthcare.
Debra (Chicago)
Yes this is another exception situation - legislators need to make exceptions for training. It's about good health care. Probably they need to train part-time in a pro-choice state, where they will see a variety of situations.
Tireddoc (Rural Wisconsin)
As a longtime rural family physician, I want people to understand that the eventual consequence of the Dobbs decision is the undermining of all physician care in states that refuse to allow abortion care. All medical care. Not just women’s care. As this article makes clear, physicians are not going to train in these states. They are not going to practice in these states. These states, including mine, are going to become medical deserts. We are already struggling to recruit physicians to practice in rural areas. This is our death knell. If I were just completing my training as a family doctor who delivered babies, there is no possible way I would choose a state where I could be criminally prosecuted for the standard care of women. Think of this the next time you cannot get a doctor’s appointment. Think of it when you vote.
Blossom (The Buckeye State)
@Tireddoc Thank you for saying this. Please continue to shout it from the rooftops. Maybe it'll get through to some of the single issue anti-choice voters.
A (B)
@Tireddoc Thank you. Maybe those who are pro-birth at any cost have not considered such consequences of their decisions on the quality and access to health care and whether physicians will feel safe to train and practice their professions in their state. Or maybe they don’t care. If they truly cared about life and quality of life, they would be ensuring government funded maternal health care and benefits, maternal/parental leave, etc. Overturning abortion rights is more about control of woman’s rights than about life.
Judy Baumgarten (New York)
Your comment is spot on. Pro-choice groups should be shouting this from the rooftops.
Penny (Connecticut)
Semi-retired MD here. This is the proverbial tip of the iceberg. Any doctor in training in a red state might have a woman patient with abdominal pain while staffing an Emergency Room or clinic that could need a D and C or have a life threatening ectopic pregnancy. Good luck getting proper help for your patient. In my opinion all medical students in hands-on clinical specialties should seriously consider whether they want “local politicians” determining the care of their patients and choose their residencies accordingly.
FerCry'nTears (EVERYWHERE)
@Penny I also wonder about women who cross state lines for abortion care who can't get it where they live. If they present in the E.R. in a neighboring state can those Blue States sue the Red States for the cost of their treatment? Are military hospitals considered Federal property and not subject to the laws of the state?
Marty M (Dallas, TX)
We need to get judges, legislators, and lawyers out of the medical practice/delivery of healthcare/medical decision-making business. Full stop.
Joe (USA)
For those who are anti-Choice. This is a good thing. They want to prevent ob-gyns from receiving training on abortion care. They want to drive doctors and clinics who perform abortions out of business through harassment and threats. They want the laws banning abortion to be hard to understand. They want to spread misinformation and they want to limit access to care by every means possible. Unfortunately clinics that provide abortions will not be able to survive if the laws allowing or banning abortions changes every time the political party in power changes. This is why even if there are "exceptions" in red states for the "life of the mother," rape, or incompatible-with-life fetal anomalies, the actual access to abortions even in these circumstances will still be very difficult, delayed and will likely require travel out of state. Anti-choice groups don't care if the abortion is delayed by months or the mother's life is put at risk. While we are mainly focused on the political and legal front; they are fighting abortion access from every possible angle.
Blossom (The Buckeye State)
@Joe Well said. Anti-choice Christians will just shrug off the deaths of girls and women as "God's will" or as justified punishment for sex outside marriage or teen sex, or "allowing" oneself to be raped.
Dominic (Astoria, NY)
I hope they vote on November 8th, and vote for Democratic candidates up and down the ballot. Medicine should be left to medical professionals and their patients, in privacy, with no outside interference. Bodily autonomy is one of the most fundamental and crucial aspects of human freedom and safety.
Sven Svensson (Grebbestad)
@Dominic Then the unborn child also has bodily autonomy.
Blossom (The Buckeye State)
@Sven Svensson There is no child until birth. Fertilized eggs are not children. Fetuses are not children. Children have birth certificates.
Irina (backstage)
@Sven Svensson Not when it is dependent on a maternal life support system, that is NOT 'autonomy'.
Blossom (The Buckeye State)
"A reviewing committee of the accreditation council debated whether simulation modeling, a staple of medical education that is a precursor to direct care, would suffice for residents who could not travel to another state. In abortion training, for example, residents watch videos and practice on low-tech uterine models, including papayas. The committee decided that simulation was not an acceptable substitute." No man would tolerate having a physician who has no hands on training other than simulated procedures on a piece of fruit treat him. As as a mom of a young adult daughter, as a woman who experienced a missed miscarriage, which required a D&C (exactly the sake as am abortion), I am furious. I'm not surprised though. Republican politicians and judges couldn't care less if girls and women die in their states, because they cannot get miscarriage care or terminate a dangerous pregnancy.
whitebuffalo (SE PA)
@Blossom Every OB/G who refuses to do abortions and has not been trained should have a warning sign and a mandated requirement to put all their patients on notice that they can not provide quality care in any emergency situation and that any woman going to them (a trans man who becomes pregnant is a woman presenting as a man whether that person refers to self as a Martian, man or giraffe, so let's not even go there) is putting her life at risk. Or better yet, they should not be allowed to practice OB/G medicine.
American Girl (Santa Barbara)
Dobbs will lead inexorably to fewer medical students specializing in ob-gyn. They will choose less controversial fields where they’re less likely to be sued or hunted/harassed by vigilantes. It’s undoubtedly happening right now.
c (Pennsyltucky)
@American Girl this is undoubtedly true. Im a psychiatrist and I stopped collecting information about pregnancy history. And I keep anything in the chart related to contraception, pregnancy, etc to a bare minimum. I'm afraid that if the laws change in PA and that if the police come knocking with a warrant that my medical records could be used against my patients or their other doctors.
MS (CA)
@American Girl I am not an OB'BYN but I know they already sustain some of the highest malpractice premiums of any medical specialty. In particular, because parents can sue the doctor for any problems up until the patient is 21 years of age. That has led to frivolous lawsuits. These types of laws will further drive people away from OB/GYN and then ALL women will suffer, including patients who have never been pregnant, e.g. people with ovarian/ uterine cancer. I bet that even non-OB/GYN MDs will shy away from these states (many of whom already suffer from a lack of healthcare workers). We all take care of women and most of us take care of women of reproductive age.
Todd Stultz (Pentwater, MI)
One of the reasons I'm a Neuroradiologist.
teresa (Eugene, Oregon)
@Todd Stultz So, no skin in the game at all? Not even a nod to the struggle - just a congrats for your own self about choosing the easy route. OK.
bakereast (Pennsylvania)
@Todd Stultz that is a weak answer. What do you do about MRI cases where the stroke is so severe that any intervention is foolish and not helpful? Do you play god and tell them you refuse? Or if people say they want no care, do you argue that their life is worth saving no matter the outcome? These issues are not solely abortion or pregnancy. When the religious radical right gets involved, we all pay the price
Todd Stultz (Pentwater, MI)
Separate 6 person neurointerventional group that takes the lead on the interventions
chickpea (California)
That state’s are being allowed to mandate inadequate training and substandard healthcare care for pregnant women is the stuff of a dystopian nightmare. Or it used to be. This is no country for women. Every woman who can move to a country or state where abortion will remain legal should do so. And in blue states, do what you must to not deliver your child in a Catholic hospital. Getting pregnant in a red state, or delivering child in a Catholic hospital in a blue state, may well damage your body permanently, or even cost you your life. There is no world where the status quo in the United States isn’t barbaric. All women deserve best practices when delivering a child. All women deserve the right to decide if they wish to care a pregnancy to term. All women deserve basic civil rights.
Fritz Lauenstein (Dennis Port, Mass.)
I'm only half joking when I say that this is ok with me. Better med school candidates will come to my state, Massachusetts, and will remain to offer exceptional care here. Meanwhile, in Florida and Texas, your primary care physician will treat your daughter's complications from her ectopic pregnancy while you pray for her in your church. Seriously...what the heck has made these Republicans go off the deep end??? They're like lemmings running into the sea.
Blossom (The Buckeye State)
@Fritz Lauenstein Do you understand that there are millions of Dems living in "red" states? My GOP controlled state is nearly half Dem. Before you wish ill will on people stuck in "red" states, go read up on gerrymandering and voter suppression. And no, we can't all just move.
Fritz Lauenstein (Dennis Port, Mass.)
@Blossom I understand that vividly. Many red states are close to 50/50, and it isn't lost upon me that Kansas voted overwhelmingly to retain abortion access. That is the "half" I'm not joking about. However The Buckeye State, Florida, and other purple states are becoming more red. This is infuriating to me. Unless and until residents in those states convince their neighbors to change their tune, the chances that we lose our democracy are increasing. Please understand that my federal tax remittances go to support those states, such as West Virginia, which often thumb their noses at "East Coast liberals" such as myself. Governor DeSantis is flying Venezuelans from Texas to my county for spite. We happily welcome them, and health care refugees as well who will inevitably find their way to us. I'm hoping that instead of considering a move to Cape Cod, that you find a way to reverse the political wind that is blowing in Ohio.That's not an easy job, but as my Rep Tip O'Neill once said...all politics is local.
c (Pennsyltucky)
@Fritz Lauenstein weaponized Christianity is the answer.
lehomme (marin1950)
"It’s also used for management of miscarriages and complications of pregnancy like infection and bleeding,” said Dr. John Combes To which Republicans respond - "Tough. I rather see the mother die than allow a medical procedure to save her - because I'm pro-"life".
Bluebird (NYC)
Wouldn't it be ironic if pregnant women living in states where abortion is now illegal had to travel to states where it IS legal just to be able to deliver their babies, because no OB/GYN in their right mind will want to practice in the former states?
CTMD (Nashville, TN)
@Bluebird It wouldn’t be ironic, it will be unconscionable.
mmmaier (NYC)
@CTMD it would be a logical consequence of forced birth legislation. Until the voters throw the bums out it's likely the reality for those states. It's not ironic though.
Ted Theodore Logan (Music City, USA)
"I swear by Apollo the physician, and Asclepius, and Hygieia and Panacea and all the gods and goddesses as my witnesses" - The first line of the Hippocratic Oath. Now we know why christian nationalists are trying to reframe the Hippocratic Oath.
Garrett Booth (Nashville)
For states with abortion bans, will pathologists that train in these states also receive suboptimal post-graduate medical education? If one does not know how to accurately identify, diagnosis, and report products of conception or perform a fetal autopsy, are they a fully qualified pathologist? The downstream impacts of abortion bans will clearly impact OB-GYN training programs, but will this also be felt by various medical fields that assist in the diagnostic process (eg pathology and radiology)??
Dr.Amos (NYC)
The biggest impact, other then a decrease in qualified ObGyns, will be on patients who cannot get the necessary medical procedures they absolutely need, often to save their lives. Maternal mortality will go even higher. So so so sad.
Caitlin (Delaware)
Experience makes a procedure safer. If your OBGYN did 15 D&Cs on first trimester miscarriages over four years, would you be satisfied? Would you trust them with your (or your wife/daughter/sister/etc) life and fertility? By doing a four week abortion rotation during my residency (which was at a Catholic hospital; I had to drive 7 hours and be away from my own infant for a whole month to get this experience), I finished residency having done 600 procedures from 4 to 22 weeks. When a second trimester abortion is needed to save a woman’s life and time is of the essence because of hemorrhage or sepsis, how many OBGYNs with the skills and experience to do it quickly and safely will be available?
mmmaier (NYC)
@Caitlin if you are an obgyn, why do your residency at a catholic hospital? That seems very limiting.
Robert Nahouraii (Charlotte)
OBGYN residencies are extremely competitive, as the article states. 85% of applicants today are women. Pediatrics is 90%, I believe. Medical students will vote with their feet, and residency programs may fail to fill in the Match.
Deirdre (New Jersey)
It takes a lot of training. A young woman I know got an iud inserted by a resident in training. After a few weeks she could feel it slip - it needed to be addressed right away. Skill matters, training matters, accessibility matters. And the only reason the 20yo was even getting an iud was fear that contraception wouldn’t be available after the midterms Look what we are doing to our girls!
Somebody (Somewhere)
@Deirdre Did she live in NJ too? I don't think that is a state that will limit abortions.
Deirdre (New Jersey)
@Somebody She is in PA and my point is that the person who did her procedure was new and unpracticed and while she is not angry she had to fight for an immediate appointment, had to get it removed and then chose a different form of long term BC. This time in her arm. I was terrified of a puncture to her uterus and infertility. We are forcing young girls to make decisions they shouldn’t be making yet.
Anon (USA)
@Somebody We are always going to be one election away from a federal abortion ban.
HML (Buffalo, NY)
One solution for the profession would be to de-certify any residency program that does not provide a "complete" preparation in women's health. That would steer any potential residents from radical states that limit care options, and put pressure on the OBGYN's in those states to rethink their practice locations. Hospitals cannot operate without medical residents. The bulk of the work for day to day patient care falls on them. There is nothing the medical profession fears more than "de-certification." Were I looking for a residency, I would avoid any red state. And, the blue states could count on a lot of great residents applying.
Dejah (Williamsburg, VA)
The D&C is a common technique used not just for abortion and miscarriage, but also for issues in menopause and uterine cancer treatment. D&C is used to treat pregnancy complications *after* a live birth. Doctors who are not properly trained and experienced in doing D&Cs SHOULD NOT BE DOCTORS. Period. Women will die directly from these ill considered bans. Women will die indirectly from these bans. Women will die from lack of medical care due to lack of doctors from these bans. It's pretty clear, Republicans do not care if women die.
BerkeleyGirl (Chicago)
@Dejah Not just that - all kinds of issues... When a close family member started menses, she was both irregular and experienced a dangerously high level of bleeding. At the age of 13, she was given a D&C, and prescribed the birth control to regulate her periods. This occurred 48 years ago. It's unconscionable to think that, in much of the country, she'd now be at risk of being denied such care.
Todd Stultz (Pentwater, MI)
@Dejah Um - there are quite a few specialties in medicine that have absolutely nothing to do with these procedures. Pretty broad uninformed statement.
Plant Lover (Iowa)
@Dejah Republicans don't care if women die it just means less women in the workplace, Congress, and everywhere else and more control for men.
M (Mississippi)
Other considerations for medical student and resident applicants include bans on LGBTQ care and whether states have expanded Medicaid to cover the uninsured. Why would any student want to live and learn in a state with so many restrictions and limitations in place? Oftentimes, these restrictions are rooted in misogyny, homophobia, transphobia, and racism. It’s abhorrent, and it will ultimately hurt the economies and citizens of these deep red states. The Republican politicians don’t seem to care.
Plant Lover (Iowa)
And to think Justice Alito recently said the leak at the Supreme Court regarding Roe v. Wade put the justices lives in danger without a care in the world for all the women whose lives are now in danger and will continue to be in danger without appropriate health care.
J Kile (White Haven, PA)
@Plant Lover Inside the beltway the only thing that matters is inside the beltway. That’s where the money flows.
Nanner4584 (Columbia, SC)
And pharmacists denying medications to females of child bearing age. Doctors afraid to treat miscarrying women for fear of being prosecuted. https://www.dailykos.com/stories/2022/10/26/2131394/-Dear-Justice-Alito-here-are-some-people-whose-lives-are-really-in-danger-that-you-should-meet?detail=emaildkre&pm_source=DKRE&pm_medium=email
Plant Lover (Iowa)
@Nanner4584 Republicans have turned the country upside down and seem to be enjoying it. Their next plan is to dismantle Medicare, privatize Social Security and do away with Medicaid.
priceofcivilization (Houston)
As an educator in the field, this will be a slow-rolling catastrophe. Training programs in anti-abortion states will either fail to fill their slots, or will get decidedly inferior residents. Terrible news for the women who live in those states. It will get worse in the longer term, as most residents stay to practice where they trained. So there will be fewer, or lower quality OBs, in the red states. BTW Despite my header, I left Texas. Seeing this coming was a part of why. They had already defunded planned parenthood, and sent that money to "crisis pregnancy centers." It was a prequel to the current disaster. Before Roe 200 women died per year from illegal abortions in the US. After abortion was legalized in a few of the largest states that number dropped to 100. After Row it dropped to 1-2 per year. So my prediction is we could go back to as high as 100 per year, almost all in the red states. With pills by mail and abortion legal in 26 states, that will probably be closer to 50. But those stories must be publicized very loudly. The US will have its Savita Hallappanaver in the next year, and her totally unnecessary and tragic death must become a rallying cry. I propose a new political slogan: Women's lives matter.
JB (Santa Rosa)
@priceofcivilization I left Houston 10 years ago. I am still in the OBGYN biz....in California now....so very sad what is coming
J Kile (White Haven, PA)
@priceofcivilization 100 deaths will not even be acknowledged. All to support the base who does not care if it isn’t them.
Deirdre (New Jersey)
@priceofcivilization uS population in 1974 was 213 million US population today is 330 million So the number that die will be higher by 50 percent because the population is higher.
Terri (Bethesda, MD)
At this rate, thanks to religious conservatives, there will be no doctors trained to save the lives of women whose non-viable pregnancies are killing them. The US already has far and away the highest maternal mortality rate in the developed world. It’s about to get much, much worse.
Jacob Nataki (California)
@Terri The dark ages and misery is the consequence of beliefs and the wealthy dominating society.
Sam (Houston Now Elsewhere)
I am a board-certified OB/GYN who practices in a state without the current abortion restrictions. I also am a senior faculty member in a very large OB/GYN program. I can attest that we have seen a substantial increase in the number of applications – in fact we have received the most number of applications we have ever received for our program. This is almost certainly because of the horrendous restrictions that are in place in half the country Preventing or nearly preventing all abortions. What people don’t realize is that termination of pregnancy happens for a host of reasons other than as an “elective procedure” including to save the mothers life. I have sadly had to do this procedure on numerous occasions because of cancer in the uterus, the septic woman who is pregnancy was literally killing her and for other reasons. When we devalue a woman’s life we are saying that half the population is not worthy and that is what all of these restrictions show. Good luck trying to recruit outstanding physicians to states that restrict this procedure. It is the women in red states and will ultimately suffer the disastrous consequences of a politicalization of our healthcare system.
Vivek36 (New York)
If your patient has hernia or flu it shouldn't be necessary for you to know how to perform an abortion. Obviously blue States will need Physicians who can perform abortions but there is no reason why red states have to have them
Sam (Houston Now Elsewhere)
Except you can have your hernia repaired jn all 50 states. If you need a termination for urgent medical reasons, it is unreasonable to have to travel 300 miles to have a life saving procedure.
Ilonka (Silver Spring MD)
@Sam not to mention that most may not survive even an hour of travel to another state. The laws are horrendous and antithetical to the vow to "do no harm" that doctors promise when they graduate from medical school.
chickpea (California)
@Vivek36 Please see the post above by OB GYN Sam. These procedures save lives. I’m sorry, but you are simply not qualified to make medical decisions for anyone but yourself.
MrVivekB (West coast)
"Well well well, if it isn't the consequences of my decisions. " - Red States, although I doubt they're this self-aware.
Paul (Ithaca)
When the so-called pro-life states find themselves without board-certified OB-GYNs, at least they can rest assured that their papayas will have top notch obstetrics care.
Thomas Zaslavsky (Binghamton, N.Y.)
@Paul Also, their politicians will gain hands-on experience with treating septic miscarriages. -- Oh, oh.
barbara (santa cruz ca)
@Thomas Zaslavsky dr herschel walker you're wanted in surgery stat.
Robin (Manawatu New Zealand)
@Paul Totally priceless!!!!
MD (Pennsylvania)
It's sad that in 2022 America we're faced with this nonsense and even have to have these kinds of conversations. The American way of life we once knew is gone. We are no longer living in the land of the free.
DianaID (West Orange, NJ)
Not only is this a consideration in colleges and medical programs, but I know of a senior male executives who are in the process of leaving an otherwise excellent positions in Georgia due to abortion restrictions. Wives and daughters can get pregnant and miscarry. I am sure this is true for female executives too. Plus remember a miscarriage is nearly always a medical emergency. It's not like you schedule them. So you are stuck with whatever the state and doctors decide. It's a great way to get sepsis or a hysterectomy while you wait to be sick enough to get an abortion.
Somebody (Somewhere)
@DianaID From my own experience I know that miscarriages are not always a medical emergency. My mother had 4 miscarriages during my childhood and 1 stillbirth (it is called a miscarriage before 20 weeks, a stillbirth after - I just looked it up). None of her miscarriages required medical care. Only her stillbirth, which occurred when she was 6 or 7 months pregnant, when she delivered a dead baby girl.
Usually Lurking (USA)
@Somebody and your point is?
dr. mom (midwest)
Well, she was lucky. As a retired on-gyn, pediatric and adolescent gyn practitioner I have seen women bleed horrific amounts from miscarriage. The patients we see may have different co-morbidities, on medications, etc. One person’s experience is anecdotal…let’s use statistics to determine the appropriate care of women.
The Fabulous Immigrant (Gucci Stores)
Oh well. If it is illegal to perform abortions in your state, why bother at all? ACGME will have to be flexible when it comes to this issue.
Terry (Ohio)
The article I read was pretty clear that the procedures are required to save the mother's life in cases other than elective abortion.
Patricia (California)
@The Fabulous Immigrant, why would the board have to be flexible? Every OBGYN should be trained in D&Cs. Would you want a cardiologist who had received inferior training?
terry brady (new jersey)
Physician training will always be confined to physiology, biology and sociology and side effects of life. Sex is innate and human's spins the roulette wheel of untold possibilities including untenable pregnancy the Pope cannot control. Legislation of medicine and sex is impossible and States doing so are at war with Mother Nature. XX's might leave the territories that value sexual (more) control and religious slavery. Outlawing abortion is akin to clasping iron around a woman's pelvis like olden times.
Gdo (CA)
If I were looking to be an OB-GYN, I wouldn't go for training in a red state, and I most certainly would never practice there. It's too risky.
KMH (Midwest)
I can't understand physicians not being taught how to perform abortions. It is a necessary part of healthcare, just as much as performing CPR or any other vital part of care. This is only going to deepen the divide between the rich and the poor as the rich will, as always, be able to get the care needed while the poor suffer and die needlessly.
Brian Michael Coyle (Oakland, CA)
Banning abortion training is a blow to American medical education. Life sciences are lousy in Russia, because the government soiled things. Political science in China? Think again. Political actions have academic consequences. Abortion isn't a minor detail of medical training. Half of patients are women, and 86% have children. It's estimated that 30-60% of conceptions end within the first 12 weeks of gestation. The potential for abortion-related needs is massive, even if abortion is forbidden. If people with a Texas or Alabama state of mind are in control, they don't want OB-GYN specialists. But don't kid yourself - women rise. Abortion bans are the last gasp of patriarchy. Academic hospitals need to hold on until the past passes.
Edward Allen (Spokane Valley)
How many obstetricians are going to have to have an asterisk next to their accreditation in the future?
Deirdre (New Jersey)
@Edward Allen and then their state board of health will pass a law that they don't need to put the asterisk next to their name poof - fixed - no one needs to know. They are only women - no one cares- lets move on they say.
northlander (Michigan)
Go to an old graveyard and check out the dates, women died very young, often in their teens.
barbara (santa cruz ca)
@northlander about 1/4th. past the 1900s. my mom was one of 12. her mom died of the 13th.
Tim (Upstate New York)
Uterine exams with PAPAYAS !!! Really ?? What is happening here with the respect we all grew up with toward one's privacy and the institutions that covet it? What's next the church? though its the religious right and the Republican Party who are ideologically conjoined who are ramming these unjust, "none-of-your-business" issues down the throats of Americans. Every woman should be outraged with the churchs' and politicians' interference in their personal lives. "Choice" is not about having abortions, its about having to choose that option when the occasion applies. No pro-choice person I know has ever advocated abortion unless its absolutely necessary - and no politician or clergyman should dictate otherwise. I would love to see the response if these intrusive institutions tried that nonsense on men. This is maddening.
Matt Warburg (Seattle)
Do the right thing and dare law enforcement to arrest & prosecute you. Nothing will happen, because even in deep red states prosecutors know they will never be able to get a jury to convict.
Rob Mills (Canada)
@Matt Warburg sure - just go through the invasion of your privacy as your personal and sex life is put display via a public trial. Think I’d pass on that option.
Ithaca Reader (Ithaca)
@Matt Warburg A civil lawsuit can be devastating, and juries can convict on a simple majority vote. Doctors will face lawsuits from both sides: a civil lawsuit by the woman if they denied a procedure, and a criminal one by the state if they performed the procedure. They may even be charged simultaneously by both parties if there is any uncertainty. The state can claim the doctor attempted a banned procedure, and the woman can claim the doctor did not attempt it soon enough.
S.Einstein asc (Jerusalem)
The American Association of Prolife OB-GYNers is a misnomer. And a challenge to various dimensions of democracy. At best THEY are pro- birth. At worst THEY have “aborted” their medical ethic; to heal and not to harm. They have politicalized, and “diseased,” medicine’s wellbeing, healing, preventative and helping functions. which THEY are licensed to “practice,” daily. Wherever the are. Conditions permitting. Consider: Should a trained medical student BEcome licensed if s/he/they note that they will not treat someone manifesting a particular disease? Condition? Lifestyle? THEY are willfully distorting the boundaries of personal beliefs, which is their right in a democracy, with willfully harming a fellow human BEing’s state of BEcomjng… THEY are imposing their values, norms, and ethics, unasked for, on “ strangers,” which can carry with it diverse, unexpected harms.
Marsha Hammond (Asheville)
“ Attorneys general from Oklahoma, Tennessee and Texas, among the states that ban abortion, did not respond to requests for comment about whether they would press such cases.” I would like to know when people are going to stand up to these bullies. I’m walking around Asheville NC with my sandwich board: “Had an abortion? Vote 4 a Democrat.”
mmmaier (NYC)
@Marsha Hammond put on the back of that sandwich board - The GOP is coming for IVF and contraception next. Vote blue.
KMW (New York City)
Abortion is not healthcare. It is the termination of life in the womb. Residency programs should not be forced to provide abortion training and hopefully this requirement will be banned. Doctors go into the medical profession to save lives not to end them.
itsmildeyes (philadelphia)
Oh, brother. What about the lives of women who have been walking around, going to the library, going to school, playing, working, drinking coffee, collecting vintage teacups?Their lives don’t count?
WB (Hartford, CT)
@KMW What about instances in which an abortion is necessary to save the life of the mother?
L.P. (Canada)
@KMW This is a narrow view of what abortion is. Abortion is a procedure that terminates a pregnancy. This is true if the fetus is already dead, if the fetus is not viable or if the mother's health is in danger. So no, abortion is not only ''terminating life'' in the womb.
Lake (Md)
This nonsense propagated by some Republicans stinks to high heaven!Unfortunately, it is going to negatively affect the quality of Healthcare women in ban abortion jurisdictions will receive. Already, those who aspire to practice OBGYN are shying away from residency programs in states where abortion is banned. Needless to say, these MDs will most likely settle in states where they undertook their residency, thus skewing the availability of their other services beyond abortion care. Second, since most would be OBGYNs seem to prefer full OBGYN training instead of the God approved version Republicans advocate for, OBGYN residency programs in pro-life states will receive less applicants for the program thus denying the programs/hospitals much needed extra MDs to take care of sick patients. Also, most top rated OBGYN faculties would prefer to teach in states where they have full control of what they teach rather than bowing to pressure to teach God's syllabus.
Leesa (Portland)
Impossible to get a job as an OBGYN if you are not certified in the specialty. Even very good medical schools will have no students, or have to accept very poor ones. Every woman should ask where their doctor went to school.
Patricia (California)
@Leesa, every woman should ask whether her OBGYN is trained in performing uterine evacuations.
Andrea Damour (Gardner, MA)
“One student wrote that performing an abortion violated the professional oath to do no harm to life.” Dear student, please choose a specialty that does not involve treating living women. Sincerely, an OB/Gyn
Jacob Nataki (California)
@Andrea Damour And take religious classes instead where belief is the foundation instead of facts, science and reality.
RG (Massachusetts)
@Andrea Damour Yeah, and the oath doesn't even say. That. I'd give that student an F.
itsmildeyes (philadelphia)
I’d be loathe to select a healthcare provider who didn’t have the skillset to at least try to save my life. Is the one hand tied behind her/his back the one holding the scalpel?
Jacob Nataki (California)
@itsmildeyes You won’t get to choose. The largest donors and owners are republicans. Their businesses will not allow you that choice.
WestCoastCALBruin (San Francisco/Los Angeles)
Fascinating. Already unattractive destinations , i.e. Indianastan & Tennesseeistan et al. , with their In-Your-Face, Proudly Misogynistic "traditions" , ACTUALLY believe that they will attract a younger , more diverse, open-minded generation of medical students to their universities by brutally enforcing their Medieval Talibangelical Women-Hating bible laws. Well, ummm...Good Luck with THAT, Houston* ! * Literally & Figuratively Houston, Folks .
Yellow Dog (Oakland, CA)
Why would medical students choose OB-GYN as their specialty now? When you have alternatives why choose to step in front of a firing squad? These new restrictive laws have doomed women's health care.
dr. mom (midwest)
THEY WON”T! why would anyone put themselves in this position.
Pat Baker (Boston)
If the government regulated male urological procedures like penile implants, then none of these issues would happen. Now my daughters not only need to live in a state will full healthcare options, they need to make sure their medical provider was trained and accredited in all of the procedures they may someday need.
Practical Realities (NorthofLA)
The states banning abortion or making a woman suffer blood loss or sepsis until they are deemed close enough to death to receive an abortion or banning medical training for doctors who may need to perform a life-saving abortion are Republican-led. Vote accordingly.
WestCoastCALBruin (San Francisco/Los Angeles)
Fascinating. Already unattractive destinations , i.e. Indianastan & Tennesseeistan et al. , with their In-Your-Face, Proudly Misogynistic "traditions" , ACTUALLY believe that they will attract a younger , more diverse, open-minded generation of medical students to their universities by brutally enforcing their Medieval Talibangelical Women-Hating bible laws. Well, ummm...Good Luck with THAT, Houston* ! * Literally & Figuratively Houston, Folks .
Deirdre (New Jersey)
Women think that they are safe in their blue state but the gop has other plans. Vote blue all the way through - up and down the ballot or your choices will be limited.
Wendy D (Wilmington, DE)
I did so this morning…won’t vote Republican until they return to sanity. They lost me several years ago with their “you’re either with us or against us”. And they should realize I’m exactly who they should be courting: Gen-X, suburban white female.
sginvt (Vermont)
Ridiculous, teach the procedure, boost your endowment and insurance policies, double or triple your program residents, go to jail and fight it. Disobey. This should be your recruitment strategy.
Akadeni (Pennsylvania)
Your comment raises a question that continues to perplex me. Where is the medical profession in the current abortion debate? I was always under the impression that the medical and pharma industries wielded significant influence on Congress. Why else don’t we have more equitable health care generally. But I’ve not seen or heard anything in the media about the AMA and other medical associations taking action against post-Dobbs state laws. Am I missing something?
Joe (USA)
@Akadeni only about 18% of physicians are part of the AMA. There is no group that represents all physicians and physicians wield very little power in congress or even in their hospitals these days. The voting public has far far more power than physicians. Please vote.
DaveD (Wisconsin)
@Joe Voting won't prevent your getting a Catholic Supreme Court.
John Virgone (Pennsylvania)
This would appear to be another notch in the anti-abortion belt and another step toward returning to pre-Row v Wade underground abortions that were performed in a basement room with a hanger and a broom.
Ansapphire54 (MA)
So another thing that will cause woman to die.
Ed (Fla Heartland)
Abortion is like "Prohibition"! When you couldn't get it "Legally" you knocked on someone else's door. If they didn't answer the door then you took care of business yourself. ps: Heck the United States had people "Injecting Themselves with Bleach" as a prevention against Covid!!! What's a little "UN-PREGNATING"???
NTS (Earth)
Please do not waive this fundamental requirement. Do not certify any program that does not require teaching OB-GYNs how to perform an abortion. It would be like certifying a surgery program that only taught how to do surgery on corpses.
Ian (NYC)
I'm curious... How did ob/gyn residents learn how to evacuate uteruses before 1973 (when abortion was illegal everywhere except in New York state). There must have been enough miscarriages for them to learn how to do a D & C.
Patricia (New Jersey)
@Ian It’s funny, but my memory of those days is that there was no problem getting a D&C for various reasons, or treatment for an ectopic pregnancy. These situations were recognized as different from elective abortion, and nobody gave it a second thought. Today’s Republicans have gone completely off the deep end.
chickpea (California)
@Patricia I was young, but like you, I don’t remember doctors having a problem doing D&Cs. But, I also remember perforated uteruses being a common outcome. We can expect them to be common again with doctors practicing on papayas.
barbara (santa cruz ca)
@chickpea if you were medical or a well paying private patient it was just called something else like endometriosis ( hope i spelled it right) and it would be ok as long as they did not do too many.
AK (USA)
What a horrifying, dystopian situation we are in. Shame on “Dr” Christina Francis, whose patients will receive inadequate care that will threaten their lives, and whose students will perpetuate this miserable agenda that endangers the wellbeing of all women.
globe (New York)
It goes against the Hippocratic oath to willfully take a life. There may be extreme circumstances where it is is required but the article describes the moral quandary that medical professionals must confront.
Blossom (The Buckeye State)
@globe Why do you feel the life of the person who is pregnant doesn't matter?? Do you understand that abortions must often be performed when a pregnancy is life threatening? Or after a miscarriage? Or to remove an already dead fetus? Or to remove cancerous tumors? Or an overgrown uterine lining? My mother, born in 1941, was a devout Catholic, who thought abortion was a grave sin. One Sunday, she passed out ina pew at Mass. She was taken to a hospital, where she found out her menstrual bleeding was dangerously heavy. She had to have a D&C, which is identical to an abortion. She'd have died otherwise. OB/GYNs not learning how to perform abortions WILL lead to girls and women dying. Unless you think their lives don't matter, you should be concerned.
PM (NYC)
@globe - Doctors do not take the Hippocratic oath, which you might consider a good thing as it involves swearing by pagan deities.
BH (NY)
I graduated from medical school in 1981 and certainly repeated the Hippocratic Oath during graduation! My son, who graduated in 2012, did as well.
Judyputt (Jerusalem)
VOTE! Vote for candidates who support women. Vote for candidates who support the idea that medical decisions should be made by doctors, not politicians.
kate (MA)
OB/GYN specialists need to understand the reproductive system and how to offer care when there are issues. Can GOP politicians even define conditions like endometriosis or preeclampsia? Do they know what procedures are available for uterine fibroids? How to help stop excessive bleeding during a period? Do they know how to avoid sepsis after an incomplete evacuation of the uterus? Women deserve knowledgeable, accurate and up-to-date medical care no matter what state they live in.
thewhigs (Chicago)
Its sad to know politicians who haven't taken a basic science class in college, let alone having an MD or specializing in OB-GYN are telling professionals with decades of education and experience in the field how to do their work. While I'm not the biggest fan of many Democratic policies, this is what happens when we don't vote blue. Our lives literally depend on it.
Constable Dogberry (Victoria, Canada)
@thewhigs Isn’t that what they were doing during the pandemic as well? Sad is an understatement.
J Kile (White Haven, PA)
@thewhigs Happens at all levels. But “local control” sounds so American. Then when elected they become “elected officials” which makes them think they are God. When I was teaching we had a board member who we believed could not read. Whenever he was asked to read something he passed it off. I used to say school board members control the strings on a multimillion dollar budget but don’t have to prove they can balance their checkbook. They vote on education matters and curriculum and don’t even have to prove they can read. They run for Congress and don’t even know the branches of government. But if what they are best at is running their mouths, they are more likely to get elected. Great country.
Erik van Dort (Palm Springs)
OB/GYN treatments always carry the risk that Dr. Oz's "local politicians" or their armed/unarmed vigilantes conclude that laws are/were violated. Better to abandon the practice of this specialty in states where voters support the enactment of even slightly ambiguous laws regarding abortion. After all, this is what the citizenry appear to have decided. Insurers should reconsider writing liability and malpractice policies in these states.
Blossom (The Buckeye State)
@Erik van Dort Are you aware that there are no entirely red or entirely blue states? Millions of Dems live in "red" states, and no, we didn't vote for this! Female children can become pregnant too, and they cannot vote. Female prisoners cannot vote. Incapacitated females cannot vote. You want all those groups harmed too??
Erik van Dort (Palm Springs)
@Blossom I realize the injustice of it all, but our election system is imperfect, and not designed to make everybody happy. Did you know, for instance, the the U.S. Constitution does not even grant every citizen the right to vote in an election? Add to that the gerrymandered Senate and presidential Electoral College, and you have something like an aristocratic system of property and kand owners in charge. Much like a monarchy. If you do not like it in a certain state, I suggest you move somewhere else. (CBS's Judge Judy's solution to everything in HER America)
Dan (Lafayette)
It isn’t just OB/GYN residents who are at risk. ANY practitioner of any medical specialty whose practice would take them into contact with any female who is, might be, or might become pregnant should realize that merely practicing medicine would put him or her at great risk of prosecution. They should get out of medicine anywhere where abortion is illegal. Also, any female living in a state that does not prohibit abortion should always check the credentials of her OB/GYN, to ensure that his or her training and residency were not in states that prohibit abortion, as the likelihood that such a doctor is not fully trained is high.
MS (CA)
@Dan Agreed. Plenty of non-OB/GYNs manage patients with chronic medical conditions who could become pregnant. I'm not an OB/GYN but my internal medicine residency program had seminars about how to handle medical conditions during pregnancy. Many of these patients are at risk for complications during pregnancy.
BG (Texas)
Perhaps all OB-GYN residency programs should be moved out of Republican states since those state politicians and their supporters do not seem to believe that women need reproductive healthcare in any form. Articles are already surfacing about do tors leaving states like Tennessee to move their practices to abortion friendly states. Perhaps the religious right will rethink their strategy when their own wives and daughters start dying from pregnancy complications because the nearest doctor/hospital is a few hundred miles away in another state. And, guess what, that medical care will be considered out of network for those with PPO health plans, so costs will add up quickly. Pregnancy is a medical condition, not a religious belief, and decisions about it should not be made by politicians—or justices.
JFW (Adams NY)
@BG on the surface this seems like a good idea, but what will happen is subpar medical students will match to these increasingly understaffed “red state residencies”. So training will continue with increasingly subpar students, as these programs become the refuge for med students unable to get chosen for better a residency
Rose Anne (Chicago)
@JFW And that is life in a red state, or a red area within a state.
Mike (Columbus)
A medical student cannot match without passing Step 1 and Step 2 and meeting licensing requirements. This is both inaccurate and offensive
Alison (Ontario, Canada)
A doctor posted a comment in these comment pages some time ago expressing concern that he was meeting more doctors that graduated from religious medical schools who would not prescribe contraception. Perhaps contraception will go the way of abortion pills - provided by women to other women through the mail, or go to another state to have an IUD inserted.
April (NYC)
I don’t want any of the women in my life buying mystery pills from some unknown supplier over the internet. They should be able to get them safely from their doctor and they should be able to talk and trust that doctors advice. If the medical community feels that religious schools are turning out unprofessional or not adequately trained doctors they should be collectively taking it to their licensing boards.
Joe (New Orleans)
@Alison Its never been easier to order medicine from India. Anyone can do it and the risk is incredibly low.
Blossom (The Buckeye State)
@Alison My twenty four year old daughter has an IUD. Do you suppose she can buy one through the mail and insert it herself??
Steve (New York)
Mehmet Oz said during the Pennsylvania senate debate that abortion decisions should include local politicians. If simulation is sufficient training for abortion, I wonder if he would also consider it sufficient for training in cardiac surgery. And if Ken Paxton doesn't like the training requirements of ACOG, he's welcome to develop his own specialty board. As a physician myself who was involved in the development of a new one and I can tell him that to get it recognized by the American Board of Medical Specialties, which makes the final decision as to whether an organization can be the legitimate accrediting body for its specialty that has specific requirements for trainees, that it is a long and difficult task. But this is what happens when politicians who have no medical qualifications making medical decisions. I wish it were just on the right but several years ago, several left wing ruled cities in California tried to ban the use of ECT, a safe and an effective treatment for several mental disorders, because of ignorant prejudice about it believing it was essentially the same as lobotomies.
J Kile (White Haven, PA)
@Steve Whenever politicians get involved in something like this they screw it up. It isn’t as life threatening but same thing has happened in education. If they touch it, it’s ruined, because they don’t know anything about it and listen for the jingle of coins to guide them.
LT (Texas)
What happens if a patient needs an abortion but her OB/GYN is pro-life? Welcome to the dystopian nightmare that American women and families are living in. Women in blue states should pay close attention, as they are next to lose their rights if the GOP takes over and passes a national ban on abortion. And the idea that a miscarriage can be managed is irresponsible. I have a close friend who opted to manage her miscarriage. She ended up bleeding out in front of her children and almost dying.
Rob Mills (Canada)
@LT Great point. I think many men, of whom I am one, fail to contemplate the implications of abortion bans; they cannot imagine finding themselves in a life-threatening situation - copious bleeding, for example - wondering if it would be safe to go to the hospital, and if, once there, the physician would use all available resources to save their lives.
DaveD (Wisconsin)
@LT The SC has already established that there can be no national law regarding abortion. It's a matter for the states. That's why Roe was voided. But the voiding of Roe was an enormous mistake.
Susan (US)
@DaveD The Supreme Court did not decide that "there can be no national law regarding abortion." That is completely false, and not mentioned in the ruling. The Dobbs decision overturned Roe v. Wade, and suggested that states should decide on abortion laws.
Janet MICHAEL (Silver Spring)
The Supreme Court’s Dobbs decision not only had the immediate effect of making abortion difficult for all women, particularly poor women, but it has introduced a two tiered medical residency training regimen-best schools with accredited training and lesser schools with rules dictated by politicians.The respected medical schools in Red States should not lessen the caliber of their programs, they should make a federal case for their programs and take it to the Supreme Court.
John Quixote (NY)
This republican power play has breathtaking consequences , only some of which are clear in the short time the separation of church and state and women's rights were breached. In the marketplace of human behavior , this is a non-starter as a woman's health needs to be at the top of the hierarchy of medical necessity. Yet the future guardians of women's health are held as felons if they do a procedure that saves a life? Unreal, unbelievable and unkind. Who can support that without shame to their daughter in Tennessee?
N. Matthew (New Hope)
Train them because these doctors will outlast restrictive laws. After conservatives ban abortion and have no choice but to confront the consequences they will see the light. For example when Kansas had a referendum on abortion recently, post Dobbs, even the deep red precincts backed off and voted against a ban.
Deirdre (New Jersey)
That’s the problem They can’t legally train them A rotation includes practice on actual people and that is no longer allowed
NYCEDDOC (New York City)
It is time the federal government steps in. These restrictive laws have implications way beyond abortion . It is creating a health care desert for all women. Additionally young women and men of all professions are not likely to choose to live in a state that has chosen to legislate their personal health care and interfere with medical decision making between them and their Doctor. The Republicans have certainly left us with quite a mess. Everyone needs to vote because only the legislative branch will save us from the judicial branch.
Dan (Lafayette)
@NYCEDDOC The GOP has precisely that idea in mind.they want the ban on abortions to be a national ban at the federal level. Careful what you wish for.
Q Frost (Boulder CO)
@Dan I wish for the election demise of every GOP candidate in these elections
J Kile (White Haven, PA)
@NYCEDDOC The Federal Government already stepped in. The Supreme Court of the United States created this mess.
Someone (Somewhere)
This is only the very beginning of the impact of Dobbs. I'm a prof at a top research university in the southeast, and already we struggle recruiting women students and professors because they know they won't be able to get an abortion if they need one. I will leave my job soon, and have quite a few colleagues planning to do the same in the near future. If the Dems don't find a way to codify abortion rights, I fear that long term, states that forbid abortion will simply lose a lot of their women, period. Also, I don't understand why Democrats don't stress more the impact of Dobbs on men: a woman can get pregnant maybe once a year, but men can create virtually unlimited babies in their lifetime. With DNA testing, women can easily come after their babies' fathers and demand financial support for the next 18 or so years. Surely that's more grave than inflation or higher gas prices??? I think that if more men understood the potential financial consequences of Dobbs on them, we wouldn't be in this fix.
Ruby (Washington)
@JerseyGirl - your comment fails to acknowledge many other things that could go wrong in a state with very strict restrictions: 1. A student or faculty member could face a complication in a wanted pregnancy and not be able to obtain proper medical care, as is already happening in states like Texas. 2. A student or faculty member with health conditions may worry that they will not be able to easily access needed medications that are in danger of being classified as abortifacients, even if they are using birth control. 3. Some of the states with the strictest abortion restrictions are also contemplating limiting access to certain forms of birth control, which leaves a pretty big hole in your argument.
Ly (USA)
@JerseyGirl There's a great deal of things that could go wrong with a pregnancy, wanted or not. When a woman is pregnant and has complications that require an abortion, she needs that surgery right there, not by going to another state. Pregnancy is already the riskiest thing that a woman takes in their life, they do not need to make it unnecessarily riskier.
Jodi (Earth)
@JerseyGirl oral contraceptives have a failure rate closer to 8-10%. Aside from the copper IUD, the most effective contraceptives are hormonal, and not all women can use hormonal birth control. Women shouldn’t have to travel to neighboring states to receive health care. This is assumption is particularly dangerous for emergency scenarios like miscarriage, etc.
Ilonka (Silver Spring MD)
I think residency programs have an even bigger problem--qualified women will not apply to their programs because they know if they live in those states they will be denied basic healthcare. Not training OBGYNs to perform abortions will result in patients not being properly cared for and is absolutely unconscionable. The "do no harm" part of the Hippocratic Oath clearly doesn't apply to women of childbearing age. If a physician is pro-birth and doesn't want to have an abortion, fine--but they do NOT have the right to decide for others.
SY (New York)
@Ilonka This is spot-on, and it doesn't affect just the female residents -- it affects medical students, fellows, attendings, female and male alike. I'm a female physician (post-training) who is on the verge of a job change due to family factors. I want children, but I would not consider living in any state where my treatment during a pregnancy defies established standards of management if there are unexpected complications. Complications can happen to ANYONE, they can be severe, and they can be swift -- killing women before there's a chance to transfer to another state with laws that allows doctors to do their jobs without impedance. This is not just a matter of the irresponsible/immoral woman trope that the GOP tries to push. In the meantime, hope some of the GOP voters in these restrictive states don't strain themselves wondering why it's harder to get doctors' appointments.
April (NYC)
Or the only ones coming will be religious zealots. Best of luck with that.
Plant Lover (Iowa)
@Ilonka To sum up, Red states will let women die due to untrained OBGYNs while Blue states will provide the health care that women are entitled to.
Jo (Nj)
This training is vital and necessary. Doctors and aspiring doctors should avoid these states at all costs. A well trained doctor is crucial
Crewsin (Near Ky)
@Jo : this training is not necessary. No medical doctor should train to perform abortions. It is a stain on the profession.
Ruby (Washington)
@Crewsin - so it's unreasonable for a woman to want a trained doctor to perform the correct medical procedure if her fetus dies and needs to be removed before sepsis sets in?
Robbiesimon (Washington)
@Crewsin Perhaps this commenter will provide his or her credentials in the medical education field?
Boggle (Here)
I had a D&C for a very much wanted pregnancy that ended in miscarriage. Abortion care was vital to my own health and to my next pregnancy, which thankfully ended with a healthy baby. This is a very common situation. Not training OBGYNs in abortion care is like a cardiologist not being able to read an EKG. Abortion care is health care. (And as many have pointed out, restrictions on abortion are the only instance in which one person is forced by the government to give their body and potentially life to another.)
Barbara (Westchester, NY)
@Boggle Everything you have said resonates with me. In 1948 my aunt, who lived in Albany NY, had a fetus that died in utero. Her doctor didn't tell her what had happened because he didn't want to perform an abortion even though it was legal under these circumstances. Instead, he decided to wait for a spontaneous miscarriage which didn't occur. She became septic, almost died, and was hospitalized for months. My mother brought her daughter to New York City to care for her for a year, which was extremely traumatic to the child. It is a miracle that my aunt was able to have a second child.
opwekdcp (boston)
@Boggle "Not training OBGYNs in abortion care is like a cardiologist not being able to read an EKG" YES THIS!!!!
Vivek36 (New York)
@Boggle it might interest you to know that the first killer of women is not denial of abortion but cancer. Reading the New York Times you might think otherwise.
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