Washington State University medical student Carmen Abbe has long been committed to reproductive healthcare access and hopes to one day become a doctor who can provide a full-range of services, including abortion.
She said the recent Supreme Court decision has made that path more complicated, and dangerous.
“There's a long history in our country of abortion providers not feeling safe, and a history of dead threats and of murder,” she said. “That felt like a history that we've overcome, like we've overcome a lot of things in this country, so to have not only be reality again, but literally being persecuted, and to go to jail, for doing our job, is pretty unreal.”
Abbe, along with Jessica McAllister and Anna Nichols, are third-year medical students at Washington State University’s Elson S. Floyd College of Medicine, and members of the student group Medical Students for Choice.
They say the Supreme Court’s decision to overturn the right to access abortion has them concerned for the future. All three hope to graduate from medical school and find residency programs with comprehensive reproductive education, which includes training for abortion.
“It’s already so difficult to get into residency programs, and now a lot of the programs we're looking at aren't even going to legally be able to train us in the area of medicine that we need to be trained in,” McAllister said, “That's a huge consideration and totally changing the whole landscape of what residency and training is going to look like for us.”
In most programs students already have the option to opt out of lessons on abortion if they if they object.
But that education may soon be harder to find for all medical students, according to the American Association of Medical College’s president, Dr. Alison Whelan.
“It is important for physicians to have comprehensive training in women’s reproductive health care,” Whelan said, “especially since the technical procedure for providing an abortion – dilation and curettage – is the same procedure that is performed after a miscarriage, or in some cases, to treat excessive bleeding or take a biopsy from the uterus.”
In a statement, she said publicly funded programs in states that have outlawed abortion are likely to face impacts, but says it’s still early, and challenging to speculate how far reaching they may be. She said a possible outcome is a state-by-state approach to training.
Nearly half of OB-GYN residencies are in states that have already banned, or will soon outlaw, almost all abortions, according to a study recently published in the Journal of Obstetrics and Gynecology. The study found that, without intervention, a swath of the next generation of doctors may not know how to perform abortions.
That will likely impact care for ectopic pregnancies, which can be deadly if left untreated, as well as miscarriage management and other reproductive care issues.
States where providers could lose their licenses, or face steep civil and criminal penalties, may lose many doctors, especially those with expertise in reproductive issues.
Dr. Jaime Bowman is the clinical education director at WSU’s Elson S. Floyd College of Medicine. She was an family physician in her home state of Ohio, but left after laws restricted the scope of her practice.
“I knew I wanted to provide care to the very most marginalized, and my home state made that way too hard for me to do,” she said, “When I left with a heart of advocacy, I also took other essential skills, like my OB training, and my full scope training of family medicine with me, which means that states that limit a provider’s practice may well lose those providers and see physician shortages.”
She said doctors practicing in states like Idaho may do the same, with physicians moving to either California, Oregon or Washington.
She said she is preparing her students for complications, and to care for patients with delayed care, and the resulting trauma.
“Whether that patient is traveling from a state where there's been a trigger ban or a limit in their access,” Bowman said, “or there in a state where it’s safe, the states where choice is being protected, we know that Washington is going to see an influx of patients who are seeking care, and those patients are probably going to show up with a delay in their care, perhaps more complexity, and certainly more trauma.”
Jessica McAllister said despite new barriers in finding training, and higher risk, she’s still committed to someday being an abortion provider.
“I am hopeful for the future,” McAllister said, “I think there's a lot of people that are angry in a very productive way and our ready to fight for human rights and for abortion rights, so I am hopeful as far as from a medical education standpoint that there's a lot that we can do, and there's a lot that people want to do.”
This story was corrected on July 27, 22 to reflect that Dr. Jaime Bowman is a family physician, not an obstetrician.