Doctors lack access to abortion medical training in Texas
Every year, more than 100 new obstetrician-gynecologists graduate from a Texas residency program and enter the medical workforce. Theoretically, all have had the opportunity during their four years of residency to learn about what's called "induced abortion" — named that to distinguish it from a miscarriage. Но the closure of abortion clinics in Texas — more than 20 since 2013 — has made that training increasingly difficult.
Training Barriers and Institutional Pressures
Texas has 18 residency programs in the field of obstetrics and gynecology, but doctors working in these institutions are walking a very delicate line. Academic medical centers in Texas receive tens of millions of dollars a year in state funding. They are fearful of the other sectors of the university coming down on them and saying, "You're threatening our funding." Consequently, in Texas this training happens quietly, almost in secret.
It's understandable why an OB-GYN resident in Texas might think twice about providing abortions. Doctors who provide the service must think about security issues for themselves and their staff. They also have to deal with the scrutiny of state inspectors as well as anti-abortion protesters.
The Resident Experience and Clinical Skills
Medical residents can opt out of abortion training for religious or moral reasons, but some feel a professional obligation to learn the procedure. A resident identified as Jane said: "This is part of OB-GYN — it's not an optional part, per se. Women can choose if they want an abortion or not, but you as their doctor need to be able to provide them with all the choices available."
Jane spent about a month at a family planning clinic during the third year of her residency. Being able to perform the abortion is just one set of skills she learned. The rotation taught her things that will be useful in other practice areas, such as:
- Counseling patients about abortion, contraception and sexually transmitted diseases.
- Techniques for pain management and dilation of the cervix.
- Performing ultrasounds to date the pregnancy, which helps determine which technique will be used to terminate it.
As Jane noted, "Before in residency, we were doing ultrasounds maybe once during a clinic afternoon... But here we do 30 ultrasounds in a morning, so it's a lot of good learning about how to do ultrasounds."
Impact on the Medical Workforce
Surveys and other research show that doctors who do abortions may have fewer job opportunities. That's because many hospitals and group practices refuse to employ doctors who do abortions, even if they do so during evenings or weekends, on their own time. The following data highlights the decline in access and providers in the state:
| Metric | Details |
|---|---|
| New OB-GYNs graduating in Texas annually | More than 100 |
| Total OB-GYN residency programs in Texas | 18 |
| Abortion clinics closed since 2013 | More than 20 |
| Doctors performing abortions (previous) | 48 |
| Doctors performing abortions (recent study) | 28 |
A few years ago, 48 doctors in Texas did abortions, but a recent study shows it's now down to 28. This trend reflects the increasing difficulty for medical professionals to maintain access to this specific field of medical training and practice.